Dr. Rakesh Kumar Bahunuthula
Dermatology
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,
Last month I visited a spa for a body massage. I did fingering, touched, and sucked the nipples of the female massage therapist. She also had an orgasm. The foreskin of my penis came back during her handjob, and she used her mouth. I touched my exposed penis head and pulled my foreskin back. She had a vaginal discharge. Then, I wiped my penis and hands. I do not have any wounds on my hands and fingers. We did not have penetrative sex (vaginal, anal, or oral). I took HIV (human immunodeficiency virus) tests after sixteen days and STD (sexually transmitted disease) tests after two days. Both the results were negative. When I spoke with the massage therapist, she told me she took screening tests while donating blood for her family member last year. She did not undergo any tests this year, as she did not have any intercourse with anyone. Should I be concerned about HIV infection?
Hi,
Welcome to icliniq.com.
I understand your concern. From the details provided, your risk of exposure is very low or negligible. Because there was no contact with the body fluids. However, you should undergo screening tests as it was a therapist. I suggest you to take the following tests. Take fourth generation test for HIV (human immunodeficiency virus) test after four weeks of exposure. Take VDRL (venereal disease research laboratory) test, HBsAg (hepatitis B surface antigen) test, anti HCV (hepatitis C virus) test after one month of exposure. Reduce your anxiety with yoga and meditation.
Patient's Query
Hi doctor,
Thank you for the reply. I have attached my fourth generation p24 antigen test report which I took after sixteen days of exposure. The result is negative. Should I be concerned? Kindly advice.
Hi,
Welcome back to icliniq.com.
From the report attached (attachment removed to protect the patient's identity), you have a low risk. Repeat the fourth generation test after four weeks of exposure for confirmatory diagnosis. You should also undergo other tests which I mentioned earlier. I hope this has helped you.
Patient's Query
Hi doctor,
Thank you for the reply. I have taken all the STD tests after 30 days of exposure. My dry cough has healed completely. I want to lead a normal life. Please help me.
Hi,
Welcome back to icliniq.com.
From the reports attached (attachment removed to protect the patient's identity), your results are negative. Use condom hereafter and have a monogamous relationship to lead a normal life.
Patient's Query
Hi doctor,
Thank you for your reply. The test result value taken on the second week of this month was 0.142 and the fourth week was 0.184. So, there is an increase in the result values. Will this value increase in the next HIV test? Does this numeric value has any significance? Am I HIV negative? Kindly suggest.
Hi,
Welcome back to icliniq.com.
The value is based on colorimetry reading and does not have any significance.
Patient's Query
Hi doctor,
Thank you for your reply. I have a doubt. A cutting plier used to repair the gas stove caused a pricking sensation on my triceps in the right hand. A mechanic held the tool while picking him up from the shop. He looked like a 30-year-old man, lean, neat, and healthy. There were no wounds or bleeding, or swelling in the area. However, today morning, there was a mild pain while touching. I became anxious when I read on the internet that blood-infected sharp objects can produce HIV (human immunodeficiency virus) infection through skin cuts. Also, HIV-positive people do this intentionally by injecting their blood into others. Did the mechanic prick me with the infected tool? Should I be concerned? Please help.
Hi,
Welcome back to icliniq.com.
HIV (human immunodeficiency virus) cannot survive outside the human body. The chances of the infected tool pricking you is low due to poor exposure. So do not worry and no need of any testing. Do meditation and yoga to divert your mind. Are you vaccinated with tetanus toxoid injection in the last three years? If there was an injury, you should take TT (tetanus toxoid) injection within 24 hours.
Patient's Query
Hi doctor,
Thank you for your reply. I did not get any open cut or needle prick, or bleeding wound during that incident. It was a blunt object injury with pain. So I applied Omni gel for two days and recovered now. And I have taken a TT dosage three years back. Just for my understanding, should the blood on a sharp object or a needle from an HIV-positive person be fresh to cause an inflection when pricked onto an HIV-negative person? How long can the virus survive on the tool? Will the blood become dry inside the syringe? I will start yoga and meditation.
Hi,
Welcome back to icliniq.com.
It is a hypothetical discussion and does not hold any meaning. As there was no prick, you can move ahead and try to focus on good mental health.
Patient's Query
Hi doctor,
Thank you for your reply. To be safer, I have done another round of all STD testing three months after my previous spa massage exposure. The hepatitis B surface antibody, anti-HBs value, is shown as 141.41 mIU. Kindly advise what does that parameter or value indicate? Does this mean I am hepatitis B positive? Also, I am mentioning my exposure history. Last month I visited a spa for a body massage. I did fingering, touched, and sucked the nipples of the female massage therapist. She also had an orgasm. The foreskin of my penis came back during her handjob, and she used her mouth. I touched my exposed penis head and pulled my foreskin back. She had a vaginal discharge. Then, I wiped my penis and hands. I do not have any wounds on my hands and fingers. We did not have penetrative, vaginal, anal, or oral sex. I took HIV (human immunodeficiency virus) tests after sixteen days and STD (sexually transmitted disease) tests after two days. Both the results were negative. When I spoke with the massage therapist, she told me she took screening tests while donating blood for her family member last year. She did not undergo any tests this year, as she did not have any intercourse with anyone. Should I be concerned about HIV infection? I have attached all the latest reports. Kindly suggest your opinion.
Hi,
Welcome back to icliniq.com.
I have reviewed your attached reports (attachment removed to protect the patient's identity). With regards to HIV (human immunodeficiency virus), you are negative. As the tests are done well beyond the window period and include even p24 antigen, the result can be taken as conclusive, and no further testing is required. Even hepatitis C, RPR (rapid plasma reagin), and herpes antibodies are negative; hence no infection of syphilis, herpes, and hepatitis C. However, the result suggests that you are positive for hepatitis B. This would require further investigations to see if the infection is active or latent and then plan your treatment. You would have to consult a gastroenterologist for the same. Thank you.
Patient's Query
Hi doctor,
Thank you for your reply.
May I know what can be done next? Kindly suggest.
Hi,
Welcome back to icliniq.com.
Nothing is required at the moment.
Patient's Query
Hi doctor,
I just came across a video on the internet mentioning that PCR testing for HIV is more accurate than other HIV testing methods like ELISA or ELIFA methods. So requesting your clarification on the same. Kindly suggest. Thank you.
Hi,
Welcome back to icliniq.com.
PCR (polymerase chain reaction) test for HIV (human immunodeficiency virus) is more helpful in known HIV patients to assess the response to the treatment. Any test by any method done beyond 12 weeks of window period is equally good. Only when done before 12 weeks does the accuracy matter. You will find much-unregulated information written by any lay person on the internet. Kindly stick to standard websites for reliable knowledge. Otherwise, you will lose your peace of mind. I hope this has helped you. Thank you.
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Dermatology
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