[Question #2256] Scared after a night out at a strip club

99 months ago

Hello Experts,

I am a 37yo male.

During a recent business trip to San Francisco, I visited a strip club where against my better judgement, I ended up in a VIP room. There were two female dancers present and my penis was exposed. At some point it was rubbing against the upper thigh of one of the dancers but there was no penetration. Eventually, one of them proceeded to give me a hand job while I briefly inserted two fingers into the other one. I ejaculated and cleaned up with a sanitary wipe.

A couple days after that incident when I arrived home, I noticed there were a couple of small sores on my inner groin where the fold is about 2 mm wide. I proceeded to get STI testing and everything came back negative. They did swab the area as part of the test for herpes. It cleared up quickly before I was able to see a doctor about it. My wife who is a physician thinks it was mild jock itch. I was not too concerned about HIV at this point as the health care provider was certain I was not at risk but it was part of the initial tests that all came back negative.

At the 5 week mark (a week ago), I started to develop what felt like a cold (wet cough with mucous, stuffy nose, sore throat). I may have had a fever one night as I did have night sweats. This has not happened since and my symptoms are mostly better aside from a mild cough. At this point I became increasingly concerned since I have read that ARS symptoms can resemble this. The worst part is that I had resumed intercourse with my wife (only once however). My questions are as follows:

1) I do not believe that the sores on my groin were present during that incident however, if they were, would that be an avenue for HIV transmission?

2) I was not fingering for too long, probably under a minute. I remember examining my fingers shortly after and the skin seemed intact aside from a bit of dry skin peeling from callouses. Is this an avenue for transmission?

3) You often mention in your posts that sex workers and exotic dancers have a low percentage of HIV/STIs. What is this based on? They have the potential to service many people in an evening.

4) After intercourse with my wife (right before I got sick a week ago) , she developed a sore throat a few days after. If I were infected with HIV, wouldn't my viral loads be sky high right now? This is perhaps what I'm most scared of.

5) Should I be retesting as a test 5 days after this incident would not be accurate?

Thanks. I would be happy to donate to your organization.

Edward W. Hook M.D.

99 months ago

Welcome to ur Forum. I'll be pleased to comment. With the sort of contact you describe (mutual masturation) and no penetration, this was a no risk event for virtually all sTIs. Your testing proves this. I suspect the proximity of your recent symptoms to this encounter has made you wonder if the two are related but I am confident, bsed on your history, that this is not the case. As an FYI, I should also point out to you that your symptoms have occurred later than is typical for recently acquired HIV (the ARS) and that cough and a runny nose, which characteristic of colds, are not typical of the ARS. I would not worry.

As for your specific questions:

1) I do not believe that the sores on my groin were present during that incident however, if they were, would that be an avenue for HIV transmission?

These lesions would be unlikely to meaningfully increase your risk for HIV or other STIs. Further, fron the sounds of thins, it sounds as though the dancers you were in contact did not get genital secretions on this area, if anywhere. Even if they did however, I would not worry.

No, mutual masturbation or masturbation of another person is not associated to put a person at risk for HIV acquisition.

3) You often mention in your posts that sex workers and exotic dancers have a low percentage of HIV/STIs. What is this based on? They have the potential to service many people in an evening.

I think if you look at our earlier posts we say that such persons, while at RELATIVELY higher risk, usually do not have STIs including HIV. This is because, even in their high risk occupations, most people do not have STIs. Further, because of their occupational risks, these folks tend to get themselves checked regularly and many use condoms. Studies have shown that the risk for getting an STI is higher with a casual, one night stand in a bar with a partner who has had other partners than with professional sex workers.

This is a what if question. Yes, if you had been infected your viral load would be sky high but the encounter you describe was no risk. As long as your history is correct, she got a cold. You may or may not have transmitted it.

5) Should I be retesting as a test 5 days after this incident would not be accurate?

Your testing for the most common STIs, gonorrhea and chlamydia was accurate at 5 days. Tests for HIV and syphilis were too early to be useful. We recommend strongly against blood testing for herpes in situations like this. I hope you were not.

I hope these comments are helpful. EWH

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99 months ago

Thank you Dr. Hook,

Just a question regarding the Herpes blood test. What is the reasoning behind not recommending it?

Thanks

98 months ago

Thanks for all your assurances,

As you expected, everything came back negative. Is 6 weeks long enough for all STI tests to be conclusive.

Thanks

Edward W. Hook M.D.

98 months ago

Sorry I missed your earlier followup question. The reason we don't recommend blood tests for HSV following low risk encounters such as your is that your risk of having a falsely positive test is considerably higher than the likelihood,of learning that you acquired herpes. Further such tests can detect old infections and cause undue distress. As a general rule, following a single low risk exposure such as yours, no outbreak, no concerns is the best and most direct approach.

With negative tests at this time it is time to move on without concern. No reason to worry, no reason for further testing. EWH

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98 months ago

Actually, it was a day or two short of 6 weeks. I assume it doesn't make much of a difference? I know the risk is near zero, however, the consequences of not getting this right are dire, so I just want to make sure. I used the 4th generation test used across my province in Canada.

Edward W. Hook M.D.

98 months ago

Testing closer to six weeks than 5 makes your results that much more certain. This in no way changes my assessment or advice. I hope you will now be able to move forward without concern and urge you to do so.

This is my third reply to your questions. As per forum Guidelines, this thread will be closed later today. Take care. EWH

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