[Question #11994] HIV, Syphilis, Herpes

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11 months ago
Dear Dr. Handsfield,
Thank you again for your services. Unfortunately, I had another encounter today that I totally regret. I know I am very anxious but I'd appreciate if you respond me without taking into consideration my anxiety.

I had an encounter with a Colombian transgender escort in one of the Arab Gulf countries. The escort might also been touring in Europe as well. 

I will try to describe in detail what happened. 

There was mutual protected oral, mutual unprotected handjob, I kissed her buttocks and got closed to her anus but never touched it with my lips nor tongue. I sucked for 10-15 seconds her nipples. There was also some penis to penis frotting but mine was at all time covered and also rubbing my penis with her buttocks and touched her anus with the tip of my penis while covered but no insertion at all, just touched. 
Finally, what worries me the most is that she masturbated and ejaculated and it splashed all over and I had a few drops on my arms, hands, fingers and even felt some on my nails and probably other parts of my body. I immediately wiped and went shower after 5 minutes. 
I am now getting anxious about having some drops in my mouth or lips without me realizing and swallowed them, is this possible? What about the drops on my arms and especially the nails? It what if it went under the nail it could penetrate my body, what's the risk if STDs.? 

Finally, from what I described what's the probability I could get HIV, syphilis, herpes, Chlamydia gonnorea and any other std? 

How long do I need to wait to test?

Thank you and sorry for being long.
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Edward W. Hook M.D.
11 months ago
Welcome back to the Forum although I'm sorry you felt the need.  Like your prior visit to the Forum five months ago, this was essentially an NO RIK event.  Please understand that HIV and most STIs are transmitted ONLY by UNPROTECTED penile-vaginal or PENILE-Anal intercourse.  It is NOT transmitted by mutual masturbation, by kissing, by nipple sucking,  by penis to penis rubbing or by contact of your skin with ejaculate from a partner without penetration.  Any jaculate that was transferred to your lips or mouth did NOT put you at risk for HIV or other STIs.  This was a NO RISK event.   If you want to test, you can test for gonorrhea and chlamydia any time more than 3-5 days after your encounter and you can test for HIV and syphilis any time more than 6 weeks after the encounter.  At this time results will be conclusive.  As I have already said however, testing is a waste of time and resources. This was a no risk encounter.

I hope that this information is helpful.  Please don't worry.  EWH
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11 months ago
Dr. Hook,
Thank you for your quick reply. I understood your advise and I know anxiety is playing a role but I'd appreciate if you could clarify the following. 

1. Even if my penile was covered during the rubbing, other parts (groin and the sides) were directly touching the partner's skin. Doesn't this put me at risk for syphilis and herpes? What was the risk?
2. I forgot to mention that before we out condoms, my partner sat over me (no penetration), but it was very brief. Any risk?
3. Was there a risk for me giving protected oral and receiving as well? 

4. Please clarify the risk about if semen goes under the nails or swallowed even though I'm not sure it went into my mouth. 

And finally, is 6 weeks window period conclusive for all STDs? For syphilis what test should I take for conclusive reliable result? Dr. Handsfield advised me for RPR in my previous post. I know the combo for HIV. What about other STDs please? 

Thank you again for your service.

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Edward W. Hook M.D.
11 months ago
Straight to your follow-up questions:

1. There is no meaningful risk from contact of your groin and the sides of your legs with your partner's legs and/or secretions
2.  No risk from having your partner sit over you.
3.  There is no risk of acquiring gonorrhea from receipt or performing protected oral sex
4.  Semen under your nails of being swallowed after transfer to your mouth on your hands is a no risk event.
5.  Tests for gonorrhea and chlamydia performed on specimens taken from sites of exposure will be conclusive any time more than 3-4 days after an exposure.  Blood tests for syphilis (any approved test is fine) and HIV will be conclusive at 6 weeks.  There is no reason to do a blood test for herpes and the results are often wrong (falsely positive or negative) 

You have one follow-up remaining.  EWH
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