[Question #2056] Hiv or herpes after massage parlor experience

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84 months ago
Dear Doctor I am a 44 year old male went a massage parlor in a drunk state 5 weeks ago. While being massaged my eyes were closed. When masseuse
turned me over she performed what I recall an unprotected hand job ( possibly oral cannot remember). What I remember seeing is her throwing
a towel over my penis after I ejaculated. Massage parlor has reputation for hand job only but usually protected so I very concerned why this
masseuse did one unprotected to me.  Shortly  after this experience I had some scrotum itching and noticed 2 distinct red sores or pimples which I decided to pop. I don't know why I guess out of panic. They both bled. My symptoms progressively got worse on the following days and weeks. I got so irritated in my inner thighs and that it would bother me to walk. Sitting started to become a problem because I had pain between my scrotum and my anus. I was getting burning sensations in my scrotum also occasionally. Also I would feel better lying down or wearing lose clothing. At first I though I had jock itch or a yeast infection. Tried antifungal creams and nothing worked. Got tested at STD clinic 22 days after this event. Went back for my results 2 days ago and was told I have prostatitis. Doctor put finger and I yelled in pain. I am now in a total panic since everything I read online now convinces me that I have HIV. also my feet have started burning up since  a week or so now. I have not been tested for Herpes. Doctor please what is my next step. My doctor scared me when she checked my lymph nodes 2 days ago. She said they are fine but is she checking to see if I have HIV symptoms? I am now totally scared out of my mind.
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Edward W. Hook M.D.
84 months ago
Welcome to our Forum.  I'll try to help.  The exposure you describe is unlikely to be related to your symptoms.  Whether or not you received masturbation or oral sex, there is no risk for HIV.  Masturbation is safe sex with virtually no risk of any STI and few STIs occur after receipt of oral sex- there has never been a case of HIV related to receipt of oral sex and the lesions your suggest are neither particularly suggestive of HSV nor did they occur in a location (your scrotum) where HSV would be expected after oral sex (HSV is spread with direct contact of an infected surface/lesion with the site of infection and bleeding following breakage of HSV lesions would be unusual.   My suspicion is that the lesions you saw on your scrotum were some of the normal cystic structures that are common on the scrotum or folliculitis, either of which might bleed if squeezed.  Further the fact that your symptoms have continued for about a month is not compatible with typical HSV or recently acquired HIV.  I am confident that there is no risk for HIV form what you have described and if you have an HIV test, it will be negative.  I would recommend against blood tests for herpes as the tests are frequently misleading in such situations. 

There may be several things going on here-perhaps a fungal skin infection between your thighs and scrotum and prostatitis.  You do not mention what your doctor said about the discomfort you are experiencing between your legs and scrotum or whether a rash is present.   What you have described thus far is suggestive in part of a fungal infection and some such infections do not respond well to OTC powders a or creams.  Since your doctor had the opportunity to examine you her assessment may be more relevant than mine.

As for prostatitis, while this is not an STI, if you had major discomfort during your doctor's rectal exam, that is a reasonable possibility and should respond to antibiotics.  Prostatitis is not an STI and if that is what is going on, it is more likely to be coincidental than related you your exposure 5 weeks ago.  Your symptoms, including the area of discomfort, the pain on rectal examination, and discomfort on sitting are all suggestive of prostatitis.  A urine test for bacteria or white blood cells (as a sign of inflammation) might well support this diagnosis.  Following her diagnosis of prostatitis did your doctor start antibiotics? and if so, which one and has it helped.

Finally, let me assure you that there are few places which are a worse source of information than the internet for matters such as these.  Much of the information provided there is taken out of context of just plain wrong. 

I hope these comments are helpful.  If I have missed something or am unclear, please feel free to follow-up although you may not receive a response immediately (I just happened to be on-line when your question came in).  EWH
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84 months ago
Thank you Doctor for your quick reply. My first HIV test at 3 weeks was negative. For the prostatitis I am on ciprofloxacin at has been 2 days no change yet in my condition. The doctors said I did not have anything fungal. I tried using a combination of desonide /clotrimaderm that did not help. My biggest concerns are the following. The prostatitis is scaring me out of my mind because everywhere I read it says the bacteria is usually from an std and typically HIV.  Also I am I am having flashbacks to the encounter and worried that masseuse may have done more then I remember. If we did indeed have intercourse which I am quite confident we did not obviously my risk factor just exploded.  The prostatitis is driving me nuts because I am convinced it is HIV THAT has caused IT. How else could I have all of sudden gotten prostatitis if I was perfectly fine before this encounter. Please Doctor tell me the next step. Do I take a HIV RNA test. Why no mention of Prostatitis in HIV early symptoms online?
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Edward W. Hook M.D.
84 months ago
II urge you to stick with your doctor and not overthink this.  If the ciprofloxacin has not begun to have an effect in a 3-4 more days, I would suggest you tell your doctor and seek re-evaluation by the same person (observation of changes in time over time is an important part of diagnosis).  In the meantime, you have to stop worrying.  I'm not sure where "everywhere" is but it is not an authoritative medical source as high quality medical studies have shown that little if any prostatitis (and probably none) is caused by STIs.  Risk for prostatitis goes up with age and you are in the age range when people begin to see it.  If your symptoms were due to HIV, your test would be positive and the fact that your 3 week test PROVES that your symptoms are not related to HIV.   Similarly your beginning to 2nd guess whether or not you received more than masturbation is more a sign of your anxiety than anything else. 

Please do your best to relax and think clearly about this.  EWH. 
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84 months ago
Thank you Doctor just really worried have never felt so bad. Also had a full physical 2 weeks before encounter ( prostate not checked ) and I was fine. White blood cell count I think was done and good. So that is why I am really concerned. Would a HIV RNA test give me more piece of mind in your opinion? Would the Cipro medication affect my results?
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Edward W. Hook M.D.
84 months ago
I'm sorry that you are feeling so poorly and certainly prostatitis can do this, as can other medical conditions.  Just because you feel bad however does not mean that you have HIV or an STI however and the mind has a strange way of making associations that really aren't there, sometimes making such connections in part due to relationships with guilt or fear. 

I can't answer you as to whether an HIV PCR would help your state of mind or not but I can assure you that it would be negative, proving what I have already told you- that your current symptoms are not due to HIV.  Ciprofloxacin would not affect the performance of any test for HIV.    EWH
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Edward W. Hook M.D.
84 months ago
Our Forum guidelines permit up the three replies per question. This thread is being closed at this time.  EWH
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