Risk assessment for possible exposure to semen

[vikram111]

Dear Doctor,
Thank you so much for your service. I had a recent experience which I feel may have exposed me to HIV.
Please assess the risk and need for testing.

I visited a massage parlor and had a body massage while I was fully nude.
After about 15 mins, the therapist asked me to lie on my back and caressed me slowly.
I felt a little aroused after which she brought some moist tissue from somewhere in the room and
placed on my genital area.
She kept massaging me slowly for the next 20 mins and I was a little hard and had
little precum. There was no handjob and it concluded here. I realize that this sounds like a no risk scenario but I want to mention the following
as I am in a serious relationship and worried for my girl friend:

1) Assuming that the moist tissue she put on my erect penis(urethra) had semen from the previous
customer, what is the chance of hiv from that semen infecting me, given that the tissue was on my penis
for 20 mins?
2) Can HIV stay active in semen on a tissue paper for 15 mins or so and infect me ?
3) My girlfriend is visiting me in a few weeks so even if there is a 1 in 100000 chance of the tissue infecting me,
assuming it had hiv infected semen, I would want to get a HIV RNA test as I read it can detect virus
two weeks after exposure.
The only thing I am worried about HIV RNA test is the high chance of false positive.
If I get a false positive, should I go for two repeat HIV RNA tests to rule it out?

4) You may think I am crazy, but I am crazy about protecting my girlfriend and won't mind spending $ 500
on tests to be sure I am not going to infect her. Please let me know if testing would be advised given the above.

Thank you so much in advance !

[vikram111]

Thanks Doctor, appreciate your advice and concern.
Thanks a tonne !
Wish you good luck with everything, you do a great service !

[H. Hunter Handsfield, M.D.]

The chance of a false positive RNA test is very low; cross that bridge if you come to it, which I'm sure you will not.  (In the past we have spoken of false positive results, but that was a few years ago and the current tests have little problem with it.)

I hope you're financially secure and that you'll be paying for the RNA test out of pocket.  RNA testing is expensive, and I hope it won't be covered by your insurance -- which would be a waste of money.  You are at no more risk of HIV from this event than from shaking hands with an HIV infected person, which you probably have done several times, probably without knowing it.  If you really need the reassurance of a negative HIV test, suck it up, wait another couple of weeks, and have a much less expensive antibody test.

Sorry to lecture you, but I want other users to understand how inappropriate such testing would be in this circumstance.

That's all for this thread.  I won't have any more comments or advice.

[vikram111]

Thank you doctor.
Just one repetitive question

With HIV RNA test, If I get a false positive, should I go for two repeat HIV RNA tests to rule it out?

Thanks

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

HIV is hard to transmit.  You cannot catch it by the kinds of exposure described here.  There is no risk without direct exchange of blood, e.g. by sharing injection equipment; or by sex, only if a bare penis (no condom) enters another person's vagina or rectum.

1) This kind of contact carries no risk for HIV or other STDs.

2) It doesn't matter how long HIV can survive in the environment.  Nobody in the world ever caught HIV in this way and you will not be the first.

3,4) There is no need for testing.  You can safely have sex with your girlfriend.

Best wishes--   HHH, MD