Dear Dr. Bob:

Have a question that I don't see previously addressed. Went to massage parlor yesterday and first had vaginal sex with massuese with condom. Masseuse then removed condom, and put the condom on her finger while she fingered my anus (maybe one inch penetration). Am concerned that condom then had vaginal fluid on surface--not sure whether she turned condom inside out before inserting finger.

I am familiar with the CDC estimate for risk of unprotected anal sex (50 per 10,000)and know that nPEP is sometimes recommended after unproteced anal sex. My questions-1)Would this be considered unprotected anal sex? 2)Is vaginal fluid in anus a significant risk? 3)Is nPEP indicated under these circumstances?

Thank you for your outstanding service-Donation on the way.

A Fellow Democrat

Hello Fellow Democrat,

1. No, I would not consider your activities with the masseuse equivalent to unprotected anal sex.

2. I would consider vaginal fluids in the anus a theoretical risk only.

3. No, nPEP would not be recommended. The amount of vaginal fluid potentially transmitted, if any, would be minimal at best.

If you remain worried, get a single rapid HIV test at the three-month mark. I'm quite confident the results will be negative.

Thanks for your donation to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). In return I'll send my good-luck karma that your definitive three-month HIV test is negative.

Good luck!

Dr. Bob