[Question #3474] Risk assessment from encounter at strip club

35 months ago
Good day Doctors,

I'm a male and did a stupid thing 18 days ago. Went to a strip club in Canada and had a lap dance.

We started kissing. Not deep french kissing but "semi-french kissing" - no tongue but exchange of saliva for sure. 3 or 4 kisses of that kind which lasted about 2-3 seconds each so total "semi-french kissing" exposure of about 12 to 15 seconds max.

Then I caressed her clitoris and vagina with my index finger. Did not do a full penetration with my finger. It went maybe 3/4 of an inch inside her vagina. She was wet with vagina fluids. I don't even think my fingernail touched her vagina, just the bottom of my finger, but I work with my hands and always have small cuts and scrapes on my fingers. I don't think I had a fresh cut on my index finger but I'm not sure. I touched her clit/vagina 3 or 4 times for about 3-4 seconds each time, so total exposure time for my finger in her clit/vagina of about 16 to 20 seconds max.

Then she masturbated me using her saliva as lubricant and I ejaculated.

That's the encounter. First and last time I ever go to a strip club!!!

It's been 18 days now and I have no symptoms at all, I feel fine except for the anxiety!!

I'd like to know:

1. Am I at risk of getting an STI? I'm really scared of HIV and I checked Canadian health agencies sites and they almost all say that oral sex can transmit HIV (I did not get oral but the saliva from kissing and masturbation...) at the same level as anal and vaginal sex...

2. Should I get tested? I already booked and appointment at a clinic...

3. What's the real deal with oral sex and STI, especially HIV? So many contradictory facts on the Internet, and from government sites!! Do they mislead us to make sure we practice safe sex?

No more sex for me, it's too scary when you start reading about STI on the Net...that's why I want your professional advice.

Thank you very much for your help!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
Welcome to the forum and thanks for your question, which came in while I was logged on. Most users should not expect nearly real time replies!

Hand genital contact is risk free in regards to STDs and HIV. It takes much more virus and bacteria that can surive on fingers or in fluids that then contact only the outside of the penis or genital area. They call these conditions sexually transmitted for a reason: you have to have sex to transmit them, and for transmission purposes that means genital penetration into another person's genital or anal area or, less commonly, mouth. The viruses and bacteria that cause them evolved to require the hyper-close contact that comes only with real sex. In addition, exposure to saliva is generally risk free:  in fact, saliva kills HIV and also inhibits many other bacteria and viruses. (This is one of the main reasons STDs are rarely if ever transmitted by kissing.)

Those comments answer your questions, at least indirectly. But to be explicit to avoid any misundersanding:

1,3) Oral sex should be considered safe sex. It's not completely free of risk, but the chance of infection is low for all STDs (much lower than vaginal or anal sex) and zero or close to zero for some (e.g. HIV, chlamydia, herpes due to HSV2). You raise a good point about some sex education resources:  some are simply naive, not really understanding the differences in risk between oral and other sexual practices; and others may indeed have political or social motivations in a vain hope of scaring young people away from sex of any kind. However, in general I believe politically or religiously motivated misleading information is a lot less common in most of Canada than in much of the US, where such misleading information (or overt lying about risks) are more common in "red" states than "blue" ones. (It's no accident that rates of unwanted pregnancy and STDs are consistently higher in red than blue states, and bad sex education is one of the main reasons.) You can limit your exposure to misleading information by limiting your web searching to medically organized and moderated sites, like this one; those run by health departments or most other government agencies; and many academic (e.g. university) resources. For sure try to avoid sites run by and for people with or at risk for the problem you are worried about.

In any case, you didn't have oral sex anyway, only hand-genital contact and fingering, which really isn't a problem. For the reasons above, contact with saliva is not the same as oral sex and in itself carries little or no risk. Going forward, keep those condoms handy and use them if and when the situation arises. Until then, avoid actual sex -- and no worries about HIV or other STDs.

2) There is no need for testing. Certainly I would not do it if somehow I were in your situation, nor would I recommend it to a clinic patient or a relative of my own. You're free to do it, but you may find the clinic declines to spend the money on it (assuming a public clinic).

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

HHH, MD

---
35 months ago
That was fast fore sure!!!

Thanks for your advice. Finally I get an honest answer. I didn't write it in my first question (not to use up my allocated 400 words...) but before writing you I called a government medical helpline where nurses (general practice, not STI specialized) anwers your health questions about all subjects. I called 3 times to get different opinions. The first one (a male nurse) tolled me not to worry about HIV but there could be a small chance of other STI so I should get tested. The other 2 were female nurses and told me, almost without thinking, that I should get tested because I came into contact with bodily fluids...you see the confusion doctor?

So to make sure I understood:

This was a no-risk encounter.
No need to get tested and get on with my life and forget about it.

And no more strips clubs!!!  :-)

You assumed right the clinic is public and at no cost.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
In the US, even the most respected STD public information hotline (CDC) is answered by low paid contract workers who receive little if any training. They have written materials with stock answers, but these are often written in a way that maximizes risk and advises testing -- legal policy to err on the side of conservative advice to avoid legal liability for an adverse outcome. While I don't know about Canada, I imagine it's much the same.

Your summary is right on the noney! (But I would generally advise people to not make difficult to keep promises about avoiding life's temptations, whether it's diet, drugs, alcohol, smoking, or sex. It's fine to make a pledge to oneself, but not fine to take it to a point that you're not prepared if temptation arises (i.e. condoms). (That's one important reason abstinence-only sex education INCREASES risks for pregnancy and STDs:  young people don't have condoms handy when at a party, have an alcohol buzz, and your dance partner is cute!)
---
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
Now that I think about my Canada/US comparisons, I note your possibly Gallic username and my suspicion that parts of Francophone Canada (e.g. Quebec) may have socially slanted sex education similar to red states in the US....  You don't need to comment about it -- I'm just sayin'....


---
35 months ago
Your right, I'm from Quebec!   Actually French Canadians are much more liberal about sex than English Canadians...that being said government is government and I'm pretty sure they'd rather scare people from sex than have to pay to take care of infected people...because health care is "free" here so taking care of HIV+ people is very expensive...

It would be very interesting to have a conversation with you about the social differences between Canada and the US, Red vs Blue States, French vs English Canadians, etc.

Have a great day and thanks!!!
35 months ago
So I cancelled my appointment to get tested, I hope it's the right thing to do....

More than 3 weeks since exposure and still no symptoms at all so I guess if I would have been infected by any STI including HIV I would have known by now, right?

Merci!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
Asymptomatic STIs are common. Being asymptomatic is more reassuring for some STDs (e.g. gonorrhea, syphilis) than others (e.g., chlamydia, HPV). But the main reason to not be worried is simply the nature of the exposure. As I said above, had I been in your situtaion, or if I were counseling my own patient or a close family member, I would not have or recommend testing. All is well!

That concludes this thread. I hope the discussion has been helpful. Best wishes and stay safe.
---