At the first. I had a full naked massage and then the masseuse (Assume CSW) was naked and gave me a handjob and also fingered my anus, I also touched her vagina for a few minutes (no instertive) and then touched my penis shaft briefly with her juices and at the second she was naked and gave me handjob but no touching of her from myself. 

2 days later I noticed a fissure on the outside of my anus which hasn’t bled etc.

Am I at risk of any STD from this? I didn’t notice any open cuts or sores but it was dark and I was under influence so am not sure.

Please help

No STD, including HIV, ever is transmitted by massage, hand-genital contact, or fingering. Contacting a partner's genital area and then your own carries no risk for any infection. Catching HIV and other STDs requires exposure to lots more virus or bacteria than can be carried over by such contacts, even if genital fluids are used for lubrication. Presence of an anal fissure does not significantly raise the chance of infection. Finally, saliva rarely if ever transmits STDs. If fact, saliva is toxic to many of them; saliva kills HIV, for example.

So you are not at risk at all and do not need testing. You can safely continue your usual sexual practices with your regular partner without any risk to her health.

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

HHH, MD

For some added context, I think the first masseuse’s fingernail may have cut my skin.

To be overly cautious, I ideally would abstain from sexual contact with my partner for 6 weeks however cannot guarantee that will be possible. Without visible sores etc and using condoms, would it be safe to do so? 

Also (UK Based so no charge) I will seek to get a HIV duo, syphillis ECLIA,  HCV and HCB test as well as chlamydia and gonnorhea at 45 days done, will these be conclusive? 

I have been checking my whole body since the event 4 days ago and will continue to do so, how soon do syphillis sores appear?

Many Thanks!

The initial sore of syphilis occurs only on a sexually exposed site and is called a chancre. They typically appear 10-20 days after exposure. There is no point in checking your "whole body" for sores. Hepatitis C isn't even sexually transmitted between males and females (in contrast to common misinformation online and elsewhere). Hep B testing is nonsense if you have been vaccinated, as most people have (in the UK).

I do not really "appreciate [your] caution" about testing. You are way off the deep end on this.  But of course you're free to have any tests you like, whether or not wasteful of NHS resources!

Hi Dr handsdield, I thank you for your response,

I am aware of the response limit so will use this final follow up to have any further points hopefully clarified.

1. Just to confirm, I am at no risk of HIV? I assume the viral load needed for infection does not meet the threshold for hand genital contact and I can confirm there was ZERO penetrative contact, oral, anal or vaginal.

2. I haven’t noticed any chancre or lesions in my genital/ mouth area so far and am approaching the 20/21 day mark now, would you say that if no apparent lesions that syphillis wouldn’t be a possibility as usually “asymptomatic” cases would usually have internal chancre?

3. I am going to have a full STD panel including blood tests done around day 45 from exposure, would these results if negative be entirely conclusive for syphillis, HIV and hepatitis? I note your point re gonnorhea/ chlamydia but as no penetration occurred am not overly concerned with these as I believe you confirmed no risk to me for those.

4. I have had protected sex with my partner twice since the incident date and have covered any pimples/ inflamed follicles etc with plasters to be extra safe, do you think I can continue to do this without worry? 

I appreciate your advice.

Best wishes

2. Some asymptomatic cases of newly acquired syphilis have no chancre at all. But yes, absence of a visible chancre should be reassuring to you.

3,4. As I said above, "you are not at risk at all and do not need testing. You can safely continue your usual sexual practices with your regular partner without any risk to her health." I haven't changed my. mind on this aspect either!

As you are aware, that concludes this thread. Please do not be tempted to return with a new question just to let us know your negative test results. But I'll make this deal with you:  If any tests are positive, let us know and we well refund your posting fee. In the meantime, I hope this discussion has helped you. Best wishes and stay safe.

I just wanted to follow up quickly with a few more points to clarify regarding my exposure mentioned here.

I am not worried about the fluid based STD’s as I understand that it is essentially no penetration = no fluid transfer, even if the secretions from the masseuse’s vagina came into contact with my shaft after I touched her and due to no penetrative sex, these are very low risk.

I have been checking my genitals/ mouth for chancre’s and sores or anything unusual and I have come across something slightly concerning. 

Upon inspecting my anus I have noticed something that has me alarmed, at the top of my anus, there appears to be an area that is (possibly) ulcerated - it appears as a shallow circle that is connected to the creases of my sphincter if this makes sense (apologies if not) as opposed to an independent circle and can only be seen when I flex my sphincter muscles.  Do you think this could be a chancre? It doesn’t seem wet or blistered but I am concerned that it is there at all! It is more like a dent in my sphincter

I also wanted to clarify that as I have had protected sex with my female partner 3 times since my exposure, would a chancre on the anus pose any risk for syphillis if she does not come in to contact with it or can syphillis be passed on even without contact to lesions.

I am planning on getting an ECLIA syphillis test next week (around 40-42 days) and a HIV duo test as well as checks for the other STD’s as they all come as one package, would this be too early for syphillis to show? And if they come back negative, would these results be conclusive? I see a lot of different advice (not on this forum) regarding window periods and am under the impression if this was a chancre, it would be positive 

Please do let me know! :) 

I really can't judge the likely cause of the lesion you're describing. It doesn't sound like a chancre, and we have discussed the reasons you were not at risk for syphilis or other STIs. Rather than relying on self directed testing, I strongly advise your anal area be professionally examined so that direct (and immediate) testing for syphilis and herpes can be done without waiting for a blood test. A blood test would likely be positive if it's syphilis acquired during the event described above, but if negative -- which is what you can expect -- you'll still likely need medical attention to know what's going on. And as just suggested, herpes testing might be advised, depending on its appearance and a clinician's judgment. 

But to answer your direct question, a syphilis blood test would be positive if that's what you have.

That ends this thread. I hope the discussion has been helpful.