a 44 year old male and on Oct 4th I had a body to body massage with a nuru massage specialist. She rubbed her naked body up and down all over and flipped me over and did the same to my front side. During the massage she rubbed her vagina at the very base of my penis for a bit with no penetration. I then barely rubbed the head of my penis near her vagina but again with no penetration. About two weeks later I discovered a small genital wart that was diagnosed by a dermatologist. He assured me I could have gotten this months or years before in a normal relationship. I began to have severe anxiety that a wart exposed me to her bodily fluids and my doctor tested me for all STI’s and 4th generation HIV test on day 20 after exposure (all negative). On day 49 after exposure I had another 4th generation test and it was negative 

You needn't worry at all about HIV or any other STD. The exposure describe was entirely free of risk, even if your partner was infected. I believe you understand you could not have acquired your genital wart from the exposure described here; genital warts do not appear sooner than several weeks after exposure. And warts do not significantly raise the risk of HIV or other STDs if exposed -- i.e. the wart did not increase the chance of HIV from that exposure. There really was no need for testing -- but in any case, the negative results prove you did not catch HIV or any of the STIs for which you were tested.

HIV and other STIs do not cause the kinds of symptoms you describe. Your symptoms are typical for anxiety and stress, and when someone suggests his or her own symptoms result from anxiety or stress, usually s/he is right. That's the obvious explanation.

Do your best to move on with no further worries. You're fine. I hope these comments are helpful; let me know if anything isn't clear.

HHH, MD

To clarify my advice testing, you didn't say exactly what tests you had. The only ones we recommend for routine testing after risky exposures are urine or urethral swab for gonorrhea and chlamydia and blood tests for HIV and syphilis. Assuming those were done, your test results are conclusive. The one that theoretically could be transmitted by genital apposition without penetration is herpes, for which negative blood tests are not conclusive until 12 weeks. However, the chance of herpes is too low to have needed testing anyway, and the combination of no symptoms plus negative test (even at 49 days) is nearly 100% proof you were not infected.