I would like your opinion on the level of risk I put myself in a few days ago. I got a full nude body to body massage from a lady which including rubbing bodies against each other and a handjob.

Her breasts and vagina were massaging my back and front all the time with the lady's vagina also rubbing against my buttocks.

The one thing I'm worried about is that I had cleaned my anal area with a soap bar around 1 hour before the message, and it caused some irritation and pain. One day after the massage, I felt increased pain in the anal area and some small blood spots when wiping. (Which was most likely due to the anal cleaning, and which means I must've caused an anal wound/fissure just before the session)

I know that massages/mutual masturbation does not lead to infection generally - which is why I chose to have this service rather than risking a condom breakage with full penetration. 

But I'm worried whether the lady's vagina or vaginal secretions touched my anal wound/fissure and put me at risk for HIV, as I have also read that wounds on mucous membranes can give the virus direct access to the body. 

I would love to hear your assessment on this matter.

Within the context of deciding to have a sexual massage, you were wise in not having penetration, even with a condom. I really believe you were at zero risk for any STD.

As you might imagine, there are no data on which to base an answer to this question. Nobody has ever done research on the risk of STIs from body massage, with or without non-penetrating genital-genital or genital-anal contact -- let alone analyzed the effect that an anal (or genital) ulcer or fissure might have. What we know, however, is that the busiest STD clinics consistently report that they never see infected patients whose only exposures involved non-penetrating sex:  none from fingering, hand-genital contact, or rarely genital contact without penetration, etc. The occasional exception, in my experience, has always involved non-penetrating penile contact, not vaginal. If you think about the anatomy involved, it would be difficult for your partner's genitals (vulva) to contact your anus, even if there was buttock contact. Even if there had been brief, fleeting contact, STDs are not so easily transmitted (which is why penetration almost always is required).

So I see this as a zero risk event and recommend against testing for any STD. And would advise that you continue your normal sexual practices with your own primary partner, if you have one.

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

HHH, MD