[Question #5037] STI risk from protected intercourse

26 months ago
Hello Dr's, I would like to ask about another encounter I had just yesterday 2/26/19 at an Asian massage parlor. The encounter was fellatio performed on me with a condom, then protected vaginal intercourse. My only concern would be before the intercourse she put what appeared to be hand lotion from the bottle, such as jergens or an off brand, but the white creamy type, and not a lube that would be safe for condom use. Of course, as you may know from my last question, I have followed both of you throughout the years, and do know if a CSW uses protection it is for her benefit not mine, there is no such thing as micro holes or tears, and if a condom rips it would be very noticeable. I suppose my only real risk would be from skin to skin contact due to our pubic area touching, and I could not see if she had any sores or lesions. I feel as though I should be protected from any bacterial STI from the condom, even with the hand lotion applied, would you consider this correct? I'm sure this soon is probably too early for symptoms, but I will pay attention for the next couple weeks. I do not have anxiety, or will not let anxiety cause "symptoms" from overthinking as some would. Would you recommend testing from this event? 

Sorry for the long read, and once again thank you both!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
26 months ago
Welcome back. I'll be responding this time, but I reviewed your recent discussion with Dr. Hook and agree with his advice. Thanks for your continued confidence in our services. 

STDs are not transmitted by hand genital contact, fingering, etc -- even if genital fluids are used for lubrication. These sorts of contact do not transfer a sufficient amount of fluids, or the STD bacteria or viruses, for infection to take hold. Skin to tkin contact also is no significant risk. You are going about these sorts of events with maximal saftey. After any single exposure of this type, there is no need to "pay attention" to symptoms. If you would like additional reassurance, you could plan on having standard STD testing from time to time, such as once a year (urine for gonorrhea and chlamydia, blood tests for HIV and syphilis). But in the absence of symptoms, I would recommend against testing after any single such exposure.

Also, the problem with oil based lubricants and condoms is that they weaken latex so the condom is more likely to break. However, it does not promote leaking etc through an intact condom. In other words, no matter what lubricant is used, if the contom doesn't rupture wide open, protection is complete.

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

HHH, MD
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26 months ago
Thank you very much Dr. HHH, I expected as much. I guess the main concern was the lotion before the vaginal intercourse, but figured from past readings there is no concern with mico tears/holes myth and I would clearly be able to tell if a condom was broken. I also do make sure to get tested yearly as recommended, but have not been tested after any single one protected encounter as I've never had symptoms.

Thanks again, and have a great day.