[Question #3590] Worried sick after massage

37 months ago
Hello Doctors

2 days ago I committed a blunder by visiting a massage parlour. The massage was by a Thai lady. I went half naked and she first gave me body to body massage by lying on top of me, with me facing down. She then made me wear a disposable underwear and after that convinced me to let her give me a handjob. She applied lotion and started the handjob. All this while she was constantly kissing me everywhere so there might have been her saliva in contact with my body (including my nipples). I also had some slight bruises on my chest. She then asked me to allow her to give me blowjob but I refused. She then made me lie down (straight with face up) and lied on top of me (she was only in her underwear). She rubbed herself on me and made me climax. All this while her underwear was on and not removed, even though I am not sure if she might have momentarily removed it whilst rubbing me. However I am quite certain that there was no actual penetration. After me climaxing, she got up and wiped my sperm from her stomach and chest. The disposable underwear I was wearing was half removed on my body but my sperm went on that too.  Following are my concerns:
1. What if her vaginal fluids through her underwear came in contact with my bare penis
2. What if she did remove her underwear whilst rubbing me at the end which I did not realise
3. With her casual attitude (not offering condom when offering blowjob) and that she is from Thailand, I am worried that she merely wiped my sperm from her body after finishing and put on her clothes. She might have done the same before me with others and I might have come into contact with other people dried and remnant liquids
4. The same concern with the bed sheet I was lying on in the room
5. Quite a lot of lotion was used for the hand job which made things slippery between us when she rubbed me lying on top of me (on my bare penis)

Please let me know if I face any risks as I am extremely worried. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Welcome to the forum. Thanks for your question.

I would encourage you to not worry at all about STDs or HIV from these events. They were completely risk free. With rare exceptions, STDs require penetration for transmission. The bacteria and viruses that cause them are not simply infections that happen to primarily involve the genitals. These organisms evolved to require penetration for transmission. In addition, saliva or oral contact is rarely a source of infection. Among other things, saliva kills HIV and also is toxic to most STD bacteria and viruses. Further, these organisms cannot be transmitted through clothing materials; the cloth fibers would effectively filter them out, at least to numbers that are not infectious. While nobody can say that such exposures are truly risk free, the overall chance of any infection is so low that it can and should be ignored. In my 40+ years in the STD business, I have never seen nor even heard of any patient who acquired any STD or HIV from exposures like yours.

Those comments pretty well cover your specific questions. But to be explicit, so there is no misunderstanding:

1) No significant risk. In addition to the above comments, contact of infected fluids with intact penile skin is not a risk. (The skin of the penis is no more susceptible to STDs than skin anywhere on the body.)

2) It seems pointless to speculate on potential exposures that almost certainly didn't happen. But this still would be very low risk:  genital apposition, without penetration, is very low risk.

3) Even if her personal hygiene is as you describe, any semen from previous clients would be too small in amount, and would have dried sufficiently, that transmission of STDs would not occur. 

4) STDs are never transmitted by contact with linens, towels, etc. No risk at all.

5) Use of lots of lotion does not increase risk. In fact, it probably reduces it:  a) Many (most? nearly all?) lotions contain anti-infective preservatives or are otherwise toxic to bacteria and viruses. b) Improved lubrication probably reduces the kinds of contact that could transmit some STD organisms, i.e. less chance of microscopic abrasions.

So as I said above, you really needn't be worried at all. You don't need any STD testing and if you have a regular partner, you can safely continue your normal sexual practices without risk of transmitting any STD from this even. Of course you are free to be tested for common STDs anyway, if the negative results would further reassure you. If so, have a urine gonorrhea/chlamydia test any time more than 4-5 days after the exposure and blood tests for HIV and syphilis after 6 weeks. (This does not mean I believe you are really at risk. I do not.)

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
---
37 months ago
Thanks Dr  Handsfield for your answers.

I am sorry but I have some confusions here. You begin by saying that there is no need to worry about any testing but under answer (1) you say that there is no significant risk - so does that mean that there is a slight risk? Also, you mention bare penis skin but what about the penis opening (I am circumcised)?

Also under (2) you say that genital apposition is very low risk but again, is there a risk in case the undergarment was removed (?) which I am quite certain did not happen.

You have mentioned at a few places that there is no need for STD testing and I can safely resume sex with my wife but at a few places you also do say that these exposures are not truly risk free.

Are you able to please clarify? My apologies for counter questions.
37 months ago
Hello Doctor Handsfield / Dr Hook

Sorry, just anxious to hear back on my question posted 7 hours ago. Requesting either one of you to kindly address the same. Apologies for the follow up! 

Very anxious!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
The moderators are not on call 24/7. We typically have replies to follow-up comments within 24 hours.

There are few absolutes in biology and medicine, and I cannot guarantee that nobody in the world ever caught an STD from the sorts of exposures you describe. But in 40+ years in this business, I have never seen such a case or heard of one. I also cannot guarantee you won't be struck by a meteorite, but I would not encourage you to take steps to prevent it. I have also said that you are free to get tested if the negative results will help reassure you.

Really, mellow out. This is not the sort of contact that should be the source of so much anxiety!
---
37 months ago

Thanks Dr. Hands field. I certainly never meant to push you for a quicker answer, that was not my intention. I am sorry if this created a misunderstanding.

 

For now, I am going with the assumption that I can carry on with my normal life and continue having unprotected sex with my wife. I am going with the assumption that the likelihood of contracting an infection is extremely improbable. My main worry is for HIV and from what I have gathered from your answers is that there is no need to get tested and there is zero risk for the same.

 

Please correct me if I am wrong anywhere, so that I can move on and close this thread.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
You've got it exactly right. It's not only my professional advice, but is is the path I would personally follow if I were in your situation.---
37 months ago
Thanks Dr Handsfield. Really appreciate your advice on this. Best wishes for using your competence and expertise in carrying out this noble work! Even though it is not the topic of discussion here, my guilt is weighing down on me and I find it hard to look into my wife’s eyes. I wish to never repeat this mistake ever. I don’t wish to ask any further questions so please feel free to close this thread. Thanks very much again!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
My final advice is that you not beat yourself up over a very common and very human error. Don't make more of it than it deserves.

Thanks for the thanks. I'm glad to have helped. ---