[Question #13019] Risk assessment over these last few exposures

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3 months ago
Hello again Drs and staff, your guys' forum has been a complete life changer and saver to my sexual health anxiety and has been a standard for me to assuage my worries. I know I asked a question not too long ago, and found many stories like mine but just to kind of finally cease any anxiety, wanted a direct response from one of you for my exact cases.
4/28 - fully condom protected vaginal sex, oral sex with something like a plastic wrap? This was done at an asian massage parlor, the masseuse has a child and doesn't do any unprotected services so she says (she said she likes working there because they don't make their workers offer unprotected services)
5/7 - fully condom protected oral sex (again the masseuse said she takes her health seriously and gets tested every week)
5/12, 5/16, 5/19 - all handjobs that involved my nipples getting licked and bitten, non-tongue kissing, and rubbing my penis on their bodies, but not directly on their vaginas (the encounter on 5/12 was the same lady from 4/28 and the one on 5/19 is a asian masseuse I've gotten an unprotected blowjob from - the lady from my last post)
I had a full blood and urine panel done on 5/19 (before the encounter that day), all came back negative

I was just wondering if I had anything else to worry about from these encounters?

I appreciate all that you do. Thank you.

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H. Hunter Handsfield, MD
3 months ago
Welcome back and thanks for your note of appreciation. However, I have to advise that we are not an appropriate resource to resolve every "sexual health anxiety" that arises after a sexual encounter. And you describe no sexual activity likely to have resulted in any STI.

Oral sex is low risk for all STIs even without condom protection and zero risk with condoms. Hand-genital contact also is entirely risk free, and so are the other sorts of exposures you have described. I would have advised against being tested, but the May 19 "urine panel" was proof you didn't acquire gonorrhea or chlamydia. The blood tests that day were too soon to detect any infection acquired within 6 weeks prior to that time. But since you were at no risk anyway, I would not advise repeating these tests. And by the way, most tests in labs' "comprehensive" test panels that actually are useful are urine for gonorrhea and chlamydia (and trichomonas if there has been a known exposure to it); and blood tests for HIV and syphilis. All other tests in such panels are pretty much useless.

All things considered I see no cause for worry at this time and I do not advise any further testing.

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

HHH, MD
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3 months ago
Thank you for the reply as always.
The main things I was concerned about were possible lesion-based infections such as syphilis or herpes, but again it seems like those are virtually no risk at all as well? Granted, if I were to develop any symptoms, the only encounter that presented any risk if at all would be my first one I assume? Because it seems like oral contact to my nipples and lip contact really doesn't warrant any attention at all.
Also, I know you said you wouldn't advise testing, but if I were to do anymore testing, should I use my latest exposure as a benchmark for how much time I should wait before all tests are conclusive? Or are the non-penetrative encounters things I can ignore entirely?
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3 months ago
As in the protected vaginal exposure
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H. Hunter Handsfield, MD
3 months ago
Correct, little or no risk even for "lesion based" STIs like syphilis and herpes. If you choose to be tested, I would base the timing on the vaginal sex event and the only tests you should consider are urine for gonorrhea/chlamydia, valid any time more than 4-5 days after the event, and HIV and syphilis blood tests after 6 weeks. No other tests are useful in people without symptoms that suggest they were infected.---
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3 months ago
Thank you for the reply.

So as a generalization, just to reiterate, any non-penetrative action (i.e. handjobs, light kissing, fingering, nipple getting licked, sucked and bitten) and condom protected oral sex are entirely risk free?
Also, I haven't had any glaring symptoms indicative of an infection yet such as a chancre, sores, lesions, blisters, discharge, nor burning urination (minus slight discomfort sometimes during urination if I'm dehydrated or just masturbated). My final question is would I be out of the woods in terms of the symptom window periods for any STIs given the nature of my exposures and the dates they happened? Should I still be on the look out for any symptoms from non-penetrative encounters? How many days after my latest exposure (5/19) would it be extremely unlikely to develop any symptoms if they were to occur theoretically?

Thank you for the final follow-up, wish you all the best.
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3 months ago
But overall it seems like a pretty much zilch chance I caught anything from any of these exposures as well?
Thank you.
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H. Hunter Handsfield, MD
3 months ago
"overall it seems like a pretty much zilch chance I caught anything from any of these exposures...?" Yes; that is the main point of all my comments above.

The type of exposure affects the chance of infection (the chance is zero or close to zero for all the ones you mention) but makes no difference in the symptoms themselves or how quickly they might appear. You should not be "on the lookout" for anything; any symptoms that mean anything will be obvious without special attention. If within 3 weeks you have no penile discharge, painful urination, or genital area sores or blisters, you will be home free.

That complete the two follow-up comments and replies included with each question and so ends this thread. Take care and stay safe.
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