Anh smile hay ai pro tiếng anh vô giúp em dịch với

Dear Dr,  
 
Could u pls help me assess risk from the following:  
 
- Body to body massage with the lady being topless and rubbing her breasts against my back and anal area. Im extremely concerned about this because she appeared to be lactating and, as I suffer from severe chest and back acne, I have several open cuts in my chest and back which form when pimples are popped. This is of particular concern to me because the probability of transmission is very much increased due to the number of 'cuts' I have.  
 
Concerns:  
 
1) The area between my buttocks always appears irritated and when I apply alcohol it stings alot, showing that there is a lesion.  
 
2) She was kissing my back and chest with open mouth (I could feel saliva) and then massaged the area, probably exposing some of the acne spots making them bleed. I get the sensation that this could be "massaging the virus into my cuts"  
 
3) At the end of the massage, she placed her breasts on my penis and I ejaculated. The area around my genitals was recenty shaved (that very day).  
 
4) Does a popped acne spot or infected follicule provide a route to the blood stream for the purposes of HIV infection?  
 
5) What is the risk of transmission if those cuts come into contact with fresh vaginal fluid?  
 
6) Would you recommend routine testing if this is a regular activity for me?  
 
In order to avoid repeating any questions on your website which may not add educational value to your readers, I was looking at your responses and I came across a question titled "massaged" which related to "Tantric Therapy" in which Dr. HHH said that the patient's risk "was low but not zero" and that "he could not advise him as to whether or not he should resume sex with his wife". In that instance, the patient was concerned that some vaginal fluid may have come in contact with his anal area during a similar activity as the one I was a part of. I am very concerned because I feel my exposure was even higher risk with my cuts. 
 
 
 
 
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<a href="http://www.medhelp.org/personal_pages/user/300980" id="user_300980_230345" style="box-sizing: border-box; color: rgb(0, 108, 200); text-decoration: none;">Edward W Hook, MD</a><img alt="Blank" class="doctor_icon icon_link_img" src="http://d2h6mj3zl2uk5d.cloudfront.net/cdn/1372382940/RoR/images/blank.png?1372382940" style="box-sizing: border-box; background-image: url(http://d2h6mj3zl2uk5d.cloudfront.net/RoR/images/forum_page_assets.png); width: 16px; height: 14px; border: 0px; background-position: -10px -159px; background-repeat: no-repeat no-repeat;" /></div>
 
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Dec 05, 2008</div>
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I have read this post, the 12 other posts you have had of late and the messages you inserted into others' posts today.  In doing so, I think you are "reading between the lines" of many of both my and Dr. Handsfield's responses, perhaps continuing to explore your own anxieties about potential exposure to genital and other bodily secretions encountered in the context of erotic massage exposures.  My own sense is that your repeated questions and tendency to worry about what I consider nuances in our comments both to you and others betrays substantial anxiety over such exposures.  Our job is to provide the information and we do our best to do so.  Please try not to over interpret what is said.  
 
Before I go to your questions, let's review a few messages that we have given repeatedly on our sites.  
 
1.  Massage is safe in the same way that mutual masturbation is safe, perhaps even more so.  It is typical and not at all unexpected that in the course of mutual masturbation, or erotic massage that there will be contact and genital and other bodily secretions that are spread between participants in the course of the activities.  Despite that HIV and other mucosal STDs ARE NOT spread through these activities.  
2.  To expand on point #1 above, just about everyone had "defects" in the integrity of their skin and mucous membranes..  Sometimes those are rashes, including acne, other times these  are cuts (paper cuts, scrapes, etc), sometimes these are dental disease or cuts within the mouth.  The fact that such cutaneous defects exist DOES NOT change the facts and proportions that we quote on our site.  These figures are typically generated thorough rigorously performed scientific studies involving large numbers of participants and are the best data available.  The data generated in this way are thought to be scientifically generalizable and therefore applicable to other similar situations which occur regularly in everyday life.  
3.  There are no absolutes in science.  To think otherwise is naive and fails to account for the infinite variability of human beings and their activities. There may have been someone, somewhere, somehow who had the misfortune to have the right combination of exposure and susceptibilities to allow them to get HIV infected through mutual masturbation or massage.  Having said that, I would advise you and all of our clients not to look at themselves as that 1 in a million (or many million) exception to the information provided here but to realize that your risk is indeed reflected by the sorts of figures we use in providing advice.  Of course these things could happen, but with about the same frequency that you will be hit by lightening while reading this or that you will win the lottery on the first  time you try.  To govern your activities and life based on those sorts of long odds is a formula for pathological anxiety and unhappiness, both of which in and of themselves can lead to unfortunate health consequences.  
4.  Most people who assume that their contacts are lactating based on appearance are wrong.  
5.  Much of your concern is based I think on the supposition that whomever is providing your massage is HIV infected.  This is not the case in the vast majority of instances.  
 
With that as background, let me address your questions:  
 
1.  The crack between the buttocks and the anus are susceptible to fissures, hemorrhoidal irritation from stool or over vigorous wiping, fungal infections and many other causes of irritation.  Application of alcohol to the area (which I would not recommend- this is unlikely to provide meaningful cleansing and is drying, making the skin and mucous membrane more susceptible, not less) is not a surprise.  Still, as explained above, not in and of itself a risk.  
2.  If she was infected which is in and of itself unlikely, saliva has little virus in it and transmission in this way is not biologically plausible.  Please remember, acne is not an open cut unless pustules have been squeezed. the contents of pustules are, if anything a more hostile environment for microbes, including HIV than normal skin since they are filled with pus which is the body's host response to infection.  lots of white blood cells and other things which fight infections.  
3.  There is not data to indicate that shaving increases risk of HIV acquisition.  this is the case whether you are talking about shaving your face or pubic area.  
4.  No.  See no. 2 above.  
5.  None, see no, 2 above.  
6.  No, my own opinion is that testing is not warranted for the sort of exposure you describe.  Whether or not you get tested however is, of course, your decision.    I cannot help but also wonder why you participate in such activities if it leads to the sort of anxiety and concern you express.    
 
I will not try to interpret Dr. Handsfield's statement however it is my impression that he does not consider massage, whether in your case or that of others to be risky.  Having said that, decisions about whether or not to have sex with one's regular partner involve more than just risk of infection. For instance, if one already is anxious about their own health, then having sex is likely to only further increase that anxiety by generating (illogical) concerns about transmission of an infection to a loved one.