[Question #13727] Massage CSW protected sex and penis kiss

1 months ago

7 days ago I visited a csw and had protected sex with her. It was dark in the room and I couldn’t see her vagina however she seemed very reluctant to not let me see her vagina. I fingered her and could feel some lumps in her vagina but was unable to see them as the room was dark. I then proceeded to put on a condom and we engaged in protected vaginal sex. When we finished we showered and was hugging naked together, no penetration just body parts rubbing together. As I was changing she knelt down and kissed the tip of my penis. I am uncircumcised but I was unable to tell if any of her saliva entered my urethra. I am concerned that I may be at risk from an std (gonnorhea and chlamydia plus any others), especially when she kissed my penis. It wasn’t full oral sex but what are the chances of contracting an std from this episode and can I continue regular sex with my partner.

H. Hunter Handsfield, MD

1 months ago

Welcome to the forum; thank you for your confidence in our services.

First, contrary to common online advice, there is little if any value in visually observing (or feeling) a partner's genitals before sex. That is, there are no data that this lowers the risk of any STI -- since the large majority of transmissible STIs cause no visible abnormality. And most sexually active persons who do have sores, abnormal discharge, etc avoid sex in the presence of those symptoms. Further, the ability of untrained persons (i.e. without medical expertise) to detect significant abnormalities is very low. While it certainly isn't harmful to make such an observation, the inability to do so certainly does not elevate the risk of STI. I also very much doubt the "bumps" you felt were abnormal or indicate an active STI.

Second, brief oral contact (e.g. a kiss) of the penis tip carries little or no risk of any kind, whether or not a small amount of saliva entered your urethra. Even entirely unprotected oral sex for several minutes is low risk for all STIs. Your condom protected vaginal sex probably was statistically a greater risk of STI than the fleeting oral contact you describe. But still low risk of course.

All in all, I would view this as a near zero risk sexual exposure. From a personal standpoint -- i.e. if somehow I were in your situation -- I would not feel a need to be tested for anything and would continue unprotected sex with my wife without worry. That said, nobody can say your risk was zero, and testing is a personal choice: reassurance alone is a valid reason for testing. If you're going to continue to worry about it, you could have a reliable urine gonorrhea/chlamydia test at any time (valid any time 4-5 days or more after exposure); and also consider blood tests for HIV and syphilis in a few weeks. I'm definitely not recommending these -- but there's no reason not to test if you remain concerned.

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

HHH, MD

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1 months ago

Hi Dr

Many thanks for your swift reply and clearing up this query.

Let’s say some saliva did enter my urethra would this tiny amount contain enough bacteria/virus to be effective, bearing in mind the kiss was literally for 1s. I know this may sound ridiculous but I’m trying to understand more about how STDs actually transfer from one person to another.

Regards.

H. Hunter Handsfield, MD

1 months ago

There was still little of any risk even under this circumstance. Saliva inhibits or kills many STI germs and therefore is rarely a source of infection. This doesn't change my risk assessment or advice. As I said, you're free to get tested if you remain concerned.---
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1 months ago

Many thanks doctor.

I will test as per my usual routine.

Regards

H. Hunter Handsfield, MD

1 months ago

Thanks for the thanks. That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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