She massaged my back and made me ejaculate by playing with my penis with her hands from reaching under.

I am extremely worried about HIV. Is it possible that I could have caught it with this episode? For last 2 days I have been peeing much more frequently but I think this is anxiety as no other symptoms of any STI.

You can think of STDs in two groups: those transmitted primarily through infected fluids (gonorrhea, chlamydia, HIV, hepatitis B virus) and those transmitted by contact between infected surfaces (herpes, HPV, syphilis). Genital apposition, without penetration, is rarely if ever the source of the former; i.e. even the busiest STD or HIV/AIDS clinics never see infected patients whose only exposure was like yours. While nobody can say the risk is zero, the absence of recognized cases obviously indicates an exceedingly low risk, low enough to be considered zero for all practical purposes. However, genital contact without penetration is more commonly associated with the second group. However, even these are truly rare -- higher risk that for chlamydia, HIV etc, but still extremely low.

In addition to the inherently low risk of transmission, we can consider the chance the masseuse was infected. Assuming you're in the UK, she chance she has HIV is extremely low. Even among the most risky commercial sex workers in your country, fewer than 1 in a thousand have HIV. It could be higher in certain subgroups of CSWs, but for sure under a 1% chance. The chance she had other STDs probably is higher, but for all STDs, at any point in time most people at risk are not infected.

No STD causes increased urinary frequency as the only or main symptom. And this certainly is a very common occurrence with anxiety, especially anxiety over sexual exposures.

For those reasons, I don't recommend testing for HIV or any other STD. Certainly if somehow I had been in your situation, I would not be tested and would continue unprotected sex with my wife, without worry. That said, if you would like the extra reassurance of a negative test, you could have a 4th generation (antigen-antibody) HIV blood test at 4 weeks, by which time the result will be conclusive.

I hope this has been helpful. Let me know if anything isn't clear.

HHH, MD

In regards current symptoms for a couple of occasions I have felt heat (not very uncomfortable as such, not really burning pain) when peeing and also a bit sore and tingly burn today after ejaculating. Also this full feeling in my bladder as if pressure causing me to need to urinate after any drinks. However I have spent last 2 or 3 days opening my urethra to check for redness about 15 times per day so could this be irritating it? 

Also there was one other incident about 1 year ago with a call girl where I massaged her and fingered her to climax and then she gave me hand job to climax. No genital to genital contact.

I have just been back to the maessuse for 30 min appointment to ask her directly. This is why I ejaculated today as she gave me Swedish massage plus happy ending, no body to body. She was outright that she only uses stomach and thigh in that region as she does not want risk to her. She is from Romanian and sees her doctor whenever she returns every 6 to 12 months last time 7 months ago.

She has boyfriend who owns his own IT business as well and seeing him for 1 year and she has been in U.K. For 2 years. She was very clear that she only offers the massage and hand relief and I am only person she has had this way with anxiety. She was very relaxed and nice about my questions.

Let's not mince words:  your masseuse is a commercial sex worker. However, it sounds like she looks after her health, and if she limits her commercial contacts to the kinds of exposure you have had, she is at no risk of HIV and little risk of other STDs. OTOH, I suspect many women in her situation are suscepible to bargaining higher risk practices (e.g. intercourse, perhaps without condoms) for higher prices, in which case she could be at higher risk. Still, given the exposures you describe, there still is no significant chance you have caught HIV from her, and low risk for other STDs.

So my overall assessment and advice are the same as above:  optional but for sure not definitely required testing for HIV and perhaps other STDs.

Also he used a needle in arm to draw blood rather than finger prick which I found strange. Anyhow is it ever possible to catch HIV from the having the blood taken if old needle. He told me fresh needle from packet but I wasn't watching plus he said I was his first HIV test of the day. The clinic I went to specialises in sexual health and travel vaccinations.

Your advice greatly appreciated.

You came herre for reassurance, and I've done my best with reasoned, science based facts and judgments. But all your comments are skeptical. Do your best to accept the scientific evidence and my expertise. Trust me on this: you were not at measurable risk of HIV. Any testing you continue to do will be negative.

We're beyond the two follow-up comments and replies included with each thread, and so this thread is closed.