[Question #3650] Paralysed with fear

35 months ago




Hi 
Please help me . I’m worried to the point of not being able to eat , sleep or work . 
I’m married and yesterday I went for a massage in India. I made a huge mistake.  It ended up becoming a happy ending massage which lasted about one minute. It was only a Handjob with some cream - nothing else . Stopped her in one minute . She was completely clothed. Am I at risk of any std ?
I am extremely worried
Some additional info -
1. She used some sort of oil . 
2.i couldn’t see any visible blood on her hand or my penis . But who knows if there Amis microscopic amounts of blood.
3. Since I was very worried, I went today and checked her hands in a regular massage . I couldn’t see any visible cuts, lesions or sores. 
4.No visible lesions on my penis . I am NOT circumcised and my skin was not pulled back . She did however touched the tip of my penis. 
I stopped her within a minute. 
5. I am already hsv1 positive 

My questions are as follows 
1. Am I at any risk at all for hiv ? Is this encounter considered a zero risk event ?
2 if not , does it warrant any testing? 
3. Without visible lesions - am I at risk for hsv 2 or hsv 1 in the genital area ?
4. Lastly - what is my risk for syphillis , hpv , chlymadia and gonnorhea
LASTLY CAN I HAVE SEX WITH MY WIFE OR DO I NEED TO WAIT TO GET TESTED ? 
I feel so terrible about what I’ve done . A weak moment of one minute could ruin my life . I need your guidance . Please
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
Welcome to the forum. Thanks for your confidence in our services.

You needn't be worried at all. Like many anxious persons, you tacitly assume or believe (maybe not consciously) that "sexual transmission" means potential infection by any kind of sexual contact. Not true. The STD viruses and bacteria, including HIV, evolved to require much more intensive exposure than can occur by hand-genital contact. Without intercourse, i.e. a penis inside another person's vagina or rectum, there is no risk. Even oral sex carries little or no risk, with only very rare cases transmitted penis to mouth and none ever proved mouth to penis or by oral-vaginal contact. And for sure there is no risk by hand-genital contact, even when genital fluids are used for lubrication. For an HIV infection to take hold, large amounts of virus must have direct contact with specialized cells that in general are deep inside the body. Hand-genital contact simply doesn't allow such exposure to occur. The same is true for all STDs. Whether or not there were wounds or other skin conditions of your massage partner's hands make no difference.

Those comments pretty well answer your specific questions, but to be sure there is no misunderstanding:

1) This encounter was zero risk for HIV.

2) There is no need for HIV testing.

3) Neither of the herpes simplex viruses (HSV1 and 2) are transmitted by hand-genital contact.

4) Also no risk for these STDs.

5) You can safely continue unprotected sex with your wife without worry and without testing.

Don't confuse your anxieties about a sexual decision you regret with disease risks from that decision. They aren't the same. Deal with the former as you need to -- some men in your situation would discuss it with their wives -- but do not worry about the latter. It simply is not an issue and should not be a cause for worry.

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

HHH, MD

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35 months ago
Hello. 

I decided to share it with my wife even before your reply. I was feeling very guilty and couldn’t take it anymore. I feel a little better knowing I have nothing to hide.

Your reply is very appreciated.

A final clarification . I’m  afraid that if there was some microscopic blood that I couldn’t see , wouldn’t that be a concern . Iv understood that even if there was a cut or some small amount of blood - I am still at zero risk and I don’t warrant any testing for HIV . Is my understanding correct ?

I would really like to move on and rebuild my life with my wife. I will try after this clarification 
35 months ago
Just for clarification - I didn’t see any blood or cut but there could be microscopic ones .
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
I'm really glad to learn you have spoken with your wife about all this. Good move!

If there wasn't enough blood to see it smeared all over your penis, there almost certainly wasn't enough to transmit HIV. Microscopic amounts probably are not risky at all. But even if they were, just think it through logically. At any point in time, some proportion of the population undoubtedly have blood on their hands -- they picked a scab, had a minor cut on a finger, rubbed a recent wound, etc. I don't know how frequent this is, but even if it's one in a thousand persons at any time, over the 4 decades of the known worldwide HIV/AIDS pandemic there must have been millions of hand-jobs by HIV infected people with small amounts of blood on their hands. And still no known cases of HIV transmission.

Does that help?

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35 months ago
Hi Doctor
Yes I guess it helps.
There certainly wasn’t that much blood on my penis. So finally to close my question . Can my wife and I treat this as a zero risk encounter and move on with our lives ? 
35 months ago
Sorry about asking for the final clarification . While your last answer helped us understand - we couldn’t be sure  if we can treat it as a zero risk encounter.
Since Your first reply said it’s a zero risk encounter , I assume that is still valid and I can move on without testing.
Apologies for taking so much of your time and thank you for helping us both out.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
From my initial reply above:  "1) This encounter was zero risk for HIV [and] 5) You can safely continue unprotected sex with your wife without worry and without testing." I haven't changed my mind!

That completes my third reply and so concludes this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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