[Question #13594] Mutual masturbation and fingering

1 months ago

I visited 5 different massage parlors over the last 6 weeks and I received a hand job and was anally fingered at each one. Before I visited the first massage parlor I took PrEP (Truvada) for 7 days. I have continuously taken PrEP every day since. Was the 7 days enough time to give me full protection?

About 2 weeks ago, after every day I went to the gym, I started experiencing body aches. These symptoms went away for five days when I took a break from the gym. They returned once I started going again, and now I’m feeling sick with body aches, fatigue, and a slight sore throat.

Is there any chance I could have acquired HIV? I have a few concerns. The first is that my immune system might already be weakened by HIV, and I know that working out vigorously can tax the immune system, which could explain why I’m getting sick.

My other concern is that there might have been blood on one of the women’s hands and that it could have come into contact with one of my mucous membranes. I know Truvada is quite effective, but I’m worried that I may have been exposed to a resistant strain of HIV. I live on the west coast of North America, and all the women at these massage parlors were of Asian descent.

Ultimately, I would like the most up to date expert advice which is why I’m reaching out here. I want to make sure I don’t infect my wife once we have sex again. Thank you so much for your help!

H. Hunter Handsfield, MD

1 months ago

Welcome to the forum.

My first comment is based entirely on the title of your question, before reading any further. If your only potential risks were indeed hand-genital contact ("mutual masturbation") and fingering, there is no realistic chance of any STI and you don't need testing. Unless there is a surprise when I read further, you can expect my advice to be along those lines.

Now I have read on. Guess what?

You have significantly over reacted. There was no need for PrEP to prevent HIV on account of the exposures described -- but of course it's good you're using it if you have had other (or anticipated) any genuinely risky events. In general, PrEP is advised only for men having high risk sex with other men, meaning penile-anal penetration (or sometimes penile vaginal in unusually high risk situations).

The symptoms you describe fit with at least a hundred medical conditions -- but are most common with minor viruses we all experience from time to time. HIV is not possible, especially after taking Truvada for a week. In the 40+ years of the worldwide HIV/AIDS epidemic, no cases have been known to occur in people whose only exposures were like yours. And of course there must have been billions of fingering or hand-genital contacts in the presence of menstrual or other blood.

If somehow I were in your situation, I would not have taken Truvada -- and I would be critical of any doctor willing to prescribe it, assuming you were truthful about your expected sexual exposure(s). I wouldn't be tested for HIV or any other STI, and I would be continuing unprotected sex with my wife without worry of infecting her with HIV or other STI.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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23 days ago

Dr. Handsfield,

Thank you for the quick response. I completely understand.

I was doing some research on TRUE PrEP failures and I found that the only time PrEP truly fails is when it involves resistant HIV strains. How frequent is this? If somehow I were exposed to one of the sex worker's blood during the handjob and/or anal fingering can I be 100% certain the Truvada would have destroyed the virus?

Thank you very much again for your time!

H. Hunter Handsfield, MD

23 days ago

Sorry, I don't know the latest data on frequency of relatively drug resistant HIV strains, although I understand it remains low (under 5%?).

As I said above, there are no known cases of persons with HIV acquired by hand-genital contact or fingering -- but in any case there is no reason to believe the effectiveness of PEP should be affected by the mechanism of virus transmission. And I doubt any legitimate HIV experts would ever advise PEP after such an exposure.

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11 days ago

I undertand, thank you.

I think you mean "there is no reason to believe the effectiveness of PrEP should be affected by the mechanism of virus transmission" not PEP, correct?

In any case, several of these massage parlors were basically brothels and gross and unsanitary. I know the individuals working there have sex with customers.

I just want to be 100% certain that I won't transmit HIV to my wife from the hand jobs and anal fingering I received. But, if I'm understanding you correctly, what you're saying is that there's no chance I acquired HIV at any of these places and if somehow I were exposed to it, the PrEP would have protected me. So therefore I don't need to test and I can move on with my life.

If that's all correct, then I want to say thank you for your time and Happy Holidays/New Year!

H. Hunter Handsfield, MD

11 days ago

Correct. Your sentence and mine are equivalent to one another.

Although a "gross and unsanitary" setting may be unpleasant to behold or experience, it does not elevate the risk of HIV or other STIs.

For the reasons you state yourself, you definitely can be "100% certain" you did not acquire HIV and therefore that you cannot infect your wife.

Thanks for the thanks. Happy new year to you as well.

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