[Question #270] Question 257 Follow up

35 months ago
Dear Doctors,

I am still so worried about my massage from last week. I just wanted to confirm that even if you were certain the massage attendant was positive I could continue having sex with my wife. Furthermore, I have begun feeling all kinds of symptoms. Bad diarrhea, headaches, flushed red face, some neck pain, and fatigue. I could really use some more reassurance. Are you positive this is no risk? Even if she was HIV positive? I truly have nothing to worry about? I will avoid this kind of behaviour in the future as trivial as it may seem as I clearly can not handle it. Dr, would you get yourself tested for such an exposure in theory? Any risk of other STD's? Please please please answer my questions. Thank you so much. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
Welcome back. But having reviewed your recent discussion with Dr. Hook, this is not the sort of forum or service that can help you. This is a problem of mental health. It is simply not normal to find it so difficult to believe, accept, and act upon the repeated, science-based, reasoned reassurance you have had. You obviously are obsessed with a sexual decision you regret, causing anxiety and stress. However, you need to separate that aspect from the potential disease consequences of that decision. They aren't the same. Deal with the former as you need to, but ignore the latter.

I will answer these questions one more time -- they have already been covered clearly by Dr. Hook. I certainly hope another round of it will help, but I suspect you're eventually going to require professional counseling to help you get beyond this. 

1) If the massage attendant had HIV (almost certainly she did not) or another STD, you still would not have been infected.

2)  Your symptoms are not typical for HIV. They are, however, perfectly typical for physical monfiestations of anxiety and stress.

3) If I were in your circumstance, I would not be tested for anything and I would continue unprotected sex with my wife.

Despite absence of risk, you might want to consider seeing a doctor and getting tested for HIV and common STDs anyway. This does not mean I have changed my mind and think there is any risk. I do not. But perhaps the in-person reassurance and negative tests would help you move forward.

If concerns remain, I suggest you also re-read your earlier thread and Dr. Hook's responses. I'll answer up to two follow-up questions if any remain -- but will not be as generous as Dr. Hook was in going over the two follow-up question limit!

I hope this has helped. Very best wishes to you--  HHH, MD


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35 months ago
Dear Doctor H,

Thank you so much for your reply. I have definitely calmed down. I feel like going and asking the girl about her std status but I think that is crazy when I really think about it. I need to accept this was a no risk event. 

I think something that might be helpful to me is if you could explain why her vagina coming in contact with pimples on my buttocks/backside that are red/irritated is not a risk. Pimples pop all the time! I think if you could just explain that to me I could firmly put this behind me. 

Thank you so much for your kindness. I really want to go and ask the girl but this would be another indiscretion on my part and I want to be 100% loyal and faithful to my partner moving forward. What do you think? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
STDs are not simply infections of the genital area transmitted by genital contact. The bacteria and viruses that cause them evolved to require the intimate contact of insertive sex for transmission. And intact skin is highly resistant to them, so there was little risk even if she was infected and had active disease on her external genitals. You can't simply apply HPV, herpes virus, syphilis bacteria, etc on the skin and have infection take hold; they must be massaged into the skin with microscopic trauma. And for chlamydia and gonorrhea, the skin isn't susceptible at all, even with trauma. This is why that the primary lesions of herpes, syphilis, and genital warts typically occur on sites exposed to maximum friction during sex, such as head of the penis, and rarely on peripherally exposed skin, such as the scrotum -- even though infected fluids probably always contact the scrotum during sex with infected partners.

I can't give you definitive advice on contacting the massage lady. There is no medical basis, but I can see how it would be psychologically reassuring. If you do it, a way to repect her is to put iinto the two way context that it is:  you're pretty sure you couldn't have had an STD she could have caught, but thought she might like the reassurance; and by the way, can she say the same? Be prepared for her to laugh out loud, if she's wise about these things -- which probably is a good bet. But if she is a kind soul, she probably will understand. But again, if I were in your circumstance, for sure I wouldn't do it.


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35 months ago
Dear Dr. Handsfield,

This will be my last comment. I believe I am ready to put this behind me and am really looking forward to reading your reply. 

I sought out the massage girl and got another handjob. ( I know! no risk :) ) 

When I talked to her as you suggested she indeed did laugh and say she does not have any diseases whatsoever, and that EVEN if she did we never did and she never does anything that could spread them. This is not a full service massage parlour. It is just body slide and hand release. 

There is one thing in your previous comment which worried me and I am sure it is just a product of my anxiety. You wrote "so there was little risk" when describing how STD's are transmitted. She did not have any sores on her vagina or anything of the sort and our genitals certainly were not in contact. I am assuming you probably copied and pasted that? I'm sure you have answered that question a million times. 

Finally, I feel if I could just get one last reassurance that from everything I described there is no need for testing for any STD's and I SHOULD continue having intercoruse with my regular partner, I could truly put this behind me. No more massage visits for me. I can not handle the guilt! 

Thank you so very much. I really appreciate what you and Dr. Hook do here. All the best.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
I thought you said her genital area came in contact with your skin somewhere. But for goodness' sake, don't hang on every word! Just concentrate on the bottom line messages; the rest of it is an attempt at reassuring scientific explanation.

I doubt this one last bit of reassurance is going to solve your problem. You are obviously obsessed, and I'm predicting you'll continue to come up with more "what if" or "yes but" questions. As I started out in my first reply, you have a mental health problem over this, not a medical or STD problem. I also think it's fanciful for you to declare there will be no more massage visits, when you were even when you went back for STD information and ended up with a hand job!  Do you not understand the implications of that decision and behavior? You appear to have little self control or self awareness. Professional counseling should be in your future. I suggest it from compassion, not criticism.

In any case, that will end this thread -- and I will ask that you not post any further new questions on this forum about this or similar exposures. The answers will never change! Best wishes to you.


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