[Question #2744] HIV and STI query

42 months ago
Hi Doctor
I visited a massage parlour in Malaysia. It looked like a decent one until the massage lady offer me masturbution. I agreed and other than masturbation the only physical contact I had was deep mouth kissing in that heat of the moment. I am not sure if she or I had any sores or cuts etc. Although my mouth was slightly sore from a hard tooth brush. I am now worried. It has been 12days and I have serious anxiety. Could I contact HIV or any STI? Yesterday I saw a very small transparent ulcer in 2 places inside the lower lip (not clearly visible until checked carefully) since then my anxiety has become worse. I am surely going to be tested in the next 2 weeks (4 weeks from exposure) but until such time my worries are shooting the roof. I can't concentrate. Please help! I have no other symptoms except some discomfort in the neck lymph nodes although I think I have been touching it out of fear and have been opening my mouth too often to check the inside.
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
Welcome to our Forum. I'll be glad to comment.  there is no meaningful risk for HIV form the encounter you describe and vry very little risk for other STIs as well. Estimates are that 1/2 of 1% of Malaysians have HIV of 90% of those who are infected are men. Thus is it very unlikely that your partner had HIV.  Even if she did, there is no risk of HIV from receipt of masturbation or from kissing, including deep mouth kissing with exchange of oral secretions  I certainly would not be worried about HIV and realistically see no medical need for testing.

As for other STIs, again, there is no meaningful risk.  Common STIs like gonorrhea and chlamydia are not ever transmitted by receipt of masturbation or kissing.  Lesion diseases like herpes or syphilis are primarily transmitted by direct contact so there is a very, very small chance you might have acquired HSV-1, the cold sore virus through kissing this person but this is statistically very unlikely for several reasons.  First, even though they do not know it, most people already have HSV-1 (most people with HSV-1 do not get or remember cold sores) and even if she were infected, the infection is rarely transmitted by kissing.  If the small lesions you saw were oral herpes, they most likely would have grown in size and become obvious by now.  We find that often as people who are worried repeatedly examine themselves they imagine that they have seen lesions that are not there. Similarly, just as you mention, repeated prodding as part of self examination for swollen lymph nodes can cause soreness of the sort you describe. If you had swollen lymph nodes you would not need to push to find them.

I hope these comments are helpful.  Please try not to worry.  EWH 
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42 months ago
Thanks a lot doctor. This has allayed some of my fears. 

However, coming to the lymph nodes, I could understand that there is soreness on the ones below the jaw as I constantly kept touching them. They are slightly  better now as I havent bothered them.  

I am now seeing a slight bump near my collar bone on the left side which is not very clearly visible unless seen carefully, but when I move my hand, I can clearly feel a slight bump. I never touched this earlier so this new occurrence is bothering. It's not painful or even sore - just a bump when I move my hand. That's not the case on the right side at all. May be it's my anxiety but it's all very worrying - I hope you understand and would advise.

Thanks for your help doctor.



Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
There are lymph nodes in that part of the body but these lymph nodes are virtually never seen as a sign of HIV.  My advice would be for you to see a health care professional to find out if indeed it is a lymph node (which, to be honest, I doubt).   It is not a sign of HIV or any other STI, of this I am quite confident.  EWH
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42 months ago
Thanks Doctor. I know this is my last follow up question.

So summarizing, even if this was a possible "symptom", I could be that of an STI which I could have remotely contacted. However, there is no fear whatsoever of HIV based on the exposure I had?

Thanks for helping all people like us who are anxiuos about every possible symptom.  I will post my results on another thread once I am tested, even of it means I have to pay  cash charge. This will make some other people relax their anxieties.

P.s. I value your experience and opinion about not being tested for HIV but I just want to put my anxieties to rest and it in no way disregards your valuable suggestions.


42 months ago
Sorry doctor..I just heard from my insurance provider. For the application I had undergone a CBC. They advised that my WBC is high. I am now doubly worried.  Thanks for your response
Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
Your elevated white blood cell count is a non-specific finding and does not, in any way change my opinion.  there is no realistic reason for you to be worried about HIV from the activities that you have described.  My suggestion remains the same, see a trained, qualified doctor to determine what the bump near your collar bone is and at the same time, ask about your elevated white blood count.  I would not be the least bit worried that it is an STI of any sort.  EWH
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Edward W. Hook M.D.
Edward W. Hook M.D.
42 months ago
This thread is now closed.  EWH---