Dear Dr. Handsfield,Thank you for everything you and your colleagues do.

On July 9, I visited a soapland in Okinawa. I received unprotected oral sex for approximately three minutes and had condom-protected vaginal intercourse for less than ten minutes. The condom remained on throughout intercourse. The activity took place on an inflatable mat covered with lubricant.

I noticed approximately four to six dark-red, pimple-like marks or scars around the lower part of the woman’s buttocks, near the crease beneath them.

I have read reports that syphilis cases have increased in Japan in recent years, so I am concerned about the possibility of contracting syphilis or another sexually transmitted infection.