[Question #1397] STI Risk from Full Body Massage

82 months ago

Married 20 years, always monogamous.  However, three weeks ago I received a full body massage from a commercial sex worker.  We were both completely naked and she used her body and oil to massage my back and front sides.  She may have grind her vagina against my penis/scrotum.  I'm not sure. It was all a blur.  But definitely no penetration occurred and she was particular about rules and cleanliness.  Had my shower before/after and she said no touching her vagina.   I felt guilty and put the experience behind me.  However, two days after event I started to feel tingling/burning sensation in head of penis.  But no pain urinating, no discharge and no sores.  At one week a took full set of STD test which all came back negative.  I now know that was too soon.  But from my research I thought I was at low risk and began to feel better.  Then 19 days after the event I had sex with my wife again.  After I immediately started to feel worried/guilty that I may have infected her and symptons  returned.  So that day I got tested again.  And again all negative.  I also went Urgent Care that day and doctor thought I was at minimal risk but she prescribed Doxycycline just in case I have non-specific urethritis.  I've taken 3 pills.  That evening a noticed a small white pimple on my scrotum.    Ugh  so confused/worried.

- Am I at any real risk from full body massage assuming genital/genital contact?

- Could small pimple be chancre?  No redness, just small white pimple.   If chancre wouldn't I have tested positive the day before (19 day mark)?

- How at risk is my wife from our one tryst?  If I continue Doxycycline it will clear syphilis and at 5/6 week test I won't know if I was ever infected. so should I stop taking the meds?  Start again if I receive a positive test?

This was such a mistake and not worth the stress/anxiety.  Your insight/help will be much appreciated.   

H. Hunter Handsfield, MD
82 months ago
Welcome to the forum. Thanks for your question, which arrived while I was logged in. Most users shouldn't expect nearly real time replies!

The quick reply to the title of your question ("STI risk from full body massage") is zero; there are no STI risks from nonsexual massage. And the details of this event do not change that assessment. While direct genital apposition could transmit herpes, HPV or other STDs that go from skin to skin, even this would require your penis between her legs rubbing her labia (some might call it "outercourse"). The possible fleeting contact that might have occurred between her external genital area with your body (scrotum or anywhere else) carried no measurable risk for any STD.

Your symptoms were not at all typical for any STD, and I would have recommended against event testing and would not have prescribed doxycycline (or anything else) had you come to my clinic. There 'is no way you had NGU from this event. Your symptoms are perfectly typical for anxiety over this event magnifying trivial symptoms or normal body sensations that otherwise would not be bothersome or that you wouldn't even notice except for your anxiety and fears.

Those comments pretty well cover your direct questions, but to assure there is no misunderstanding:

1) No risk, see above.

2) Chancres don't appear as pimples (or folliculitis), which are common on the scrotum. That has nothing to do with your massage.

3) There is no risk to your wife.

4) It is true that if you continue doxycycline for a full two weeks, and if you had been exposed to syphilis, it would prevent infection and also prevent having a positive syphilis test in the future. As I said, I would not have prescribed doxycycline (or penicillin, which is what you would need if you really were exposed to syphilis). But you were not exposed:  the exposure itself was no risk, and syphilis is rare in partners like yours -- in the US the large majority of infections in recent hears have been in gay men.

Really, let this go. Separate your anxieties over a sexual decision you regret from the disease implications of that decision. They aren't the same. Deal with the former as you need to, but forget the latter and move on with your life.

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


82 months ago
Thank you for the fast response.  You made me feel much better.  I guess one follow up question.  Would your advice regarding risk change if there was more than fleeting genital to genital contact?  I really can't remember if it was fleeting, or she was grinding on my leg or grinding her vagina directly on my genitalia.     And just to confirm, I will stop doxycycline and resume regular sex with my wife.   If I was infected - is she at great risk from our one event.   I'll put this to rest after your reply.  thanks
H. Hunter Handsfield, MD
82 months ago
Thanks for the thanks. I'm glad to have helped.

We don't provide direct medical care or treatment, so be clear that I am not formally recommending you stop doxycycline. That's your decision and should you choose to do it, I have to advise you to discuss it with the prescribing doctor. Whether you actually do that, of course, is up to you. (Sorry for the legalistic stance, but it's necessary.)

I would still consider the risk of any STD to be nil from the kind of contact you describe. STDs are not simply infections that happen to involve or be transmitted to and from the genital area. Sex per se, not simply contact, generally is required for transmission. If skin contact with body fluids could transmit these infections, there would be risks from, say, shaking hands or exchanging money with people who didn't wash their hands after toilet or scratching their balls; they would be far more common than they are; and they wouldn't be classified as STDs. Your exposure was more intimate than these examples, but for purposes of STD transmission, it wasn't sex.