The elevated risk from a skin break refers only to HIV (or in theory, hepatitis B) and means that transmission risk is higher if a skin break is present when one is exposed to HIV. Usually this means a sexual exposure to an infected partner while having a cut or sore on the penis, e.g. herpes or something like that. Also, a skin injury or wound generally must be brand new and actively bleeding at the time of sexual exposure. Having had injections in the exposed area doesn't count. Theoretically the risk of syphilis might be elevated by such wounds, but there is no known increased risk for gonorrhea, chlamydia, etc.

You obviously should be having safe sex, i.e. choose your partners wisely and use condoms for vaginal or anal sex, and you are aware of the in herently low risk of oral sex for HIV/STD transmission. In the event you have an infected partner, having had a penile injection for ED would not increase the risk of any STD.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

Sadly, many (most?) HIV/STD prevention resources don't adequately distinguish levels of risk. I don't know who is in charge of the webiste you mention, but CDC (as one major example) basically takes the position that if there is any risk at all, it is so labeled. Partly the idea is that it's safer to advice against any particular activity with any risk at all, rather than take the risk of people misinterpreting low risk as zero risk. But some agencies, and certainly on this forum, we pay close attention to the data and routinely advise about the differing risk levels. CDC itself has published data estimating the chance of HIV transmission by fellatio, if one partner is infected, as 1 chance in 10,000 penis to mouth and 1 in 20,000 in the opposite direction. Those numbers are equivalent to giving or receiving BJs by infected partners once daily for 27 years or 55 years before transmission might be likely. Accordingly, I strongly disagree with characterizing fellatio as "relatively high risk".