[Question #6438] Hand job and test window period

15 months ago
Hi there,

First, I'd like to say thank you for providing this service – it's amazing to have access to leading experts in the field!

I'm hoping you can give me some advice, please...

I paid for a "tantric massage" a few months ago, where a female gave me a massage with oil and then finished with a hand job. There was no oral, vaginal or anal sex whatsoever. My testing timeline since then has been:
- 4 weeks post-exposure: HIV DUO (1+2 Abs, P24 Ag); syphilis (IgG/IgM by EIA); chlamydia;  gonorrhoea [all negative]
- 5 weeks post-exposure: Started taking 50mg sertraline to help with ongoing mild depression and anxiety issues. Experienced mild side effects – mostly dry mouth.
- 8 weeks post-exposure: HIV DUO (1+2 Abs, P24 Ag); syphilis (IgG/IgM by EIA); Hep C (Ab ELISA + core antigen); Hep B (surface Ag); chlamydia; gonorrhoea [all negative]

My questions are:
1) How would you assess the risk level of my exposure for HIV?
2) Do I need any further HIV testing beyond the 8-week HIV DUO test?
3) How would you assess the risk of level of my exposure for other STIs?
4) Do I need any further STI testing beyond my 8-week tests?
5) Could the fact that I started taking sertraline at 5 weeks affect the accuracy of any of my tests? For example, could it delay the production of HIV antibodies?

Many thanks for your time!
Edward W. Hook M.D.
Edward W. Hook M.D.
15 months ago

Welcome to our Forum and thanks for your question.  We're pleased to be able to help and to clarify much of the all too common misinformation which is widespread on the internet. 

Before I address your specific questions, I'll provide some general comments.  STIs are less common than widely believed and not particularly easy to spread.  Even persons who engage in commercial sex work are typically not infected and when they are DIRECT, penetrative sexual contact is typically required for transmission.  Even with direct contact, STIs are only transmitted on a fraction of exposures.  STIs are NOT transmitted through non-penetrative touching, hand to genital contact (even when genital secretions are transferred in the course of sexual activity such as massage or mutual masturbation).  Thus the events you describe were no risk events- had you asked if any testing was needed from a medical or scientific perspective, the answer would have been an emphatic no.  With that background, let me address your specific questions:

1) How would you assess the risk level of my exposure for HIV?
This was a zero risk event for acquisition of HIV and other STIs.

2) Do I need any further HIV testing beyond the 8-week HIV DUO test?
No, even if you had engaged in risky activity, the DUO tests provide entirely conclusive results at any time more than 6 weeks after exposure.

3) How would you assess the risk of level of my exposure for other STIs?
Zero risk

4) Do I need any further STI testing beyond my 8-week tests?
No, even if you had been exposed, these too would have been conclusive results. 

5) Could the fact that I started taking sertraline at 5 weeks affect the accuracy of any of my tests? For example, could it delay the production of HIV antibodies?
No, no medication other than medicines specifically used for HIV treatment and prevention would change the accuracy of your test results.  Sertraline would have no effect on the production of HIV antibodies.


I hope this information is helpful to you.  EWH


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15 months ago
Thank you for your reply – it's very informative.

I'm still considering getting a 12-week HIV DUO test for peace of mind, as I'm struggling to control my anxiety around the issue. A couple of questions around this:
1) Why is the idea of 12-week window still around in some places? Is there any science to support it?
2) I got the flu vaccine a few days ago. Could this interfere with a HIV test taken a week or so later? I've read that it can cause false positives.

Many thanks!
Edward W. Hook M.D.
Edward W. Hook M.D.
15 months ago

1.  The recommendation for testing for HIV 12 weeks after a possible exposure is an outdated concept reflecting less sensitive tests and concepts that have now been shown to be overly conservative. 

2.  No vaccine or medicine, other than medicines superficially designed to treat HIV would interfere with a test for HIV.  Certainly the flu vaccine would have no effect, including no increased risk for false positive tests.  EWH

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15 months ago
Hi again,

I had another set of tests at 10 weeks, all of which were negative:
HIV DUO (1+2 Abs, P24 Ag)
- HIV-1, HIV-2, Hep C, Hep B by PCR (Roche Cobas Multiplex)

I'm going to call it a day there.

Thanks so much for your help and advice, and keep up the good work!
Edward W. Hook M.D.
Edward W. Hook M.D.
15 months ago

Thanks for your thanks.  I encourage you to accept your test results and defer any further testing- it is not needed and your results are conclusive. 

This thread will be closed shortly.  Take care. EWH

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