Worried about HIV

Two days ago I got an erotic massage by another male.   The massage therapist got on top of me while I was lying face down on the bed.  He then "grinded" on me rubbing his penis on the crack of my butt.  There was a point where he actually tried to insert his penis into my anus.  I do believe that a little bit (maybe the head of his penis) went inside of me but it wasn't there for more than a second or two.  I then asked that he please stop.  He did, but now I am paranoid that I have contracted the HIV virus.  Also, I believe I have a small cut or irritation above my anus in the crack of my butt.  It almost feels like a cut.  I felt it the day before as well.  I am worried that I have contracted the HIV virus by either his temporary insertion OR from him grinding on me and letting his pre-cum (if he had any) onto my cut (I don't know if my cut was open, scabbed, or what).  The next day, I called the massage therapist to make sure that he was negative.  He said he was tested on the 9th of January (3 weeks earlier) and was negative.  Due to my high concern, he agreed to go and have another test done that day (a rapid test).  That test came back negative as well according to him.  I would love to believe that he is telling the truth but I wasn't there to see the results with my own eyes.  SO, with all of that being said, here are my questions...

1)  Most important, how much of risk did I put myself into by getting myself into this situation?  I am still in disbelief that I let this happen to me.  

2)  Are there high volumes of HIV in pre-cum and does what I described put me at great risk?

3)  Should I go to a hospital TODAY to get on any sort of medications to try and stop the progress of HIV?

4)  Even though he tested negative, is there still a chance that he is positive?  Maybe he contracted it last week and it didn't show up on the test.  If that is the case, could I still be at risk?

5)  Would the massage cream help to kill the virus?

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Thanks for your question.

My first reaction is that you were sexually assaulted, or very close to it.  Maybe not legally, since he stopped when you protested.  But if you weren't expecting such contact during the massage, this strikes me as exceedingly inappropriate behavior that could get the massage parlor and/or the masseur into grave legal difficulty.

OK, I got that off my chest.  You know for sure he didn't have HIV.  Yes, it is theoretically possible he is in the incubation ("window") period for a positive blood test, but that is statistically very unlikely.  And although people can lie, most HIV infected persons don't lie about it.  Regardless of his behavior, the odds are strong he would not want to infect anyone with HIV.  And even if he had HIV, without overt anal penetration there was no tisk to speak of.

I would advise you to not overthink the situation.  Details like whether or not massage lotions would kill HIV, or how much HIV is in pre-ejaculate secretions, are pretty much irrelevant.  The important facts are that he almost certainly wasn't infected and it is likely that HIV has rarely if ever been transmitted by such minor and brief anal penetration.  The biological reasons for it are not crucial.  To your specific questions:

1) Virtually no risk, as discussed above.

2) Pre-ejaculate fluid is considered infectious, but really hasn't been studied.  Probably few if any HIV transmissions occur because of such exposure, without semen.

3) I would not recommend post-exposure prophylaxis (PEP) after such an exposure, and I doubt any other experts would do so.  It might be different if the other guy were known to have HIV, but probably not even then.

4) Theoretically possible, but statistically very unlikely, as noted above.

5) Assuming the cream contains a preservative, as I would think, it probably would kill the virus.  But maybe not instantaneously.  But as noted above, this isn't an important consdieration in assessing your risk.

If I were in your situation, I would feel no need to do anything -- no testing, and would continue unprotected sex with my wife.  But you still might benefit from testing.  For many anxious people after potential exposure, a negative test result is more reassuring than anything I can say.  So testing is up to you.

I hope this helps.  Best wishes--  HHH, MD

[Worried121212]

Thank you for your valuable feedback.  I really appreciate it!  I made an appointment to get both the NAAT and rapid HIV test, free through a local organization.  Although I fully trust your opinion, a negative test will further put my mind at ease.  Until then, your comments will suffice.  Thanks again... You were a life saver!

[H. Hunter Handsfield, M.D.]

Thanks for the thanks.  Take care.