[Question #521] Unprotected Handjob. Paranoid and frightened.

91 months ago
As the title suggests i got an unprotected handjob. 

Ive read most of your posts and was convinced that i dint need testing for anything but then certain circumstances filled me with anxiety and its got the better of me. 

The lady never took off her clothes amd dis not touch herself.  I was naked and got tje handjob after a 60 back min oil massage. 

At 11 days got hiv combo, hsv igg amd igm, tpha, chlamydia and ghonorea. All came negative. 

16 day test results awaited. Please drill some sense into me... At this rate im sure i will do this agin for 28 days and so on till 3 months. Do i need to? Just for peace of mind is 16 day hiv combo conclusive or better 28 day?

Any other sti risks? Have a bit of a sore throat. 

The other thing is that i noticed a small red spot on the inner foreskin. One doctor said its a blocked sweat gland and the other said could be bacterial folicitis. 

Just to rule out gonorreah, syphillis and chlamydia can i take azithromicine 2g at one shot as a precaution. My urethra is burning mildly.  I am G6PD. I cannot take doxycycline as i get quite bad pounding headaches. 

Please help me out. 
91 months ago
Hello, while im waiting for an answer i have started feeling a tingling / itch / irritation of the skin all over. Its not localised anywhete. I feel it on my fore arms, wrists, feet , stomach, palms but not so much around the groin. It also just feels hot under the skin of my arms. 

Is this the onset of some form of herpes? Today is the 19th day post the incident. I jabe read the posts that say a handjob is no risk but wpuld the same be true also if she had lesions on her hand?

Also, does this mean that any massage even a normal one (without anyrhing sexual) can spread herpes assuming she has lesions. If thatvwere the case be cause the rubber her hands on my back amd hands for nearly 90 minutes amd the hamdjob lasted for just a minutes i could get herpes anywhere on the back or hands. Is that why im feeling strange on my hands?

Please help me understand the risk of herpes in this case.  

Lastly what test can i do? The antibody igM ive heard is useless, the igg needs 6 months and the pcr is known to give false positives.... How do you know if ur infected!!!
H. Hunter Handsfield, MD
91 months ago
Welcome to the forum. Thanks for your question and for your confidence in our services.

Hand genital contact doesn't transmit STDs. Even if she had "touched herself" (i.e. saliva or genital fluids) the risk would be nil. I have little doubt that your "mildy burning urethra" is just heightened awareness, because of anxiety, of normal body sensations or a trivial symptoms you otherwise would not have noticed. I would have recommended against testing for any and all STDs on account of this event; if something had been positive (or is positive on the repeat tests), it would have to be from some previous exposure. I recommend against having still more testing at 28 days or any other time. The chance of a false test result that means nothing at all is a lot higher than the possibility you were infected, but think how anxiety-producing it would be while you sort it out with repeat testing. And I would also strongly recommend against azithromycin or any other treatment.

Do your best to move on without worry. There is no chance you caught anything. Do not confuse your regret and perhaps shame or guilt over a sexual decision you may regret with infection risk from that event. They aren't the same. Deal with the first as you need to, but disregard the latter.

I hope this has helped.  Best wishes--  HHH, MD

H. Hunter Handsfield, MD
91 months ago
You were writing you follow-up comment as I was replying. The additional symptoms you describe are not typical of herpes or any other STD, and herpes for sure doesn't cause widespread tingling. Even more than your urethral discomfort, I am confident this is a physical manfestation of anxiety magnifying otherwise trivial or absent symptoms.

Could a massage, with or without a sexual component, transmit herpes? Conceivably yes. But in my 4 decades in the STD business, I've never seen a patient with genital herpes or any other STD in someone whose only contact was massage, with or without genital contact.

Do not have HSV testing on account of this event. The chance of a false or misleading result is far, far higher than the chance you caught HSV from the events described. Even if a test result were truly positive, it would have to be from some past exposure, not the recent one on your mind.

91 months ago
Thank you doctor for your two very reassuring replies. I would never have got tested in the first place because i have read so many of your other posts but my dermatologist told me i jad to get tested at 3 months and to have protected sex with my existing partner till then. 

This shook me up.... When i asked him why he feels there is a risk he said the same cuts / sores / blood on the hands possibility. 

My 16 day test came in as NEGATIVE FOR HIV P24 COMBO and VDRL. But as luck would have it (or may be a blessing in desguise) they could not perform the HSV IGM and IGG and asked for a resample. Some issue with the container. 

So... I take your advise that there is no risk but I could not live with the remotest possibility of passing something to my loving partner however small that risk may be. She is as it is on DMARDS for Arthritis. I cannot be that cruel to risk it. 

Since i have started down the testing road i will do just one more test for HIV P24 combo and HSV Weatern Blot. Please give me one time period when i should do this. 6 weeks? (Hope you wont say 4 months). Ill take ur reply to this as conclusive. 

Today is day 19 from the incident. 

H. Hunter Handsfield, MD
91 months ago
This additional information does not change my opinion or advice. Your level of concern for your partner is admirable, but it doesn't raise the risk that you caught something. As I said above, the chance of a false and misleading test result is higher than the risk you caught anything and it is anti-intellectual nonsense to be tested.

Since you're going to do it anyway, the HIV combo test is conclusive at 4 week or more after the last exposure and syphilis testing at 6 weeks. Sorry to say it, given your comment about 4 months, but that's how long you must wait for definitive HSV testing. But Western blot is exactly the wrong HSV test anyway. It is less likely to pick up an HSV infection than a standard IgG ELISA test. If you're going to do it despite my advice, at least do the right test.

But my advice remains to not be tested. If you feel you need the reassurance and want to spend money on it, get professional counseling to figure out why you are so resistant to reasoned, science based reassurance -- and not on the tests.

As you can tell, I have no patience with irrational nonsense. Sorry.

91 months ago
Ok Doctor. I understand what you are saying and I will listen to you. I wont test again. Its just that I am genuinely very scared especially after the Dermatologist told me exactly the opposite that I needed to wait for months and test because there is a risk. Anyway, thinking about this 24 / 7 for the last 3 weeks is really affecting me badly so I will take your advise and try my best to just put it behind me.

One last question please: since yesterday my skin feels very hypersensitive. I feel a very real burning / hot sensation that comes and goes on my forearms, back shoulder blades and foot. Don't really see much redning though - but it feels hot under the skin. I know rashes are a common listed symptom of HSV and new HIV infection. Have also read that this could be a manifestation of anxiety. Would you say this burning is also not related to any HIV / HSV risk in my case?

Lastly I must genuinely thank you for your patience and sheer determination to go on answering such questions from 100's of unknown people everyday. Im sure many of these questions must seem stupid and unnecessary (just like mine) and it must get tiring. Just want to say thank you for being there for us... I have not been able to speak to anyone openly in the last 3 weeks and you have no idea how helpful you have been - I genuinely mean it. A BIG THANK YOU.
H. Hunter Handsfield, MD
91 months ago
Although some dermatologists have pretty good understanding of most or some STDs, it appears yours doe not understand the epidemiology and transmission of STDs. He is simply wrong -- and regardless of what credentials he might have in the STD field, I will stand mine against his.

The skin sensations you describe are not those of any STD, but are typical for anxiety, nothing more. I'm confident nothing physical is wrong.

Thanks for the thanks about our services, and for your understanding of my position, advice, and perspectives. Best wishes to you.