Hello Doctor,

I recently went to a masseuse who while giving me a handjob inserted her finger into my anus. Initially, she was outside the anus however at the end, the finger went into my anus about 1 inch (for about 20 seconds). After the session, I reviewed her finger nails where I didn't see any wounds nor did I see any blood on her hands. There may have been a nick in my anus from constipation earlier. However, I am extremely concerned as it was a momentary lapse in judgement. Do I need to get on PEP since this exposure was only a few hours ago (by the time you are reading it) and if so, does PEP have major side effects I should be concerned about? Anyhow, what are my next steps?

Thank you very much

Fingering and other kinds of hand-genital contact are zero risk for any and all STDs. Even if the masseuse had HIV -- which statistically is very unlikely (probably under 1 chance in a thousand), there would be no risk. Nobody has ever been known or, to my knowledge, even suspected to have caught HVI in this manner. You definitely do not need PEP -- if you were to find a doctor or clinic willing to prescribe it, I would seriously question either their knowledge of HIV or their ethics.

So my advice about "next steps" is to forget it and move on without testing or PEP, and with no further worries. If you have a regular partner, you can safely continue your usual sexual practices without risk of transmitting anything related to your massage.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD