Can I get HIV via hand job, fondling or sucking the breasts of a sex worker?

Question

Hi doctor,

The incident happened a few days ago. I had asked for a massage service. The service person washed my body and did a soft hand job using a lotion and a soap. Then, later on, I was wearing my underwear during the massage, and she was fully naked. I sucked her chest and nipple heavily, but I did not notice whether she was a lactating person. I asked her about her actual job. As she is a sex worker and I have seen two customers before me on the same day. I noticed a healed skin rash on her right shoulder. When I asked, she said it was not an allergy, and she had this since her birth in that region. Can you please advise if such an experience may transmit HIV? Is hand job a risky or a safe sex practice? Can I get infected with STD via hand job as it lasted for less than three minutes, and I asked her to stop? She is unmarried and not sure if she is lactating, and I did not taste anything. Is it possible that licking her chest or nipple may transmit any STD? In particular, HIV? I have a regular partner I am trying to avoid for a week since this happened, and I am unsure if I can get into my everyday sex life again. Is it safe to resume my regular life with my partner? Does HIV or STI usually transmit through a micro crack or damaged skin? I started to feel headache and night sweating after 20 days of this incident. And I can feel my lymph node while swallowing and not feeling well. I am very concerned, and I wish this never happens. I cannot get it over. Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your query. On seeing the history, the chances of acquiring sexually transmitted infections are meager. We cannot say that it is impossible, but the chance is significantly less. Hand job is not risky, but it is not a safe sex practice, too, as we do not know if those hands are contaminated with the pathogen, which can cause sexually transmitted diseases. Indulging in practices like sucking the breast can sometimes but not always, lead to exposure to breast secretions or discharge. Sexually transmitted infections can spread infection very quickly through a damaged skin than non-damaged skin. The chances that you may have acquired sexually transmitted diseases like HIV (human immunodeficiency virus), hepatitis B, hepatitis C, etc., are significantly less. However, I cannot say that it is impossible as you are exposed to a community sex worker.

My suggestion is to get yourself tested for RPR (rapid plasma reagin) and HIV 1 and 2 antibodies, hepatitis C antibody, and hepatitis B surface antigen after three months from now using ELISA (enzyme-linked immunosorbent assay) methodology. For now, you can get your blood tested for HIV p24 antigen, which is the earlier marker of HIV infection as you have few symptoms. Those symptoms can also be psychological. For three months (window period), it is better to avoid unprotected sexual practice with your regular partner until you get your blood tested for those I mentioned above. Stay calm. Do not worry. I suggest you avoid sexual activity with community sex workers in the future. Stay healthy, Stay fit. You will be alright. Take care.

Answer 2

Hi,

Welcome back to icliniq.com.

I advised for those tests because of the following reasons,

1. Those four tests that I mentioned are RPR for syphilis, HIV, hepatitis C, hepatitis B, which are the usual infections transmitted following exposure to any secretions from infected community sex workers.

2. As you mentioned, she is a sex worker, and she was fully naked at the time of massage. There are many chances of exposure to secretions like vaginal secretions and breast secretions which we cannot exclude.

3. Exposure to any secretions from the infected individual with a mucous membrane or damaged skin, even in microscopic amounts, adds up the risk of transmission of the disease. However, it is significantly less (we can never say it is zero, which depends on the factors like viral load, etc.).

4. Coming to the risk factors, we can never tell if you had any micro-injuries to your skin or mucous membrane, which is not usually not felt or visible to the naked eye.

5. Your contact with the community sex worker in terms of exposure and activity, which you mentioned, are extremely rare because of low infection transmission or shallow risk of transmission. Still, there is a possibility of transmission of sexually transmitted infections (but never zero risks).

At this moment, we may not know if you had any mucosal exposure to secretions like vaginal secretions or breast secretions. When you stimulate a female nipple by fondling or sucking, the nipple can stimulate milk ducts to secrete fluid. These kinds of liquids can transmit the infection when in contact with the damaged skin or mucous membrane. I want to make sure that you never acquired any of those infections, even though the risk of transmission is significantly less, and you had few symptoms like night sweating, feeling unwell, and feeling the lymph node. I want to make sure 100 percent that you are healthy. Kindly avoid these circumstances in the future to avoid unnecessary worries. We want you to be healthy. We want to make sure that you never acquired any sexually transmitted infection following the exposure. You will be fine very soon. Take care.