[Question #8703] Possible Exposure

40 months ago

Hello Doctors,

I have questions that've been undoubtedly asked many times but I would like to ask again with a very specific scenario as I try to fight anxiety brought upon my stupid decisions and the internet.

Facts:

1) Visited massage parlor in Istanbul where I received a full body massage to alleviate tension in hamstring from long hours of walking bazaars. Lots of massage oil was used

2) In a moment of stupidity, I was offered happy ending via handjob at the end of the massage and I said yes.

3) Masseuse spent around 5 minutes lathering my genitals and apply pressure which ultimately lead me to release

4) Other than the full body massage and the handjob, no other activity took place. No oral, No anal, No vaginal penetration.

5) Room was dark so I cannot 100% attest to the cleanliness of the environment, towels, or even the masseuse.

6) I observed her hands the next day and did not notice any visible blood or deep punctures.

7) She was fully clothed and from Kazakhstan

8) I do not have any open wounds around my genitals, back, legs or arms aside for a very superficial cut on my forearm where massage was also applied

Here come the anxiety fueled questions:

1) Let's assume she had cuts, sores, abrasions, or just simply a wet blood wound on her hand while performing the massage, could that be of concern for HIV/STD transmission if she is massaging my body and rubs against a cut on my back?

2) What about rubbing against the skin on my penis/genitals assuming the skin on the genitals is not as thick as the body?

3) What if she is making direct contact with the opening of my penis and the mucous membrane assuming blood got on the membrane?

4) If we assume that blood from a wound could transmit it for all intents and purposes, would the copious amount of massage oil used across the body and during the handjob dilute or kill the virus carrying blood/material?

5)What if the oil from her hand dripped into my rectum?

6) Is there any risk? Should I get.a test?

Edward W. Hook M.D.

40 months ago

And welcome to our firm. Thanks for your questions. You were correct, these are familiar questions but I will be happy to address your specific issues. Before I address your individual questions, let me tell you that the exposure you describe was a entirely, 100%, no risk event. No STI including HIV is transmitted through receipt of masturbation. Further, no STI nor HIV is transmitted by contact with contaminated surfaces towels or clothing. The presence of cuts abrasions and other lesions on either yourself or your masseuse do not change this statement in anyway. Categorically add unequivocably this was a no risk of it. With that introduction, I will provide brief responses to your specific questions:

1. Hey see my comments above. Even if she had an active, bleeding wound on her hands this would be a no risk event. Further, the presence of massage oils, lather etc. serve to further reduce the risk for any infection if it is possible to reduce risk to below zero.

2. Zero risk

3. Still no risk

4. Yes, if anything the massage oil and other lubricants used in the course of your massage would serve to further reduce your virtually nonexistent risk for infection

5. . Hey said repeatedly above, this was an absolutely no risk event. Testing would be a waste of time and money. I urge you not to worry about this event and to move forward without concerned.

Take care. EWH

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40 months ago

Thank you for the prompt and detailed response Dr. Hook. I do apologize for the length of it. In my anxious mind, I try to assess all the possible scenarios in detail and this really brought me at ease.

With that being said, haha, I only have one follow up question-- being that it was a dark room and I was enjoying the actual body massage as pressure is applied to my back and legs, I would still feel it if there was a needle/foreign object being jabbed anywhere in my body right? Is that a safe assumption assuming that it would have to be a deep jab and not just something superficial like a prick from a tack? Or am I mistaken that even a small prick could be risky? My anxiety mainly stems from not knowing what constitutes a deep tissue puncture.

I know the obvious thought would be what motivation would a masseuse have to do this but the mind is a scary place and I just like to get everything out in the open addressed. This will be my last follow up because I can't think of any other hypothetical from my scenario.

Edward W. Hook M.D.

40 months ago

You are correct, even in the dark, if you had been stuck with a needleyou would certainly be aware of it. Further, you have to ask why someone woul intenetionally try to infect someone else. Please don't worry. this was a no risk event. EWH---

40 months ago

Dr Hook,

Forgive me for the persistence. I realize this is my last eligible question in this thread.

My only other concern is that later in the day on my athletic underwear I noticed 2 brownish blemishes that automatically registered as blood in my mind. After my massage I sat in a sauna room for 15 minutes with only a towel on. I then proceeded to take a 10-15 minute shower. So roughly 30 minutes after the massage I put on my undies and clothes.

1)Hypothetically, with the towels, sauna, and shower would that have been enough time lapse for any hypothetical needle prick to stop bleeding?

2) When you even consider the hypothetical prick itself-- would you say it would have to be a deep puncture or something superficial like a jab from tack could cause transmission? I read somewhere else where you wrote most needlesticks from infected people don't lead to infection

I accept the fact that I don't recall ever being pricked and I also accept the fact it would be unlikely for the masseuse to even be infected to begin with; not to mention a lack of motive for a normal person to do a heinous thing like intentionally prick someone.

The guilt and anxiety however have been persistent however after this final response I am done and will be excusing myself from the interwebs.

Edward W. Hook M.D.

40 months ago

I really believe you are overthinking this. That said let’s go directly to your final follow-up questions:

1. If you had sustained a needle stick during your massage it still would’ve been obvious following your sauna. The absence of any obvious bleeding, as well as the absence of any sensation of a needle stick is very, very strong evidence that this did not occur.

2. Correct on both counts. Less than one percent of needle sticks from untreated infected persons lead to transmission of HIV. Further any minor scrapes or abrasion which failed to draw blood would not be sufficiently deep to transmit HIV.

I hope that my responses and the facts that I provided to you have been helpful. Please realize that receipt of a massage is not an act of infidelity and there is no reason for you to feel guilty or troubled by this. I hope that you will be able to move on without continuing in certain. Take care. EWH

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40 months ago

Dr Hook,

You've been a great help and I think you can go ahead and close this thread to give me some closure. To conclude.

1. I've assumed the masseuse had HIV without any proof and the statistical probability of her having it is tiny

2. I've put into my head the thought of a potential needle prick which would raise the question of "why would a masseuse intentionally do that," and even if so, I would definitely feel it no matter how distracted I was.

3. Even if all the above were correct assumptions, it would be a less than 1% of transmission via this method.

In short, testing in this scenario is a waste of my time and money.

40 months ago

Forgot to add this last point to the more recent comment above^^^

"fresh blood must be injected deep into tissue to access the blood stream"--- from a previous question you answered. Assuming this does not mean a simple poke or jab. It quite literally means someone inserting a hollow needle with blood "deep" into the tissue like an actual doctor would.

Please close the thread after your last remark Dr. Hook. I'm done.

Edward W. Hook M.D.

40 months ago

Thanks for your summary. You are entirely correct and I agree with it. I entirely support your plans to move forward without testing. Take care. EWH---