My only added suggestions are to make sure that you have been vaccinated against HPV as HPV infection is hard to avoid if not vaccinated and that you, like your partners periodically get tested from time to time (not after every casual contact but every 6-12 months, just as an added precaution.

Again, you're doing everything right- congratulations

EWH

I am fully vaccinated for HPV (gardasil) as well as hep B and I get tested at least twice a year. My last test was about a month ago (blood and urine).

If you don’t mind, I have a couple follow up questions especially around testing and window periods:

1. I understand that the only way to be 100% protected against STIs is abstinence of course, but testing and condoms help to substantially lower risk. When it comes to testing, can you explain why experts recommend testing every 6 months or so (I’ve also seen 3 months) when it comes to causal partners? Pardon me if I’m splitting hairs, but wouldn’t that still leave risk for certain infections (particularly HIV) given that it takes several weeks for a test to pick up an infection? In my particular case, theoretically if my partner had sex with someone 1-2 weeks ago and somehow acquired HIV, could I be at risk since they wouldn’t know their status? (Obviously this is purely hypothetical, but I am curious about the suggested testing intervals).

2. This leads into my next question — how soon after acquiring HIV could someone be able to infect others? Days? Weeks? Woild seroconversion need to occur?

3. Lastly (this one does pertain to myself) am I correct in stating that heavy genital rubbing without a condom (frottage) is a form of mutual masturbation which carries little to no risk of STI acquisition?

I’m not particularly worried about my specific scenario, but I am genuinely curious about the epidemiology at play here and how to lower my risk as much as possible without going overboard or wasting medical resources :)

1.  There are no hard and fast rules about testing frequency.  Factors such as numbers of partners, their histories, your sense of them, etc. all factor into this.  So does your own confidence about those partners and levels of concern.  It would be quite uncommon for persons with negative tests to transmit and STI which was developing.  There is much on the internet about "window periods" which reflect the fact that persons with recently acquired HIV (although it is true for all STIs) can have negative tests and theoretically transmit infection.  The internet has blown this completely out of proportion can created much unnecessary anxiety for many people.

2. On average when a person acquired HIV their HIV RNA PCR test (the one that becomes positive first) is reliably positive after 11 days.  Once that test is positive, the virus can be transmitted.  The more widely used 4th generation tests for HIV take longer (4-6 weeks) to become positive so such persons could transmit infection.  This is quite rare and as I mentioned above, blown entirely out of proportion on the internet.

3.  Correct.  There is no risk for nearly all STIs from frottage without penetration.  In theory, the STIs which cause lesions such as syphilis or herpes could be transmitted in this situation but it is exceedingly rare.

I hope this information is helpful.  One follow up remaining.  EWH

I have one last question that pertains to myself. I frequently experience anal fissures that extend to the external part of my anus. Is frottage still a low-risk activity with this in mind (for HIV especially)? I assume so especially without ejaculation from a male partner. I understand HSV and syphilis could still be a risk with skin to skin contact. 

Thanks!

As you know, this completes this thread which will now be closed.  I hope my comments have been helpful.  Take care.  EWH