Ive had a date in Dubai.The lady isnt a sex worker.We have been kissing but not sex.Now we are planning to meet and I think the sex part is coming.We will absolutely use a condom.Do I need to worry about Syphilis? assuming she has syphilis,what should i do to avoid the transmission? Internet is saying (SKIN to SKIN) transmits Syphilis! Any other STDS can be transmitted? I am sure HIV wont.  Note: I have mild psoriasis.

Congratulations for a thoughtful and careful approach to your potential new relationship. If your expected sexual encounter plays out, you will be at little risk for any STI. Don't get hung up on the fact that syphilis and other STIs are transmitted skin to skin. That does NOT imply that any skin contact is risky:  it's just the mechanism how syphilis, HPV and HSV are transmitted during sex, i.e. by direct genital contact. And condoms still are effective. They aren't perfect, because they allow some skin contact, and condoms work somewhat less well in preventing these three STIs than they do against gonorrhea, chlamydia and HIV, which are transmitted primarily through genital fluids. But still consistent condom use is very good protection against syphilis.

You don't say anything about your prospective partner's likely STI risks. But even among the most sexually active women, and even in settings where sex is free and easy (which might be the case in Dubai), the vast majority of women do not have syphilis. Or, at any point in time, other serious STIs. The most likely exception is HPV, which is so common and so easily transmitted that almost everyone has been infected at one time or another. But the large majority of HPV infections remain asymptomatic and rarely causes serious health problems.

If it seems likely this situation will become an ongoing, committed relationship, you and your partner might discuss your past sexual histories, including known STIs -- and maybe consider mutual testing for the biggies (gonorrhea, chlamydia, syphilis and HIV). If negative, you'll both know neither of you is at risk for infection from the other.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

Just a small question about any transmission of syphilis while using a condom. How can this transmit? I mean there is no fluid contact with the penis. 

Internet says, areas around vagina or anus can be infected. But even then, how do they enter the skin of the male while a condom is used. Does it go through only when wounds are there?

No scientific data can answer your question about exactly how syphilis is transmitted in presence of a condom. All we know is that a small risk exists even in people who routinely use condoms for sex with new or potentially risky partners. Presumably it is because of skin contact above the condom, although undoubtedly sometimes it's because of improper condom use (e.g. transient penetration before putting the condom on). There are no data that having penile wounds etc would increase the risk, although that's a logical possibility.

For the reasons discussed in my initial reply, you really should not be worried so much about syphilis. Almost certainly your prospective partner doesn't have it anyway. Considering that fact plus your plan to use a condom, your risk of syphilis will be near zero for all practical purposes. I would recommend you not be tested for syphilis or any STI afterward.

1- If we have foreplay, do you recommend wearing a condom and if I finger her or massage clit, do you recommend finders to be covered by kind of condom?

For sure I need to make sure to not touch my eyes or genitals or mouth after doing this.

2- If we go for the vaginal sex. As there are risks of uncovered areas of penis, if i make sure to not go in till the uncovered area, will that ensure extra safety? and the same for the oral sex with condom?

3- They say Syphilis can transmit through skin to skin contact. So any infected skin if it touches another healthy skin it can cause infection? even if there is no cut?

2. There is no point in attempting to prevent all skin contact during vaginal sex. Some contact above the condom is expected, normal, and little risk.

3. Re-read my opening comment above starting with "Don't get hung up...." You need not worry about skin contact and syphilis except for directed genital contact, and even that risk is near zero with a condom.