[Question #247] HIV and Syphilis

36 months ago
Hi, Doctor!
Let's assume that my masseur has both - syphilis and HIV...if he gives me a massage provided he has a syphilitic chancre somewhere on his  body, and part of my body comes into contact with the lesion itself on his body, can he eventually pass both diseases to me, or only syphilis? All the articles that I went through are so contradictory; some of them state that HIV cannot be transmitted through sensual massage, but others point out that very often syphilis and HIV go together.  Where is the truth? I am asking this question, because I am worried my masseur could have eventually transmitted syphilis, but how about if he had HPV virus as well? Will it lead inevitably to the conclusion that he could have passed both diseases simply through a body massage?
Thank you!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
Welcome back to the forum. But I'm sorry to see you remain so concerned after the reassuring responses you had from Dr. Hook. He really answered these follow up questions in your previous thread.

Nobody has ever been known to acquire HIV from a massage, kissing, or hand-genital contact. No direct sex means no risk. Period, no exceptions. As for syphilis, your symptoms don't suggest it; and also there is simply no realistic risk of catching from this sort of exposure, even if your masseur is infected. (I assume your mention of HPV is a typographical error; you meant HIV.) And from what you said in the other thread, it seems very unlikely he is. Further, I would point out that the large majority of syphilis in North America is limited to gay men; heterosexual syphilis is uncommon, further reducing the cahnce the masseur is infected.

As for "assuming" your masseur has both HIV and syphilis, I think that's a pointless exercise. The fact is that it is very unlikely that he does. But if he does, I would still rate the chance of transmitting either one as zero from the kind of exposure described. For sure it will not "inevitably" lead to the conclusion he could have transmitted either one by massage.

So you're really barking up the wrong tree. I suggest you stop searching the internet about it. Like many anxious persons, it seems you are being drawn to information that inflames your anxieties. Finally, if you remain concerned, I would suggest you get tested for both infections. I suggest it strictly because I think you might find the negative results reassuring, not because I believe there actually is some risk; I do not. But if you do it, you can expect negative results.

Best wishes--  HHH, MD


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36 months ago
Thank you for your answer! I feel significantly relieved! 
Please, disregard this particular case...I would like to know, hypothetically, if a person
is infected with both, will it be possible to pass the HIV virus trough a syphilitic chancre by skin-to-skin contact?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
Probably yes, but only if the exposed person had an open cut or sore. Contact of a chancre with intact skin for sure would not transmit HIV and probably not syphilis.---
36 months ago
Thank you for your answer, Dr. Handsfield!
I have one last question. Can a dermatologist always successfully distinguish a cyst from a chancre (on the 4th day of its appearance)?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
36 months ago
No health professional, and certainly not a dermatologist, would mistake a chancre for a skin cyst.

To be frank, your level of concern is far too high for this situation. It really isn't normal to be so fearful and uncertain after the repeated, reasoned, science based reassurance you have had from your doctor, Dr. Hook, and now me, and suggests an underlying emotional/psycological issue -- perhaps guilt or shame over a sexual decision you regret. You truly can and should just let this go. Please consider counseling, and/or discuss the potential value of counseling with your personal physician. Also follow through with a syphilis blood test, as discussed above -- it will be negative, but that result might also help you get beyond these fears.

That completes your allotted two follow-up questions and replies and ends this thread. Best wishes to you.
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