[Question #257] Not a relaxing massage.

36 months ago
Dear Dr,
I'm having panic attacks. About a week ago I was with an erotic massage parlour attendant. I'm a 26 year old male, from toronto, circumcised with genital HSV-2 and a history of genital warts (mostly gone). I had my last HIV test 3 months ago. Result was negative, of course. I don't engage in unprotected sex. I had done so once by mistake many years ago which resulted in my herpes. I'm going to try to be as descriptive and clear as I can so I may receive an accurate assessment.

Here's what we engaged in:
She offered me a body slide which is when the bodies rub together. I was face down. She sat at different positions. On my back her vagina came in direct contact with some acne/pimples on my lower back and buttocks (unprotected). I doubt any of them were actively bleeding. At both times I could feel her vagina with oil and/or fluids. She also slid her breasts between my buttocks i think even touching the anal opening. I then flipped over and she gave me a handjob. I do not believe she touched her vagina prior to that. 
I did not go inside her. I do not believe there was any frottage either. In fact I know that for a fact. 
At one point she also put my penis near her mouth and breathed on it.

I'm worried about my HSV-2 status and the potential contact of her vaginal fluids. I don't think I was having an outbreak at the time but what if I had shedding? Is this safe fun for me doctor or do I need to worry? Do I need any testing? I made a bad mistake. Can I resume sexual relations with my wife? This morning I noticed a small red dot on my penis does not look herpetic might just be friction. Would this change my risk at all?

Unfortunately I don't know the status of the massage attendant. Please assume she is HIV+. 

Thanks.
Edward W. Hook M.D.
Edward W. Hook M.D.
36 months ago

Welcome to the Forum.  I will try to help.  I will do that by providing you with some facts.  Before I do however, let me challenge your supposition that your masseuse was HIV+.  The odds of this are quite low- most commercial sex workers do not have HIV.  Having said that, we have had many questions of the sort you ask over the years.  Thus, based on my more that 30 years of work in the field, my own research, and my reading of the scientific literature I can say:

1.  Much research suggests that persons with genital herpes are at somewhat increase risk for HIV IF exposed through sexual contact.  This increase is about three-to five-fold.  Having said that however, HIV transmission through ANY sort of physical contact is quite rare.

2. There are NO data whatsoever to suggest that acne, active or otherwise is a risk factor for HIV acquisition.

3. There are no data to indicate that HIV is spread through rubbing or other forms of masturbation, even if an infected person who is performing the masturbation has active lesions or cuts.  Similarly there is no evidence that HIV is spread by the direct or indirect transfer of genital secretions to person to person on someone's hands or through skin-to-skin rubbing.

Thus, I am completely comfortable in telling you that the activities you describe constitute NO RISK activities.  This is the case even if the "dot" you saw on your penis was a herpetic lesion. There is no medical reason to seek HIV or other STD testing related to the activities you describe, nor is there any reason not to resume sexual relations with your wife. 

I hope my comments are helpful to you. EWH

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36 months ago
Dear Dr Hook. Thank you so much for your response. You have really alleviated some of my worst fears.

To follow up. I am not certain what I have is acne. My dermatologist says it follicullitis mixed with sweat and they are like pimples on my buttocks and lower back. I have had them for years and years. Sometimes they get irritated like and acne/pimples. She basically sat on them when I was lying face down. Her vagina came in contact with them for sure. This changes nothing? 

Also I am 99% sure there was no frontage (more like 100) but just In theory would this change the risk assessment at all? 

The was no vaginal anal or oral sex or fingering whatsoever. I can definitely put this sordid tale behind me and have sex with my wife this evening? I feel really guilty for what happened. No testing required for certain? 

Thank you for all that you do. 
36 months ago
I could have never imagined what was essentially a rub and tug massage could leave me with such anxiety. I'm sorry :(
36 months ago
After the session I told the girl I feel guilty and I'm worried about stds she essentially stated she did not have any but even if she did we did nothing risky whatsoever. Sorry for all the messages. 
36 months ago
I called a local hotline here in Toronto. One volunteer told me it was no risk and another suggested PEP. Now I'm really freaking out. How certain are you Dr. Hook? 
Edward W. Hook M.D.
Edward W. Hook M.D.
36 months ago
I am completely confident that there was no risk from the events you described.  Whomever suggested PEP for you was giving irresponsible advice.  EWH---
36 months ago
Doctor Hook. Thank you so much for your reassurance. So just to confirm absolutely no testing is required right? This was a one off lapse in judgement and I have an amazing wife who is 100% faithful to me. I am not putting her at any risk correct? I understand there was none of the classic risks here for HIV. You are certain absolutely NO RISK for HIV or and other STD's? 
36 months ago
Dr Hook,

Sorry for being so annoying. I just wanted to add I am not positive I have HSV 2. I just strongly suspect it. I have never had the classic symptoms. 

I 100% have hpv genital warts that have been treated in the past and are still there as small little bumps. I was just wondering if you are positive no matter what this was no risk for hiv or any other std's including herpes if somehow I dont have it?

Thank you so much for your time. I feel so guilty about what I have done. I can for certain have intercourse with my partner without putting them at risk for HIV or any other STI's? 
36 months ago
Anxiously awaiting your reply. Dr also I shaved my genital region 2 days before my massage.  I had no bleeding or anything. 
Edward W. Hook M.D.
Edward W. Hook M.D.
36 months ago
Your anxiety and guilt are getting the best of you.  Repeating your question will not change my assessment.  This was a no risk exposure.  This is the case whether or not you have HSV-2 or warts.  Still no risk.  Since it was no risk, there is no need for testing.

Our forum guidelines specify a three interaction limit per question.  Thus there will be no further replies.  EWH
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36 months ago
Doctor just to confirm no risk for HIV? Or no risk for anything at all? My wife is wondering why I am not eager to have intercourse with her. Please reply if you can I will happily pay for another question but if you could reply I would be very grateful. 
36 months ago
Doctor I am panicking I feel like I am coming down with a cold/flu. Some symptoms. I'm really nervous. You are certain there is absolutely 0 chance and I can sleep with my wife? I described everything accurately. No risk for sure right? Any symptoms are coincidental and I can relax?