I am now so full of anxiety about contracting an STD and feel I’ve been really stupid and naive. I’m going through a lot at the moment and shouldn’t have done this. I will take tests but understand I need to wait several weeks. Please can you advise on the risk of infection from such an encounter. 

In general, STDs are less frequent and sexual contact less likely to transmit them between women. HPV is nearly as common as in heterosexual women, but HPV is perhaps the most readily transmitted of all STDs. There really hasn't been much research on other STDs, but it is well known that chlamydia and gonorrhea are rarely transmitted by cunnilingus. Syphilis certainly could be transmitted, but transmission between female partners appears to be rare. HIV also is rarely transmitted by cunnilingus or other sexual contact between women. And I would judge that body-body contact (frottage) is little or no risk, and also that the brief contact of your partner's vulva with your buttocks was no significant risk. Fingering also is generally little or no risk.

The most significant risk probably is for bacterial vaginosis -- if your partner happened to have it. Did you notice any abnormal vaginal discharge? Or most important, strong vaginal odor? If not, it probably is unlikely you partner had BV. But if she did, BV is very easily and commonly shared between female partners, and fingering probably can transmit it.

Jumping to your follow-up question, neither shaving (with or without visible nicks) nor a healed genital piercing is likely to raise the chance of transmitting any of the STD bacteria or viruses.

Having said that, there really hasn't been enough research to be confident about the details, and it is reasonable for you to be tested -- but mainly for the anticipated reassurance you would gain with negative test results. But the only tests advised in such situation are urine or vaginal swab testing for gonorrhea/chlamydia (valid 4-5 days after exposure) and blood tests for syphilis and HIV -- i.e. no need to wait "several weeks". Valid blood tests for syphilis and HIV can be done at 6 weeks, but the risks are so low that I would consider testing optional; you really shouldn't be worried! I would strongly advise against the "comprehensive" test panels offered by many labs. Most tests in such panels either are unnecessary or are not highly reliable, often giving misleading results.

Ideally your evaluation should include an in-person gyn exam, the only reliably way to detect BV. But I would consider this optional if your partner didn't have obvious odor or vaginal discharge, and if you do not develop these symptoms in the next couple of weeks.

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

HHH, MD

I think my main concern is around the fact that this occurred with a sex worker, who deals with many clients (mainly men). I was very restricted in the word count so wasn’t able to share much detail on context in the initial post, but essentially, I had sought out someone to provide a tantric ‘yoni’ massage in an attempt to work through some previous sexual trauma I experienced. I was only anticipating receiving the tantric massage - the frottage and oral were not expected and (frankly) quite traumatic too. I only realised she was performing oral on me when I noticed the sensation had changed as I had my eyes closed at the time. Which is why it was such a short duration; and I left immediately when I realised. It very much felt non consensual. 

Are the chances much increased with it relating to oral from a sex worker?