We kissed, and mutually masturbated one another. There was no oral or anal penetration with one another’s penis. However, he did the following:

- Used his saliva to finger my anus for a period of time.

- Masturbated to completion on the side of my face. (My eyes were closed and mouth closed to ensure no contact with semen in mucous membranes.)

What is my risk here for any STIs, including HIV? In addition, should I employ the DoxyPEP approach here given the contact I had? Concerned about transmitting to someone else. I am of clean STD status currently based on recent testing.

First, in my experience and that of most similar experts, people in your and your partner's situation generally are truthful about past STI risks etc -- so you probably can trust your partner's "clean" status. Second, kissing and hand-genital contact are free of any significant STI risk. For sure there is no HIV risk. Evolving research, especially from superb experts in Australia, has shown gonorrhea can be transmitted by kissing. However, the risk is low for any single exposure; and the chance your partner had oral gonorrhea seems zero for all practical purposes. Anal fingering also is risk free for STIs (although it could risk non-STI gastrointestinal viruses and a few other infections).

All in all, your risks are nil. From a medical/risk standpoint, I would not advise testing for anything and you do not come close to the standard criteria for doxyPEP. Of course reassurance alone can be a valid reason for testing -- i.e. if you're going to keep worrying and lose sleep despite my assessment, feel free to seek STI testing (gonorrhea/chlamydia in a few days, syphilis and HIV in a few weeks). But if somehow I were in your situation, I certainly would not be tested and would continue unprotected sex with my wife with no worries about her health.

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

HHH, MD