[Question #3688] HIV/STDS/STIs from Mutual Masturbation

33 months ago
Please forgive my bothering ya'll yet again, but I have read a few posts recently which have raised some questions which I genuinely feel are legitimate.  After reading #3366, I'm wondering if your stance on gay  mut. masturbation being completely safe sex has changed.  I notice in your response that the activity described there could possibly be an exposure to all stds.  I know in the past, you have always maintained that mut. masturbation is completely safe sex, so again, I'm just wondering if you still think that it is.  I have engaged in mut. masturbation with a couple of men several times since last talking with you, and I had come to accept it as a completely safe sex method.  I had even, for the most part, let go of any anxiety related to doing such activity, but now that I've read the above mentioned question, I'm just wondering if I need to worry.  (I have always asked about their HIV status, and both assured me they were negative, but of course, you never know.)
Also, I notice your advice for testing is now 6 weeks for conclusive HIV instead of 4.  This is probably a ridiculous question, but would that apply to exposure after mut. masturbation?
And, for today's stupid question, is there any difference between stds and stis?  I know that's probably dumb to ask, but just wondering.

Edward W. Hook M.D.
Edward W. Hook M.D.
33 months ago
Welcome back to the Forum.  I'll try to help.  Let me first thank you for reading our replies to others.  Part of the reason we are part of this Forum is with the intent that what we write in response to one person's questions will be applicable and useful to others.  I went back and read 3366 again and suspect that Dr. Handsfield's answer reflected the possibility in the interaction described the mucosal surfaces of two urethras might have been in direct contact and that with such direct contact infection might (but probably was not) be transmitted.  This does not contradict our repeated and continued statements that mutual masturbation is safe sex with no appreciable risk for STI acquisition.  Admittedly, strange things do happen.  Stepping away from the topic of STI risk, as an illustration, let me point out that I am entirely comfortable stating that you can walk outside today and not worry about being struck by a meteorite falling from space and that to walk outside is safe.  OTOH, it is theoretically possible that this could happen but the chance is so low that it is not a practical concern.  My sense regarding mutual masturbation and STI risk is the same.  I have never seen or heard of an STI acquired as a result of hand to genital contact and transfer of secretions or transfer of secretions during mutual masturbation.  I hope this answer, and my analogy are helpful.  I would not worry about STI risk from mutual masturbation.

With respect to the STI/STD terminology, in recent years the term STI has become increasingly favored over STI for reasons of increased precision of language and possible efforts to reduce stigma associated with infections acquired through sexual contact.  The reasoning related to the former statement reflects that persons can be infected without having disease per se, i.e. they can be colonized with a microbe but not suffer and ill effects.  The reasoning behind the latter reason is part of ongoing efforts to reduce the stigma associated with sexually transmissible infections- thus just as years ago the term venereal diseases evolved to become sexually transmitted diseases, today more and more of us are preferentially (but interchangeably) referring to this group of infections as sexually transmitted infections.

I hope these comments are helpful.  Bottom line to your 1rst question- we still consider mutual masturbation safe sex.  EWH
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33 months ago
Thank you as always for your help/reply!  I hope you all realize how much I always appreciate your help and your putting up with me.  Just to clarify...no risk of any sti or hiv from gay mutual masturbation?  I’ve never engaged in putting my penis head against another, but I have definitely had other’s precum on my hand and then masturbated myself.  Still no risk?  No need for testing after doing this?  If I only engage in mutual masturbation, with the given that fluids will be exchanged, can I expect to never have to worry about hiv or stis?  Lastly, is testing ever necessary after what I do, and if so, would I still have to wait six weeks?  Thanks again
Edward W. Hook M.D.
Edward W. Hook M.D.
33 months ago
Correct, no risk form mutual masturbation, irrespective of who is engaged.  If you only engage in mutual masturbation I see no reason for concern and no medical reason for testing of any sort (for classical STIs or for HIV.  If you do decide to test for HIV however, results are only completely definitive six weeks after your exposure of concern.  EWH
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33 months ago
Thanks again as always.  I honestly hate to use up my last response/question this way, and I swore this time I was not going to let anxiety get the best of me.  It’s just that since my last incident of mut. masturbation, I’ve developed what I think are all the symptoms of hiv/ars or whatever.  Approx 12 days after exposure, I was in the midst of what I thought was just a head and chest cold with minor sore throat.  The congestion is finally clearing up, but the throat is still scratchy.  During this time I’ve woken up a few nights and been a bit sweaty.  I never check my temperature but never felt as if I had one.  Also, approx 14 days after exposure, it feels as if my ankles are “giving way” when I stand still.  I have been working out harder on treadmill and using some weights, but I don’t know why this would happen all of a sudden.  Since the incident, I’ve also felt as if I’ve had to urinate more and that my penis just feels different...not really a burning sensation but tingling? I’m not in panic mode, thanks to you all, but would any of this make you change your mind about testing?
I’ve read and re-read everything I can find here, and I keep coming back with nothing to worry about.  I just seem to have too much wrong.  
Also, what are your thoughts on the early detection rna tests?  I thought about doing that while I wait for the six weeks window to go by for 4th generation test, but from what I’ve read, that really wouldn’t be of any use?  
I’m truly sorry and hope you’ll forgive me.  I’m only asking because I keep thinking that I’m having symptoms and maybe your response about mut. masturbation as safe sex is only in the absence of symptoms?  I promise you I’ll accept your word and pray you’ll have a chance to answer.  I realize I won’t get another response, but based on everything I’ve said, still no risk of anything, no testing necessary, and no reason not to have unprotected sex with wife?  And mut. mastication is always safe?  You guys are life savers, and you can’t possibly know how much it means to have your help.  I know I speak for everyone who has ever asked for your help.  I don’t know why you put up with guys like me, but I hope you will one more time and thanks in advance for doing so!
33 months ago
I’m embarrassed...I didn’t mean mutual “mastication “...that’s probably safe sex!  He-he! I meant mutual masturbation as I’m sure you knew!  
Edward W. Hook M.D.
Edward W. Hook M.D.
33 months ago
thanks for your follow-up.  You have my sympathy related to the immense power of anxiety to amply symptoms and to lead concerned persons to connect unrelated symptoms to their worries (and undeserved guilt).  As you suggest, I am confident that this is what is going on, i.e. you are not at risk for HIV.  Despite the mis-information promoted by on-line sources mutual masturbation of the sort you describe has never been proven to lead to HIV infection.  Further, most of the symptoms you are concerned about are not related to HIV, i.e. congestion, urinary frequency, feverish-ness at night, and isolated ankle sensations are not signs of HIV. 

You need to put your concerns aside.  If testing would help this, a negative PCR test. albeit expensive, would reliably prove that you do not have HIV when taken at ANY time more than two weeks beyond your exposure of concern.  Similarly, combination HIV antigen/antibody testing at any time after your symptoms had resolved would prove the your various symptoms were not due to HIV as symptoms are a sign of circulating virus and antibodies.  that said, I remain steadfast that there is no medical need for testing related to the exposure you describe. 

I hope these further comments are helpful to you.  As  you know, this thread will be closed later today and there will be no further responses forthcoming.  In addition, please no further questions regarding this exposure- continued posting of anxiety-driven, repetitive questions may be deleted without a response and without refund of your posting fee.  This policy is made from a practical perspective and reflects our ongoing concern for you and your mental health and our desire to not continue to fuel your anxieties.  EWH
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33 months ago
I don’t expect a response as I know I have gone over my limit, and I’m sure I’ve pestered you enough...just wanted to double check on a couple things...my fault for not asking last time and for being not smart enough to understand your reply.  First off...thanks! I especially appreciate the “undeserved guilt” comment, although naturally I think I deserve whatever happens to me.
I meant to ask if your responses regarding my “symptoms” applied to all stds and no testing needed?  I feel as if they do or you would’ve mentioned that I should test for others.
Also, I’m guessing that it’s safe to have unprotected sex with wife?  
The only thing I didn’t quite get was...are you saying that if I do 4th generation test I should wait until these “symptoms” go away?  And, either way, it’s six weeks after incident for accurate test results?  Last, is there higher chance of false positive with rna testing?  Again, I don’t expect you to bend the rules for me here...I just honestly am not that smart, as you can tell, and meant to ask earlier.  Thanks again!
Edward W. Hook M.D.
Edward W. Hook M.D.
33 months ago
6 week results are always conclusive irrespective of the presence or absence of symptoms.  EWH
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