[Question #2980] Receiving fellatio through underwear

40 months ago
Thank you for the service you are providing. This forum is incredibly helpful.

I met a woman online who in retrospect may be high risk. She wanted to have vaginal sex, and said we could use 2 condoms if I am worried. I declined. This makes me believe she is not up to speed on safe sex practices. We kissed briefly, though not very deeply. She performed oral on me through my boxer-briefs for about a minute.  I then put a condom on and she performed fellatio on me with the condom on for a couple minutes. I fingered her for a minute or so. Would this encounter be considered a risk for anything, particularly having the cotton boxer brief barrier for fellatio? I guess I am concerned because I am assuming she is a high risk partner.

Also, I hope it's ok if I ask this somewhat unrelated question.. Is there any utility in males getting oropharyngeal high risk HPV testing? I.e. if I have performed cunnilingus on at least a few partners in the past, would there be any point in getting an oropharyngeal swap for high risk HPV? Also, for any future partner, is there any way for me to know she does not have high risk HPV before performing cunnilingus?

Thank you, Dr. Hook and Dr. Handsfield!
Edward W. Hook M.D.
Edward W. Hook M.D.
40 months ago
Welcome to our forum and thank for your vote of confidence in our service.  Our goal is to provide useful information to clients. 

The activities you describe do not put you at any risk for any STI.  STIs cannot be transmitted through clothing/underwear, even if the underwear becomes wet with genital or other secretions.  Similarly, condom protected sex is safe sex as long as the condom is worn throughout the encounter and there is no STD risk from masturbation of a partner, even if that partner has an STI (including HIV).  Thus this was entirely a no risk event.

Your question also introduces several points which are worth mentioning.  First, I agree that, as an on-line partner who used the on-line service to identify casual sex partners,  your partner was a somewhat higher risk than someone you might have met through other means. 

Second, you mention the possibility of wearing two condoms.  We also recommend against this practice as the risk of condom failure is actually a bit higher with two condoms than with one.  Stick with one condom and use it correctly.

Regarding your other questions, the issue of oral HPV is a topic of much ongoing research.  Recent studies show that about 8% of American male adults have oral HPV vs. about 3-4% of women.  Having said that, this just serves to substantiate the fact that 80-90% of sexually active adults who have not had the HPV vaccine will have or have had HPV and for most of them, there will be no serious health consequences from their infection..  Most such infections, irrespective of their location however resolve on their own and are of no health risk for the very rare complications which can follow HPV infection.  Further, there is currently no recommended HPV test for men, or for pharyngeal infections.  Given the high prevalence of infection and rarity of related problems, our recommendation to clients is to do your best to not worry about HPV risk or testing unless you develop signs or symptoms and, should that happen, then to seek medical evaluation by a knowledgeable health care provider. 

I hope these comments are helpful to you.  EWH
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40 months ago
Thank you so much for your helpful and informative response, Dr. Hook.

If you don't mind commenting, I have another general safe sex question. What is the safety profile of vaginal sex with a female condom with respect to STIs and HIV? Is it considered as safe as using a male condom for vaginal sex?
Edward W. Hook M.D.
Edward W. Hook M.D.
40 months ago
Good question. There are fewer studies of the efficacy of female condoms for STI/HIV prevention than for the male condom.  Those that have been carried out suggest that they work well.  That said, female condoms are generally believed to be about equal to the efficacy of male condoms for this purpose when used correctly and consistently.  Sorry there are not more data available.  EWH
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