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I saw the suggestion to keep your hands in your pocket and to have something in your hands. Both of those were suggestions I would have made.
If you want to alleviate the social repurcussions of a refused handshake (or lessening the "rudeness" towards the other person, in other words) my suggestion would be to maintain eye contact and speak directly to the person while saying your goodbye.
Do a lot of nodding, smiling, and maybe speaking fast to keep the focus on one another's face--but don't avert your eyes to the extended hand (which you know is certainly "down there"). At least this way you'll just be thought of as socially inept as opposed to rude without having to take a ridiculous long time to keep explaining yourself to acquantances and strangers (I'm assuming your friends are aware of the situation and your feelings--if not, it's probably worth the time to explain your views to them).
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