[Question #4169] Massage with Happy Ending and Vaginal Secretions (HIV Risk?)
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83 months ago
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Hello Doctors, thank you so much for answering my questions and running a great forum.
I am assuming that the activity I engaged in is very low risk but would like to discuss the details in full. Here are the facts of the event:
1. Massage with a happy ending was mixed in with masseuse's vaginal fluids after she touched herself. She did not penetrate herself with her fingers. so not huge amounts of vaginal fluids on her hands, just some. She applied massage cream (like oil of olay) on her hands and my hands, which mixed in with the secretions.
2. I had a cut from a piece of glass on my palm which was 5 days old and fully scabbed over, not open and not bleeding.
3. We both proceeded to engage in the massage of the penis, but I was not able to finish.
4. She offered to give me a boob job and so I lubricated her boobs with my saliva and finished.
5. After about 10 minutes or so of the boob job upon finishing I applied spray alcohol on my hands and genitals.
6. About 5 days later I started getting multiple gastro-intestinal symptoms such as: bloating, acid reflux/gastritis, dry mouth, metallic taste in mouth, burning sensation in mouth, fatigue, burning sensation in arms, and random muscle aches ie: one day lower back, other day shoulder, etc. These symptoms are freaking me out with this exposure. You should know that I do suffer from GERD and hiatal hernia and prior to the massage I had ate a very spicy food, fried foods, coca cola, and has been taking lots of advil, all which I believe can irritate the stomach. I also sometimes suffer from protracted withdrawal symptoms from a benzo I had stopped taking over a year ago.
Here are my questions:
1. What is my risk of HIV considering it had to survive the air, massage cream, my saliva and then the alcohol?
2. Please explain if the massage cream helps to kill the virus or actually keep it alive? I read that HIV deactivates when it dries, would the cream keep it moist and alive?
3. Are my symptoms worrisome?
Thank you!
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H. Hunter Handsfield, MD
83 months ago
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Welcome to the forum. Thanks for your confidence in our services. I happened to log in soon after you posted it. Most users shouldn't expect nearly real-time replies!
The crux of your question is how long HIV might survive and be transmissible in the circumstances you have described. That's really the wrong question. The important fact is that there has never been a confirmed case of HIV transmitted by hand-genital contact, even when genital fluids are used for lubrication, and no cases ever known to be transmitted by saliva. For example, transmission by kissing is nonexistant, or almost so. Since there have been billions of such events during the known worldwide HIV/AIDS epidemic, and no known cases, it is obvious the risk is nil from the exposure events you describe. Therefore, the biological reasons really don't matter. In addition, although you can find lots of statements -- including many by me and Dr. Hook on this and other forums -- that the virus is rapidly killed by drying and perhaps exposure to air, this really has never been carefully studied. Why? Because there has never been a need. If no such transmissions occur, who cares how long the virus might survive.
That said, it is likely that the virus indeed is non-infectious after fluids dry or perhaps on exposure to air. Certainly alcohol and soaps kill it instantly. And saliva kills HIV. But the main reason there is no risk probably isn't related to HIV survival anyway. It's due more to the low amounts of virus to which one is exposed in such events, and because transmission requires access of the virus to certain cells that generally are deep inside the body.
As for your symptoms, 5 days is much too soon for onset of HIV symptoms. And your symptoms are not suggestive of HIV anyway. They also do not hint at any other STD.
To your specific questions:
1) Zero risk from all the events described.
2) I would guess that massage cream would be toxic to HIV, either because of its soap-like ingredients or because of preservatives it might contain. OTOH, I suppose you could be right that the moisture would keep the virus alive. But for the reasons above, it really doesn't matter.
3) Your symptoms are not worrisome at all. For sure they are not due to any infection from the sexual events described. (If some of them are related to that event, almost certainly it is due to anxiety over the event.)
I hope this information is helpful. Let me know if anything isn't clear.
HHH, MD
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83 months ago
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Hi Doctor, thank you for your prompt and informative response. You're response has reassured me a bit but I am still a bit scared.
I wanted to follow up with you on several points:
1. I went to the urgent care this morning because for the past two days I started feeling a bit of an irritation and/or burning sensation on the tip of my penis (the top of the urethra). I told that doctor exactly what happened with the masseuse ie: only vaginal secretions on hand and no penetrative sex (no oral, no vaginal, no anal penetration) and the tip of the penis symptom. He proceeded to give me a dose of Metronidazole for Trichomoniasis and a Zpak for Chlamydia. He thinks it could be one of these. I also took a full panel of STD blood and urine including a 4th generation duo test. I am at 4 weeks of the massage event. The burning sensation came on very gradually starting 3 1/2 weeks after the incident, and last night it was bad enough for the first time that I lost some sleep. I do not see any other symptoms ie: no discharge, no itching, etc. not sure what else I should be looking for? What is your assessment? Keep in mind the massage is the only sexual encounter I have had in many many months, so absolutely no other risky behavior whatsoever.
2. If I were to get chlamydia or trich or herpes form this lady, would that increase the risk of getting HIV from her? Does your hiv risk assessment change?
3. Also to follow up on one of your points: if the reason that hiv is not transmitted by hand-genetal contact is because of low amounts of virus to which one is exposed in such events, then would the risk of transmission change if the masseuse had just recently been infected and had a high viral load? Keep in mind that neither she nor I fingered her, and so there was not tremendous amounts of vaginal fluids on the hands to begin with. The other thing in my favor is that the handjob did not concentrate on the head/urethra of the penis, so I see that as a positive.
4. Following up on the boob job: is it possible for the thrusting of the penis in the boobs with vaginal fluid and massage oil to somehow mimic vaginal penetration and increase any kind of hiv risk? Again, everything was outside the body.
5. Following up on the massage cream question: you mentioned that soap kills hiv, so I would assume that "soapy" lubricants like oil of olay type massage creams would have similar effects. Do you have more information/consensus on this?
6. I am really scared with all these symptoms, its just a lot of them at the same time. My gastro symptoms have persisted for the entire 4 weeks with the gastritis and the papillitis on the tongue still persistent. Are the length of these symptoms consistent with hiv?
I could use a bit more education (and hopefully good news) from your years of expertise in these matters.
Thanks so much for your feedback.
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H. Hunter Handsfield, MD
83 months ago
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You should not have been treated and I stand by reply above. The urgent care doc overreacted. Either s/he doesn't understand STD/HIV risks. Or, giving him or her the benefit of the doubt, perhaps you were so frightened and anxious, or insisted so strongly, that s/he found it easier to just go along with your fears than to do what would have been medically more responsible. Therefore:
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1) My assessment is no different than above.
2) Not possible, so I won't speculate further and suggest you stop doing so.
3) The main point of my reply above is that we do not understand all the details why such exposures carry no risk for HIV. The fact is there is no risk. I've given you a summary of the main probable reasons.
4) No, this scenario has never occurred and on the face of it is impossible.
5) I have no more information on this topic,
6) That you are "really scared" is irrational, especially given the reasoned, science based reassurance you have had. Do your best to separate your anxieties over a sexual decision you regret from medical consequences of it. Deal with the former as you need to. There is no risk for the latter.
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83 months ago
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Hi Doctor,
I wanted to follow up with you. I took the 4th Generation antibody/antigen test at 4 weeks and it came back negative. Also negative for all other STDs. I big load of stress and relief is off my shoulders. I have a couple questions:
1. Would this test now be conclusive for HIV, or should I wait for 3 months and test again? Is this conclusive for all STDs?
2. Would the 4th generation test pick up all forms of HIV ie: HIV 2 or other forms of known HIV?
3. I still have the on and off again burning sensation in tip of penis. If its not an STD, what could cause this?
Also, I did some research while nervously waiting for my results and found that Ivory soap (and water) was effective in killing HIV. Also is lab studies, lubricants like Vagisil also proved effective in killing the virus. As you recall, the maseusse used a massaging cream, which I checked as having ingredients like alcohol, water, and preservatives. So your educated guess was spot on, its very likely these creams may be toxic to HIV as well.
Again, I feel relieved and I thank you for all the important work that you do.
All the best,
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H. Hunter Handsfield, MD
83 months ago
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1) Three months is old news for HIV testing; waiting that long used to be required for the initial HIV antibody tests, but those tests now are used rarely. With the antigen-antibody (4th generation) HIV blood tests, 6 weeks is conclusive. (4 weeks is nearly so, and you can expect another test at 6 weeks to also be negative.)
2) The test detects HIV2 as well as all currently known subtypes of HIV1.
3) Urinary burning that comes and goes ("on and off") almost never is due to any infection. I would wonder whether your urine feels slightly irritating when particularly concentrated, e.g. low fluid intake or increased fluid losses in hot weather (noting it's summer in the northern hemisphere). Often it's anxiety magnifying trivial symptoms or normal body sensations that would otherwise be ignored or not even noticed. If it continues and you are sure it's abnormal for you, see a doctor. But I am confident it's not due to any STD, or to any infection from the sexual exposure described above.
I agree with the observations you found in your research. But I would also point out (again) that even without washing, this was a zero risk event for HIV.
That concludes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been useful.
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