[Question #3741] Any risk to this encounter?

35 months ago
Dear Drs,

Recently I had sex with a bar girl in SEA. Initially she performed oral sex on me for 3-5 seconds and then we engaged in intercourse using a condom. My frenulum had been torn a few weeks before and retore during this encounter, causing bleeding (inside the condom). I removed the condom and she cleaned me with a towel. Then I applied a new condom and we engaged in intercourse again. I ended up removing the condom later and noticed it was only covering the top quarter of my penis.  We finished with mutual masturbation.

My questions are:

Is oral sex risky with a torn frenulum? Also, is there any risk because the condom was not fully covering the shaft of my penis? Are any of the other activities in my story a risk factor?

Thank you in advance. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
Welcome to the forum. Thanks for your question.

As you might imagine, there are no research data on this. But in general oral sex is safe sex, with much lower risk than unprotected vaginal or anal sex, with low risk for all STDs and zero risk for some. Part of the reason is that even among the most sexually active (risky) partners, oral infection is reliatively uncommon -- and of course if there is no STD in the mouth, it cannot be transmitted by oral sex. In theory, exposure of a torn frenulum or any other wound could increase the risk of HIV, but HIV is one of those infections that rarely are present orally (saliva kills HIV) and never transmitted by oral sex.

As for condom coverage, the important thing is that the head of the penis and urethra (penile opening) need to be covered. And in your case, it's good your torn frenulum was covered. The skin of the penis is really not very susceptible.

So all things considered, this sounds to me like a safe encounter. But if you would like the increased security of negative test results, wait until 4-5 days after the event and have a urine test for gonorrhea and chlamydia; and after 6 weeks, have blood tests for HIV and syphilis. The chance of any of these is low, but some people are more reassured by negative test results than by an expert's opinion based on science and statistics.

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

HHH, MD
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35 months ago
Thank you for your answer. Got it, so oral is no risk. Just to clarify, The oral sex occured brefore the frenulum was re-torn. It had been healing for about 12-13 days before this encounter.. Does this change your assessment of the risk in any way? Also, so with condoms they are effective at preventing HIV so long as the head of the penis is covered? 

Thanks.
35 months ago
Also, a continuation of my previous question (don't know how to edit comment) she used, what I think was an oil based lubricant, I read this can cause condoms to break. Neither condom broke in this instance, but does this affect risk in any way?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
Sorry I misread the timing of the torn frenulum, but it doesn't change my evaluation or advice.

The main route of HIV entry into the body through the penis is via the urethra or, in uncircumcised men, specialized cells in the surface of the inside of the foreskin (which is why being uncircumcised raises the risk of HIV if sexually exposed). Hence, coverage of these parts is considered complete protection against HIV, and also against those STDs transmitted through genital fluids, like gonorrhea, chlamydia, trichomonas, and viral hepatitis. Condoms are inherently somewhat less effective against infections transmitted skin to skin, like syphilis, HPV, and herpes.

And yes, oil can weaken condoms, increasing the risk of breakage. But they don't cause microscopic leaking. If an oil-lubricated condom doesn't break wide open, protection is complete.

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35 months ago
Thank you for your thorough advice. In your opinion, would you say I do not need to get tested for HIV based on this encounter? I would rather avoid it if it is pointless.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
From a purely medical and risk standpoint, you don't need HIV testing. Among other things, from personal and professional knowledge and history, it is exceedingly unlikely that a partner like yours, in Seattle, has HIV. And if somehow I or ony of my own loved ones was in your situation, testing would not be done. But only you can decide whether you're likely to keep worrying about it, i.e. whether a negative test will be more reassuring than expert opinion based on probability and statitistics.

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