[Question #3664] Blood in mouth vs Blood during handjob

34 months ago
Dear Doctors 

I have been suffering a lot of anxiety over something you and several other(websites) have described as a zero risk encounter. I asked 3 days ago and it was very kindly answered.  Iv went to a therapist and started anxiety pills as my anxiety has been out of control.  I have been feeling much better about the incident ever since you Doctor HHH described it as a zero risk encounter . The encounter was a handjob at a massage in India. 24 hours after the massage i went to see the ladys hands - no cuts, lesions or ulcers . My penis has none either . At the time of the massage i dont know if there was any blood on her hand but i assume that since it was at the end of a 30 min massage - there was little or no blood.

While even with a possible cut, i understand it was a zero risk encounter 

However one thing has confused me and i couldnt find the answer anywhere- Several places have mentioned that blood on mucous membrane and blood in mouth is significant risk. If that is true, how come a blood drop on the penis wouldnt be a risk ? Is it because it gets exposed to air while in other cases it doesnt get exposed to air  or is because the penis is differently structured from the mouth ?

If you could just help me with this answer, i would be VERY VERY GRATEFUL and i could return to my family and my life. I would finally be able to accept that its a no risk encounter. My mind keeps playing the scenario that in the dim light, some blood touched my penis (mucous membrane) and transmitted hiv. While i checked her hands next day and they were without cuts - perhaps it healed fast .

Your explanation on the comparison with blood in mouth vs my situation would give me all the re-assurance i need to understand this was a zero risk encounter and i will move on back to my family.

Hope you answer. 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
34 months ago
Welcome back, but sorry you found it necessary.

This question was answered last time, when I wrote "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."

Like many anxious persons, you have been misled by the kinds of questions you searched online the answers you found. You're really asking the wrong question entirely. The fact is that nobody has ever been known to catch HIV by the kind of exposure you had. The biological reasons don't matter:  if it doesn't happen, why to the biological reasons make any difference? 

Blood contact with the mouth is low risk. You have apparently read that blood contact with mucous membranes is a transmission risk. But that doesn't mean any and all contact, no matter how small. Swallowing blood, for example, rarely transmits HIV, and certainly a small drop or two of blood on oral mucous membranes very rarely results in infection. As for penile contact, dry skin -- the outside of the penis -- is even lower risk. All these are zero risk, even if your massage partner had blood on her hands. Once again, see my comment above.

As I also said last time, "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."

And for goodness' sake, stop searching online about all this. Your anxieties are just leading you to information that inflames your fears but doesn't really apply to your situation.

I hope these additional comments settle things for you. If they do not, professional counseling (or perhaps discussion with your wife) would be a logical next step.

HHH, MD
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34 months ago
Thank you for your reply doctor. As I mentioned Iv already started going to a professional counsellor as I’m having a very hard time with my anxiety. Il take your advise and stop searching the Internet. Your answers have truely helped my anxiety.  Thanks once again

Going to move on assuming
1. Zero risk 
2. No need for testing 



H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
34 months ago
Correct, as noted previously in both threads. Best wishes for success in counseling.

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