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Handjobs and semantics
Mar 10, 2003

Dr. Bob: please forgive me for this being framed as a personal question, but considering both your immense knowledge of HIV and your HIV status, I feel that asking on a personal level would be very reassuring and more friendly than the typical stoic medical response.

My question concerns the risks inherent in receiving a handjob from someone who is HIV+, and whether the 'theoretical' risk is something that should even be acknowledged in a 'real world' setting.

Would you consider it safe to for a + person to give a - person a handjob?

I ask because I tried something many men these days are trying (so it seems - there have been pop-culture references over the past year to the trend), which is going to an asian massage parlor and receiving a massage with a 'happy ending' - being masturbated by the female masseuse.

The frightening part is that the place I went to, as I have now learned, practices full service prostitution. From what I understand, the young asian women do tend to use protection at this place, but I think it's safer to assume she was HIV+. What criteria would need to be met for transmission to take place, considering that I have genital warts (which will be treated soon - something I've dealt with since high school), which may or may not be a point of entry, and considering that there was no lubrication used for the encounter (meaning that there could well have been some micro-abrasion from her hand).

Would she have to have had visible blood on her hand (I didn't notice any, but didn't get out the magnifying glass or even really think to look), a large fresh cut, or would microscopic amounts pose a risk (not theoretical, but real)?

I tested negative at 49 days, and am awaiting the completio of 90 days with great anxiety, as I've had tender glands (all over), a sore throat, and what may or may not constitute a recurring rash on my chest and belly (looks like I'm blushing, is splotchy, but widespread, comes and goes over an hour or so).

I guess I was just wondering if you, as a doctor, would consider this a safe sex practice, or whether you would file it in the risky category. Would you, if you were to do this, check your hands very closely for minor cuts or anything, or is the risk really non-existent?

Thank you immensely.

Response from Dr. Frascino

Hello,

So, you are wondering, since I'm HIV-positive, do I personally feel it is safe for an HIV-positive person to give an HIV-negative person a hand job??? Well, yes, I do believe that is safe, but why are you asking? I hardly even know you. You haven't even bought me a drink, let alone dinner . . . .

Oh, I see, the rest of your question involves the ever popular "happy ending" massage. (This, by the way, is not solely an "Asian" custom, and certainly not anything new.) Most prostitutes, especially in countries where prostitution is legal, are very savvy about HIV and STD prevention. After all, sex is their business, right? "Micro-abrasions" are not a concern, nor is it necessary to inspect a masseuse with a "magnifying glass."

Your risk is so low as to be essentially non-existent. Go ahead and get your 90-day test, if you like. It will be negative, if this has really been your only risk. Your symptoms are not at all concerning to me.

Hope your next happy ending comes without all the unnecessary worry. Stay well.

Dr. Bob



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