ONE FINAL QUESTION FOR THE DOCTOR

[SeattleMan]

Dear Doctor—

I thought it was only fair for me to pay another $10 to ask my question with a new permutation.  I wish I had thought of this yesterday in my original posting.  

Not sure if you recall my posting from yesterday:  basically, I was concerned about receiving unprotected fellatio (blow job) from a massage parlor worker.  

Duration was probably somewhere between 45 seconds and 120 seconds, although I am inclined to say that total “contact time” of her mouth with my penis was probably less than 30 seconds total.

IN OTHER WORDS:   although the whole event lasted two minutes, her mouth was not in contact with my penis for an entire two minute; thus, total contact time with her mouth was 30 to 45 seconds at most.  I consider this to me very minimal contact.  correct me if I'm wrong.

After some research, I concluded and, you agreed yesterday that my HIV risk was zero, because her mouth was NOT bleeding.  Additionally, it goes without saying that saliva is NON-infectious. (Correct??????)


The ONLY issue that I have, and this is where the after-thought permutation comes in is as follows:

**Suppose she had a sore in her mouth, BUT it was NOT bleeding.

**Would I need to be concerned about HIV-infected cells “attaching to her sore,” AND THEN consequently infecting me?  

Or is HIV ONLY transmitted through infectious fluids?

I guess I’m asking, because I’m not circumcised.    So, there is a fear of being infected despite NOT coming into contact with blood. In other words, I'm concerned about cell-to-cell infection.  

Does any of what I write above change the conclusions of yesterday?  

Literally, this is the ONLY time that I have strayed from my fiancée, and as such my only risk involved.  Thus, I’m prepared to “let this go,” but I wanted your knowledgeable feedback on this new permutation.  I'm guessing, even though I cannot read your mind, that my new permutation does not change the risk assessment of being zero for HIV.  

Also, saliva is NON-infectious, correct?

PS, I don't mind if other people "chime" in, BUT please do not hijack my thread, UNTIL AFTER the doctor answers.  I simply cannot afford $10 again to post a new question.

[H. Hunter Handsfield, M.D.]

I was going to respond in the other thead.  But since you started a new one, my reply is here.

There are no data to address the effect of short vs long duration of sex, oral sex with and without sores, or other issues at the detail you request.  It stands to reason that if a sore is present in the mouth, transmission risk (in either direction) is higher than without a sore.  It also stands to reason that sex for 10 min is riskier than, say, 1 minute.  Being uncircumcised raises the risk if exposed.  It is less clear whether blood in the mouth makes a difference, but maybe it does--who knows?  Butthe bottom line is that when transmission risk is almost zero for any particlar exposure, it still is low with those additional factors:  2X almost zero = almost zero.

Transmission via saliva is extremely rare, if it occurs at all.

HHH, MD

[SeattleMan]

And this is a legitimate "what if?"  Basically, I'm asking "does cell-to-cell" transmission exist?  Why am I asking this? Because I have read that the presence of other STDs can increase the risk of HIV transmission?

[JohnnyV]

Hi,

I fear I may add to the maelstrom, but Sweet Caroline has perked my curiosity about one point.

What are these massage parlors that keep coming up on this forum? I've lived in major cities all my life and I've been pretty seedy from time to time. I have to admit I'm confused. When I see ads for massage therapy. are these usually just code for these places where men seem to go for routine gratification as part of the price? How do you find them?

Are you scared of getting busted by the cops? That seems more of an imminent danger than HIV, especially because you can get raped in prison and inmates don't get condoms.

Do most of you guys who go to massage parlors, go with the intent of getting a massage, and then slip into the behavior by accident?

Trust me, I don't want to find out so I can start going, but I am curious because it seems to give me a peek into a heterosexual world I've never known anything about.

J

[SeattleMan]

Thank you for your responses.  After reading everything, I don't know how I've come to this, but here it is:

I can't lose my fiancee over having contracted HIV from this blow job at the massage parlor.  If I get HIV from this exposure, the relationsihp is over, that I know for sure.

I am still within the 72-hour window period for PEP.   I do not have much money, but I believe that I can dip into my saving for pay for PEP.   Seems like my risk assessment has changed somewhat.

Do you recommend PEP, doctor?????  

I know it's a crappy regimen to take, but I'm willing to make these sacrifices to reduce my HIV transmission risk from this particular and only risky scenario.

Please respond, doctor.  The 72-hour window period is CLOSING and CLOSING FAST.

Regards,

Barry

[ChicShane]

JohnnyV I am curious too.  I've been on this board for almost two years now, and a disproportionate appropriation of time is dedicated to oral exposure at massage parlors.  I don't understand the allure of a massage parlor, as you can hop on a flight to Las Vegas and go to the Chicken Ranch and have legal sex with clean girls who are tested for everthing every two weeks.  Or even in your local town, you can find tons of girls on the internet who you can meet in an anonymous hotel room, plus I watch that show "Cops" and they are ALWAYS busting those massage parlors and setting up sting operations.  Anyways Im sure the Doc will delete all these comments, but the whole massage parlor thing is a phenomenon I don't understand.  Maybe it's convenient?  Inexpensive?  Or a cultural thing?  Dunno.

[Imdumb]

Your fear of getting HIV via insertive oral is not rational.  You need to distingish between theortically possible and reality.  No responsible HIV Dr. would recommend PEP.  They wouldn't even recommend HIV testing for medical reasons, only for mental reasons.  I have walked in your shoes my friend and as the Dr. says, if you can't get past your irrational fears of HIV, see a mental health professional, this is not a critism, but suggested out of compassion.  

You would be the first person to get HIV from receiving a BJ.

[Christie2004]

I couldn't get PEP after a needlestick at work from someone who I felt was at risk for HIV.  The infectious disease doc pointed out to me that those are not benign drugs, and that the risk to me from their side effects or possible adverse reactions was higher than the theoretical risk of contracting HIV from a person of unknown status.

[veryconcerned123]

MASSAGE PARLOR INFO: (For those who want to know)

It all started for me about 10 years ago. I had a freind that went to one and told me about it so I went and liked it. $40.00 for half an hour. You get a real massage then at the end is where they will ask you if you want more. The house gets the $40.00 and the girl gets the rest. Each one will have their own rate. Hand job usually $20-40, Oral higher and sex higher.

I would only get a "Happy Ending" handjob. Seemed innocent enough. This went on for about 8 years. I would go about two times a year for my "Treat".

Well a little over two years ago I went to a different one and agreed to the handjob at the end and much to my suprise she bent over and put the head of my penis in her mouth. This only lasted for about two seconds, and I stopped her.

THIS WAS A TURNING POINT IN MY LIFE

I had always been safe before. (Hand to genitals=No Risk).
I freaked so yes Caroline I became one of those guys that started posting and worrying about catching something.  I suffered from severe anxiety. I convinced myself that I had caught HIV and every possible STD from this exposure. When you are scared it will take over your life. It will make a sane rational person into an obsessive compulsive person that is no where near rational.

I almost lost everything. I almost got fired from a very good job because I couldn't concentrate on my job. I also wasn't paying attention (lack of concentration) and had an accident and broke 4 bones.

After 6 months I went to Dr. and confessed to him exactly what I did and told him I was afraid I had an STD.  I had two STD workups and took 5 HIV tests out to six months. All Negative.

It took me 1 1/2 years to fully recover mentally from this. The good news I have never ever gone to another massage parlor and I never will.

Concerning how do you find a place like that? Easy. Almost all of massage parlors that advertise in the Sports section of the paper are more than massage parlors. Also if they are open till 2 or 3 in the morning they are selling more than massages. (they stay open till the bars close)

Very easy to spot. The place where all the housewives go for a massage is not the place that sells happy endings. These types of places very rarely will have a women customer.

[SeattleMan]

Well, I change my mind about one thing:  it's good to read the postings from everyone, including Sweetcaroline, becuase it's made me realized how much of a waste of time it was for me to go to this place, if only because of the anxiety I'm facing now.  No more of this **** for me.  It's not worth the time, energy, stress, and money.

[SeattleMan]

What's your recommendation to recover from all this?  I also want to make sure that I do not repeat this episode ever again.  Sometimes fear may not be enough.

Do you suggest counseling from a mental health pro?

[veryconcerned123]

Hello WBarry,

It took me a long time to get over this. I am married with a family. The guilt that I could have endangered my family is what almost sent me over the edge.

I wanted help from a mental health pro, but couldn't b/c I couldn't tell my wife. She knew something was wrong with me and asked a lot of questions, but I never told her.

For me it is easy. I went through Hell over this. I don't ever want to go feel that feeling of helplessness and hopelessness that I felt back then.

I know it is tempting to go back. Believe me I know, but YOU make the decision to either do it or not do it.

On one hand I miss the carefree fun of it all, but I am a better man now than I used to be since all of this happened to me.

WBarry just think about how bad you feel now and the next time you are tempted to go flashback to this bad feeling.

You can stop if you really want to and try.

Good luck my friend!

[SeattleMan]

That totally makes sense.  After all, I am the ONLY person who decides whether to go to those places.  Thus, I am the ONLY person who can say "yes" or "no."

I don't ever want to feel this way.  I feel crappy.  For me, it's less guilt, and more fear of HIV.  Fear of HIV should be enough to stop me from going back ever again.  It really is a crappy feeling.

[SeattleMan]

I'm interested in knowing "why" I won't get HIV from insertive?

Is it because I'm coming in contact with only saliva?

[Imdumb]

WBarry - I'm sorry you haven't found what you were hoping on here, but truely your risk of HIV from your oral exposer was non existent. The reason doctor HHH can't and won't give you hard science on the risk of insertive oral is because no science exists on it. It remains a theoretical risk with no scientific studies to prove that it is a risk. It should be of comfort that in 20+ years science cannot prove that insertuve oral is even a risk. You would be 1 in 40 million.

[Imdumb]

That is correct. It is not spread through saliva. Only blood, semen, vaginal fluid, and breast milk.

I have been in you shoes. No matter the 1 in 40 milllion odds I still got tested at 3 months (negative of coarse). I also have been working to make sure it doesn't happen again. I have been to personal counseling and also am in a group for sexual addiction. There are many books out there. I suggest Out of the Shawdows by patrick carnes as a start.

[SeattleMan]

Thank you very much.  I guess "feeling anxious" about HIV and actually being "at risk" are two totally different things.  I just called the Minnesota AIDS Hotline and they also say, "NO Risk" of receiving oral, UNLESS there were blood in that person's mouth.  They said the same as you.  

You know, I thought about what everyone else said, and basically, aside from Fear of HIV...the possibility of losing my career, my freedome (i.e., jail time), and public embarassment make a compelling case to not revisit these places.  I've gotten massage in the past, but never have I gone this far.  

I guess what scared me was that this girl told me that she generally does not give BJs, and most certainly not without a condom...but this time she did.  Overall, the massage place was legit, because she actually gave a real pressure point massage on a real massage table.   But it did scare me.

[scaredman75]

I am in the same boat as WBarry (and i wish you luck getting your mind back into order we shouldn't be so worked up over this but i understand where your coming from), under extreme guilt and anxiety (because i have a girlfriend), i had insertive oral (and noticed an abrasion on my penis after from the womans teeth), I tested negative for STI's at 10 days, and i have tested negative for HIV  and syphilis at 4 weeks, i just can't get by the 1 in 40 million  theoretical chance, do i require more testing? or is it all in my head? i am trying my hardest to get through this, i was good for about a week after my negative result then i got an itchy throat and i started thinking again about the possibility of infecting my girlfriend.

[JohnnyV]

Hi,

Trust me, if you just check in with this forum each day and read through the comments, you will find it easy not to repeat that behavior. I had a slightly different problem of constantly picking people up in bars, public places, the steam room, saunas, adult bookstores, sex parties, etc... and I did go to counseling. But the best help was actually this forum for some reason! I guess just hearing all these stressed out voices every day reminds me -- it isn't worth it! One tidbit from my counselor that can help: "one day at a time!" Never say "never again," just say "not today." And it will work out.

J

[SeattleMan]

What really irks me is that "THIS IS NOT EVEN FUN."  It's VERY momentary FUN.  Only MOMENTARY.  I need to move on.

Do I really have no HIV risk here?