massage spas for the last 4 years ( mostly of white American females in apartments by appointment) and I always play safe, almost everything   was a handjob except one occasion of protected vaginal sex which lasted only for 40 seconds  a year back. I am single and for almost a year I have been seeing only a girl ( white) in her thirties - frequency is like once in a month. The activities are  fully naked - massage, deep french kissing, body to body massage , cuddling, genital rubbing etc. I ensure that there is no penetration. Given that I would like to understand a few things on the STI risk for the below questions. By STI i mean only HIV over here. In fact in the last two years I got tested several times for HIV and one time for sphyllis and everything was negative. 

1)  As I am in the habit of seeing this girl once in a month, does the above activities put me to HIV risk ? I discussed long time back regarding her status and she said she is clean. She might be seeing lot of other clients, but she is  not a escort , only a massage provider with a happy ending.

2) What is the risk of HIV in getting a blowjob from a female  assuming there is no condom. If I happen to get oral sex ( she is the giver). Does the HIV risk increases with number of times its done  in a year or it is  close to zero. 

3) Assuming there is no bare vaginal or anal penetration, is there any HIV risk from above  and does this warrants testing once in six months.

4) If I do condom protected sex a couple of times in a year, should I get tested. In all the above instances , no bare deep penetration.

5) Any risk of other STI s from these activities. Do you recommend complete abstinence from a medical point of view to avoid STI.

Thanks and have a great day.

Thank You.

You describe no exposure that carry any significant risk of HIV. The riskiest event was you single episode of protected vaginal sex (condoms are very good in protecting against HIV, but not quite perfect -- although of course this depends largely on correct use of the condom, no observed condom breakage, etc. Equally important, assuming your massage partner's sexual history is accurate -- i.e. she limits her exposures to other clients to the same sorts of practices you describe, and that "clean" means she gets tested periodically for HIV, with negative results -- it is very unlikely she has HIV. To your questions:

1) Addressed in my opening comments. No measurable risk of HIV.

2) There has never been a reliably reported case of HIV that clearly was acquired by fellatio (mouth to penis). Based on how HIV infected people believe they caught the virus, CDC estimates the risk at one chance in 20,000, if the oral partner has untreated HIV. That's equivalent to receiving BJs by HIV infected partners once daily for 55 years before infection might be likely. (And there is reason to believe that even this seriously overstates the risk.) Of course the chance of infection rises with each exposure, but when the risk is nil to begin with, it makes no significant difference.

3,4) See initial discussion. However, for reassurance I suggest you indeed be tested once every few months, or maybe once a year. You're clearly concerned about the slim possibility of catching HIV, and probably will find periodic negative HIV test results indeed are reassuring. My advice is the same with or without condom protected intercourse.

5) Unprotected oral sex carries risks for gonorrhea, genital herpes due to HSV1, and nongonococcal urethritis (NGU), often caused by normal oral bacteria and probably harmless. Even with consistent condom use, vaginal or anal sex risk infection with those STIs transmitted skin to skin, primarily syphilis, genital herpes due to HSV2, and HPV (because condoms allow significant skin contact above condom coverage). Sexual abstinence probably would be overkill in your situation, but you should be aware of the possibilities. 

So assuming your sexual exposures continue as you have described, you still need to be on the lookout for symptoms (penile discharge, painful urination, penile blisters, sores, and warts), and I would advise roughly annual testing, to include urine testing for gonorrhea and chlamydia and blood tests for HIV and syphilis. You can expect negative results, but better safe than sorry!

HHH, MD

1) So if I limit my sexual practices to only hugging, deep kissing, cuddling, and body massage with a hand job, and completely abstain from vaginal /oral sex, does this still carry risk for Hiv and gonorrhea ? I am much worried about HIV , so when you say " better be safe  than sorry"  even if I restrict to only the above activities, still it poses a risk for HIV ? Because when you say " better be safe" then abstinence is the only way.  I understand that there is a risk of herpes and syphilis due to body contact. But if I don't see any lesions, can I assume to be safe. 

1) So in the medical point of view , a protected vaginal sex is more riskier than an unprotected oral as far as HIV is concerned.

2) Any risk in getting saliva on the eye ? I have read that saliva is not risky. What is the risk for hiv if when somebody talks very near to you and saliva ( small spits from mouth while talking) gets into the eyes. Does it makes any difference if saliva has small quantity of blood in it.

Thank You.. 

2) Zero risk, or close to zero. Nobody has ever been known (or to my knowledge, even suspected) to catch HIV in this manner. Saliva kills HIV, which is one reason exposure to saliva is low risk, so a bit of blood in saliva probably carries little or no chance of transmission.

I recommend you entirely ignore the biology of the matter. Disregard (and do not search the web) whether or how long HIV "survives" in various circumstances. ONLY true sex (uncovered penis in vagina or rectum) or direct blood exposure (transfusion, sharp instrument with wet blood, perhaps massive blood exposure if caring for a severely injured person) transmit HIV. You can disregard any and all other exposures.

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.