[Question #528] Risk of infected by HIV and syphilis

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103 months ago

Respected experts, my English is not well, and I apologize for it.

In November 2015, in massage parlor, I received a massagist's service. (1)Massagist spread oil on my breast, back and lap, and massaged me. (2) We both dressed briefs and rubbed private parts each other. My briefs was wetted by my genital secretion, whether massagist's briefs was wetted by her secretion was not known.(3)Massagist used her hand to provide masturbation for me without condom, and four minutes later, I ejaculated. Subsequently, massagist used her wet towel to wipe my penis and balanus. My penis and balanus had no seeable wound, but whether massagist’s hand had wound was not known. Besides, it was possible that her wet towel was reused without washed, so residual semen containing HIV or sexually transmitted virus of other customers was retained on the wet towel. (4) Massagist sucked my mammilla with her mouth full of water, and I was not clear whether ulceration was in her mouth. (5)Massagist used her hair to bind one pimple on my breast for joke. I felt so pain that I wonder the pimple was torn.

I have 4th generation HIV Ag/Ab test on 45 days from my actions, and HIV antibody test and syphilis specific antibody test(TPHA) on 59 days from my actions. All is negative.

My questions are as below:

(1)     How high is risk infected by HIV and syphilis?

(2)     HIV and syphilis could be ruled out?

(3)     How long time could HIV in semen on wet towel survive?

(4)     How long windows period of HIV and syphilis respectively?

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Edward W. Hook M.D.
103 months ago

Welcome to the Forum.  I'll be pleased to comment on your questions.  Before I answer your question let me provide a more general comment- This was a no risk event.  You engaged in mutual masturbation and frottage (genital rubbing without penetration) with your masseuse-partner.  Most commercial sex workers do not have STIs and thus most contacts are low risk.  Further, while there is a theoretical risk that ulcerative STIs such as syphilis or herpes might be spread through non-penetrative sexual contact, this is exceedingly rare with the rates of occurrence approaching zero.  Further, STIs are not ever passed from person to person through clothing, even when that clothing becomes wet or on material such as towels which are wet with genital secretions.  If present, the bacteria and viruses die almost immediately on contact with air and have a tendency to stick to the cloth fibers rather than going on to be transmitted to the sex partner.  With this as background, let me address your questions:

(1)     How high is risk infected by HIV and syphilis?  Close to zero.  I urge you not to worry about the risk from this event.

(2)     HIV and syphilis could be ruled out?  If you wish to test for HIV and syphilis at this time, the results would be definitive and should be believed.  There is no reason for more than one test.

(3)     How long time could HIV in semen on wet towel survive?  Semen on a wet towel would not be infectious to others for the reasons I mentioned above.  Furthermore, the semen on the town was yours. 

(4)     How long windows period of HIV and syphilis respectively?  For HIV tests, if tested with a modern, 4th generation test, results are definitive any time for that 4 weeks after exposure.   For syphilis, while from a theoretical perspective, testing could turn positive as long as 3 months after an exposure, the fact is that if your test is negative any time more than 4-6 weeks after exposure to an infected partner, you could be confident that you were not infected.

I hope these replies are helpful to you.  I would not be at all worried if I were you.  EWH

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103 months ago

Thanks very much for your quick reply, doctor. Because of words limited, another question is not mentioned above. About forty minutes later from masturbation by masseuse, I took a bath and poured a little alcohol into my meatus urinarius. I felt tingle but for a while tingle disappeared. The next day, I felt pain in the urethra. This status continued for many days, so on 22th day from my actions, I started to eat roxithromycin and time amounted to 11 days, but it seemed no effect. On 59th day from my actions, I also had mycoplasma and chlamydia test, as well urinalysis. No leukocyte, erythrocyte, epithelium, mycoplasma and chlamydia were founded. At present, namely 85 days from my actions, my urethra is still so pain and itch, scarcely any secretion. Inguen on both sides are also distending pain.

I want to learn about:

(1)Is it possible reason for urethritis? Masturbation transmission or alcohol incentive?

(2)What further check do I needs? Do inguen pain has relation with urethritis?

(3)I ate roxithromycin for 11 days, which could defer syphilis antibody generation, and then as a result the window period is prolonged?

(4)I have 4th generation HIV test on 59 days, not on 28 days, and is it sufficient effective?

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Edward W. Hook M.D.
103 months ago

(1)Is it possible reason for urethritis? Masturbation transmission or alcohol incentive?

Alcohol can be irritating but would not last this long.  I cannot tell you what is causing you your persistent pain in the urethra but it is most unlikely to be due to an STI or anything that happened during the events you have described.  I would suggest you see a urologist to have this evaluated.

(2)What further check do I needs? Do inguen pain has relation with urethritis?

See my reply to question 1 above.

(3)I ate roxithromycin for 11 days, which could defer syphilis antibody generation, and then as a result the window period is prolonged?

No, roxithromycin has no activity against syphilis and nothing you have described would suggest you have syphilis.

(4)I have 4th generation HIV test on 59 days, not on 28 days, and is it sufficient effective?

Your HIV test at 59 days is conclusive and does not need to be repeated.  Believe the result.  EWH

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103 months ago

Thanks a lot, Dr. I'm sorry there is a mistake in my last post. I have 4th HIV Ag/Ab test on 45 days and only HIV antibody test on 59 days from my actions. Does HIV could be ruled out? Besides, how long time is window period for only HIV antibody test of 3th generation agentia? I hear about some statements: 6 weeks, 8 weeks, and 3 months for 3th generation agentia.

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Edward W. Hook M.D.
103 months ago
For a 3rd generation test, results any time more than 8 weeks after an exposure are definitive.  EWH
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