Hello and thank you for your time. I have an idea what Dr. HHH and Dr. Hook will say but want to ask for my peace of mind. What are risks and suggested follow up for these events?

43 male with two recent exposures from recent trip to Tijuana strip club and American escort. 1) TJ-full protection through oral and vaginal sex (condom placed before any other contact was made). Session lasted perhaps 4-5 minutes tops. Also had one lap dance with dancer who licked finger and rubbed around glans/urethra beforehand but no other direct contact. 2) America-brief contact (seconds) from mouth to penis before protection being used through oral and vaginal sex. Session again last 4-5 minutes total.

My concerns are for HPV and other skin-to-skin contact, given their profession (no obvious lesions noted but did not look closely). It appears both were pretty careful but surely have had many customers who do not use protection. Would you consider these low risk? Due to single exposure(s), fairly brief and protected? 12 days post and no symptoms, but if HPV, when would symptoms appear and how long before I could consider myself in the clear? This was a stupid mistake and do not wish to repeat again. I want to keep my spouse safe and would feel better hearing your assessment of these events. Do I need testing and how concerned should I be?

I think that your concerns about HPV are off base.  As a sexually active man in his 40's there is an 80% likelihood that you already have HPV. most likely due to multiple strains.  Within 6 months of the onset of sexual intercourse with a single partner, 60% of persons have HPV.  In other words, virtually everyone has it.  It is an innocuous, mostly self-limited infection which causes complications for infected persons in a 2-3% of infected persons at most.  For an unvaccinated male, the only think that needs to be done is to have any lesions which might appear looked at by a trained clinician.  If you wish to learn more about HPV I would encourage you to look at some of the hundreds of other threads on the Forum devoted to other aspects of HPV- we leave them available for clients to learn from.  Just scroll through the Forum looking for posts with HPV in the title.

Bottom line, I would not be particularly worried about the  encounters you describe.  I do not feel strongly that testing is needed from a medical perspective.  EWH

EWH

Sorry for delay in asking my last question. I've read through a ton of posts and feel better about my situation but still confused on some things. I've used condoms with all previous partners and with spouse (neither of us are "tied"). My question is where would my risks for HPV have been transmitted? I know condoms are not perfect but would HPV be deposited (for lack of a better word) to base of penis above condom line aka a few centimeters/inches or would HPV be all over groin, pubic area and scrotum? Just trying to understand where it could have occurred with past experiences if a condom was always used.

I have never seen/noticed any symptoms and I know most infections would have been cleared within 1-2 years, but if I would have lesions, they would likely appear within 1-6 months? (Assuming I was fortunate and never had HPV before, which I understand is unlikely). I will continue to use protection but want to ask if my risk of acquiring anything from these last events are deemed small enough to continue without fear of anything showing up in myself or my partner? I'm mostly concerned about the incident from south of the border given it may be "higher risk". Again, thank you for your service and expertise (and patience with all of us!)

You are correct that when a person acquires genital warts, they appear within 3-6 months of acquisition.  

I urge you to put your concerns aside and move forward.  Your risk of a new HPV infection and giving it to your regular partner is too low to worry about.

As you know, this final reply completes this thread which will now be closed.  EWH