Getting Conflicting Information - Little Expert Help Please

[TadWorried]

I had asked the following on the STD forum here, however I also called our local STD clinic and the nurse gave me a much different answer. Here's what occurred followed by my questions.

Have always been extremely careful. Monogamous and never unprotected anything. Traveling in Asia, got a massage and the masseuse was kind of aggressive. She licked the base of my shaft and scrotum. Her saliva could have trickled close to my anus but there was never anything close to oral/anal contact. I would not let her suck me and covered my penis with my hand.  However, as she kissed my stomach she may have quickly either licked, kissed or sucked the very tip of my penis before I immediately stopped her after noticing (was probably 1-2 seconds or less max). She also kissed my nipple and the insides of my ears. That was the extent of what occurred.

The local STD clinic nurse responded that I could have "definitely" contracted mouth-to-genital herpes, HPV and/ or syphilis from the masseuse's licking of my scrotum, shaft, nipples and stomach. She also said that the ultra-brief mouth/lip/tongue contact with the tip of my penis could have transmitted ghonorrea, ngu, etc. to my penis. She also said there was potential, although low risk from being masturbated by hand.

Little expert help please? I'm not sure quite what to believe at this point and to be blunt find myself teetering on the brink of getting very worried about what happened.

Thank You!

[Edward W Hook, MD]

No need for additonal payment.  If I were you I would not hesitate or have any qualms about having unprotected sex with my regualr partner.  

There is no meaningful risk for HIV from the exposure you describe- this is not a concern.  EWH

[TadWorried]

Thank you for the quick reply. In the interest of trying to continue to be responsible - another quick question (will gladly pay again for your reply):

- With respect to the activity that was previously described, would it be irresponsible of me to have normal, unprotected sex (we were both tested before becoming intimate/both negative) with my monogamous partner? This is the only (very unintentional)  instance of anything ever happening outside of that long term relationship. We're both professionals in our 40's and pregnancy can't happen. I simply would not want to misinterpret your answer and risk passing something on. Wrong forum but assuming HIV is also not at risk.

Please let me know if this follow up question warrants another contribution and thanks again. I should be done rehashing this now.

[Edward W Hook, MD]

Welcome to our Forum.  I am with Grace and the others on the STD Community site about this question – this was a virtually no risk exposure.  I will admit that there is a small theoretical risk of getting one of the STDs transmitted by direct contact (HSV, syphilis, HPV) from this sort of exposure but that risk is almost purely theoretical.  Please remember that the risk for getting any STD is determined by the duration of exposure (yours was brief), the amount of friction/rubbing that occurred (this tends to "work" the virus into the skin - sounds like there was virtually none in your case), and the amount of infectious microorganism present (no lesions, few if any organisms present) and all of this is operative ONLY if your partner was infected (which is unlikely- most commercial sex workers are not infected).  I have never seen or heard of an STD of any sort transmitted in this way.  Thus based on what I've said above, while PERHAPS this is theoretically possible, form a realistic perspective I would not be worried and would not seek testing.  I think the nurse you spoke with was being overly conservative.

If you develop a lesion at any site of contact I would be pleased to discuss this more with you but am confident that this will not occur.

I hope my comments are helpful. EWH