Foot massage risk 2nd opinion

Hello Doctors. I would like to ask your opinion on the likelyhood of the following:


I recently gave a foot massage to a woman for 10-15 minutes. Subsequently, I've gotten worried about whether this put at some risk for HIV transmission. I posted on the community forum and got a reassuring answer.

However, I checked yesterday with an HIV councilor and he said that he could not provide me with risk assessment since he hasn't heard anything specific about foot massage as a transmission route.

That brought back to this forum. I don't remember if I or the woman had any cuts at the time, but is this something to worry about? I imagine any cuts that are bleeding would be a risk.  
Since then Ive had headaches and sinus congestion, but those don't sound worrrisome.  I don't want to get all worke up for what seems like a safe activity.

Lastly, do rapid oral tests at 4-5 weeks provide reliable results and should I bother testing. I was last tested 2 years ago an it was all fine. Thanks.

[H. Hunter Handsfield, M.D.]

Of course no risk.  It wouldn't matter even if you or your massage partner had cuts etc on the skin.  Your symptoms cannot be due to that event and don't sound like HIV anyway.  If you haven't shared injection equipment or participated in sex (with an unprotected penis inside another person), there is no HIV risk.  You definitely should not "bother testing" if this is your only potential risk for HIV.

If you don't mind, how and where did you come across the "HIV counselor" who didn't give a direct answer?  Any appropriately trained counselor would have the understanding to answer based on general knowledge.  You don't need research on foot massage to know there is no risk.  This goes to show that there are some pretty weak people and services out there, especially on the web.

HHH, MD

[questioner11]

It was a councilor from my neighborhood clinic.  He said that any break in the skin poses risk and thus, the activity doesn't really matter.

I went ahead (for "psychological peace") and took a rapid OraQuick test today and it came out negative.  This is 28 days after the event.  Is this a conclusive result in general, or is 4 weeks not enough?

Thanks, Doc!

[H. Hunter Handsfield, M.D.]

"Any break in the skin poses risk and thus, the activity doesn't really matter":  That's so wrong!  It is just wacko for counselors, or persons at risk, to view all potential risk scenarios as equal.  Does the counselor really tell people the risk is the same, and that testing equally important, following a foot massage versus vaginal or anal sex, or sharing injection equipment??  That "the activity doesn't matter??!!"  Ask if he has ever seen, or heard of, someone catching HIV from a massage.  Even by rumor.

Given the zero risk nature of this exposure, and no need for testing at all, 4 weeks is plenty of time.  But it does take up to 6-8 weeks for antibody tests to become positive.

Be very clear:  If you should have a positive HIV test, the first thing the counselor would do (and which I would do) is sit you down, look you in the eye, and ask what other exposures you had.  Because you couldn't have gotten it from the foot massage.  If you continued to stick to that story, I wouldn't believe you -- and I'll bet neither would he.  (I'm not accusing you of anything.  Just telling you how I would handle it to illustrate how impossible it is that you caught HIV.)

That will be all for this thread.  Consider showing it to the HIV counselor.  I stand behind the scientific basis of these views.

[questioner11]

Hi Doc,

I never doubted your expert opinion.  In fact, I most grateful for it, because I am infinitely more educated about HIV transmission.  When I went back to the councillor, it was not my intention to compare your advice with his.  In fact I relayed your initial post to him for his own illumination.

I now understand that foot massages pose no risk.  This particular episode was in the context of light bdsm with a friend that included me massaging her feet and she giving me face slaps for a minute or so.  I didn't mention the face slapping because, as far as I could tell, it was a non-exposure event.

Thanks again for taking the time to help me out on this.  

[H. Hunter Handsfield, M.D.]

Thanks.  It was not intended that either you or your counselor would take those comments as personal criticism.  (Well, maybe the counslor....  but definitely not you!)  An important purpose of forums like this is general education for all readers.  This was just a way (I hope) to emphasize some useful points about HIV transmission risks.