Out of nowhere I have the fear that I may have passed hpv to her. She is not having any symptoms what so ever and her last Pap smear in 2020 was normal. However, I can’t shake the “what if” feeling.  My questions are as follow:

1. What is the likelihood that I could have contracted the cancer causing hpv from handjobs/mutual masturbation and passed it to her?

2. Do you recommend I tell her about my encounters? 

3. Should I get the hpv vaccine, or would it not make sense - i am 31 years old. 

4. She only received the first hpv vaccine shot when she was 18 (she is now 30) . Can getting only 1 shot provide her with some protection or did she need to take all 2-3 shots? Should I encourage her to get re-vaccinated? 

Your questions imply you have some basic misunderstandings about HPV. Here are some facts pertinent to your situation. First, almost certainly both you and your partner already have had HPV, probably more than once, and may still be carrying it. Getting HPV is a normal, expected, unavoidable consequence of being sexual. At least 80-90% of all people have been infected. The high risk HPV types are among the most common, so there's a good chance you and your partner already have infection with these types. (This assumes that both of you had other sex partners in the past, before your relationship began.) HPV is not transmitted by hand-genital transmission, so those encounters over the years are irrelevant. Most important, those encounters did not raise your (and your partner's) chance of having HPV, including high risk types of the virus.

To your specific questions:

1. There is little or no risk of HPV from hand-genital contact, even if genital fluids are used for lubrication.

2. From a medical or risk perspective, there is no need to say anything to your partner. 

3. Assuming you and your partner remain committed, I would not advise you be vaccinated against HPV at this time. 

4. A single dose of HPV vaccine is partially protective, but it isn't known how long such partial protection might last. So she might wish to be revaccinated, planning on getting at least two doses. However, given your sexual lifestyles, I doubt it would make a difference in either her or your risk for any kind of serious outcome of HPV.

5. No HPV tests are recommended for males and none are approved by FDA for use in the United States. Urine testing alone cannot detect infections involving genital skin. I recommend you not be tested.

Consider reading up on HPV. Two excellent resources are the American Sexual Health Association, the sponsor of this forum (www.ashasexualhealth.org); follow the links to STD and HIV information; and CDC (www.cdc.gov/std).

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

HHH, MD

1. What is the risk of syphillis from mutual masturbatuon?

2. I read that azithromycin and gonorrhea treatment can cure syphillis. I remember a doctor gave me these antibiotics as just a precaution. Is it possible/probable that I passed syphillis to my partner but tested negative because I took those antibiotics? 

3. I tested negative for syphillis antibodies. Does this mean I never had a previous syphillis infection? I read that once you get syphillis your antibodies test will always be positive) 

2. This depends on timing. If you had syphilis well before you received azithromycin, you could have infected your partner before you were treated. But then you probably would have had a positive blood test. All in all, this is too unlikely a situation to worry about now. On the other hand, roughly half of syphilis bacteria (more or less in different parts of the world) are resistant to azithromycin, in which case it has no effect on either prevention or treatment.

3. This depends on which syphilis test(s) you had. With a negative RPR screening test, it is possible you had past syphilis -- successfully treated or self-cured by your immune system. If you tested negative with any other syphilis blood test, such as EIA, TPHA, FTA-ABS and others, then you never were infected.

That description of your partner's rash does not fit with HIV, syphilis, or any other STD.

I really want to put my mind at ease but keep reading conflicting information about handjobs/mutual masturbation causing STDs. 

That concludes this thread. I hope the discussions have been helpful.