Dear Dr., I fell for my old behaviour and frequented massage services again. That went on for the last 3 months with about 30 exposures of the same sort. I fingered the girls and they masturbated me and I again feel the urge to get tested to put that behind me. I worry especially about the large number of exposures that might multiply a basically very low risk into a substantial risk. Do you think I shall get tested? If, for what and when and what is about sex with my wife (that I have avoided lately)? Thank you for your input, this is a great service, keep it up!

Welcome back, and thanks for your kind comments about our services. Sorry to see you find it necessary. But the question is identical to your previous one and I have no different answers. Quoting directly from my replies there, "Without overt sores or other moist skin lesions, no [STD] transmission occurs. That includes body to body rubbing and hand-genital contact of all kinds." I also went through a rough numerical calculation of the chance you were infected, if you assume there is some small risk from each exposure. If you apply those estimates to these more recent exposures, there remains no realistic chance you were infected. I see no reason not to continue unprotected sex with your wife. That's what I would do if somehow I were in your situation.---

Dear Dr. Handsfield, thx! And you are so right. I just realized I have asked substantially the same question, sorry! How can I assume the answer might change (Einstein...). That taken into account your answer makes so much sense: To be tested as a "worry well" for peace of mind. I followed your advice to "re-read your previous replies about specific tests I could do." That was "What were you planning to be tested for anyway? Syphilis? No chance. HPV? No test available, and we all have it anyway. Herpes? Unlikely in the absence of symptoms; the tests sometimes give false results; and 10-50% of the population has a positive result due to past infection." ... so I conclude Herpes/HPV really make no sense. I don`t fear HIV or the bacterial STD`s (besides Syphilis) as I understand that there is clearly absolutely no chance. So I conclude Syphilis would be the only test but still for reassurance only, right? As it finally does become more and more clear to me that my problem is purely an anxiety/guilt issue I think this is where I primarily should invest my energy and time, that means counseling, right? 

I agree with your reasoning. However, whenever a lab or doctor tests for syphilis, usually they expect to test for HIV as well -- but of course there is no risk (never a known case transmitted by the kinds of exposures you have had). I agree that guilt/anxiety is the main issue here, and that counseling is likely the best way to address it.---