Syphilis is rarely if ever transmitted without penetrative sex. Certainly busy STD clinics rarely see persons with syphlis who had not had penetrative sex. That doesn't prove it can't happen, but in general all STDs are exceedingly rare -- or do not occur at all -- buy hand-genital contact, even if genital fluids are used for lubrication. As for direct penis-to-penis contact, this too has not been documented as a source of syphilis. However, logic suggests there could be some risk if one partner happened to have an infectious syphilis lesion on the part of the penis involved in contact. After all, back in the days when health care providers did not consistently use gloves or other barriers in examining patients or otherwise in physical contact, syphilis of the fingers was an occasional occurrence, especially among dentists. However, even in those circumstances, probably there was minor injury to the finger in addition to contact with blood or body fluids.

If you have had such contact with someone with syphilis, I would advise treatment, as given automatically to persons who have had penetrative sex with an infected persons. And if this is a fairly regal sexual practice for you, it would be reasonable to consider routine blood testing for syphilis from time to time. These steps might not be unnecessary, but better safe than sorry.

Does that answer your concerns? Let me know if anything isn't clear.

HHH, MD