[Question #2545] STI Assessment

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97 months ago

Fully body massage from “fully clothed- tshirt and shorts”  female masseuse. Proceeded to a happy ending, with limited participation (2-3 rub/ tugs) from masseuse and most of the work by me. Massage lady then proceeded to get on top of me, while I lay on table facing up. She pulled a towel over my genital region to prevent any contact with her clothes (ensuring barrier between us). She proceeded to grind her body against mine (viral shedding/ contraction risk?) , while I tugged myself to climax under the towel. Once done she cleaned me up with hot towel. No self touching from masseuse through entire event and she remained fully clothed thru out. No oral/ vaginal/ anal contact with masseuse at all through event.  Event led to panic and guilt. Went and checked her hands 2 days later and no signs of any lesions. Tested 10 days out and negative for CHLYM/GON/HEP/HIV/SYPH/HSV-2 but HSV-1 Positive.  I am seeing no lesions on myself, but anxiety is rough. Also, using cream for penile yeast infection.

Do I face any risk (HIV/ SYPH/ HSV2) or should I be tested at any other time period? Considering getting pregnant and do not want to put wife at risk of anything? This is a regretful event whose guilt I will have to deal with. Medically need some re assurance.

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Edward W. Hook M.D.
97 months ago
Consider yourself reassure d.  The events and activities you describe are incompatible with STI/HIV acquisition.  Mutual mastubation, even when participants get each others' genital secretions on one another, is not an activity which leads to STI/HIV transmission.  No STIs, including HIV are transmitted by rubbing of the sort you describe (medical term is "frottage") nor are they transmitted through clothing.  There is no reason for concern and was no reason for testing, now or in the future related to the events you describe.  Please do your best to get by your guilt and move forward without concern.

I hope my comments are reassuring and helpful.  EWH
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97 months ago
Hey Doc, Thanks for your words of reassurance...they are really comforting.. Today is 3 weeks since the incident, and I (thank god) still dont see any leasions...Thats a good sign isnt it....? A coupel of curious follow ons....to prod a bit further. HSV-2..with the vigourous frottage (her nether regions covered)... would that pose any risk.  Could the virus say shed from her thighs, and on contact with say my thighs accomplish transmission.? Could her hands have achieved the same when she handled my penis for a few seconds. Similarly, with regards to any Syphillis lesions present on an uncovered portion of her body. If they did touch my exposed skin/ penis (if on hand) would that transmit. ?  Im fearful but trying to move on.... Anxiety is causing all sorts of symptoms....burning palms, curious skin conditions (under excessive ) review.....O man!... 
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Edward W. Hook M.D.
97 months ago
Several things make this quite unusual.  Both syphilis and HSV-2 lesions are rare in areas of the body other than the genitals which, in the case of your masseuse, were covered.  Secondly, even though it would seem that simple,frottage could result in HSV or other STI transmission, the fact is it is not seen with any meaningful regularity.  Similar.ry, neither HSV nor syphilis are transmitted by hand to genital contact.  Really, there is no reason  to worry about from the contact you describe and no reason for concern.  Don't let your guilt talk you into unnecessary concerns.  EWH---
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97 months ago
Hey Doc, 
May i please request elaboration on what you mean by  "transmission not seen with meaningful regularity"?
On a very practical note and with the greatest respect, If you personally went through what i did- the actions (being 100% sure of a clear history prior to this incident), would you proceed with normal relations with your spouse/ partner?  i have, 3 weeks on from my incident,  retested serologically for Syph and HSV2, due to heightened anxiety. If -ve can i  move on, knowing the risk....or must i wait till 6/12 weeks respectively.
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97 months ago
Hey Doctor...looks like i spoke too soon...  3 weeks in penis head is all red with small bumps and i have 1 pin-tip sized lesion with what seems like pus. Does HSV/ Syph manifest like this ? Could this be allergic reaction to condom usage?
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Edward W. Hook M.D.
97 months ago
First, what I meant by "transmission not seen with meaningful regularity" is that in medicine and science in general, strange things happen and nothing in these fields is 100%.  Our research results are generally considered estimates, not because we lack confidence in the results but because tomorrow something new could be discovered or described for the first time.  So, just as I cannot give you 100% assurance that you will not be struck by lightning while reading this, I also cannot give you 100% assurance that there was zero risk for STI from the exposure you describe.  Having said that, I have complete confidence both that you are not going to be struck by lightning while reading this and that you were not at risk for ANY STI from the exposure you describe above.

For the same reason, I am confident that the bumps you have detected are not an STI from the events you describe.  They could be a none-STI fungal infection ("jock itch") or some other dermatologic problem.  The best way to find out is to seek the opinion of a trained physician.  If he/she suggests this is an STI of any sort (herpes, syphilis, HPV), I would request a test and not rely upon visual diagnosis.  Further if herpes is suggested, you need a PCR swab test, not a blood test!  The bumps you have detected are appearing later than would be typical of herpes, too soon for HPV, do not sound like syphilis and are occurring too late to be an allergic reaction to a latex condom (which typically appears within a day of contact).  EWH
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97 months ago
Hi Doc, Thanks for your note and support...I really do hope that science and the odds play in my favor on this.
The latex condom reaction was immediate (post last night activity- it was immediate, and has happened in the recent past). The bumps were not obvious and were not inflamed until the condom use, so I'm hoping this is allergic in nature.
I am visiting a doctor shortly and do hope that this is sorted out and is in line with your estimations. Wish me luck. 
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Edward W. Hook M.D.
97 months ago
Did not realize the condom exposure was so recent.  Yes, this could be a latex allergy.  

Our forum calls for up to three responses to questions.  This is my 4th and therefore there will be no further responses.  I will leave the post open for a few days however in the hope that you will let us know what the doctor says on seeing your rash.  eWH
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97 months ago
Hey doctor. Thanks for keeping post open. I visited a urologist today, and he too was of the opinion that the lesions did not look herpetic. Never the less a viral culture swab was taken on my insistence . I hope to have results back in a couple of days. Hey wanted me to do an igm test, but i refused as i understand that it can be misleading. Please leave post open fir a few more days and i will inform on results. Wish me luck. 
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Edward W. Hook M.D.
97 months ago
Congratulations on declining the IgM.  You are correct, the tests are unreliable with both false negatives and false positives.  EWH
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97 months ago
Hi Dr Hook, as i said i would, i am here posting the -ve results of my viral swab. I really hope i can put this all behind me and resume my normal life. I am trying different treatments for my penile yeast infection, and hope to have that resolved soon. I thank you for your help through these trying times, and wish you the best for any of your future undertakings.
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Edward W. Hook M.D.
97 months ago
Glad to help.  I'm not surprised that your test is negative and am pleased that you feel that this result will allow you to move forward without concern.  Take care.  EWH---