[Question #1100] Risk of protected sex with condom

49 months ago
Hello Doctors -

If you have sex with a sex worker while wearing a condom, what is the probability that one would get HPV or some other STI?  As for HPV... Is it only dangerous to a female when it is transmitted inside of her vs being transmitted from the scrottal area of the male to the outside regions of the female genitals?

Thank you




49 months ago
To add a little more info, I had protected sex with an Asian sex worker.  The condom worked fine but she was very wet and I felt it wet on my scrotal area afterwards.   Am I more likely to get HPV or something else?
Edward W. Hook M.D.
Edward W. Hook M.D.
49 months ago

Welcome to the Forum.  As long as they are put on before sex starts, worn throughout the encounter, and do not obviously break condoms remain the most effective means of preventing STIs when having sex with a potentially infected partner.  Thus we would refer to the encounter you describe as safe sex and would urge you not to worry.  Interestingly, contact with genital secretions on the outside of the genitals (i.e. the scrotum, pubic area, abdomen, etc.) does not typically lead to STI transmission even when partners are infected unless penetrative sexual contact occurs.  This appears to be, at least in part, because the mucosal surface of the urethra (the tube inside the penis) or within the female vaginal are more vulnerable to STI acquisition than the thicker skin on the outside of the genitals which resist infection quite well.  I would not worry about the encounter that you describe and see no reason for STI testing.

You will notice that I did not comment on your question about HPV. this is because there is still much to learn about HPV transmission and the fact that nearly all adults have HPV infections whether or not they know it.  In nearly all adults, HPV infections are innocuous and go away without therapy over a period of months.  In general however, most single exposures to HPV infected partners do not lead to infection, and the risk for infection from the sort of exposure you describe, being condom protected, is quite (very, very) low.

I hope these comments are helpful. this was a very low risk exposure which should not worry you. EWH 

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49 months ago
Thanks for your response. 

I'm glad to hear that my exposure was in the safe sex category with minimal risk. 

I'm curious to ask if one could acquire a skin irritation from sex.   I've felt a little itchy in my groin area, specifically between my scrotum and inner thigh. When I looked closely it appears there is  a rash or reddened area that extends a little bit up my leg on both sides.  The itchy parts is more in the crease.  It's not a major itch, just enough for me to be aware. Since I discovered it, it seems more bothersome. I'm 40 years old and active but not a major exerciser. 

Could this be the result of an STI or perhaps more likely fungal, like a jock itch?

Thank you!


Edward W. Hook M.D.
Edward W. Hook M.D.
49 months ago
Glad you found my comments helpful.  Regarding this issue of skin irritation, there are many sources of irritation that are not STIs.  Let's start by remembering that sex is all about friction and the thinner, softer skin of genital region can get abraded and sore from sexually activity. Secondly, the groin region where you describe your irritation is a common area for fungal infections or "jock itch".  this sort of irritation is worse in the summer months or at times when persons perspire a bit more than usual and typically respond well to over the counter antifungal powders.  The other part of care for such irritations is keeping the area clean and dry and wearing cotton rather than synthetic underwear.  EWH
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