Dr. Seikhoo Bishnui
Psychiatry
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I had been to a spa for a body massage. I had given the female massage therapist fingering, and she also cummed on my fingers. Not sure if I had touched my penis with her cum, and also, there were no cuts on my fingers. There was no penetrative sex vaginal, anal, or oral. I am worried now about HIV(Human Immunodeficiency Virus) and other STD(Sexually Transmitted Disease) infections. Please advise if this activity is high-risk for HIV and other STD infections? Please advise as I am a little worried. Should I need to do any testing for HIV? Can I take PEP(Post-exposure Prophylaxis) treatment? I had a discussion with the spa massage therapist who did massage to me if she had ever tested herself for HIV, syphilis, herpes, or hepatitis viruses; she told me that last year one of her family members needed blood for an operation, and she had donated her blood and during that she got herself tested. She did not have to perform any testing this year; however, but she also mentioned that she does not offer sexual service to any client. Based on this information, will the risk of HIV, syphilis, herpes, and hepatitis virus infection be nil in my case? I am getting married in the coming month, so I wanted to know if I have to get tested for all the STDs once. If yes, when can I get tested?
Please help.
Hi, Welcome to icliniq.com.
I understand your concern. If we consider the transmission of HIV, then the risk is almost nil in the sexual activity you had. HIV (human immunodeficiency virus) dies in coming contact with air. Even if we assume that the finger touched the penis, there is no risk. You are safe. No need to go for HIV testing or start PEP (post-exposure prophylaxis). Now coming to other STDs, yes, there is a risk of transmission of minor treatable STDs if your finger had touched the tip of the penis. But the risk is extremely rare and no chances of infection. You can sit relaxed. Most spa therapists do not engage in penetrative sexual activities and they follow safe practices. You are safe. Now coming to your main question. I would advise you to go for an STD (sexually transmitted diseases) screening before marriage. There is no harm in going for that. This is a routine practice that should be followed by any sexually active individual. I hope this helps.
Patient's Query
Hi doctor,
Thanks for your reply.
One more piece of information I need to add is my penis foreskin had come back while the spa therapist gave me a handjob and after I had made her cum I touched my exposed penis head with the same hand and pulled my foreskin back. I had some amount of vaginal fluid on my hand which I wiped off before adjusting my penis foreskin. Am I still safe from HIV inflection? When you say the HIV dies when it comes in contact with air, does it mean immediately after I pulled out my fingers from her vagina the HIV would have died? Also, I want to understand how HIV only manages to get transmitted by unprotected vagina-penile intercourse? What happens during such intercourse which enables HIV transmission? I have taken a few STD tests in the meantime which have come, negative doctor. I am attaching the same. Am I free to lead a normal life without worrying about any further testing?
Please help.
Hi, Welcome back to icliniq.com.
I understand your concern. You are safe because your hands were dried when you touched your penis. Human immunodeficiency virus (HIV) gets transmitted when fluid to fluid transmission or contact occurs. The results are fine and you can sit relaxed. Always follow safe practices. I hope this helps.
Patient's Query
Hi doctor,
Thanks for your reply.
I am having anxiety and guilty feeling due to these tests and waiting for the results. I am feeling guilty for going to massage and performing this act. As I had gone to this place with an anxious feeling and was not sure why I planned in visiting this place. I keep questioning myself about this entire act that took place. I am also losing concentration at my work. Please advise on coping with this mental experience and returning to my normal life.
Please help.
Hi,
Welcome back to icliniq.com.
I understand your concern.
Please do not feel bad about this. Try to remain relaxed and feel better that at least you followed safe practices. What is wrong and what is right depends upon the boundaries we set. Do not feel guilty, just remain relaxed that you are safe. The test results are negative and there is no need to get worried. Focus on your work and try to suppress the anxiety. The more you engage in work, the more you will forget about that incident. This is normal and a lot of people visit massage parlors these days. Just do not feel bad about this.
I hope this helps.
Patient's Query
Hi doctor,
Thanks for your reply.
Could you please check my tongue for any oral thrush? I am noticing some oral thrush today on my tongue. I have attached the pictures of the same. There is oral thrush forming at the internal part of my tongue. I read that oral thrush shows as a symptom of HIV-positive individuals. After noticing the oral thrush, I am little shocked.
Please help.
Hi,
Welcome back to icliniq.com.
I understand your concern.
I do not think this is oral thrush. This is sure. This could be some other skin issue like oral lichen planus that is not related to human immunodeficiency virus (HIV). So you can sit relaxed. It is difficult to make a diagnosis by seeing pictures. You can visit a dermatologist for evaluation. But stop worrying about HIV. Oral thrush is observed in the late stage of illness.
I hope this helps.
Patient's Query
Hi doctor,
Thank you for your reply.
I have a doubt, if I had swallowed or came in contact with the female's vaginal fluid or cum or blood with my mouth during this act, would that cause any HIV inflection? Also, please prescribe a mild medication for anxiety and stress, which I can use for one week to control my negative thoughts and constant questioning which is going on in my mind.
Please help.
Hi,
Welcome back to icliniq.com.
I understand your concern.
If we consider saliva, then saliva is not a suitable medium for the survival of HIV. Saliva is hostile to HIV (human immunodeficiency virus). So unless you have active bleeding lesions, even if you put her vaginal fluid in your mouth, you are safe. So stop worrying about that. Oral sex carries a minimal risk of transmission of HIV. Still, I would suggest you always to follow safe practices. I suggest you can use tablet Etizolam in 0.25 to 0.5 mg once or twice a day when required. This will relieve your anxiety. You are safe, and do not worry about anything.
I hope this helps.
Patient's Query
Hi doctor,
From last night l started getting night sweats while sleeping. My face, neck, and hair are all sweating. There is no AC in my house, but not sure if this is due to the summer temperature. I do not have any fever or sore throat, or other symptoms. Only night sweats. I have these reports at the moment, which I have taken one and half days post-exposure. Please advise if these night sweats are related to HIV Inflection? I am very worried now as I do not want this in my life. Please advise if I have performed any other tests to rule out HIV Inflection?
Please help.
Hi,
Welcome back to icliniq.com.
I understand your concern.
Night sweats or sweating are not symptoms of HIV. These are due to anxiety only and not due to any other issue. So remain relaxed. The test reports are fine. But if we consider HIV tests, then an antigen-antibody test done after four weeks of exposure rules out HIV in most cases. After four weeks of exposure, this sensitivity test accuracy is 98 % to 99 %. But the sexual activity you engaged in has negligible carrier risk. So stop worrying about that. I do not think there is a need for more tests. Just remain anxiety-free and do not overthink.
I hope this helps.
Patient's Query
Hi doctor,
I have been feeling kind of low and demotivated lately. I am feeling low on energy and not sure if this is an HIV symptom. My father is also not keeping well, and I am unable to support him also morally as I am going through so many health-related dilemmas of myself. I got into the habit of reading your replies often to get reassurance repeatedly.
Please help.
Hi,
Welcome back to icliniq.com.
I understand your concern.
But believe me, you are safe if we consider the transmission of human immunodeficiency virus (HIV). HIV does not spread so quickly. As I mentioned earlier, you have to keep the focus on your work. You should focus on your daily life and avoid analyzing the symptoms. You have no HIV risk. There was no penetrative sex nor any risky sexual activity. So stop worrying about this. Feeling low, low motivation and reduced energy are due to overthinking and mild depression due to these thoughts. These are not at all related to HIV. Fear of infection, illness of your father, and overthinking result in these symptoms. Please try to relax. You are safe. I can say this with complete confidence.
I hope this helps.
Patient's Query
Hi doctor,
Thank you for your reply.
I started having these symptoms yesterday. It has been two weeks post the spa massage and fingering exposure. Current symptoms are tiredness, extreme exhaustion, mild sore throat, fatigue in the legs and thighs, stress, and confusion. I do not have fever or temperature, rashes, diarrhea, headaches, weight loss, or cough. Yesterday I checked my sugar levels and BP. They are normal. I know, doctor, you had confirmed and advised me that my exposure is not enough to get HIV but as the above symptoms showed yesterday, I gave my blood test for HIV antibodies ELISA and P24 antigen ELISA yesterday. Please advise if I am going through the seroconversion phase? Will these above two tests be enough to detect or rule out HIV inflection in my case?
Please help.
Hi,
Welcome back to icliniq.com.
I understand your concern.
No, this is not a seroconversion. Please do not read much on the internet. This will increase your anxiety. The tests will come negative. I am confident in that. At 16 days of exposure, the sensitivity is close to 90 %. Please remain relaxed. Some of the symptoms are due to anxiety only. A mild sore throat can occur due to an allergy or cold. This cannot denote HIV infection. You have no fever. So do not worry.
I hope this helps.
Patient's Query
Hi doctor,
Thank you for you response.
My reports have come and the tests are negative. Please review and advise if I should go for another confirmatory test after three months or if I must forget about this incident and move on.
Please help.
Hi,
Welcome back to icliniq.com.
I understand your concern.
The test results (attachment removed to protect the patient’s identity) are negative. In my opinion no need to go for any more tests. Just remain relaxed and avoid overthinking. You are safe and have no risk of HIV.
I hope this helps.
Patient's Query
Hi doctor,
Thnak you for your reply.
Since today I have had a dry cough. I am not getting any phlegm, and I also do not have a fever. I just wanted to inform you about this new issue.
Please help.
Hi,
Welcome back to icliniq.com.
I understand your concern.
This is just because of mild URTI (upper respiratory tract infection) or could be allergic. Do not get afraid or worried because of this. You are safe. Ignore minor symptoms. There is no fever or no symptoms of severe flu. Remain relaxed for that.
I hope this helpes you.
Patient's Query
Hi doctor,
Thank you for your reply. I see some red spots on my penis head and red rashes on the inner part of my foreskin. There is no itching or pain in that area. There is no burning sensation also during urination. I still have a mild dry cough even now. It has been 25 days now post the spa massage exposure. Please advise if these are related to syphilis or herpes, or is this normal? My initial VDRL test came negative after three days post-exposure. Should I need to repeat VDRL(Venereal Disease Reasearch Laboratory) and herpes tests? Please help.
Hi,
Welcome back to icliniq.com.
I understand your concern.
I do not think that is related to herpes or syphilis, but I would suggest you to get repeat VDRL (venereal disease research laboratory) and herpes tests done. However, your sexual activity was safe. At three days of exposure, the tests have no value.
I hope this has helped you.
Please follow up with the results.
Patient's Query
Hi doctor,
Thnak you for your reply.
Attaching the pictures again doctor.
Please check.
Hi,
Welcome back to icliniq.com.
I understand your concern.
I hope there is no itching over that part. I am sure this is not related to herpes or syphilis based on the picture you uploaded (attachment removed to protect the patient’s identity). This is normal erythema and nothing else.
I hope this helps.
Patient's Query
Hi doctor,
Thank you for the response.
My dry cough is still present, but I do not have breathing issues or wheezing sounds. It is not constant, and I get it mostly during the evening. Please prescribe a good medicine to get completely cured of this dry cough. I had taken Chlorpheniramine maleate syrup two times a day for one week, but that only reduced my symptoms by 30 %. Since this dry cough is not going, I am getting worried if this is due to HIV inflection.
Please advise.
Hi,
Welcome back to icliniq.com.
I understand your concern.
This could be an allergic cough because it occurs at a particular time of the day, not an human immunodeficiency virus (HIV) symptom. You can take any good anti-allergic like the tablets Levocetirizine 5 mg and Montelukast 10 mg to relieve the cough. The tablets should be taken regularly to get proper relief from cough. You are safe. Just remain relaxed.
I hope this has helped you.
Patient's Query
Hello doctor,
Thank you for your reply.
I have taken another round of sexually transmitted disease (STD) tests after 30 days of the spa massage and fingering exposure. Please review them and advise. I hope these tests after 30 days are confirmatory for my exposure. I just wanted to forget the entire incident and move ahead. My dry cough has now healed completely. And I thank you for being with me for the whole of the one month during my doubtful and stressful situations. I just wanted to leave the whole HIV situation and move ahead in my life.
Thank you.
Hi,
Welcome back to icliniq.com.
Yes, the test is negative, and you can completely forget the human immunodeficiency virus (HIV) thing. Ignore minor bodily symptoms like mild fever, flu, or sore throat. These are common infections and do not denote HIV. You are negative and now try to move past this. Just remain relaxed.
Avoid any high-risk sexual encounters in the future too.
I hope this has helped you.
Take care.
Patient's Query
Hello doctor,
Thanks for your confirmation on confirming that my HIV status has remained negative. I wanted one last piece of advice from you. The test result value taken on the 21st day was 0.142, and the value taken on the 31st day was 0.184. There is an increase in the result values. Does that mean this value will increase in the next HIV test if taken? Does this numeric value have any significance? And can I say that I am HIV-negative with these results?
Please advise.
Hi,
Welcome back to icliniq.com.
No, the values have no meaning. The test is an immunological test, and it is either negative or positive. The values denote nothing.
I hope this has helped you out.
Patient's Query
Hello doctor,
I need your opinion and consultation on my below concern. Yesterday our gas stove had some functional issues. So I went to a nearby stove repair mechanic and got him on my scooter to my house to repair the furnace. The shop which he works is known shop as we had purchased from that shop couple of times. So after the mechanic had repaired the stove, I took the mechanic back to the shop to drop them off. While I was riding back, I felt a minor pricking sensation on my right hand near my triceps the mechanic was holding some tools in his, and I think it has pricked me. I touched and saw if there was any bleeding from that pricked place on my bicep area. There was blood or swelling. The mechanic was a man in his mid-30s who looked healthy, neat, and lean. Today morning also I checked the tricep area where I got hurt, there are no cut marks or swelling, but there is mild pain if I touch it. Please excuse me if I am asking a very illogical question. I just needed your opinion. I was worried and wondered if the mechanic was holding a blood-inflected sharp object which had been pricked. And if this might lead to HIV inflection. So I did not stop the vehicle and look at my hands and what he held. But he was having a pair of cutting players. I read on the internet that there are a few incidents where HIV-positive people are intentionally pricking others by drawing their own inflected blood and injecting it onto others with syringes. This thought has come, and I needed your honesty and thoughtful advice. I am not sure if it is my anxiety or my thought process which is causing these worries. I am sorry for my wild imagination.
Please help.
Hi, Welcome back to icliniq.com.
Why would a mechanic whose whereabouts are known to you dare to prick a sharp object on you to transmit infection? First, it is not possible to share infection by this mode. Human immunodeficiency virus (HIV) dies in seconds of coming in contact with air. So it becomes practically inactive. Deep inoculation is needed to transmit infection. I hope this has helped you out.
Take care.
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