Mutual Masterbation (Involving Saliva) With Southeast Asian Sexworker

[mranxiety44]

Dear Doctor,

A couple of days ago I got drunk while in Cambodia and foolishly paid a sexworker to go to a hotel room with me. I knew that there should be no genital to genital or oral to genital contact, so specified "hands only". However, at one point she spat on my penis for lubrication (which may have had a small graze just at the edge of the opening), and I think I may have had a small opening on my index finger (a small one that occurs when half a cuticle peels back).

I have tried to do my own research into the dangers of this, but the mountain of information available has overwhelmed me in my anxious and exhausted state. What do you think of this situation? Is it an HIV worry? I restate that ultimately there was no genital to genital or genital to oral contact.

Thank you.

[Edward W Hook, MD]

Doxycycline is a frequent cause of rashes, including rashes which occur on the penis.  It is a possible cause of your rash.  In addition, as an uncircumcised man you have a slightly increased risk for fungal infection sunder the foreskin and the doxycycline also increases the risk for fungal infection.  If the rash progresses, drug rash or fungus infections are good possibilities. EWH

[mranxiety44]

Dear Doctor, I have an update for you. Approximately 48 hours after the event described above I inspected my penis and found that under the foreskin I had developed red spots/pimples that I can best equate to heat rash. They are, as yet, painless and don't itch, but I am extremely anxious.

On the day after the incident I began to take 100mg of doxycycline hyclate twice a day for malaria prevention purposes and wondered if that might be the cause. I feel, however, that I am clutching at straws now.

[Edward W Hook, MD]

Glad to help.  TAke care. EWH

[mranxiety44]

Thank you for the information Doctor Hook, I felt relieved after reading your words.

You are correct about my alcohol consumption being a causal factor behind my anxiety. I don't even have to drink to excess to end up making decisions I later regret, just a few drinks seems to lower my guard and cause my curiosity and desire to take precedence over my better judgement. This is something I need to resolve.

Thank you once again, and hopefully I won't find myself in any such situations anymore in the future.

[Edward W Hook, MD]

Welcome back to the Forum.  I'll be pleased to address your question but before I do, I should point out that there appears to be a pattern developing here in which you drink to excess then engage in sexual activities that leave you anxious or worried.  If this pattern goes beyond the two episodes we've corresponded about in the past 6 weeks, I would suggest that you address the issue of your drinking as a causal contributor to these recurring concerns.

The good news for you in this reply however is that even if your partner had HIV or for that matter, any other STI, there is no meaningful risk for HIV from the exposure.  Masturbation is no risk for HIV and minimal risk for all other STIs no matter what lubricant, including saliva, is used.  That you may have had an abrasion on your penis or a cut on your cuticle in no way changes this.  There is no need for concern and no need for testing related to this exposure.  EWH