I went for an oil (Swedish) massage and although it was normal, nothing sexual, I was naked except for disposable underwear. The massage therapist had long nails though which I could feel but could not see any visible scratches (maybe one tiny) on my back afterwards. She went quite far up my legs but didn't touch me intimately.

I didn't see if she had any cuts or blood on her hands and am worried because i have quite badly torn cuticles and on my thumb had some skin peeled back (red, but not bleeding). She only momentarily touched my hands but I am worried about the whole incident.

Was there any risk here? Please answer urgently in case I need to seek treatment as a precaution.

It was in SE Asia but in a 'nice' spa (not seedy).

How bad do cuts really have to be to constitute a risk? Information is really mixed on the internet. If it was bleeding when I pulled off the skin, but had since stopped?

Thank you for your inquiry. From what we gather from the question, you were asking about your risk of acquiring HIV from a massage. You are concered that your blood from her hands could transmit HIV to you through some badly torn cuticles. From the information given, this scenario is determined to be No Risk (transmission of HIV is not possible in the given scenario).

The scenario mentioned above does not meet the three components of the transmission equation(1). It does not satisfy the equation because:

* For transmission to occur the three components of the HIV Transmission Equation must be met: there must be HIV present in a bodily fluid (ie: in blood, semen or rectal secretions), direct access to the bloodstream (ie: inside of the vagina, anus and other mucous membranes) paired with a high risk activity (ie: unprotected anal or vaginal intercourse, sharing needles, mother to child)(1).

* HIV does not survive long outside the human body (such as on surfaces), and it cannot reproduce outside a human host(2).

HIV is not transmitted through social contact such as hugging, kissing, shaking hands, sharing toilette or dishes or getting a massage(2). Remember from above that HIV does not survive long outside of the human body. This means that any blood on the other individual's hands would have been outside of the human body, exposed to environmental conditions, and thus, unable to reproduce or transmit HIV to you. There also must be direct access for HIV to enter your bloodstream. The torn cuticles you describe can be likened to that of a superficial cut, or a cut that is very much surface level (think paper cut). While a superficial cut may bleed, they are simply not deep enough to provide that conditions necessary for HIV transmission to occur.

As to your question about "how bad to cuts have to be to constitute risk", it isn't so much about how bad the cut is, as it is about looking to see if the scenario as a whole does or does not meet the three components of the HIV transmission equation(1). This is how we can reliably assess the risk of HIV transmission. Remember as well that the only conclusive way to know if you have acquired HIV is to have an HIV test.

Recommendation: No need for HIV test with the scenario provided, refer to a physician for other health related questions.

AIDS Vancouver Helpline/Online, Hilary

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