[Question #4667] Receiving Cunnilingus STD risks.

28 months ago
I received cunnilingus from a straight American male 40 year olds on 12/08. This took place on our first date where he verbally stated that he had been tested and had no stds. A year ago he ended of a 9 year relationship and he said the last time he had sex was 6 months ago. He stated he has never had sex with men.  He manually with his hand rubbed me on the outside of my vaginal folds which resulted in an abrasion on my vaginal fold (no blood). He then preformed cunnilingus on me. We also did "frontage" with his penis on my clitoris and there seemed to be some pre-cum. He also put his fingers inside my vagina as well. My concern/question is what STDs am I at risk for with this situation? Especially in light of the fact that there was vaginal broken skin (no blood) and his mouth and saliva in contact with that.  I did not preform oral sex on him and we did not have any penile to vaginal or anal penetrative sex.
Edward W. Hook M.D.
Edward W. Hook M.D.
28 months ago
Welcome to the Forum.  I'll be glad to comment.  The exposure you describe was low risk for a number of reasons including:
1.  STIs are relatively rare in 40 year old men (STIs are disproportionally more common in the teens and 20s)
2.  He said he'd been tested, most people tell the truth
3.  His masturbation of you with his fingers was a no risk event- STIs are not transmitted by masturbation.  That the masturbation resulted in an abrasion does not change this, nor does it change your risk from the other activities that you describe.
4.  Cunnilingus is a inefficient way to transmit STIs.  When persons with STIs (usually gonorrhea) of the throat have cunnilingus with an uninfected sex partner, the infections is not transmitted well because the tongue does not read the uterine cervix where infections occur.
5.  frottage without penetration does not lead to STI transmission.

I hope this summary is helpful to you. From what I understand about your exposure, your risk for STIs is miniscule and I would not worry or bother to seek testing.  EWH
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28 months ago
Thank you Dr. Am I correct in assuming that  HSV1 would be the most chance for potential exposure to while receiving cunnilingus? Sphyillis, HPV, HIV, and Chalmydia are what risk if at all, while receiving cunnilingus with an abrasion?
Edward W. Hook M.D.
Edward W. Hook M.D.
28 months ago
Hard to say- all risks are quite low.  As far as HSV-1 is concerned, unless you have been tested, there is about a 50-60% chance that you have HSV-1 and don't know it.  If so, you cannot get it again.  If he has HSV-1 and you do not, the risk of you becoming infected is less than 1/10th of 1%.  

In the situation you describe, your risk for syphilis and chlamydia is equally low or lower.  No one has ever been proven to have gotten HIV from cunnilingus.  Finally there are no data regarding HPV but again, risk is likely low and close to zero if you received the vaccine.  EWH
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28 months ago
Thank you again. I tested positive for HSV1, which I infrequently get in my nose. What is the risk if in the future if I preform oral sex and my partner is negative for HSV 1 and or 2? I have antivirals available and can take those for preventative measures if need be.
Edward W. Hook M.D.
Edward W. Hook M.D.
28 months ago
If you already have HSV-1, there is no risk for future infection with HSV at any site.  In addition, your risk for HSV-2 is somewhat but not perfectly reduced.

As for your risk for transmission, we estimate (there are no good data) that in the absence of an active outbreak, your risk for transmitting infection to a person who does not already have HSV-1 is certainly less than 1 in 1000 and perhaps as low as 1 in 10,000.  

EWH
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28 months ago
Thanks again Dr. I was tested for high risk HPV and am negative and just got an RX for the vaccine. Im 53 and so the vaccine was never made available when I was in my 20s. Im going to take it regardless of the low risk potential.
Edward W. Hook M.D.
Edward W. Hook M.D.
28 months ago
I applaud your approach.  There is little downside (other than cost) of taking the vaccine and, because it works well, there are good reasons to take it.  

On this Forum our guidelines call for providing up to three responses to each client's questions. This will be my final response and the thread will be closed shortly.  Take care.  EWH
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