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Can hiv be transmitted by the hard penis head with pre

cum brushing the skin of...
can hiv be transmitted by the hard penis head with pre cum brushing the skin of another person for just a second ot two- no penetration.at all
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Answered in 1 minute by:
1/4/2011
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18,892
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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DrDLove :

It is theoretically possible, but the likelihood is vanishingly small.

JACUSTOMER-31exc65p- :

what do you mean `vanishingly `small?

DrDLove :

The HIV virus is actually relatively hard to transmit.

DrDLove :

Even with full intercourse, the likelihood of a single sexual encounter is very low.

DrDLove :

Vanishingly small means that the risk is so low that it would be impossible to measure.

JACUSTOMER-31exc65p- :

just in case it brushed the body part in between the buttock cheeks or even brushed the top of the anus opening?

DrDLove :

It is theoretically possible, but the risk is extremely low

DrDLove :

The risk would [rimarily exist if there were contact with mucosa, which is the moist ling of the anus or genitals.

DrDLove :

HIV is not transmitted through intact skin in other locations.

DrDLove :

The reason the risk is so low is the fact that the contact was so brief.

JACUSTOMER-31exc65p- :

since it most certainly did not touch the anus - the question really is what if the penis head touched the buttocks and the surface had any pimples or lacrerations?

DrDLove :

If there were a sore or laceration, that would increase the risk, but the brief nature of the contact wold still make the risk extremely low.

JACUSTOMER-31exc65p- :

i assume for transmission to happen, the penis head must have been in direct contact and not merely the tip of the foreskin?

DrDLove :

There is some risk of transmission by the pre-cum, even if only on the tip of the foreskin, but again the risk is extremely low.

JACUSTOMER-31exc65p- :

would there be some symptoms to watch out for in case transmission happened?

DrDLove :

The early symptoms of HIV are very non-specific and mimics the flu.

DrDLove :

The current recommendations in the US is that everyone that is sexually active should be screened regularly for HIV.

JACUSTOMER-31exc65p- :

and how many days later does such flu like symptom, if any, appear typically?

DrDLove :

Even though this encounter has no significant risk, there is some risk from other sexual encounters.

DrDLove :

Usually, the acute symptoms develop 2-4 weeks after transmission.

DrDLove :

In some people the symptoms are minimal, so may not be recognized.

JACUSTOMER-31exc65p- :

thank you doctor

DrDLove :

You're welcome.

DrDLove :

Please remember to click the Accept button so that I may get credit for my work.

Dr. D. Love
Dr. D. Love, Doctor
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Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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Customer reply replied 6 years ago
Doctor. I am the male whoose hard penis (uncircumcised) brushed against a massessue`s body and the penis head and side rubbed against it. If the body had rashes or pimples, could those transmit hiv to me

A rash would usually not cause loss of integrity of the skin. However, if there were a rash, pimple, or other sore that causes loss of integrity of the skin, such as with bleeding or seepage of bodily fluid, then there would be some risk of transmission. Even if present, the brief nature of the exposure would still make the risk extremely low.

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Customer reply replied 6 years ago
has there been any such cases you are aware of and for it to happen would it have to enter the urethra and/or the underneath of the foreskin- right?

There are reported cases of blood splatter onto a mucosal surface resulting in transmission, but I am not aware of a rash being documented as the source of the blood splatter. Yes, sexual transmission occurs by the virus entering the genital mucosa.

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Customer reply replied 6 years ago
my apologies- but I presume the seepage of fluids from a sore or rash would have to be extensive for a possible transmission to take place or could it simply be based on a limited or scanty flow?

Any amount of blood or seepage would have some risk, but the greater the amount of blood or fluid, the greater the risk. Also, the greater the amount of fluid, the greater the likelihood that the fluid would make contact with the partner's mucosa.

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Customer reply replied 6 years ago
I suffer from regular sinus attacks had a sinus attack 7 days after the event and it recurred intermittently over the next 3 weeks with a feverish feeling and light sore throat as I travelled to a quite a few cities and was exposed to cold weather extensively. . Finally I went to the Doctor who scanned and found chronic allergic rhintis and put me on antibioitics. During this time I had loose stool one day as well. After 10 days of antibotics my sinuses are clear but there is the usual sensation of post nasal drippin down my throat. Are these signs of hiv ?

HIV can cause flu-like symptoms that typically occurs 2-4 weeks after transmission, but it does not typically appear as a sinus infection 7 days after a potential exposure.

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Customer reply replied 6 years ago
Doctor- just for my sanity. would you consider my experience an extremely low risk or moderate risk, I cannot believe I was at risk in the first place!

This exposure would be extremely low. If you have been sexually active in a non-monogamous relationship, that sexual activity poses far more risk to you than this encounter, even if a condom was routinely used.

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Customer reply replied 6 years ago
what would be the typical signs I should expect after 2 weeks if hiv was transmitted?

The symptoms may include fever, headache, sore throat, and swollen lymph nodes. As you can imagine, the vast majority of persons that have these symptoms have a simple viral infection rather than HIV, so these symptoms usually do not raise concern. That is why the CDC recommends that everyone be regularly screened for HIV, as noted above.

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Customer reply replied 6 years ago
just one final question- does mild diarrhea accompany common cold infection?

Yes, it can accompany a simple viral infection, although it is a less common symptom.

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Customer reply replied 6 years ago
but is mild diarheaa noticed within 2-4 weeks of hiv transmission as a sign of early symptom?

No, not typically.

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Customer reply replied 6 years ago

Doctor- as you can see I am very nervous about this 'low risk' episode. Can I think a bit and come back to you later tonight or tomorrow. Please dont worry about payments- I will do the needful after we finish this conversation.

In the meanwhile please help me to understand if my chronic sinusitis and the subsequent infection which needed antibiotics could have been triggered by the hiv related virus?

No, the sinus infection would be unrelated to this exposure.

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Customer reply replied 6 years ago
If i may ask- why would the sinus attack be unrelated?

Because it would not be due to a direct infection of the virus and the HIV infection could not have progressed to the point of impairing the immune system in this short a period of time.

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Customer reply replied 6 years ago
pls tell me what the typical symptoms of common cold is and how is it different from flu?

There is a tremendous amount of overlap in symptoms, but congestion and sinus pain is more typical for a virus infection than with an early HIV infection. The flu tends to cause more significant fever, general malaise (feeling bad), and muscle aches.

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Customer reply replied 6 years ago

the hiv infection resembles the flu more- right?

Correct, with the symptoms noted above. The flu tends to cause more significant fever, general malaise, and muscle aches.

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Customer reply replied 6 years ago

dr Love- i hope you understand my anxiety. I went for a massage with no desire to have sex or be unfaithful (in my definition I suppose). But the masseuse sat down on me and took hold of my penis and rubbed on her buttocks and against the side of her back for a few seconds before I realised and took it out. . Ever since then I have been paranoid.

May I sign off now and maybe reconnect tomorrow?

you can re-connect at any time, just as you did earlier today long after our prior discussion.
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Customer reply replied 6 years ago
doctor- was wondering. I was told sex with condom is practially 100% safe. Yet you say my experience is even lower risk than that. Am I to assume therefore its largely a theoritical and remote risk and I should stop worrying about it?

Condoms are ~80-90% effective at reducing the risk of transmission of HIV and other fluid based STDs. But this reduction is relative to the risk of the sexual act (anal sex is higher risk than vaginal sex, which is higher risk than oral sex). These are not theoretic risks, in that they are based upon clinical studies. Even though the risk of a single exposure is low, the risk becomes more significant in persons that have repeated exposures. The risk of the recent encounter is more theoretic, as an extrapolation from the knowledge of viral transmission, which is what I told you in the first answer that I provided.

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Customer reply replied 6 years ago

just a question unrelated perhaps to the issue.

My sinus started bothering me on the 7th day after the said episode, stayed with me for 3 days, abated for a day and then as I travelled to another city- came back for a couple of days. Over the next 10 days i travelled to 4 different cities and every 2nd or 3rd day the sinus abated but came back as I got exposed to air conditioning or cold wind.- almost immediately as it got exposed.

Finally after what was 14 days of this intermittent attacks from the beginning; I went to the GP who said I had no fever , throat was clear but there was signs of an infection and he prescribed a 7 day general anitbitoic.

This reduced the sinus symptoms (light headache, sorish thraot and feverish) but the sinus again hit me 2 days after I completed that spell of antibiotics but very marginally so but was there.

This is when I finally went to a ENT specialist who did a scan, diagnoised chronic allergic rhinitis and put me on a 14 day antibitoic and has also recommneded Surgery for what he a called `acute s -shaped septum`.

Doctor-please tell me that these signs are all consistent with sinusitis and not a possible HIV related sign?

I have already told you that these symptoms would not be related to any possible exposure to HIV from this encounter. These symptoms could be from either an infectious process or an inflammatory process, but both would not be related to this recent exposure.

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Customer reply replied 6 years ago
Doctor- thank you. I shall endeavour to relax a bit now.

You're welcome.

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Customer reply replied 6 years ago
hi doc. my partner came down with a strep throat signs 3 weeks after i had unprotected sex with her. she has no fever but a cold and very light nasal drip type symptom. No fatigue either . Sign of hiv transmission from me?

HIV transmission would not cause Strep. If she developed the typical symptoms for HIV noted above, it is possible that she could have caught HIV from you, but the likelihood is still vanishingly small that you contracted HIV, so it is an equivalently small likelihood that you could have transmitted it.

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Customer reply replied 6 years ago
are her symtoms typically hiv symtom or should there be more signs?

A Strep throat would not be typical of an HIV infection. A simple sore throat can occur with an HIV infection. There may not be any other signs; indeed, there may not be any signs. Many people with HIV do not develop any symptoms during the early phase of HIV infection.

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Customer reply replied 6 years ago
whats the difference between strep throat and a simple sore throat?

Strep throat is an infection caused by the Strep germ, whereas a sore throat can be caused by many different germs.

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Customer reply replied 6 years ago
symptomatically they are the same?

Yes. A Strep throat tends to be more severe, but it is not always severe, and a severe sore throat can be caused by other germs, so severity does not reliably differentiate what type of germ is present.

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Customer reply replied 6 years ago
she teaches in a school where 3 of her kids have been down with strep throat. So I can assume its strep throat or is there a way to check it?

If she has been exposed to three kids with Strep, then it is very likely to be Strep. The test to confirm that it is Strep would be a rapid Strep test or a culture of the throat.

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Customer reply replied 6 years ago
thanks- will revert

You're welcome.

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Customer reply replied 6 years ago

the one thing that concerns me is that almost everything that is common withe weather changes and normal life (minor or major sore thorat, light or high fever) and even complete lack of these signs over a longish period (2 to 6 weeks) can be sign of HIV infection.

Is there nothing uniquely distinctive or at least unusual that is more symtomatic of hiv rather than common illnesses?

No, there are no uniquely distinctive symptoms early in the disease process. The only distinctive method to identify HIV infection is blood testing. It is only years later, when full blown AIDS develops, that there are characteristic symptoms.

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Customer reply replied 6 years ago
I read somewhere that early hiv symptoms invariably come with high fever as a pre requisite and generally with other signs like a severe sore thorat or rash or lymph node swelling. I presume those are merely statistics not evidence?

This is simply untrue. An early HIV infection can have these symptoms, but there are some people that have no symptoms at all. Therefore, these symptoms are not invariably present.

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Customer reply replied 6 years ago
essentially trying to check on symptoms in the first 2-6 weeks is really more stressful than instructive; especially given the nature of my risk?

Yes, even if you have symptoms, it still would be far more likely to be due to a different infection.

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Customer reply replied 6 years ago
what a mad house this world is Doc. Maybe hypochondriacs like me has no place here!

You just need to learn to deal with the way that you are.

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Customer reply replied 6 years ago

Let me tell you why I am so paranoid. I live in a place (Dubai) where every 3 years there is mandatory HIV testing and you have to leave if you are positive. Mine is due in 2 weeks time and my 'above exposure' (if indeed it was) could come up at this test. I have no chance of screening out the possibility as its withn the 12 week period.

I am therefore analysing every possible sign to assure myself and its obviously making me very stressed.

Maybe the problem really is Dubai and I should go and live somewhere eles and stop worrying like this very 3 years

Regardless of why the testing will be done, the risk of this recent exposure is vanishingly small, so there is little reason to worry. It still may be appropriate to consider moving, but that is a personal question rather than a medical issue.

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Customer reply replied 6 years ago
doctor- i was fine when you said my sinus attacks were unrelated. But I got really uptight when my partner showed these 'cold' signs after 3 weeks. She has a runny nose, a light sore throat but no malaise. And that set me to start stressing again

I don't know what else to tell you. Even with typical symptoms, it is far more likely that it is another type of infection. If you can't help but obsess about the situation, then it may help for you to seek counseling.

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Customer reply replied 6 years ago
I agree Doctor. I have decided to seek counselling after I decide whether to stay in Dubai or not. I am mature enough to know nothing in life is fool proof but I was wishing this was- thats all! Maybe because its tied to so many other decisions and obligations

Life is never simple. I hope that everything goes well.

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Customer reply replied 6 years ago

Doc. I understand completely that early symptoms of HIV are very general and may or may not happen and if it does happen, it can happen over a fairly long period, ie between 2 and 8 weeks post infection. I assume I am right here.

What I now need to understand is the chances of a person coming down with a common cold or flu simply because he/she is in an environment where a lot of people have it (its the season) is completely unrelated to whether he/she might have been infected.

In other words, what I am asking is: exhibiting cold and flu symptoms as an early sign of hiv is different to acttualy getting a cold or flu virus from the enviroment. Its just that the symptoms can be the same- am i right?

The symptoms are similar if they occur, but the underlying infection is different. It is only by testing that the underlying infection can be identified.

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Customer reply replied 6 years ago
is there a test to know whether its the common cold virus or flu virus since the HIV test can only be picked up conclsuively after 3 months

There is not an easy test for the cold virus. Specialized labs can perform tests, but there are so many different cold viruses there is no reason to develop the tests because it would mean that a simple office visit for a cold would generate a prohibitive expense to test for all of the possible viruses.

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Customer reply replied 6 years ago

I am sure I am becoming a real OCD now!

But regarding the cold/flu symptoms my partner exhibited; our live in house maid has the same symptoms now, plus I myself felt a bit like I had a 'cold symptom' plus 3 of her school children are down with cold and flu and yesterday our son startes sniffling a bit

My mind tells me its the 'cold after all'- given the evidence around.

Your comments?

These are almost certainly a simple viral infection. It is certain that neither you or your partner could have spread HIV to your maid or the children by casual contact (I am sure that you have not sex with them). Since all of these people are contracting the infection, it is something that would be transmitted by casual contact, such as a cold virus.

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Customer reply replied 6 years ago
I think so too. Thank you

You're welcome. Please remember to click Accept so that I may get credit for my work.

Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18,892
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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Customer reply replied 6 years ago

doctor- one question:

If a rash or rashes are due to HIV infection, is it:

1> Accompaned by fever?

2> over an extended patch or could it be 1 or 2 pimples

3> could it show up a 1 pimple on the finger

Yes, there can be a rash during the early phase of an HIV infection. If it happens, it usually occurs with other symptoms of an early HIV infection, including fever. It is usually a more diffuse rash, typically multiple bumps or blotches that are dark red or brown. It would not be 1 or 2 pimples on the finger or elsewhere.

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Customer reply replied 6 years ago
thanks doc. More later as i continue my journey toward mental sanity~!

You're welcome.

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Customer reply replied 6 years ago

Hi Doc- back again. Am i right in assuming that the only way the hiv virus could have been transmitted from my experience is if the masseuse`s body had a pretty open wound or bleeding skin and fluids from there got into the urethra. or under the foreskin and that too would have reqeuired extensive rubbing against the affected skin since the contact would have been surface to surface.

A normal skin with some rashes on it would not have enough fluids to transmit the virus- right?

Correct. There would have had to have been a source of blood or body fluid from the masseuse that then got to the tip of the penis. It would not have been transmitted from normal skin nor from most rashes, as most rashes do not result in seepage of blood or body fluid.

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Customer reply replied 6 years ago
is it possible for the precum on the penis head to be come in touch with the boddy fluids on the sore or the wounds (if any) and then transmit back the virus into the body

If there is blood or body fluid present that contact the tip of the penis, the presence of precum dies not increase or decrease the risk.

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Customer reply replied 6 years ago

Doc- I am pretty sure that the penis head did not directly contact the skin`s surface but may have brushed it. But what the masseuse did was to hold the hard penis up and rub the side against her lower back/upper buttocks for not more than 2 minutes at the most. So I am concerned if the foreskin (which did not go down the shaft ) could have attracted any fluids underneath or if the side tip did

Your first post said that it contact only a second or two and now you are saying that the contact was no more than 2 minutes, which may well be increasing in your mind because of anxiety. Regardless of length, it would need transmission from a source of the blood or body fluid to the tip of the penis. There is not a vacuum effect to draw the fluid to the penis tip; it would require contact for transmission.

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Customer reply replied 6 years ago

You are right Doc- I am losing it I think. For the life of me- i have not seen anyone (and did not notice on the masseuse) any glaring open wounds or open sores that was spewing out fluid. But I did see some skin acne type on her face. And now I am terrified she had open sores or burst acne that could have transmitted onto my penis head or under the foreskin.

Yet when I asked my GP about it, and then another friend who is a Doctor- they just dismissed it as a 'non risk` completely.

You are of course more knowledgeable and I find you saying 'low` risk and also saying there has been no documented cases like this.

What else could you tell me Doc to make me feel this is all my OCD playing up .

By the way I do suffer from OCD and there have been times in the past 8 years when I have had myself believe for long periods that I have HIV and then got tested and saw I was negative.

Now this imminent test in Dubai so soon after this experience when I have no time to rule it out before going for the test with the local authorities is driving me insane thinking 'what if the masseuse had something that transmitted HIV to me`.

Hence I am going round and round thinking.

Please tell me medically what my real risk was if the masseuse was indeed HIV positive but had generally healthy skin with no serious cuts or abrasions but maybe a few (didnt see any) acne type skin lesions on her body

It is not just low, it is vanishingly small, as noted above. There is nothing else that I can tell you beyond what has already been discussed. At this point, the only way for you to be reassured is to be tested to see that you are indeed negative. It may be better for your peace of mind to go ahead and be tested so that you can see that the test is negative. If you are hesitant or embarrassed to go for testing, then simply donate blood, as they would test all donated blood for HIV.

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Customer reply replied 6 years ago

Bear with me Doc on this question.

You say `vanishingly small` and thats obviously very reassuring. I assume you say this not merely from a statistical point of view but also medically?

By medically I mean that even if there were sores or wounds, there would have to be active seepage (not merely open) and that then would have to be in contact with the urethra opening or the inside of the foreskin for a decent period of time and must also ideally rub actively against each other for transmission to occur- right?

It is vanishingly small by every perspective. Yes, there must be seepage of blood or body fluid that would have to get to the tip of the penis. The period of time is also a factor that determines that your risk is vanishingly small.

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Customer reply replied 6 years ago

Doc- I will try and think all this through and maybe use a hammer on my head for sometime as well before I revert back to you.

Please bear with me- I am sure you have faced such neurotic cases before! I feel guilty about this so much that I almost think that if i stop worrying it will either be unfair to the problem or that someone wil think I am being ungrateful to the fact that I am safe or that if dont keep thinking about it ; it cannot be true that I am safe.

That's fine. The other option to help you deal with this would be to seek counseling, as noted above.

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Customer reply replied 6 years ago

Doc- to add to my worries.

I have always had from time to time little red boils and pimples on my back.

I have now had 3 separate ones in my back over the past 2 weeks and also 1 on my right chin and i last week on my left chin; all of which i attributed to stress/anxiety of my current state.

Today at the shower i drew my foreskin down and saw 2 little pimples on my penis tip. One ws red and round and the other was red but with a break in the middle.

I have no fever, no other symptoms of ill health.

I have been on a 20 day antibioitic course for my chronic sinusits and the course completes in 3 days.

what could all this mean?

There are several possible causes of this problem. It is possible to get simple pimples on the penis that are like other pimples, due to oil glands in the skin. It is also possible that this could be reaction to bacteria or yeast that has gotten under the foreskin. It is also possible that early herpes can present as small bumps, that will then progress to blisters or ulcers. You would need to be seen by your doctor to determine the cause.

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Customer reply replied 6 years ago

Doc- if its a bacteria or yeast infection- i presume it will go away soon.

Since I do have a foreskin, I try to clean the penis head regularly by pulling down the foreskin. Today when I did it I noticed that it was not very clean underneath as I have not been cleaning it regularly recently.

If its herpes- it will, as you said, develop into blisters or ulcers. I presume the herpes could be from my experience with the masseuse or is that unlikely?

If due to a reaction to bacteria or yeast, it may resolve spontaneously, but it may be a recurrent or chronic problem. If you have not been cleaning well lately, that would be the most likely cause, and regular cleaning may make the problem resolve. The herpes is transmitted differently than HIV in that herpes is transmitted by skin to skin contact rather than through blood or body fluid transmission. Herpes would have to come from contact with affected skin, although the fingers can serve as a mode of transmission if done quickly, meaning that she touched a sore on herself and then immediately touched you. The degree of risk is partly dependent upon the degree of contact. If the contact was only one or two seconds, as you originally stated, it is very unlikely to be transmitted in that way. If the contact was longer, then the risk would be slightly greater.

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Customer reply replied 6 years ago
while hiv transmission was unlikely as you said through my experience; the same experience could have very well led to a herpes infection?

It is still unlikely, but the HIV transmission is vanishingly low, and this is merely unlikely.

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Customer reply replied 6 years ago
why is that Doc? Isnt it the same fluids that transmit herpes that also transmits HIV or is Herpes more easy to transmit?

As I said above, herpes is transmitted differently than HIV, although it is also true that HIV is much more fastidious. But the primary difference is the ability for the hands to have played a role in the transmission, as noted above.

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Customer reply replied 6 years ago

Doc

Allow me to understand this.

A skin to skin contact can transmit herpes even if the affected person`s skin had no open sores or body fluids seeping - right? and the person transmitted to (me) could get it only if it touched on the skin wihtout it having to contact any mucosal or open surface- right?

The skin would usually have a herpes sore, but there can be shedding of the herpes virus even at times when no herpes sore is present. Herpes can also be transmitted to normal skin; it does not require a mucosal surface. You also don't know where her hand has been and if she touched elsewhere on her body that was shedding the virus and then touched your penis, that could transmit herpes, whereas it would not transmit HIV.

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Customer reply replied 6 years ago

Doc- what a predicament!

Allow me to ask:

1> So its possible to contract Herpes from someone but not HIV- even of that person is (assume) HIV+?

2> Herpes can be cured?

If its indeed Herpes-is it normal for it to show up as it did 8 weeks after the possible exposure?

Is it usually with no other symptoms?

Since the herpes is transmitted by skin to skin contact and HIV is transmitted by blood or body fluids, it is possible to have risk for transmission of one but not the other. Even if the person has both diseases and you had a full sexual encounter, it is possible to transmit the herpes and not the HIV as they are independent of each other.

There is no cure for herpes, although there are medicines that can help control the condition, such as Zovirax or Valtrex. Herpes can occur at a variety of times, but 8 weeks is possible. The typical presentation is the development of genital sores with or without pain or discomfort. Some people never develop visible symptoms, even though blood tests show that they were infected at some time in the past.

This is something that you can be seen now and the evaluation done to determine whether it is herpes so that you will not have to worry about it.

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Customer reply replied 6 years ago

Doc- I am embarassed about being a real pain. But may I ask:

These pimples on the penis are not some typical early sign of a possible HIV infection?

No, it would not be a sign of a possible HIV infection.

Dr. D. Love
Dr. D. Love, Doctor
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Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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Customer reply replied 6 years ago
Doc- I am worried but perhaps also in a strange way relieved that its not an obvious HIV sign. Allow me to pay you for this round and then we will talk again. Bloody Dubai!

I hope that you get some answers soon. Let me know if I can provide any further information.

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Customer reply replied 6 years ago

Doc- some questions;

1> Is herpes considered a STI disease or it can happen otherwise as well through touch?

2> What would be the simple rules to avoid transmitting to your partner and children and others?

3> If left untreated, will it go away and recur again or will it cause complications left untreated?

4> Does it normally only happen where contact was made or does it spread to other parts?

Please advise

Genital herpes is a sexually transmitted infection. Although the hand can play a role, it must happen quickly, so is performed during a sexual encounter. There is no concern about transmission occurring from casually shaking hands or other types of hand contact. The herpes virus will typically only infect the skin in the genital region, although it is not limited to mucosal surfaces and can affect surrounding skin. It also can cause oral sores, but not be widespread on the body. Herpes tends to resolve spontaneously and then flare-up periodically, although the pattern varies from no flare-ups to frequent flare-ups. The general recommendation to avoid transmission is to avoid intercourse when there is an active lesion and to use condoms, but this does not work perfectly, as there may be viral shedding even when there is no active sore and condoms are not perfect at preventing transmission.

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Customer reply replied 6 years ago
Doc- let me understand this. You said Herpes can be transmitted skin to skin. so why is sexual activity , which then implies sexual fluids, be necessarily always involved?

Since it involves genital skin, it involves touching of one person's genital skin with another's, which usually only happen during sex. There actually does not need to be any penetration, nor any completion of the sexual act, but the vast majority of the time that people are exposing and contacting genital skin is during sex.

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Customer reply replied 6 years ago

So unless there is a direct genital to genital contact, the only way it could have been transmitted is through the hands after it touched her genitals as there are no other herpes areas? or are there?

But for HIV, it has to be more than genital to genital contact- it has to be direct `entry` of the infected body fluids from the host to the target?

The buttocks are included int he skin around the genitals, but also the hands going directly from the one person's genital region to the other's. The only other area affected by herpes is the mouth, as noted above. HIV must include exchange of blood or body fluid, not just skin contact.

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Customer reply replied 6 years ago

Doc- You already know my state of paranoia.

The way I see it- if a person is hiv+ (the massuese) and also had herpes- I got saved from HIV only because, (in the absence of a sexual act anyway) my penis head or the skin under the foreskin did not come into contact directly with body fluids from either her vagina or anus and the scope of enough blood flowing from a sore, etc (in this case could have been a herpes sore now) and making direct contact was remote.

However I mught have contracted herpes either because her hands touched her genitals and then my penis head or if my penis head touched the buttock cheeks?

Sounds like one should worry about Herpes more in future. Are there much many more such cases reported where someone got herpes from a hiv+ partner but no HIV, even wiht unprotected sex?

Doc- Please give me a full comment on this statement for my sanity

First, your chances of both are unlikely to vanishingly low, but the herpes is more of a risk. The degree of risk is also dependent upon the length of contact. One or two second contact with the skin of the buttocks is far less risk than a two minute contact. Herpes is more common in most countries, although it varies significantly from one country to another. There are some countries in which the HIV is more prevalent. The overall risk is dependent upon the frequency of each disease in your country.

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Customer reply replied 6 years ago
doc- assuming the rubbing agaisnt the skin of the buttocks was a minute or two- does it significantly change your assessment on boht the hiv and herpes possibility?

I have already answered the HIV aspect and I included the variance in contact when I addressed the possible herpes exposure above.

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Customer reply replied 6 years ago
Ok Doc- I will try and digest all this now. thanks! will be in touch

You're welcome.

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Customer reply replied 6 years ago

Doc. I applied a Clotrimazole based cream on the glan twice a day for the last 3 days- today included. The pimples have subsided signficantly and currently I can only see 2 or 3 small reddish bumps which hopefully will go away soon.

What could this mean? Could it have been a simple fungal or yeast infection or could it still be herpes?

If the pimples have improved with the clotrimazole, either it is because of a simple fungal or yeast infection or because it was going to improve spontaneously. In either case, it makes herpes less likely, since it is not progressing to a blister or ulcer.

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Customer reply replied 6 years ago

Doc- i read that a fungal or yeast infection ,like balinitis (whose description seems to match what I saw on my penis head) would appear soon after infection happens.

Is that so or it can surface much later as well

Also, for men, how can typically this infection happen? A simple non-washing for a few days under the foreskin reguarly can be the cause?

The penis is regularly being exposed to fungus and yeast, as they are ubiquitous int he environment. Therefore, there is no conception of whether there has been a period between exposure and the onset of symptoms. Simple non-washing does increase the risk, the fungus or yeast to which it is regularly exposed to grow.

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Customer reply replied 6 years ago

Doc- I dont need to tell you again how obsessed I have become with this whole HIV issue.

I need to accept that all your assurances are based on sound medical grounds and I really should accept the fact that I was on a `negligible or vanishingly small risk` category- and more so as there apparently are no documented cases of such a transmission.

IYet just cant shake off the recurrent thought that there was a sore or a wound- which had fluids- and my penis head rubbed against it.

Most bodies can have pimples or small cuts or acne.

All of these can seep fluid or have an open face to which a penis head can touch.

Yet in all the stuff I have been reading- I can see possible cases where precum touched an open sore or a boil and there being a possibility of hiv transmission from the pre cum.

But I just could not find a case or example or even a query from someone which is similar to mine

This should reassure me- yet the nightmare remains.

May I ask you - one time more- if you could explain yet again why inspite of a body having a rash or a boil or an open pimple- a penis head or foreskin rubbing against it represents such a low risk to the extent that most Doctors I spoke to just dismissed my concern as a 'zero concern` and I should just stop thinking about it completely.

Why Doc? Please advise

There is nothing more that I can tell you. The risk is directly related to the amount of blood or body fluid present. If there were the degree of risk that you are concerned about, then HIV would be transmissible by casual contact, which simply does not happen. If you cannot come to terms with this, then it would be appropriate for you to seek counseling to address these obsessive concerns.

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Customer reply replied 6 years ago

Doctor. Today is 81 days after my incident in Bangkok. I went for a Rapid HIV test (HIV 1 and 2) and it showed Negative. Please advise if I should worry any further

The vast majority pf persons exposed to HIV would have a positive test by this point. There are rare cases of persons that convert after this point, so the current recommendation is that a final HIV test should be performed 6 months after exposure. However, since the baseline risk for this exposure is so low, most doctors would argue that testing need not be performed after this exposure. The only reason to consider performing testing for you is because you have shown that you are particularly anxious about this, so the reassurance may be good for your mental health.

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Customer reply replied 6 years ago

thank Doctor. I will have to go for the Immigration process in Dubai in 2 days time and I am hoping that it will all be fine.

Why is it that in places 90 days is seen as the right period to be sure. Has there been cases where people have tested negative after (say) 80 days and then postive after 90? Or is it just a benchmark range?

The vast majority of people will convert by 90 days (and also by 80 days). There are only rare case reports of persons that convert after this time, but a test performed at 6 months will detect the rare cases that occur. There are no case reports of anyone that have converted after 6 months.

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Customer reply replied 6 years ago
Thanks Doctor- I wil be in touch . I wish I had 90 days. But then i would have perhaps worried after that also.

You're welcome.

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Customer reply replied 6 years ago

Doctor - in your experience and knowledge, it would appear that a negative result after 81 days is pretty confirmatory- right?

Please could you advise why some HIV foundations and States in the US actually state that 60 days is conclusive - which they say is because all current tests are more advaced than they were 10 years back ?

On what basis are these drawn and would that be reliable?

Yes, a test at 81 days is extremely accurate. Different recommendations are a function of the level of acceptance of rare occurrences. The CDC still recommends the testing at 6 months so that there is no possibility of a later conversion after a specific exposure.

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Customer reply replied 6 years ago

Final question Doc on this issue,

Do typically people who take to convert longer ones who usually have a compromised immunes system already.

In other words- what I am really asking is for those cases where conversion took longer than (say) 60 days were there ever any analysis done on the data and see what could be the reason??

No, there are no reported common characteristics of the rare cases that convert late, but it is rare, so it is difficult to accumulate a sufficient number of these cases to look for commonality.

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Customer reply replied 6 years ago
Thank you Doc.

Yes, you're welcome.

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Customer reply replied 6 years ago

Doc-I went for my Medicals in Dubai on. 20th March (which was the 84th day after that experience in Bangkok) and I was cleared and have now got my residence papers renewed.

You can imagine how much stress I was under the couple of days before that and ever since then have been stressed thinking what might have happened. Thanks for your advise and counsel.

One Question: I have always had a very oily skin and do get small acne /boils on my head and chest around the hair follicles. I went on the 13th March for my monthly hair cut where the barber uses a razor (not scissor as I usually keep my head close cropped military style) and after that I see quite a few pus boils around the area where I have hair -which is on both sides of my head (I am mostly bald on the top).I am told these are stress related which produces these and i shouldnt worry.Please give me your advice on this Doc and could it be linked to my earlier worry?

There are several issues to consider in this situation. Certainly stress is a common factor that can lead to exacerbation of acne and related disorders. However, stress has been shown to exacerbate virtually every disorder that has been studied. This can occur regardless of the cause of the stress. As the stress resolves, then the exacerbation of the acne should improve.

It is also true that there is a form of folliculitis (inflammation or infection of the hair follicle) that is related to close shaving with a razor, referred to as folliculitis barbae, which may be the problem that you noticed after visiting the barber. If it resolves quickly, there is no reason for concern. If it is a more significant problem, then changing to using electric clipper is usually better tolerated.

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Customer reply replied 6 years ago
Doc-my OCD is still kind of there with HIV. Given everything you know thus far, could I beleive its not some delayed symptom of HIV infection? I know you said I need a Counsellor for this- but do give me your considered medical opinion on this please.

No, these symptoms could not be related to HIV, and besides, your test was negative.

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Customer reply replied 6 years ago
Doc- could you perhaps explain why my symptoms (the acne/boils on my head hair follicles) are not an usual early symptom of HIV? Is it because there is no other symptoms with it, eg: fever, etc?

It simply doesn't happen as part of an early HIV infection. Later, when the HIV is causing immune suppression, there are a wide variety of infections that h=can occur due to the immune suppression, but that is many years later.

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