2 nights ago I visited an unsavory MParlor drunk but not intoxicated. I remember what happened.

I was in there hours. Tried to find similar situations but struggled to find a near exact scenario in the discussion.

Basically, there was some face sitting and grinding. No real contact with my mouth though. Been in this situation before and I am well aware of no risk/negligible risk activities. Still, I touched her outer vagina, although she mainly pleasured herself, pressing my hand into hers.

In MEast, but she was Thai she said. I also touched her anus but it seemed unnatural - t he a hole tbh - like it had a wart perhaps. I stoped this immediately, but did touch her outer anus for a period with finger and thumb.

My main cause for reassurance is that I think she secreted vaginal fluid over my face, she was high up so I think it went into my eyes. I definitely noticed something. This concerns me a little. Should I be concerned with an y STDs? Notably HIV, syphilis, hsv 2 or anything bacterial?

There was also some limited kissing that I tried to avoid and a little momentary breast sucking.

She masturbated herself to climax pressing my hand into her hand, exposing me slightly but I did not enter her. I never let her touch my penis although she bit it through thick sports shorts. Any risk doc and if not can you explain why eyes seem not to be being a mucous membrane.

Finally, I felt she looked suspicious, although very small - maybe 5:1. Possibly a trans. Not my thing at all. Can modern day surgeries be that convincing? Definitely a female ass, and vagina seemed natural and organism seemed genuine. Sorry to go on. Family man and worried of my stupidity. I will move on if you think I can without fear. However if I need to test I will also. Thanks.

Welcome. Thanks for your confidence in our services.

HIV is not required by contact with blood or body fluids in the environment; and just being in a place that might be attended by people at high risk has no chance of resulting in HIV infection. There has never been a confirmed case of HIV that was not acquired by actual sex, meaning penile penetration (anal or vaginal:  even oral sex is nearly risk free). And the risk of other STDs is almost as low. Skin to skin contact, touching (including fingering an infected person's vagina or anal area is not risky. Why is eye exposure low risk? Probably because it takes lots of HIV exposure for the virus to take hold, and most eye exposures are not likely to have large virus amounts.

As for your partner, clearly she was born and remains female. As your question shows you suspect, the genitals look quite different than natural female genital in M to F trans persons, after surgery.

Accordingly, the risk for HIV definitely was zero -- or close enough to zero that you can safely ignore it. The possibilities of other STDs -- gonorrhea, chlamydia, herpes, syphilis, HPV -- are higher, but still low. If you would like the reassurance of negative test results, I would advise a throat swab for gonorrhea (which automatically includes chlamydia, even though chlamydia rarely infects the mouth and throat), which would be valid any time more than 2-3 days after the event; and, for reassurance, syphilis and HIV blood tests in a few weeks. (And no, you don't need tests from your eyes; assuming no symptoms -- i.e. pink-eye -- in the next few days, you can be sure they were not infected.) If somehow I were in your situation, I would resume unprotected sex with my wife once I had the negative throat test for non/chl, i.e. without waiting for the HIV and syphilis test results in a few weeks.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

Also, I can get doxycycline hyclate effectively cure incubating syphilis, chlam, gonn? 

Difficult for me to avoid kissing my wife for this period if the risk is virtually non existent. I can get doxy too in the country I am in. But, just to be clear, my mouth did not really contact the genital area - more worried about the potential for an STI eye infection. I did not really see my mouth as a risk due to lack of prolonged - only superficial contact. In light of this, are these tests necessary? Regarding hsv. I do have childhood cold sores - hsv 1. Do you think there is a risk of hsv2 here? I may have bit her buttock cheek a bit, but nothing else. No tongue in anus or vagina. Just to make it clear doc. What is said advice?

Doxycycline post-exposure prophylaxis (doxy-PEP) is the latest new development in STD prevention. As it happens, the national leader in the US studies of doxy-PEP is my close friend and colleague and I'm intimately familiar with it. When 200 mg doxy is taken within 72 hr of an unprotected anal sex exposure by men who have sex with men, it is nearly 100% effective in preventing syphilis and chlamydia and reduces the chance of gonorrhea by 50%. Surprisingly, it was not effective in the first study done in heterosexual women; it is likely that the study subjects failed to take the drug as directed. In any case, the consistent recommendations of all health agencies so far (CDC and its counterparts in UK, Australia and others) is that doxy-PEP should be limited to men having high risk (unprotected anal) sex with other men. When the risk of infection is as low as in your situation, the potential downsides (side effects, antibiotic resistance) are felt to outweigh the benefits. And as just noted, it's not reliable in preventing gonorrhea, so it does not replace testing.

Having HSV1 modestly reduces the risk of HSV2 if exposed. But oral HSV2 is extremely rare, even after overt oral sex with an infected person. Your risk of facial/oral herpes from this event is under one chance in many thousand, probably millions.

I am aware this is probably my two follow up questions doc. I will take you advice and run with it. If you think I need to test, I will, and possibly be back in future to post results.

Just to be clear.

1. HIV is zero risk even with potential eye exposure? Forget about this.

2. Syphilis, chlam negligible plus 200 mg in 72 hours would abort both infections? I failed to mention i took 300 mg today (48 hours)  as I could get it over the counter. So I should be all the more clear for this - do not take more?

3. Finn - very unlikely, plus 50 percent chance of abortion with doxy? Would taking more reduce this further? Is there another antibiotic that could abort this quickly if taken tomorrow?cefixme? A small sharp dose like 200 mg.

4. HPV harmless anyway and unlikely?

5. HSV2 highly unlikely to acquire orally and negligible as my mouth did not enter her vagina/ass?

6. Any brief touching of vagina/anus is negligible? No known cases of anything from this?

Once again doc, appreciate your help.

1. Correct -- zero or very close to it.

2. There is no advantage to taking any more doxycycline; your 300 mg is maximally effective against both syphilis and chlamydia.

3. "Finn"?? Gonorrhea, it seems, by the nature of the question. Taking more will not increase benefit against gonorrhea; resistance to doxycycline is all or none. The risk is too low to take anything. If you're going to not follow my advice here, as well as in regard to doxy, then I would suggest 800 mg cefixime.

4. Correct.

5. Correct, but this has nothing to do with whether or not your mouth was exposed.

6. Correct. Low enough risk to disregard.

Just an update and a final post if I may. Not anxiety driven, quite cool and this is more for curiosity.

1. What is the non in ‘ non/chl, i.e. without waiting for the HIV and syphilis test results in a few weeks’, that you posted? Would this be taken care of by the antibiotics?

2. I know against your advice, but got cefixime, just because I am in a situation where we are traveling and it is impossible for me to have a throat swab for a few weeks. Furthermore, even if one in a million risk, if 800 cerfixme is a guarantee of aborting any incubation (although more like 80 hours now) I will take that. With the 300 doxy and 800 cefixime, no fears and no need for throat swab? Forget about syphilis, chlam, gonn  and ‘non’? Correct?

3. Regarding the hsv2 risk (or lack of) one in hundred of thousands maybe a million is more than reassuring. Purely for education, why would access to mouth not reduce the exposure further? I assumed facial skin is not a mucous membrane, so without me licking her mucous membranes, I should be completely negligible no? Reading yourself, hook and Warren, this seems to be standard knowledge I thought. Also, from Terri I read exposure to fluid is most unlikely, must be skin in skin? Is this correct? I take it as red you would be dead against me testing here?

4. Very final point doc - I contacted her and she claims she is risk free of hiv. Also claimed ‘she is clean’ and said ‘we did nothing’ anyway. Read hook has many times said this is a good sign - people tend not to lie. 

So all in all doc, forget and move on? No testing? All good.

Apologies for repetition, this is it.

Thanks doc.

2. I agree completely.

3. Given the anatomy of the genitals and face, I would assume all surfaces and orifices were exposed. And with sufficient massaging or micro-abrasion, intact skin can be infected. So can the eyes.

4. All three forum moderators have said this repeatedly.

Indeed that concludes this thread. thanks for the thanks. Best wishes and stay safe.