Last few days, I am filled with anxiety and feeling many symptoms like itchiness and tingleness feeling over my body, black small spots, white tongue, blister at my back of tongue ( but I feel its been there for years now), headache and tiredness.

1. What's my risk exposure with HIV? When and what test i should take to be sure?

2. What's my risk exposure with other STDs and STIs?  And even for the very low risk one, when can I test to make sure?

3. I am already engaged in unprotected sex with my wife, should I stop? Have I put her in any risk?

I want to leave this episode behind me, so would appreciate your help on this.

You really needn't be worried about HIV or any STIs from the events you have described: congratulations on your approach to safe sex. Sexual transmission of HIV requires direct penile penetration into the vagina or rectum. The virus is not transmitted by saliva (which actually kills HIV) and therefore is almost never transmitted by oral sex, and not by hand-genital contact even if saliva is used for lubrication. So even without a condom for the oral sex, and despite the other contacts you describe, there was no measurable risk of HIV transmission. The risk of STIs other than HIV is somewhat higher, but still very low. Here too, unprotected vaginal, anal or oral penetration almost always is required for transmission. As for your symptoms, they are most consistent with anxiety and none suggest HIV or any other STI.

Those comments address most of your questions, but to be explicit:

1. Your HIV risk was nil for all practical purposes. From a medical or risk perspective, there is no need for testing. However, you are of course free to be tested if you would like the additional reassurance of the negative test result. IF so, have an antigen-antibody (AgAb, "4th generation") blood test. Such tests are 98-99% conclusive by 4 weeks, and 100% at 6 weeks or later.

2. Here too I see no need for testing. However, for reassurance you could have a urine test for gonorrhea and chlamydia, which is valid any time more than 3-4 days after exposure; and a syphilis blood test at 6 weeks. I strongly recommend against any other STI testing.

3. I see no need to stop having sex with your wife. You have not put her at risk.

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

HHH, MD