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Massage from sex worker
Hello Dr. Today I brought a sex worker home and while on my bed I was naked and she gave me a full massage whith an hydrating cream I had. This included touching my testicles, masturbating me and also touching my anus (she put pressure on that zone with her fingers but didn't insert them, or maybe just a little, it was more like a rubbing/pressing). I was completely naked and she was wearing some sort of baby doll (a very thin, kind of transparent one. She did not get on top of me. There was no oral, genital to genital or mouth contact, nor vaginal or anal sex (apart from she touching me as I said before). Also, I touched her breasts and nipples for a while and rested my head on them for a while. I was masturbating during the encounter and she masturbated me too, I did not cum. Another thing that worries me is that about 2 weeks ago I had 2 warts on the sole of my foot cautherized (burned) by a dermatologist. By now I had 2 regularly sized clusters on my foot which she massaged too with and without cream. I also had athletes foot on on the other foot. Also, after she left I did not shower and just went to sleep on the same bed. My penis never had any kind of contact with her mouth, vagina or anus nor my mouth with any of her parts, nor kissing. I didn´t touch her vagina or anus either. My penis is a bit sore on the top part right under the head (no wounds however or visible blood, justa little reddish and a bit itchy) i suppose for marturbating too much. Also I feel pain today on my right buttock, I think it's illogical, especially because I was awake all the time, but at times I think the sex worker may have pricked my buttock with a needle or something although I understand that seems a bit far fetched. Am I at risk for contracting HIV? For peace of mind i'm planning on having a P24+AB 4th generation at 3 weeks and another AB at 1-1.5 months. Is that approach/timeframe correct? I hope my risk is zero but need to hear it from you for my peace of mind. Thank you.
MEDICAL PROFESSIONAL
Welcome to our Forum. The events that you describe were zero risk for acquisition of HIV or for any other STD. HIV in adults is spread among adults only by penetrative genital or ano-genital contact or by injection of infected material deep into tissue. It is not spread by massage, kissing, or masturbation, even if you were to get some of her genital secretions on you. That you had warts cauterized two weeks ago in no way changes this. There really is no medical need for you to test at all. The testing you suggest would reliably detect HIV if there were any risk.
I will not even comment on the possibility that she somehow stuck you with a needle to purposefully infect you- this makes no sense.
Your symptoms are not related to any infection acquired through the events you have described.
I hope you find my comments helpful in relieving your concerns. EWH
I will not even comment on the possibility that she somehow stuck you with a needle to purposefully infect you- this makes no sense.
Your symptoms are not related to any infection acquired through the events you have described.
I hope you find my comments helpful in relieving your concerns. EWH
MEDICAL PROFESSIONAL
Our time and space is limited. Your exposure was zero risk and testing is not required. Despite that, you wisk to be tested and that, of course is your choice. This will have to be the final reply to this thread however.
1. I cannot not comment on why tets are priced as they are. It makes no difference whether you have the p24 antigen teted seperate from the antibody test or have a combination test.
2. Again these are questions for the lab.
3. You seem to be confused about what tests are what. While a p 24 antigen test is a seperate test which tests only for that, the term "4th-generation" test typically refers to tests that tet for both the p24 antigen and HIV antibody at the same time. Testing for only the p24 antigen is not sufficient to rule out HIV.
4. As I have said several times, you do not need testng at all. If you insist, testing for p24 antigen and antibody at any time more than 4 weeks after an exposure will provide definitve results. Similar tests that test only for antibody will give definitive results at any time more than 8 weeks after exposure.
5. See above.
6. Yes, there are timew when only the p 24 antigen test might be positve, very soon after an exposure. Simialrly, p 24 antigen may disappear later in the course of disease but only antibody is present.
7. No, AZT does not make your body "stronger" against the virus. AZT only works during the relatively few hours that it is present in the body.
There will be no further replies. EWH
1. I cannot not comment on why tets are priced as they are. It makes no difference whether you have the p24 antigen teted seperate from the antibody test or have a combination test.
2. Again these are questions for the lab.
3. You seem to be confused about what tests are what. While a p 24 antigen test is a seperate test which tests only for that, the term "4th-generation" test typically refers to tests that tet for both the p24 antigen and HIV antibody at the same time. Testing for only the p24 antigen is not sufficient to rule out HIV.
4. As I have said several times, you do not need testng at all. If you insist, testing for p24 antigen and antibody at any time more than 4 weeks after an exposure will provide definitve results. Similar tests that test only for antibody will give definitive results at any time more than 8 weeks after exposure.
5. See above.
6. Yes, there are timew when only the p 24 antigen test might be positve, very soon after an exposure. Simialrly, p 24 antigen may disappear later in the course of disease but only antibody is present.
7. No, AZT does not make your body "stronger" against the virus. AZT only works during the relatively few hours that it is present in the body.
There will be no further replies. EWH
Thanks a lot Dr Hook, I know I am worrying too much. Maybe because I haven't engaged in risky behaviour and had nothing to do with sex workers for almost 2 years (altough I never really get to funky with it either) I learned my lesson (or thought I learned it) years ago. And I had promised myself never to pick up a hooker again, let alone bring her home but this time alcohol and cocaine got the worst of me.
Anyway, I found another lab, not as hyped as the one I usually go to but also a well known one that has been around for many years and works with many top clinics. They do offer a single AB+Antigen test and state it clearly on their webpage, but don't mention it is a "4th generation" test (I suppose it must be?) It is much cheaper than getting a separate AB test plus another P24 test. I really don't understand why a test for only P24 ismuch more expensive than one that combines both assays. I would think the first lab also searches for P24 in their 4th generation test but they don't state it clearly, not even in the results which I´ve had before. They just say "HIV antibody 4th generation recombinant" I think I understand they can "say whatever they want" but why would the top lab around not include p24 on their 4th generation tests? maybe commercial reasons... I don´t know....If they tell me they do look for it shouldn't I believe them? I guess maybe not if it isn't clearly stated on the test....
So my last questions are:
1) Is a combination test as effective as taking an AB test and an Antigen test separately (that cost a lot more)? And why would a single Antigen test cost more than a combi test? Maybe because they were the first to offer it?
2) If the test they offer in this other lab searches for both, is it for sure a 4th generation test? and should I go with it rather than taking 2 separate tests and paying more?
3) What I used to do when I had a risk before was take only a p24 test at 3 weeks (If the risk was bigger take an AB test as well) and then follow up with the said 4th generation AB test which I'm not sure if it looks for P24. I did this since they stated that P24 was detected at 3 weeks for peace of mind and then followed up with the regular 4th generation tests. I ask this also for future reference. Was that approach correct? or would it be better to wait one more week and take a combo test (taking into account that every day matters and handicaps my health, wellbeing and profficiency), so the earlier peace of mind I get the better for me for I'm a nervous wreck regarding these issues.
4) After my surgery I would want to do the same (get tested as soon as possible whenever I can get reliable results) if possible before my exams which start around september 10th. My surgery would be 2 weeks after this incident so I might as well kill 2 birds with a shot. I cannot be testing every week as you may understand, so what would you suggest I do (Keeping in mind I want fast but reliable results, although having more than 1 test is ok with me, just not too many). Would you recommend a single combi test after 3 or 4 weeks after each each episode or taking a p24 test at 3 weeks and then follow up with the combi tests which are cheaper, or is this useless?
5) Is taking a P24 test (at 3 or 4 weeks) without an antibody test no use?
6) I have always wondered, I know there is a stage where the infection could be shown in one or both assays, but, conversely, is is it possible that after having the P24 antigen present and it starts wearing off and antibodies start to build, both assays could come off negative because there is too little amount of both antigen and antibodies, say around the 3rd-4th week?
7) Lastly, you said my taking of AZT more that 10 years ago would not affect my results for "This exposure", I suppose you meant this one and any future ones right? Is it possible that because of taking AZT in the past my body is a bit stronger against the HIV virus? (I know you don't like to discuss theoretical things on this forum so a simple answer would do)
Thank you very much for your patience, again, sorry for the long post, this is my last comment on this post...Hope you can give me some advice as to how to proceed and also for me to take into account for future reference or help other people. I really appreciate your time and knowledgeable advice.
I would also like to point out that I don't live in USA if that serves for anything, but in amajor city in South America (not in Brazil either). Thanks again.
Anyway, I found another lab, not as hyped as the one I usually go to but also a well known one that has been around for many years and works with many top clinics. They do offer a single AB+Antigen test and state it clearly on their webpage, but don't mention it is a "4th generation" test (I suppose it must be?) It is much cheaper than getting a separate AB test plus another P24 test. I really don't understand why a test for only P24 ismuch more expensive than one that combines both assays. I would think the first lab also searches for P24 in their 4th generation test but they don't state it clearly, not even in the results which I´ve had before. They just say "HIV antibody 4th generation recombinant" I think I understand they can "say whatever they want" but why would the top lab around not include p24 on their 4th generation tests? maybe commercial reasons... I don´t know....If they tell me they do look for it shouldn't I believe them? I guess maybe not if it isn't clearly stated on the test....
So my last questions are:
1) Is a combination test as effective as taking an AB test and an Antigen test separately (that cost a lot more)? And why would a single Antigen test cost more than a combi test? Maybe because they were the first to offer it?
2) If the test they offer in this other lab searches for both, is it for sure a 4th generation test? and should I go with it rather than taking 2 separate tests and paying more?
3) What I used to do when I had a risk before was take only a p24 test at 3 weeks (If the risk was bigger take an AB test as well) and then follow up with the said 4th generation AB test which I'm not sure if it looks for P24. I did this since they stated that P24 was detected at 3 weeks for peace of mind and then followed up with the regular 4th generation tests. I ask this also for future reference. Was that approach correct? or would it be better to wait one more week and take a combo test (taking into account that every day matters and handicaps my health, wellbeing and profficiency), so the earlier peace of mind I get the better for me for I'm a nervous wreck regarding these issues.
4) After my surgery I would want to do the same (get tested as soon as possible whenever I can get reliable results) if possible before my exams which start around september 10th. My surgery would be 2 weeks after this incident so I might as well kill 2 birds with a shot. I cannot be testing every week as you may understand, so what would you suggest I do (Keeping in mind I want fast but reliable results, although having more than 1 test is ok with me, just not too many). Would you recommend a single combi test after 3 or 4 weeks after each each episode or taking a p24 test at 3 weeks and then follow up with the combi tests which are cheaper, or is this useless?
5) Is taking a P24 test (at 3 or 4 weeks) without an antibody test no use?
6) I have always wondered, I know there is a stage where the infection could be shown in one or both assays, but, conversely, is is it possible that after having the P24 antigen present and it starts wearing off and antibodies start to build, both assays could come off negative because there is too little amount of both antigen and antibodies, say around the 3rd-4th week?
7) Lastly, you said my taking of AZT more that 10 years ago would not affect my results for "This exposure", I suppose you meant this one and any future ones right? Is it possible that because of taking AZT in the past my body is a bit stronger against the HIV virus? (I know you don't like to discuss theoretical things on this forum so a simple answer would do)
Thank you very much for your patience, again, sorry for the long post, this is my last comment on this post...Hope you can give me some advice as to how to proceed and also for me to take into account for future reference or help other people. I really appreciate your time and knowledgeable advice.
I would also like to point out that I don't live in USA if that serves for anything, but in amajor city in South America (not in Brazil either). Thanks again.
MEDICAL PROFESSIONAL
You are worried too much.
1. Taking AZT years ago will not change your test resutls related to this exposure.
2. If you wish to test at 4 weeks you need both a p24 antigen test and an antibody test taken at the same time. Ask the lab. While 4th genertion tests typically include both the p24 and the antibody test, the lab can say whatever they want.
3. The procedures you describe should make your hair transplant safe. I would not worry.
EWH
1. Taking AZT years ago will not change your test resutls related to this exposure.
2. If you wish to test at 4 weeks you need both a p24 antigen test and an antibody test taken at the same time. Ask the lab. While 4th genertion tests typically include both the p24 and the antibody test, the lab can say whatever they want.
3. The procedures you describe should make your hair transplant safe. I would not worry.
EWH
By the way, I'ts ok if Dr Hunter answers as well... I really trust what both you guys say.
PS: I know the question about the pricking needle was crazy, but I was crazy with fear and guilt yesterday and couldn't think right. I'm still having a bit of trouble getting the advice to sink into my head because the incident is still fresh in my mind but I hope reason will kick in and kick out those unwarranted thoughts in a couple days when I'm thinking straight again. I'm starting my last semester of lawschool and need to be calm and focused. Your advice helped a lot nevertheless (when paranoid thoughts kick in I check your answer again and it relieves/reassures me)..and I thank you for that.. (Sorry if all my arguments are not that scientific but I suppose as human beings we are not all about science meaning the emotional factor). Another specialist backed up your advice saying there was no risk whatsoever. Just wanted to say that, no need to answer this part and I'll try to keep it more simple and accurate next time.
Tnaks for the reply doctor, I Understand it well and have been in similar situations in the past worrying in vain just to get a negative test after months of suffering unwarrantedly. I am very careful with these issues but once in a while I "slip". But it's been a longtime since I last had real sexual intercourse with a sex worker, and I'vebeen testeda lot of times, last time about a month ago and got my partner tested as well, all ok.
I got a couple follow up questions if you're so kind to answer however:
1) I saw that in one of your last posts you stated that any available test taken after 8 weeks post exposure should be conclusive, as long asyou have never taken antiretroviral drugs. I have taken AZT many years ago like 3 times just in case because of some risk experiences I had (more than 10 years ago last time in 1997 I think). Could this alter any testing I get?
2) I get tested at the most reputable lab in my country, and they offer separately an antigen P24 test for HIV1, and a 4th generation test for AB called "HIV 1-2 Anticuerpos recombinante 4ta generacion". My question is, do all 4th generation tests test for p24 as well? because they don't mention anything about it, they just say "4th generation recombinant antibody". By the way it is cheaper than the test only for P24, so if all 4th generation tests also look for P24, then what would be thereason to takea separate only p24 test (They once told me because it was more sensitive/specific orsomething alonfg that lines) but I'm not sure if they really knew what they weretalking about (It wasn't a doctor or phycisian, just one of the employees). I've heard that if it does not state clearly AG or antigen P24 probably it isn't looking for it, even if it is a 4th generation test, but that comment was from arandom person on internet). Having said that, would it be a wate of money to take the 4th generation test I mentioned plus the antigen P24 only test or would it be beneficial?
3) My last question: I'm going to undergo surgery in 2 weeks for a hair transplant. Although the doctor is one of the most reputable and always asks for hiv tests to their patients, maybe one of them could be in the window period and what concerns me more is that I know of High risk gay people who have had sugery there, so I will be sitting on the same chair, etc. The doctor says every instrument is disposable and/or carefully sterilised, and I belive that is true but still gets me abit nervous. He also told me he would not perform surgery on an HIV positive person because it is too much risk for him and his crew and it is not an emergency procedure. Should I be assured there is no problem regarding this procedure I'm going to take? By the way he performs surgery almost every day and has been doing it for many years now, this would be the second time I go since late 2007.
Lastly, if I want to get peace of mind for the operation and the incident I commented earlier (although I understand there was no risk) When should I take a test? would 4 weeks be enough or 6 weeks? and Should I pay extra for the separate P24 test or would be fine with the 4th generation Recombinant AB test I mentioned? I'm not sure if by recombinant they mean they also test for P24 or they mean something else, maybe something to do with the proteins related to antibodies.
Sorry for the long post, I hope you can dispel my doubts. Thanks again.
I got a couple follow up questions if you're so kind to answer however:
1) I saw that in one of your last posts you stated that any available test taken after 8 weeks post exposure should be conclusive, as long asyou have never taken antiretroviral drugs. I have taken AZT many years ago like 3 times just in case because of some risk experiences I had (more than 10 years ago last time in 1997 I think). Could this alter any testing I get?
2) I get tested at the most reputable lab in my country, and they offer separately an antigen P24 test for HIV1, and a 4th generation test for AB called "HIV 1-2 Anticuerpos recombinante 4ta generacion". My question is, do all 4th generation tests test for p24 as well? because they don't mention anything about it, they just say "4th generation recombinant antibody". By the way it is cheaper than the test only for P24, so if all 4th generation tests also look for P24, then what would be thereason to takea separate only p24 test (They once told me because it was more sensitive/specific orsomething alonfg that lines) but I'm not sure if they really knew what they weretalking about (It wasn't a doctor or phycisian, just one of the employees). I've heard that if it does not state clearly AG or antigen P24 probably it isn't looking for it, even if it is a 4th generation test, but that comment was from arandom person on internet). Having said that, would it be a wate of money to take the 4th generation test I mentioned plus the antigen P24 only test or would it be beneficial?
3) My last question: I'm going to undergo surgery in 2 weeks for a hair transplant. Although the doctor is one of the most reputable and always asks for hiv tests to their patients, maybe one of them could be in the window period and what concerns me more is that I know of High risk gay people who have had sugery there, so I will be sitting on the same chair, etc. The doctor says every instrument is disposable and/or carefully sterilised, and I belive that is true but still gets me abit nervous. He also told me he would not perform surgery on an HIV positive person because it is too much risk for him and his crew and it is not an emergency procedure. Should I be assured there is no problem regarding this procedure I'm going to take? By the way he performs surgery almost every day and has been doing it for many years now, this would be the second time I go since late 2007.
Lastly, if I want to get peace of mind for the operation and the incident I commented earlier (although I understand there was no risk) When should I take a test? would 4 weeks be enough or 6 weeks? and Should I pay extra for the separate P24 test or would be fine with the 4th generation Recombinant AB test I mentioned? I'm not sure if by recombinant they mean they also test for P24 or they mean something else, maybe something to do with the proteins related to antibodies.
Sorry for the long post, I hope you can dispel my doubts. Thanks again.
Shedidn't finger herselfas far as I know but am not 100% sure.
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