Accumulated Potential STD Exposures

[Alfred_27]

Dear Drs, I had between January 2010 and February this year been getting massages from places every other month or so as a type of therapeutic treat after work (Malaysia & Singapore if location is important). Half of these were performed in the nude (us both) so there would have been bare body contact, resulting at most in a "happy ending" but never any oral, anal or vaginal penetration, nor as I recall, any genital-genital contact. Although, one encounter that worried me most would have been one in 2010, one of the ladies performed a "thigh clamp" while I lay on my back and ejaculated somewhere between her thighs (too close to genitals for comfort). It never occurred to me to get tested as I believed these to be massage sessions which most people get anyway. Looking back, I would be lying to myself to say these "masseuses" were not CSW's of some sort although the primary intent was massage. Research from the internet, especially the government ones seems to convince me I have certainly been exposed to every conceivable STD, most worrisome of all HIV. Now as I move on and contemplate marriage, I cannot but be overcome with anxiety trying to recall any symptom I might have had, with only two coming to mind - once a painful pimple like growth on the penis shaft and another an extremely itchy rash all over my body lasting under a week which a GP treated with anti-histamines. I am writing for some advice given that while most on this forum freaked out after one experience, I have had a cumulative many until 4+ months ago. I guess part of the anxiety is also attributable to my imagining what contact might have occurred at any of those encounters when my concentration lapsed even for a few seconds. Thank you.

[Edward W Hook, MD]

Welcome to our Forum.  It will be my pleasure to comment.  The vast majority of STIs, even those theoretically transmitted by skin to skin contact without penetration, are still most often transmitted in the context of penetrative sex.  Thus, while I agree that it is likely that some of your masseuse may have been commercial sex workers and even may have had STIs at the time you received massages, without penetration, your risk for infection is quite low.  Further, while I suppose that the penile lesion that you describe in particular might have created concern about STI, it is not likely that it was.  As to what to do, my suggestion would be to consider getting a blood test for syphilis, which I anticipate will be negative.  I presume a negative result will be reassuring.

As for the possibility of herpes, since there have not been recurrences this is less likely.  I would not suggest a bold test for HSV- these tests are not reliable and sometimes give false positive results..

Your rash does not raise concerns for me.  As for other STIs, including HIV, again they are unlikely although testing is easy to do.

I hope this perspective is helpful.  EWH

[Edward W Hook, MD]

Glad I could help. Take care.  EWH

[Alfred_27]

Thanks Dr. Hook. Comment is read and understood. Will make the necessary arrangements. I guess I can see why so many on this forum are freaked out given the prospect of a positive result and a first dose of antiretrovirals. Overwhelming.