[Question #6935] Massage with transgender sex worker

13 months ago
I received a massage from a trans female sex worker (HIV status unknown) and at one point he/she rubbed her penis on my anus without protection. No insertion at all and no fluids that I could see or feel, just rubbed against my anus for about 10 seconds, then after I turned over and finished by masturbation. Is there a reason to be concerned for HIV in this scenario? That was 1 day ago and my ass has been very itchy since (although likely from irritation from the scented wipes I used after and excessive washing too)! 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
13 months ago
Welcome to the forum.

There was no risk at all for HIV in this scenario. HIV is rarely if ever transmitted sexually in absence of actual penetration. I agree your anal itching is most likely related to a physical cause, such as irritation from the wipes. No infection can cause symptoms in under 36-48 hours. And certainly HIV itself can't do this.

In the future, I would advise discussing HIV status before proceeding with events like this, especially with anatomically male partners or men who have sex with men. Not because massage or this sort of event itself is risky, but as reassurance in case things progress more than you initially expect -- obviously objective, analytic decision making is often impaired during sexual arousal! But there is no need for testing or for any worry about HIV on account of the events described.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD
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13 months ago
Thanks HHH! Two last items - if there was pre cum there would that change anything? 

And I have antibodies for hsv2 but never had symptoms or outbreak. Not sure if that changes anything either. 

Thanks!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
13 months ago
The presence of pre-ejacu;late fluid would make no difference.

Having HSV2 (including positive blood test without symptoms) roughly doubles the risk of catching HIV if exposed. "Doubling" may sound like a lot, but first you have to be exposed, which doesn't include the kinds of contact you describe; and even with penetrating sex, if the risk of transmission starts out at, say, 1 chance in 10,000, doubling raises the risk to 1 in 5,000 -- still very low.
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