[Question #1959] Hand Job masturbation and massage

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84 months ago
Over last 3 months I have visited massage parlours on several occasions. I receive massage and hand job with oil to ejaculation and then the masseuse cleans up my genitals with wipes. I currently feel fatigued and I have white coated tongue and a mouth ulcer under tongue. I am concerned if there is any way I could have picked up HIV via the masturbation or when they clean up my genitals via cross contamination with blood on her hand or maybe semen from previous client.
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H. Hunter Handsfield, MD
84 months ago
Welcome back to the forum. Thanks for your succinct question. My reply is similar.

My first comment is to congratulate you for having the safest of safe contacts during these events. There are no STDs, including HIV, that are likely to cause fatigue, white tongue, and a single oral uilcer. These are symptoms of any number of minor viral infections and other nonspecific medical conditions. The kinds of exposure you describe are zero risk for HIV, regarldess of blood on the masseuses' hands or semen from previous clients. Such indirect transmission of HIV is not known to occur. Of course you are free to be HIV tested, which might be a good idea -- not because there is any serious risk, but because the negative results might be more reasuring than my analysis.

I hope this has helped. But let me know if anything isn't clear.

HHH, MD

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84 months ago
It's just so confusing as info online is contradictory with some official sites like thebody.com suggesting that hand job could pass on hiv in certain circumstances and other official sites saying low risk but not no risk.  This keeps my anxiety bubbling over these encounters that there may have been a risk. Along with my mouth today now having several ulcers and incredibly dry with a headache and fatigue. Are these websites just being ultra cautious and I should not worry about these encounters I have had for risk of HIV? I did get a clamydia test last week and it was negative.
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H. Hunter Handsfield, MD
84 months ago
Anyone can post anything they want online. You'll do better sticking with professionally run and moderated sites, like this one; and those run by health departments, academic institutions, and so on. But even with those, some take more conservative positions than others. Everybody agrees that in theory, hand-genital contact could transmit HIV, especiallly if genital fluids were used for lubrication. Therefore, some sites will call it low risk. However, there has NEVER been a scientifically proved case of HIV being acquired that way -- nor even, to my knowledge, suspicion that it happened. So for practial purposes we consider it a zero risk event and so should you. In any case, in the US, on average less than 1% of CSWs are infected with HIV, and in most settings it's more like 1 in a thousand. In other words, the odds are strong none of your massage partners had HIV.

Of course no surprise about your negative chlamydia test. Chlamydia also is not cquired by hand-genital contact.

The main cause of ulcers in the mouth is aphthous stomatitis, i.e. canker sores. But the second most common cause probably is an initial infeciton with HSV1, i.e. oral herpes. Cold sores, i.e. recurrent oral herpes, are localized, usually just one or two sores on the lips. But the first infection typically causes highly painful ulcers inside the mouth, usually with severe sore throat as well. If you have anything like this, see a doctor ASAP for accurate diagnosis and treatment -- which to be effective must be started ASAP. If it's herpes, most likely you acquired it by kissing an infected person. In any case, acute HIV is a rare cause of mouth ulcers, and would almost never bet he only symptom. And fatigue alone means nothing, without fever and other symptoms. There is no reason to suspect you have HIV. Still, as I said above, feel free to get tested if you will gain additional reassurance from the negative result. (This does not mean I believe there really was any risk.There was not. Strictly because negative blood tests often are more reassuring than expert opinion, no matter how scientific.)

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84 months ago
Yesterday I had the Alere determine duo hiv test and it result was negative. This one as u know does antibody and antigen p24. My question is that I now have several mouth ulcers and I feel poorly but no fever. The last massage and hand job was about 3 weeks ago. If my feeling under weather and ulcers were due to seroconversion would the test likely pick up as positive if my symptoms were due to this?
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H. Hunter Handsfield, MD
84 months ago
Your negative test result is highly reassuring; at 3 weeks the Determine rapid test is probably around 80-90% accurate. Also, it does prove your feeling under the weather and the oral ulcers were not HIV. When HIV causes symptoms, the HIV antibody tests are always positive within a week or so after onset of those symptoms.

The US Centers for Disease Control and Prevention (CDC) has issued a warning about the Determine rapid test. Even though it's a 4th generation test for both p24 antigen and antibody, Determine may take longer than other 4th gen tests to become reliably positive. If you continue to use that test, you can have a conclusive result 5-6 weeks after the last possible exposure. However, if you have a non-rapid (i.e. lab-based) 4th generation test, the result will be conclusive in a few days, i.e. 4 weeks after exposure.

And I'll also remind you that the exposure described carried no risk whatever for HIV. In fact, this is your third question that followed exposures that carries no possibility of infection. The forum does not permit repeated questions on the same topic or exposure. This will have to be your last one; future new questions about similar exposures, testing, and your fears about HIV will be deleted without reply and without refund of the posting fee. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties. Finally, such questions have little educational value for other users, one of the forum's main purposes. I trust you will understand.

That completes the two follow-ups and replies included with each new question, and so concludes this disucssion. 

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