Contact Fresh Bodily Fluid, Cuts

Dear Doctors,

I am a 28 year old male.

I was wondering whether you could help me with the following concern:

I have been regularly visiting massage parlours in which the female therapists masturbate the clients at the end of the session. No penetrative sex occurs. I am not worried for possible exposure to HIV or STDs for the following reasons:

- I have (severe) acne on my back and chest and folliculitis on my legs.
- The time between one client coming into the massage room and another one going in is a matter of minutes.
- Bed sheets and towels may or may not be changed between sessions.
- All massage therapist are chinese and the clients are mainly from Asia.
- The area where I have acne and folloculitis is vigorously massaged, sometimes with oil and sometimes without.
- I visit such places at least once a week and have been doing so for about 2 years.

I am worried that some vaginal fluid, semen and/or blood from either the massage therapist herself or a previous client may have entered my blood streem either through the folliculitis, acne on my chest and back or through the tip of my penis (which is also massaged). Such bodily fluids could have been either on the bedsheet, towels or the massage therapist's hands.

I have been to 2 dermatologists and venerologists and they were both of the opinion that "transmission can happen". The reason why I am posting this question on your website is because I want to be sure that I would need to be tested based on the exposures I just discussed.

Many thanks for your help.

[Edward W Hook, MD]

Here on our site we try not to disagree with other professionals however in this instance, I feel I must.  I am saddened that health care professionals would make such statements as they fuel unnecessary anxiety.  While I suppose there is a theoretical possibility that HIV transmission could occur in the fashion that you suggest, there has never been a case of HIV described in which that was the mode of transmission and the odds of this happening would have to be on the order of at least MILLIONS to 1.  Think of all the things that would have to line up for transmission to occur in the way you suggest.

1.  The person before you or your therapist would have to be HIV infected.  This is unlikely from the outset.
2.  There would have to be living virus present on the table, sheet or wherever.  The virus does not survive well outside the body.
3.  The virus would have to be introduced into your body through either an acne sore which was bleeding or directly into your penis.
4.  The virus would have to cause infection.

Bottom line, for all practical purposes HIV is not transmitted by casual contact including masturbation or massage.  Despite being intensely studies for over 25 years, HIV transmission in the way you suggest has never been described.  For you or any other person to worry about this is a waste of your time and energy. The odds of you being hit by lightening in the next few days is much higher than your getting HIV than the way you suggest.  Those are the facts.  Stop worrying and if you cannot, you must either stop getting messages, change where you get them or get help in dealing with this inappropriate anxiety.  EWH

[Massaged]

I meant to say "I AM WORRIED" and not "I AM NOT WORRIED". Sorry about typing error.

[Massaged]

Dear Doctor,

Thanks very much for your quick response.

Just a quick clarification, when you or Dr. HHH mention "theoretical risk", does that mean "possible but unlikely"?

Would you recommed routine testing if this were my only 'regular exposure'?

With regards to the bleeding acne spot, I presume that at least one acne sore would bleed when vigorously massaged... does this change anything?

When you say that HIV does not survive well outside the body, are we talking minutes? seconds or hours? Does oil prolong the life of the virus outside the body?

Many thanks and you can expect no follow-up questions.

[Massaged]

Does your answer also apply for all other uncurable STDs?

[Edward W Hook, MD]

When I say theoretcial risk it means "most unlikely and not worthy of testing"

I would not recommend testing if this is your only expsoure

I would be that your acne rarely, if ever bleeds.  Either way however that does not change my advice.

Minutes.  Oil would not prolong things.  EWH

[Massaged]

Does your answer also apply for all other uncurable STDs?

[Edward W Hook, MD]

Yes.  And now, as this thread moves into new anxiety-driven concerns, is an excellent time for the thread to end.  There will be no further answers.  EWH

[Massaged]

Well spotted doc!