Did you happen to see my question on reciprocal masturbation?

Question

Dr. Bob,

 I posted a question yesterday titled "Cross Mutual Masturbation with Prostitute" and wanted to see if you had a chance to look at it.  If you didn't yet, no problem just ignore this message, but if you did I was hoping for at least a brief answer based on the incident and symptoms I describe and regarding: (1) whether I am at any risk of HIV from the events described, (2) whether I should be worried about / stop having unprotected sex with my girlfriend (we only engage in penetrative sex - oral, vaginal, anal - between the two of us) or worried about whether I could have transmitted anything to her, and (3) whether you would recommend HIV testing from this incident.

Many thanks, I appreciate this charitable service and while I haven't donated to your foundation yet, I did donate $1,500 to an HIV clinic in NYC.

Cross Mutual Masturbation with Prostitute (Submitted Jan 29, 2009) Dr. Bob,

 Thanks for providing this service.  I was in Thailand on vacation and hired an escort / prostitute.  We engaged in mutual masturbation where I rubbed her vulva a little bit (but didn't stick my finger up her vagina) and then masturbated my penis.  She also gave me a hand-job, possibly after touching herself as well.  I didn't use her fluids as lubrication, but there could have been some on my hand or her hand when I / she touched my penis.  I picked several layers of skin off of my thumbs as a nervous habit, but they weren't bleeding nor did I use them when I touched her.  No oral, vaginal, or anal sex was involved at all.

Around 7 days later after returning to the United States, I developed a crampy stomach, some mild diharrhea, and fatigue. I had no temperature (checked many times), rash, or noticeable swollen lymph nodes. I did notice a slight on and off headache and slight on and off soar throat, which I couldn't tell whether it was related or not. These symptoms have persisted for a little over two week and are now much better.

11 days after I saw the escort, I started having unprotected sex with my girlfriend again (since we are the only ones we have any sort of penetrative sex with). 7 days after having unprotected sex with her again, she developed a condition with upset stomach, temperature, and some head pains (not really headache), which went away in a couple days.

Am I at any risk of HIV from the type of mutual masturbation described above? Do I need to worry about having passed something on to my girlfriend? Do we need testing from this incident?

Thanks so much.

Answer

Hi,

I combined your previous post with this current one. Mutual masturbation is not considered a significant risk for HIV transmission/acquisition.

To specifically address your questions:

  1. No. The activities you describe are not a risk for HIV acquisition.

  2. You did not pass HIV on to your girlfriend, as you can't pass something on that you don't already have. The "symptoms" you describe are not worrisome for or suggestive of HIV acute retroviral syndrome (ARS). I see no reason for you to be worried or to stop having sex with your girlfriend.

  3. HIV testing is not medically warranted. However, if my reassurance is not sufficient for you to shake off your HIV worries, get a single HIV test at the three-month mark. The results will undoubtedly be negative, but if it helps put your residual worries permanently to rest, it may be worth the effort psychologically.

Be well.

Dr. Bob