1) what is my realistic risk from this encounter and what are they? This woman wanted to have sex with me but i said i did not have a condom and she jokingly said " its ok im clean" but i ignored her comment and backed off, what sort of std could i contract, if i coukd add it up i would say it was no longer than 20 seconds in totatl of unprotected oral sex.

2) going back to last weeks post involving the masseuse, masturbation and anal stimulation, i have been having a lot of weird sensations back there sometimes its like itching but im not sure if it is anxiety related or paranoia, i am scared she had old semen or something in her hand and couldve given me hiv, it has been 2 weeks 2 days so 14 days since that encounter and i hve not developed anything else. Thanks doctors sorry for the anxiety

1) Oral sex is safe sex. It isn't entirely free of STD risk, but it's far safer than vaginal or anal sex, with low risk for all STDs and virtually zero risk for others. And your risk is even lower than for the average oral sex exposure, since your penis did not really enter the strippers mouth. Contact with tongue or saliva on the outside of the penis probably is entirely risk free for all STDs. That said, it seems your penis was inside her mouth for maybe 20 seconds, right? If so, you are at slight risk for gonorrhea, and theoretically at risk for syphils -- except syphilis in the US is mostly in gay men, and the exposure really was too brief for worry about it. You could have acquired genital herpes due to herpes simplex virus type 1 (HSV1), if you don't already have HSV1 from childhood (as do half of all adults in the US, whether or not they ever had known oral herpes). There is no risk for HIV, and little if any for chlamydia. The risk of all these is low enough that I  do not recommend testing, assuming you don't develop symptoms (penile discharge or sores) in the next week or so. However, if negative tests would reassure you more than my words, you could have a urine gonorrhea/chlamydia test any time more than 4-5 days after the exposure, and a syphilis blood test in about 6 weeks. However, if I were somehow in your situation, I would not be tested for anything and would continue unprotected sex with my wife without worry.

Hand-genital contact, i.e. when she masturbated you, was entirely free of risk -- no worries there.

2) Neither HIV nor any STDs cause any of the syptoms you describe. As you seem to suspect, they are typical for genitally focused anxiety -- i.e. your worries magnifying trivial symptoms or even normal body sensations you otherwise wouldn't notice. I will also point out that whenever someone suspects his or her own symptoms have an emotional origin ("I'm not sure if it is anxiety related or paranoia"), usually s/he is exactly right!

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

Do you fee completely certain? That comment about continuing unprotected sex with my wife seems risky to me but i respect your opinion as an expert and if thats what you would do i will continue and wait and see how i progress, the woman has agreed to test tomorrow hoping she goes through

That completes the two follow-up questions and replies included with each new question, and so ends this thread.

You shouldn't expect to come to this forum for advice every time you have an exposure that makes you nervous. This is your fourth question and your third in a month. The forum does not permit repeated questions on the same topic or exposure. This will have to be your last one; future similar questions will be deleted without reply and without refund of the posting fee. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thank you for your understanding.