Thanks for a great service. Had a male/female hand job 4.5 months ago. She touched herself and then touch my genitals. I also briefly touched her on the outside of the vulva and touched myself. I doubt there was much if any vaginal secretions on the hands. Hand job was brief. Since this encounter I have been very anxious about STI's and HIV. I have had a full panel of test all negative but I have two specific concerns.

1. HIV 4th generation combo test at 32 days and 11 weeks both negative. I know I should move on but still concerned and anxious. I think I can anticipate your answer.

2. Had a syphilis blood test IgG/IgM at 32 days negative. At 1 week post encounter I had 7 days antibiotics for urine infection, at day 25 I had Doxycyline 100m x 1 daily for 7 days at 44 days I had further Doxycyline 7 days x 100mg twice daily because I had issues that were thought to be NGU but where not. At 90 days I started a 28 day course Ciprofloaxcin for prostatitis which I have just finished. Would either of this impact my Syphilis status or test taken day 32? I never had a sore, however on three days ago at 4.5 months I developed a red spot 1.5mm x 1.5mm just below the urethra. There was no papule and spot is not raised or look like an ulcer but nevertheless it concerns me greatly. Prior to the spot appearing I have participated in some mutual masturbation. Could this possibly be Syphilis that is delay because of my consumption of antibiotics? Would the Syphilis test be impacted by the first dose fo Doxycyline?

Overall I would like to hear your risk assessment and whether I need more testing for HIV or Syphilis?

Sometimes we get questions for which the answer is clear based only on the title someone creates for his or her question. That may be the case here. At this point I haven't read beyond your title:  Neither HIV nor any other STIs ever are transmitted by hand genital contact, even if genital fluids are used for lubrication. Unless there's a surprise when I read the details, probably you have nothing to worry about!

Now I have read the rest. Guess what? This was a zero risk event and I would have recommended against testing for anything at all.

Doxycycline is 100% effective against syphilis -- if you had been exposed and infected, it would have made your syphilis blood test negative. Your negative test at 32 days is highly reliable and indicates you probably did not acquire syphilis -- and if you had, by that time you would have had a chancre (open sore) at the site of inoculation, i.e. on your penis. So there is no possibility you acquired syphilis. And even you had, your future tests will remain negative because of doxycycline cure. The "red spot" is not possibly syphilis and doesn't suggest any STD.

The doxycycline also would have treated chlamydia if you had it, and since you were not tested until you had been taking doxy for several days, there is no way to know if you might have had chlamydia that was cured. Ciprofloxacin has no effect on syphilis or chlamydia, but would have cured gonorrhea if you had it -- which obviously you did not.

The HIV AgAb (4th generation) blood tests detect 98-99% of infections by 30 days and are conclusive at 6 weeks and beyond, so HIV has been ruled out.

As I said to start, you were not at risk for any of these infections, but I hope you have been reassured by your negative test results and by these comments. Let me know if anything isn't clear.

HHH, MD

Than you for your answer. Tests for Chlamydia and Gonorrhoea were done before any antibiotics were taken and were negative.

My main concern is Syphilis. I have not had an open sore. As mentioned I had a red spot which just appeared and caused concern. My doses of Doxycycline was at 25 days 100mg per day for 7 days a gap of 10 days and then 7 days of 100mg twice per day. If I ever had Syphilis would these doses be enough to cure?

The reason for these doses were suspected NGU but the case of the issue was prostatitis which has been cured. 

The red spot on my penis is still present and it concerns me. It is not an open sore but today I am imagining that it is slightly raised. It is about 2.5 x 2.5 mm. 

The concern is that I went outside my marriage once after 23 years which i bitterly regret. My concern if for my wife. 

f you had NGU or prostatitis, it had nothing to do with the sexual exposure described.

Of course your concern is for your wife. That's by far the main concern stated on this forum for men who ask about extra-marital sexual exposure.

All is well. You were at zero risk for any infect and any fears about syphilis now should be gone. I hope these comments have been successful in convincing you.

Thanks again for your help. This certainly is a relief. One last hypothetical question. Two weeks after my exposure I had sex with my wife. If against all odds I was infected by Syphilis but had no symptoms or ulcers would I have been able to transmit the infection. This is out of anxiety I ask this. I understand your comments about the none STI transmission route hand to genital but logic fails when anxiety sets in. Again than you for a great service!

Thanks for the thanks; I appreciate it. That concludes this thread.