Exposure Question

[anom]

A massage therapist was recommended to me that I visited this morning.  About halfway through the massage she began to come on to me and put a condom on me.  I don't know why, but instead of stopping the session right then, I let it progress.  She performed oral sex briefly (less than 90 seconds).  She stopped performing oral sex and took off the condom and proceeded with the massage.  A few minutes later she put another condom on me and started climbing on me.  She started to have vaginal sex with me and I told her I couldn't.  I got up, went to the restroom and cleaned myself up with a handy wipe, and then used soap and water to make sure I was clean and that nothing from her was on me.  I was very upset about the experience, because I don't know her at all.  Her aggressive behavior left me with the feeling that she is less massage therapist and more prostitute.  I asked her if she had ever been tested for STD.  She said she gets tested often, because she swings.  I then asked her if she ever tested positive for anything and she said no.  I asked her when the last time she was tested and she said about 8 weeks back.

I am freaking out as I am faced with both the prospect of being infected by somone I don't know and the fundamental question of why I let it get out of hand.

What is my exposure here?  She never had contact with me without a condom, and it was 90 seconds oral and maybe 90 second vaginal.  I immediately washed myself off with a handy wipe (wet one), washed with soap and water (anti-bacterial hand soap.)  I showered when I got home, wiped down with an alcohol based wipe.

Is there anything I can do to mitigate my risk further?  What is your advice for my situation, other than don't get in that situation again.

[H. Hunter Handsfield, M.D.]

From your description, the chance your masseuse was infected seems low; and if she was, she protected you well with the condom use.  Contrary to common perceptions, many commercial sex workers--aside from common street hookers and brothel workers--have lower STD risks than non-professional sexually active women.  They often selectively choose low risk partners, like you; they get tested frequently, as she says she did; and they use condoms, as she did with you.  That she used a condom for fellatio suggests she is conscientious (even compulsive) about sexual safety; using condoms for oral sex isn't very common.

It all adds up zero risk, for practical purposes.  Washing with soap and rinsing with alcohol didn't make much difference, but didn't hurt.  I do not recommend any STD/HIV testing.  If you are unhappy with the experience, learn from it and don't repeat it.  But don't lose any sleep over the STD risks.  If all sex was as safe as this, nobody would have STDs and I would be out of business!

Best wishes--  HHH, MD

[puccinitenor]

It is very unlikely, probably zero, that you caught anything during this protected encounter.  The risk of HIV (even if she were positive) would be minimal for three reasons:  First, you used a condom and the event was short lived.  Second, it was a one time encounter.  That alone puts the risk below 1%.  And third, the insertive partner (male) is at a small risk anyway in heterosexual oral/vaginal sex in this country.  Those factors combined make your risk close to zero.

[anom]

Thanks for the comments.  I was less concerned about HIV as I was about Herpes or other STDs I am unfamiliar with.  All sites I read say that even wearing a condom doesn't prevent herpes.  It only mitigates the risk somewhat.  If her secreations got on me and she was infected and didn't know it, I could be exposed.  That is all that was going through my mind as I pushed her off of me and profusely cleaned up.  I called her a few hours after the encounter to ask again that she has never had anything and has been tested.  She reiterated that she has never had anything and was tested 8 weeks ago.  I know there are people that post that have had far more exposure than I had, but I am looking for reassurance and a suggestion on what to do over the next couple of weeks.  I am assuming I am to watch for any symptoms of anything for some period of time.  If something suspicious happens to get tested. So do I get tested for everything or only specific things?

[H. Hunter Handsfield, M.D.]

Assuming you develop no symptoms--and it is unlikely that you will--you do not need testing.  Just getting secretions "on" you does not lead to infection.  (The herpes virus has to be  massaged into the skin to cause infection.)  Condoms are highly protective against herpes--not perfect, but very good.  Relax, mellow out. This really was a non-event, perhaps not emotionally, but with respect to STD risk.

HHH, MD

[anom]

I appreciate the feedback.  How long should I abstain from sex with my wife to monitor for symptoms?

[H. Hunter Handsfield, M.D.]

With zero risk, there is no reason to abstain at all.  But the most common STDs (gonorrhea, chlamydia, NGU, herpes) usually cause symptoms within 10 days.

HHH, MD

[Mike300]

Hey, how did your HIV test come out? Negative?  If negative, what do you think your symptoms were?  I am having simular symptoms after a potential exposure and am scared to test.

[anom]

Day 3 - I don't think it is related to the exposure, but wanted to ask incase it changed your previous answer.  My scrotum is itching and has itched since the incident 3 days ago (including the day of the exposure).  I also have redness between my scrotum and anus that looks like chafing.  I am assuming it has to do with the profuse cleansing and use of alcohol based wipes on my sensitive skin.  I put 1% Hydrocortisone on it this morning and it has helped tremendously.  I have no other symptoms.  Should I make an appointment with a dermatologist and/or get tested for STDs?  Should I abstain from sex and watch for further symptoms?

[anom]

Day 3 - I don't think it is related to the exposure, but wanted to ask incase it changed your previous answer. My scrotum is itching and has itched since the incident 3 days ago (including the day of the exposure). I also have redness between my scrotum and anus that looks like chafing. I am assuming it has to do with the profuse cleansing and use of alcohol based wipes on my sensitive skin. I put 1% Hydrocortisone on it this morning and it has helped tremendously. I have no other symptoms. Should I make an appointment with a dermatologist and/or get tested for STDs? Should I abstain from sex and watch for further symptoms?