Nov 19 Oily massage and handjob in massage parlour. Penis touched exterior of her vagina and came in contact with vaginal fluids when straddled by her. Touched my penis with my hand after I had vigorously fingered her vagina and anus.

Dec 15 Approx 3-4 wks later, sore throat, muscle aches, not sure about fever. Do not recall any respiratory issues such as congestion or coughing.

Jan 5 Approx 6 wks later, mild pain sensation in tip of penis. 2 days later, small red sore (5mm) appeared on tip of penis near opening. Sore itself was painless, had a ring around it of dried or dead skin, red in the middle, and appeared to have split open slightly . Applied steriod cream and it disappeared in just over a week.

Saw doctor on Jan 10, tested neg for UTI in urine, syphilis, gono, and chlamydia.

Jan 11, started to develop a near constant burning/stinging along the entire underside of penis in the urethra, and in the opening of the penis which got worse over time. No change with urination. Was medium discomfort for apporx 3-4 days, but got better over time and is now barely noticeable.

Have had soaking night sweats 3 or 4 nights in the last week. Do I need further testing? HSV, HIV, Trich, others?

Thank you

The exposure described was risk free for all known STDs, which are not transmitted by hand-genital contact, even when genital fluids are present (or even when used for lubrication). No STD causes sore throat, muscle aches etc, and 3-4 weeks is too long. That includes HIV -- which can cause such symptoms, but 3-4 weeks is too late. I'm not sure what to make of your penile symptoms, but here too onset more than a month after the sexual event doesn't fit at all; no STD or anything else takes that long. Same for fever, which is the cause of true night sweats. One slight possibility is that your initial infection (mid December) was due to adenovirus, some strains of which can cause both cold symptoms with fever and urethral (penile) infection, but that's harmless (if uncomfortable) and clears up on its own, as seems to be happening.

Trichomonas, herpes and HIV are not plausible explanations for any of this. In testing you for STDs, I would have thought HIV testing was included, but you don't mention it. If done and negative, the result is conclusive proof you weren't infected. But if not done and you would like additional reassurance about it, discuss it with your doctor if HIV.

The bottom line is that your symptoms are not from anything you caught during the massage and handjob back in November and thus not due to any STD.

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

Thank you Dr. Handsfield. I had thought the CDC labelled stage 1 of HIV as in the 2-4 week timeframe, and included flu like symptoms, along with terrible night sweats as part of it.  I was not tested for HIV or HSV, but should likely do this to ease my concerns.

I guess the urethra pain could be due to prostatitis or something like that. As there is no change on urination, and no discharge of any kind, it does not seem to be acting like a UTI or other infection.

As for the single small sore, what do you make of that? I initially was concerned about syphilis, but the testing has ruled that out. Is there any other STI that could have caused that and then disappear in about 7-10 days?

If this person had a high viral load, would it not be possible to have viral matter pass under or around my finger nail, especially if the fingering was very vigorous?

Thank you

I'm not inclined to suspect prostatitis based on your symptoms. As for the ulcer, in theory it might be syphilis, and the syphilis blood test was done too soon to be conclusive. However, your description of the sore isn't typical and the onset around 6 weeks after the potential exposure is much longer than usual. And in my 50 years in the STD business, I've never seen nor heard of syphilis acquired by hand-genital contact. This also doesn't sound like herpes. Feel free to test for HSV if you wish; if you do, I'm confident of a negative result (unless you possibly have had HSV a long time and now are having a recurrence unrelated to the massage etc).

In theory could HIV be transmitted by hand-genital contact or fingering in presence of a high viral load? Probably yes. However, in the 40+ years of the worldwide HIV/AIDS epidemic there's never been a case reported to have been acquired this way. So if it occurs at all, it's extremely rare. You're not going to be the first known case.

I remain confident you have no infection of any kind from your December massage adventures.