CDC Research vs. Your Advice Re: Handjob / Massage Transmission

[for_really]

Hi Doctors,

Nice site. I can't help but notice many contradictions between your advice in this forum and several credible sources. One such instance is the risk of hpv transmission through hand-to-genital contact. At least one CDC study recently found that hand-genital transmission of hpv was very much possible:

ED Journal Volume 14, Number 6–June 2008
Transmission of Human Papillomavirus in Heterosexual Couples

"Transmission between the hands and genitals, as well as apparent self-inoculation events (primarily in men), were also observed."

"Male-to-female transmission was observed in 7 couples. All infections transmitted from male to female partners originated in the penis with or without additional involvement of the scrotum. In particular, the penis shaft was a predominant source of infection either alone or with other genital sites. The cervix and anus were the most frequent targets of transmission from the men. Transmission of oncogenic HPV 16 comprised 1 of the 5 genital-to-cervix events. Male genital to female hand transmission was observed in 3 couples (D, E, and G)."

http://www.cdc.gov/eid/content/14/6/888.htm

If there is documented proof of this type of transmission, don't you think it is inaccurate to tell people time and again that handjobs, massages, etc. pose "no risk" of STD transmission?

I also have always wondered whether of not you take into consideration other types of diseases when answering questions regarding the risk of visiting (potentially unsanitary) massage parlors and the like...surely contracting molloscum contagiosum and public lice is possible in this scenario.

I am in no way attempting to undermine your combined experience in this field, what the hell do i know anyway. I just found it odd that other highly credible sources directly contradict your position on the topic in their recent research.

I am very interested to hear your response, please let me know!

[Dallasfan]

ok you may be confusing the different types of condyloma. ALL HPV  cause warts. The genital transmitted types are certain subtypes of HPV. Hand to skin and skin to hand transmission of HPV does occur , but not the genital subtypes that cause genital HPV. I know this is confusing.

[auntiejessi]

Well, to clarify some, HPV causes all the warts on your body, but can also cause abnormal paps for women because of abnormal cell changes on the cervix.

Genital HPV falls into 2 types - high risk and low risk.  Low risk produces visible genital warts.  High risk produces the cell changes, and doesn't produce visible warts.

The issue I have with this study is that they said that hand transmission occurred, but it doesn't say how they know that.  How do they know it went from hands to genitals when these couples were having sex?   Finding HPV under the fingernails just means it was found there.  OK so it can go from the genitals to under the nails, but what we don't know is how it is transmitted from there.  A lot goes into transmission, and we don't know enough about HPV under the nails to really make any real statements about it, in my opinion.

Read this thread for more on this - http://www.medhelp.org/posts/STDs/can-hpv-spread-through-fingering-/show/732157

Aj

[for_really]

Hi AJ, thanks for your reply. I am even more confused now...you say that:

"OK so it can go from the genitals to under the nails, but what we don't know is how it is transmitted from there.  A lot goes into transmission, and we don't know enough about HPV under the nails to really make any real statements about it, in my opinion."

Then why have I seen you personally (among others, Dr. "Handsfield included) post definitive statements across this board that handjobs, specifically from massage parlors (who give loooots of handjobs during a given day) pose "No Risk" or "Risk is Zero" ? Above you are basically saying that you don't know whether or not there is a risk involved?

I feel like a more accurate (and possibly more responsible) answer would be that the risk is unknown or uncertain,but that it may be quite possible. There are definitely credible, well documented studies that indicate that HPV may very well be transmitted from hand to genital contact.

I also have seen on this board and others that people have tested positive for a range of conditions including molluscum contagiosum, hpv, and pubic lice after visiting a massage parlor as their only possible encounter.

I'm just saying that people may read this information and obtain a false sense of security about engaging in risky sexual behavior which could in fact be placing them at some risk for contraction of a disease/infection, even if that risk is "low" compared to other even riskier behaviors.

I would also really be interested in what Dr. Handsfield has to say about these studies and the true potential of hand to genital contraction from a sex worker.

Thoughts?

[auntiejessi]

Dr. Handsfield doesn't read this forum.  If you want his opinion, you need to post it in the expert forum.

At this point, we don't know enough about it to say anything with certainty.  Until we do, we say no risk.

We don't know if there is enough virus under the nails to transmit, or if the HPV cells under the nails are even intact to be able to transmit.  We don't know.

Take it for what its worth.  Its totally up to you.  

If you feel its risky to get a handjob from a stripper or masseuse, don't get one.  I'm sorry if that sounds harsh, but I can only go with facts, not theories.

Aj

[kija25]

Hi all,

Nice topic.

I am a person who developed urinary symptoms and prostate infection not once, but TWICE after episodes of receiving massages and hand jobs. I have never had that problem before.

On both times, I tested negative for Gonorrhea, Chlamydia, and all other STDS, however, I was only relieved after MULTIPLE courses of antibiotics.

I know this is actually not very common, meaning many people who engage in massage and happy ending usually walk out safe,

For cases like mine, doctors would say that WHAT I HAVE IS NOT AN STD, based on my negative results. However, when I calculate the probability that this has nothing to do with the massage, I get a very close to zero number. When this happens twice, they must be related.

it I wonder how doctors give this sense of security, while it is indeed possible (at least in my case)

Be safe. Be responsible. Do not play the odds with your life.

[vvwjjman]

Then have you seen a real case for HPV-warts transmission due to hand job??