Hi Doctors,

Thanks thoroughly answering my previous questions. I had a follow-up from an encounter with the same masseuse. A few hours ago, I went for similar service. However, things evolved differently. This time, there was a bit of deep-kissing (a minute or so) and at some point during the massage, the masseuse held my penis between her thighs (high up) to stimulate me. I realized later there was contact with her genital area, although covered with lingerie (not a thong but a semi porous underwear). To my best knowledge, there was no penetration and this was confirmed by the high-end masseuse. I was a bit alarmed because this felt more intimate that most encounters in my experience and found myself worried about STI risks, especially as I'm doubtful if the underwear would be sufficient to protect my bare penis.

I will be traveling internationally tomorrow, so I wanted to clarify:

1- From an HIV standpoint, I'm aware kissing and manual stimulation are no risk events. For the frottage, would you recommend taking PEP, given that I'm in the early window of the exposure? I feel like the contact is no risk, but I'm worried about the CSW being in a risk group and potentially changing the assessment. Would this be different say if she was known to be infected (I haven't asked since last time, and she said she was tested in May)?

2- Any other symptoms I should monitor (potential discharge or sores) and is there any testing warranted. I did a comprehensive test in August, with the exception of HSV1/2, and everything was in order.

Sorry for the potential redundancy of the question, I want to get a second opinions especially given the tight window.

For all practical purposes, STIs are not transmitted without penetration which you did not have.  Frottage and other forms of mutual masturbation are no risk events, including no risk for so-called lesion diseases such as syphilis or herpes.  Further, STIs including HIV are not transmitted through clothing (including sheer lingerie), even of the material is wet with genital secretions.  Thus:

1.  I would NOT recommend PEP following ANY of the activities you describe.  HIV is NOT transmitted through activities of the sort you describe.  They were no risk.

2.  No

Please don't worry.  There is certainly no need for PEP and no need for testing.  Enjoy your travels.  EWH