[Question #9623] Massage HIV

30 months ago

Hello Doctors,

Sorry for returning back to this forum so soon unfortunately. Firstly thank you to both Dr. Handsfield and Dr. Hook for your assurances and guidance. Just to update you guys, I ended up taking another 4th gen and PCR test 45 days after my second exposure (December 12) on January 25, and I'm beyond relieved to tell you both that the results were as you both expected. With these latest results I trust your counsel that the two earlier exposures, November 27 & December 12, are cleared and no more further testing will be necessary for them.

To celebrate after getting the results I decided to go get a nuru massage, which is an erotic Japanese massage that uses a special gel called nuru gel and has a body to body massaging technique. These massages can involve direct sexual intercourse however, I did not choose that considering I am still in mental shock from the past month of testing, anxiety and PEP. That being said during the course of the massage there was a point where I thought my penis inserted into her vagina since it was so slippery from the nuru gel as she was using her body and feet pressed up against me from the top. The instant I thought there was insertion I instinctually pushed her off to which she was surprised but understood my concern and said that there was no insertion it was simply a massage technique where it may have felt like insertion because the technique uses crevixes of the thighs, legs, and hands to immitate erotic sensations similar to real intercourse. I know I'm probably still in mental shock from the past two exposures, but I immediately went to the STD clinic and got another prescription of PEP. Obviously even if there was insertion there is no guarantee of contraction but I just wanted to ask you if there is any real risk with regards to erotic body to body nuru massages and HIV contraction and the risk of contraction if in case there really was a brief moment of penetration. To be clear, I thought there was a brief split second of insertion however, the masseuse assures that there wasn't and that she herself would never since it affects her health as well. On top of that the doctor at the clinic did not advise me to take PEP as she considered it low risk however, I guess more so for my mental health than my physical health I am still going to complete the 28 day PEP course.

As I know I'm probably overthinking and being overly anxious still from the shock of the two previous exposures, but I wanted to just ask if PEP was necessary? What really are the risks of me contracting from this massage? And how worried should I be about this case.

Thanks again for your understanding and patience.

H. Hunter Handsfield, MD

30 months ago

Yes, you are indeed seriously "overthinking" this situation. Even with unprotected vaginal sex to completion (several minutes, thrusting, etc) with a known infected female partner, the chance of HIV transmission averages once in every 2,500 exposures. Your risk is far, far lower than that -- even if you massage partner has HIV, which (statistically) is unlikely. I agree with your doctor you should not be on PEP on account of this event. Assuming you plan to get tested for HIV after you complete treatment, you are condemning yourself to at least 3 months of anxiety until you have a conclusive result -- instead of perhaps testing once with a conclusive result in 4-6 weeks. That sounds wacko to me when the risk is so trivial. You should move on without further worry. And to be clear, in my opinions you do not need testing at all.

And by the way, I do not believe for a minute that the sexual component of your massage came as a surprise. That simply doesn't happen without the customer's expectation and anticipation; and of course you could have stopped the activity before it got to that point. You also can select massage services that do not offer happy endings or other sexual components. The possibility of vaginal penetration, when it got to that point, cannot have been a surprise. You might consider professional evaluation and counseling about your sexual/massage choices plus your abnormally elevated fear of HIV. Presumably you understand (intellectually) the inherent conflict between these behaviors.

Let me know if these comments need clarification, but BRIEFLY please.

HHH, MD

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30 months ago

Hello Doctor,

Yes I know I’m overreacting it’s also why I feel I was overthinking the encounter when it most probably was not even a real exposure. The doctor at the clinic also pretty much said what you said and agreed that there is no real risk but she said if I was so scared then taking PEP would be more for my mental well-being. She said to if I opted to take PEP then to just come test the day after PEP completion and that would be the end of it although she did say there is no need for testing too. Just to be clear your evaluation of the situation is there is almost no risk to the point that no PEP or even no further testing is needed?

H. Hunter Handsfield, MD

30 months ago

My evaluation is not that there is "almost no risk". It is that there is zero chance you have HIV. No further testing is needed.---

30 months ago

Hello Doctor,

Thanks for your affirmation! I In that case I will stop taking PEP and not get tested anymore. To respond to your earlier remark, it's not that I did not anticipate sexual actions in this massage, it's that I precisely chose this massage for a specific sexual activity that was not full intercourse. The massage is either "full service" (full intercourse) or not and I opted for no full service since I was already still in mental shock from the previous incident. Perhaps during the massage nothing really happened or even got close to an exposure but it was just a mental instinctual reaction when I thought I felt like there was an insertion, she was on top with her legs wrapped around while I'm on the bottom facing up. As there is a lot of sliding I instinctually pushed her off when I thought there was insertion or near-insertion. Regardless I will not be opting for anymore full service/intercourse sexual arrangements in the future. That being said these massages are body to body massages and there is a lot of rubbing between the bodies and the skin including the tip of the penis and the outsides of the vagina and groin area, although never penetration. I wanted to ask is there any risk of contraction from these types of massages? If these massages even have a little risk despite no penetrative acts, then I may have to reconsider even getting these massages.

Also thank you for your concern about getting professional help for the mental side of this issue, which I'm noticing is very detrimental. After my test results on Jan 25 I felt a wave of relief I have never felt before but also a feeling of constant urgency and fear. I thought the massage would ease me down but that incident relapsed me into the mental anxiety I was feeling before. That being said your affirmation provides a great level of comfort and I feel your counsel is more informational than the doctors at the clinics here. I know this may not be your expertise but do you actually know how most people resolve themselves of the anxiety they experience during their exposure and post exposure periods?

I know this is my last thread so thanks again Doctor you have been very patient and understanding.

Thank again,

H. Hunter Handsfield, MD

30 months ago

"is there any risk of contraction from these types of massages" Yes, it seems there is sufficient skin-skin contact to carry at least a small risk of genital herpes, HPV, or syphilis. I would judge no risk for the STIs transmitted via genital fluids (HIV, gonorrhea, chlamydia).

"do you actually know how most people resolve themselves of the anxiety they experience during their exposure and post exposure periods?" No. As you say, this is indeed outside my expertise. However, I would guess that among people who keep returning to the forum with repeat and ongoing concerns, despite the reasoned, science based reassurance typically conveyed on this forum, rarely resolve the issues unless and until they seek professional counseling. Usually there probably is an underlying emotional or personality issue that needs to be addressed.

Thanks for the thanks. That concludes this thread. Please note the forum does not permit repeated questions on the same topic or exposure. This being your third, it will have to be your last one; future new questions along these lines may receive no reply and the posting fee will not be refunded. This policy is based on compassion, not criticism, and to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes.

Thanks for your understanding. Best wishes.

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