[Question #9351] Hiv risk

33 months ago

I visited a Massage place in Bangkok. I fingered the lady with a callous on my finger. We then engaged in Frottage both naked with a towel in between. This lasted a few minutes before my ejaculation, then the lady passed the same towel to me and I cleaned myself. I am concerned that the towel had her vaginal secretions on it that touched my urethra. She also briefly touched my penis head and I saw cuts on her hand. Not bleeding but they looked fairly fresh.

I freaked out and took PEP from a local clinic for 6 days but started feeling really sick so stopped PEP early. A few weeks later I had swollen glands in neck and jaw and under arm pits also white spots at back of tongue with sores at the side of tongue. The gland pain went after a month but I still have the sore tongue 5 months later.

I have tested multiple times with 4th generation lab tests in London, most recently 5 months since the last dose of PEP. A doctor I saw in London ruled out hiv due to low risk exposure and negative test but I worry about lingering symptoms. I also had general blood tests that showed borderline vitamin D and folate but otherwise normal. I took dactarin from GP for oral thrush but this has not helped the sore side of tongue.

What are my chances of being hiv infected from this incident?

Would the hiv tests be positive by now and do I need further tests to confirm?

Do my tests so far rule out the tongue symptoms being hiv?

Edward W. Hook M.D.

33 months ago

Welcome to our Forum and thanks for your questions. I will be glad to comment, essentially confirming what you have already been told by the doctor in London. You do not know that the commercial sex worker you were with in Bangkok had HIV and even if she did, there is no risk to masturbation (fingering) of an infected partner, nor any risk of acquisition of HIV from frottage. The presence of a callous on your finger, or any cuts or abrasions would make not difference - these were still no risk activities. There was no need for PEP following the events you describe and your subsequent testing has conclusively proven that you were not infected with HIV and that the symptoms you experienced were not due to HIV. When persons acquire HIV tests are conclusive six weeks following exposure or, in your case, after your last dose of PEP. Further, when symptoms due to HIV are present, tests are always positive and remain so thereafter.

You can be completely confident that you do not have HIV from the exposure you describe. There is no need for continuing concern or for additional testing of any sort.

I hope yu find this information helpful. Please don't worry. EWH

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33 months ago

Thank you for the reassurance Dr. Just a couple of clarifications/follow ups:

My biggest concern was about the possible transfer of vaginal fluid from the towel to my urethra. I did wipe myself down in this area using the towel she had been sitting on during Frottage. Is there no risk there?

Afterwards I wondered if the woman was trans with gender reassignment. Does this make any difference in your assessment?

The wound on her hand made me think about HSV. If I were to have HSV could this delay the HIV test results?

Finally, can I confirm that symptoms like the sore glands and the oral thrush/sore side of tongue cannot be HIV related as I tested neg several times while they were present?

Hoping to put this whole incident behind me now…

Edward W. Hook M.D.

33 months ago

Thanks for your follow-up. I happened to be online when your follow-up appeaared so you are receiving an reply more quickly than is typical

We receive many questions about possible introduction of genital secretions into the urethra during frottage or mutual masturbation. we have never seen or heard of acquisition of any STI in this way, nor are there such reports in the scientific literature. Both the WHO and U.S. CDC categorize both frottage and mutual masturbation as safe sex. Further, STIs are NOT transmitted through transfer on a contaminated towel or bedclothes.

Your partner's gender is immaterial. No change in my assessment.

If you acquired HSV you would have developed lesions at the site of contact within 10 days of the event. There is noo reason to be concerned that HSV may have been present or transmitted. Further, I she had HSV, or if you had acquired it, it would have no impact on your HSV test results.

Correct, the negative tests cannot be HIV related if they occurred before any of your negative test results. When symptoms are due to HIV, tests are always positive.

hope this helps. Believe your tests. you did not acquire HIV from the encounter you described. EWH

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33 months ago

Thanks again Dr.

I actually meant hep C rather than HSV — I got confused with the abbreviations .

So my question was meant to be —

The wound on her hand made me think about Hep C. If I were to have contracted Hep C from this incident, could this delay the HIV test results or make them unreliable?

Edward W. Hook M.D.

33 months ago

Likewise, there was no risk for hepatitis C from the events you describe. Hepatitis C is not transmitted by touching- it is transmitted on rare occasions through receptive rectal intercourse and most commonly through injection of material containing the hepatitis C virus deep into tissues..

I hope this information is helpful. As this is my 3rd reply, as per Forum guidelines, this thread will now be closed.

Take care. Please don't worry. EWHI

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