Hi , I have concerns about STDs from a  Nuru massage and protected sex from about 4 days ago. Happened in Asian country done by chinese lady.  I was lying for 10mins where her vagina was doused with lubricant rubbing on my buttocks. she held my penis with her barehands that could have her fluids while putting on a condom for me. She gave me protected oral and sex (no licking of balls)in which I came inside her. After pulling out, I saw that the condom was intact. No fishy odour from her, and didnt see any chancres/sores on her mouth and vagina as the room was dim. I bathed after with soap and warm water..

Here are my questions

STDs to test for (from commonly mentioned STDs such as Chlamydia, syphilis, HSV, HPV, HIV). Do I have to test for less common STDs such as Trichomoniasis, mycoplasma, Hep A/B/C?  Is  STD testing warranted?

No pain urinating or itch so far, on both my penis and anus.  However, I do feel slight irritation on my penis,  not sure if my foreskin had been moving with very little lubrication as I felt some tingling upon penetrating. (unsure if its anxiety and hope not caused by STDs) What are the chances that her fluids could have caused me an STD around the butt or her fluids seep into my anus?

As has been discussed innumerable times on this forum, there has never been a case of HIV, and few if any other STIs, transmitted by massage or other body-to-body contact with actual sex, i.e. penile penetration into a partner's vagina or rectum. Even oral sex is risk free for HIV.

"STDs to test for...?" and "Is STD testing warranted?" None that I would recommend, including any of the ones you mention. And certainly not for trichomonas, mycplasmas, or the hepatitis viruses. The answer to the second question is no.

"slight irritation on my penis...." and "tingling":  I would guess these feels are anxiety driven, not indicating any infection of any kind.

"What are the chances...[etc]?" Zero in my professional opinion. 

Of course risk alone isn't the only reason to test for STDs. If you remain nervous despite this advice, testing strictly for reassurance is something you could consider. Truly, not because of risk -- only because you might be reassured and stop worrying if you get tested with negative results. If so, feel free to have a urine test for gonorrhea and chlamydia (valid any time 4-5 days or more after exposure); and blood tests for HIV and syphillis after ~6 weeks. Honestly, if somehow I were in your situation, I would not be tested. But the choice is yours.

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

HHH, MD

"If I continue using paid protected sex, am I at high risk of any STD...?" Yes, of course you are. Condoms are not perfect, and some STDs (HPV for example) are equally common in regular condom users versus nonusers. And because of potential condom failure, you could catch an STD that would impair fertility, like gonorrhea or chalmydia. However, these are very rare causes of infertility in males -- really nothing to worry about. But if you go forward with such a lifestyle, you should be tested from time to time for the major STDs, i.e. gonorrhea, chlamydia, syphilis and HIV.

Your doctor probably was just being especially safe -- it's normal to test for all STIs, including trichomonas and mycoplasmas. I doubt s/he was in it for the money.