Vaginal/Penile Grinding

Dear Docs.  I recently had an exposure with a sex worker that involved frottage, whereby
she rubbed her vagina over the shaft of my penis (mainly the underside while sitting on top and facing me - I am circumcised).  The rubbing was only about a minute or two, although fairly vigorous.  I really could not inspect her that closely in terms of sores, etc.  I am fairly certain that there was no penetration as I was most concerned about that and was pushing the head of my penis up during the grinding to make sure it did not slip in or she did not come in contact with my urethra. Any idea on my risks?  I had an Oraquick fingerprick test at 7 weeks and it was negative - good to do anyway as I have not been tested for a few years and it closed the window on any other possible risks I may have had for the past while.  

Please advise.  Do I need to retest?  Everyone thus far has said no risk, just looking for some more reassurance so I can let this go once and for all.  

Also, I am not sure of my herpes status (not been specifically tested) have had what seemed like outbreaks before but not at the time of this episode.  

Thanks.  

[Edward W Hook, MD]

Frottage is safe sex and therefore there is no risk to you from the exposure you describe.  Your negative blood test at 7 weeks is just further evidence for support the statement I have made.  At 7 weeks about 98% of HIV infections acquired 7 weeks earlier would be positive.  When you combine the no risk nature of your exposure with your negative test, you can be confident that you did not get HIV.  You do not need additional testing.

Whether or not you have HSV does not change this although it would be a good idea for you to check to see if you have it.  If you do, there are things you can do to prevent future outbreaks and/or transmission to others.

Take care.  EWH

[JPGR]

Hi Doctor Hook.  Thanks for your response and reassurance.  

Just curious, in several of the posts that I have read, both yourself and Dr. Handsfield have stated that HIV is rare among commercial sex workers.  Can you tell me what you base this on?  In my experience, it seems that they are more willing to take chances, unprotected oral and sometimes offering unprotected vaginal sex, with a guarantee of more money.  Personally, I don't ever accept these offers but assume that others do.  Any thoughts on this would be appreciated.  

I have decided to stop testing over this incident based on your assessment.  

Thanks again.  

[Edward W Hook, MD]

HIV is a rare disease and is a risk for commercial sex workers.  They have more HIV than the general public but the majority of commercial sex workers do not have HIV. In North America while between 1 in 1000 and 1 in 10,000 women among the general public have HIV, among the commercial sex workers, while the rates are higher, they are still less than 10% and usually closer to 1%.  This fact has been shown repeatedly in scientific studies.  Further, despite their chosen business, most commercial sex workers prefer not to take chances and encourage clients to use condoms.  Hope this helps.  EWH

[JPGR]

Thanks, understood.  

Last question - Can you explain why the frottage that I described is not a risk?

[Edward W Hook, MD]

For starters, there has never been a case of HIV transmission describe resulting from frottage, probably because there is not penetration.  Getting a partner's genital secretions on skin, even penile skin does not lead to transmission of HIV.  EWH

[JPGR]

Thanks for everything Dr. Hook.  I'm done worrying about this.  

[JPGR]

Hi Doctor Hook.  Sorry to come back, just checking my post again and saw a post by someone else regarding infectiousness in a person that was in the process of seroconverting - could this have any effect in the event that I described?  You also mentioned to another poster that 7 weeks was not enough and you prefer 8.  I'm now at 11 weeks - do I need to retest?  

Thanks.  

[Edward W Hook, MD]

You need to srop worrying. Seroconversion is a very rare event and even if your partner were seroconcerting it would not change my assessment - still safe sex.  Time for you to move on.  EWH

[JPGR]

Just retested at 11 weeks, which was negative via fingerstick Oraquick.  

Are the Oraquick tests reliable?  I've been reading some conflicting information about false negatives.  Would a Home Access test be better?  Is there any significant difference between 11 weeks and 3 months for a conclusive result?  

I also just had a major herpes outbreak where this exposure took place, which is freaking me out.  

Thank You.  

[Edward W Hook, MD]

This will be your last answer.  You said you wanted "just one more reassurrance".  You got it and yet the questions keep coming. The exposure you had was virtually zero risk for HIV and your testing for HIV is now negative at 11 weeks (yes, the Oraquick is a reliable test) yet you keep asking and keep testing.  There is no meaningful difference for you between an 11 week and 3 month test.  You need to move on.  If you cannot control your anxiety, I suggest you discuss this with a counselor or mental health proffessional to figure out how to do so.  You did not get HIV from the expsoure you described to me almost a month ago.  EWH