I was just on vacation in Greece and Germany, and while I was in Munich I went to visit a commercial sex worker where I received a handjob with no condom. She spat on my penis and applied lube. I don’t think there was blood in her spit and I don’t think I had any cuts on my penis head but for this question I’d like to assume the case is true.

The next day, I went to go to a massage parlor where a worker unexpectedly slid her fingers in and around my anus and she ended up giving me a handjob with lube.

A week later I had a swollen uvula and what felt like a fever along with aches. I also felt like my buttocks and genitals were itchy in the days after. Bathing with cool water helped alleviate the itchiness. I am also a very anxious person.

I deemed what happened to be a generally safe sex activity, and it’s about to be roughly 2 and a half weeks since the instances. I was wondering if you believe that I would be at risk for hiv or any other STI/std.

Thank you 

Occasional questions can be accurately answered based on very minimal information, as might be included in the title the user selects for his or her question. That may be the case here. I haven't read beyond the title (except mention of travel in Greece and Germany) but I'll say that hand-genital contact and fingering carry little or no risk for HIV and other STDs, even if genital fluids are used for lubrication. Also, saliva is even less risky:  it rarely carries STD bacteria or viruses, and actually inhibits or kills some of them, including HIV. So unless there is a surprise when I read on, it seems unlikely there is any risk or that you need testing.

Now I have read the rest. Guess what? Even if there were blood mixed with your partner's saliva, I would consider this a no risk event. Inflammation of the uvula plus feverish feeling could indicate an upper respiratory viral infection, but it sounds like your mouth wasn't even exposed -- and no STD or any other infection can travel through the body from the rectum or genital area to the oral cavity. Obviously if you're close enough to someone for the exposures described, you're also close enough to acquire a cold virus, COVID, etc; or you could have been infected by anyone in your environment in the few days before onset of symptoms. And of course your subsequent development of typical cold symptoms fits with this explanation.

For all those reasons, I agree exactly that what happened was a "generally safe sex activity". In fact, you could drop "generally". In my 40+ years in the STD business I have never had a patient, or been aware of a colleague's patient, who acquired any STD or HIV from events like this. I recommend against testing for anything; and if you have a regular sex partner, you can safely continue your normal sexual relationship with no worry about transmitting anything (except maybe your cold!).

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

HHH, MD

I did some research on you and I was really impressed with what I found. I was actually hoping for your response! I am going to see my PCP tomorrow to discuss what happened with him because we have a good relationship together and I want him to know, but this has calmed me down. This work you do is so invaluable, you have no idea.

I was curious about a few things.

1. Based on what I’ve read here from other entries, it seems like HIV is very hard to catch. Is this true? (For heterosexual males )

2. The doctors on here seem to be unfazed by CSW’s in the west. I’m under the impression that it isn’t as dangerous as people make it seem.  (For heterosexual males )

2. Also true. In industrialized countries, a very small proportion of all HIV infections occur in men following exposure to female sex workers.

3. I could have stated my recommendation against testing more artfully. From a medical/risk perspective, there is no need and I wouldn't feel a need if I were in your situation. That said, some anxious persons are more reassured after negative testing than by professional opinion, no matter how expert. If you'll sleep better following a negative HIV test, feel free!