Serious Anxiety about my Risk (not sure if the previous one is posted)

Question

Hi Docs and experts, I went to a massage parlour on the 19th and at the end the masseuse offer me a handjob using massage oil. During the whole massage she didn¡t take off any of her clothes and I didn¡t even touch a piece of her skin. But after 2 weeks there¡s many ARS that makes me experiencing a serious anxiety (swollen throat, a little rash, night sweat, muscle pain and a light fever). Here is my concern:

  1. During the whole massage process my eyes were closed, even during the handjob part. Will there be any risk if she uses her vaginal fluid (assuming) as lube (Although I don¡t think she did produce any secretions due to no any flirtation and I didn¡t touch her at all)?

  2. What if she got blood all over her hands while doing the massage or handjob (since I closed my eyes all the time, I didn¡t notice did she got blood over her hands or not. But I got no bleeding wounds or cuts on my penis)? And also I got some pimples on my back which I¡m not sure is it bleeding at that time or not. (Although in my rational thinking I knew that if there¡s blood, it is hard to wipe away completely and there might still be some blood that are dried on my skin. Which I didn¡t see any, but just assume).

  3. Assuming she got blood or secretions on her hands, will the virus get me infected through my urethra?

  4. my anxiety is totally controlling me now, I start thinking of some stupid situation. Since during the whole process I¡m too relax and my eyes were closed, what if she actually did have sex with me which puts me at risk? (Although I totally knew that the feeling is different, and my penis is full of massage oil. Also in my memories the massage bed didn¡t moved at all). But since my eyes were closed all the time I started to get anxious on this ¡what-if¡ case.

  5. Since I was too scared in this experience, I went to take a Ultrasensitive RNA PCR test on day 9 after this experience. And it was undetected. My concern here will be how accurate is the test (I asked the clinic and they said it¡s over 95% accurate. But the extremely short window period is what makes me doubt the result. And I knew RNA PCR is a supplemental test to an antibody test. ) so I just want to know the actual accuracy of it.

  1. Will a Ultrasensitive RNA PCR increases the accuracy more comparing to the normal RNA PCR test?

Here are my 6 questions and concerns that put me into a serious anxiety. I really need a clear and professional answer to all of it to make my head clear and hopefully take away my anxiety and move on. Thank you so much!

Answer

I'm categorizing this one under "HIV Transmission - Non sexual risks" because there were no sexual risks in the scenarios you describe, hence no risk of HIV. But let's look at the questions medically one by one:

(1) This is an extremely unlikely scenario, but even if she did somehow find a way to use her vaginal fluids without your consent, it would still pose no risk of transmitting HIV. Why is that? Because HIV must be transmitted directly from the mucous membranes of one person to another person. It cannot live outside the body, even for a second, and cannot be transmitted through casual contact such as touching, hugging, kissing, crying, rubbing genitals, or her rubbing vaginal fluids from onto your penis.

(2) If blood had been involved you would have seen it later. Blood is messy, it stains. At some point this would have become visually apparent to you.

(3) No. See #1. The only way you could acquire HIV in your urethra is through direct penetration of another person's vagina or anus. And that person would have to be HIV+ and detectable (not on medications) in order to transmit HIV to you.

(4a) This is a little confusing to me. Are you asking if she could have inserted your erect penis inside her and had sex with you without your knowing? I don't think this is possible. Even if a relaxed state we know if our penises are penetrating other people's bodies. I have a very hard time believing in a scenario where someone could unwillingly have you insert yourself inside her with your eyes closed without your consent.

(4b) Let's say for the sake of argument that she did have you penetrate her vagina without your consent AND that she was HIV positive AND that she had a detectable viral load (many "Ands" to consider). Even under those circumstances, the chances of you acquiring HIV as the insertive (or "top") partner are nearly zero (https://www.poz.com/article/HIV-risk-25382-5829). It would be very unlikely to nearly impossible for you to get HIV from one exposure through vaginal sex.

(5) You already have the answer to this. RNA tests are extremely sensitive and will likely detect an HIV infection within the first 10 days for most people.

(6) It could, or you could just wait a couple weeks and get another test to confirm what you already know: You could not have gotten HIV from this encounter.

I know that medicine and science will be of little comfort. But it's your imagination here that is causing distress, not the massage itself. It's sad to me when I see human connection and touch result in so much fear and terror. But I do invite you to be rational and fact-based in your approach to navigating your fear. HIV is not casually transmitted through touch. Massages are a beautiful way for people to connect. And it would be extremely unlikely that a person would use her vaginal fluids or blood without your consent, nor that you could penetrate her without your knowledge.

I encourage you to familiarize yourself with the actual risk factors for HIV (http://www.thebody.com/content/30024/hiv-transmission.html), and consider ways that you can connect and seek touch in ways that lead to feel empowered, joyful, and appreciated.