[Question #5124] STDs from Saliva and Licking Genitals?

24 months ago
Hello and thank you for this service.

Two days ago I was with a sex worker at a Costa Rica strip club. I told her I only wanted her to use hands and breasts to get me off, but she briefly licked (maybe sucked) my testicle early on. Then while I had my penis in her breasts I heard her spit on it (I couldn't see because her head was down and in the way). She was mostly using actual lube, but I think that she used a decent amount of saliva too.

My question is, of course, whether herpes or any other type of STD could be transmitted this way, assuming the worst: 1) that she has it and it's active (though I didn't see any sores), and 2) that lots of her saliva contacted the tip of my urethra.

I'm super nervous because I am likely going to talk to my girlfriend soon about what a fucking idiot I am, and I would love to have some facts to accompany that conversation.

Thanks in advance!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
24 months ago
Welcome to the forum. Thanks for your question.

STDs are rarely if ever transmitted by saliva or by oral contact of any kind. And contact of infected fluids with intact skin -- of the scrotum or anywhere else -- never is a risk for any STD. In theory, herpes due to HSV1 (the virus type that causes oral herpes, i.e. cold sores) could be transmitted, but even this is very rare in this situaiton. So even assuming the "worst" scenario you describe, the risk is minimal and I do not recommend any testing. If you want to be super conservative about it, wait about 10 days to make sure no symptoms appear, such as penile sores, painful urination, or penile discharge. But if I were in your situation, I wouldn't worry about it and I would continue unprotected sex with my wfie without worry of infecting her with anything.

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

HHH, MD
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24 months ago
Thank you so much Dr. Handsfield, this is definitely helping to ease my mind. I do have a couple of follow-up questions, mostly out of curiosity.

1) Like most adults I have HSV-1 from childhood though I can't remember the last time I had a cold sore (probably as a kid), I know this from a full STD panel. Does that offer any sort of immunity to genital HSV-1 infection?

2) I know oral HSV-2 isn't as common as genital HSV-2, but if this sex worker had an oral HSV-2 infection, would the risk be the same as for HSV-1?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
24 months ago
1) Yes. Having had HSV1, you are immune to a new infection with HSV1 anywhere on your body.

2) Maybe the same risk, but perhaps lower. But indeed oral HSV2 is uncommon, and I have never seen a case of HSV2 acquired by receiving oral sex. If it occurs, it's very rare. You reallly shouldn't worry about it.
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24 months ago
Thanks for the update. I was feeling pretty at ease after your responses but today I've been feeling tingling, itching, and soreness from the back of my anus up the insides of my buttocks. It could be psychosomatic, or something else, but it makes me wonder one more thing: if (again, assuming worst case scenario, that she has oral HSV-2) her saliva made its way to my anus, could I have been infected that way?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
24 months ago
Herpes it not a likely cause of symptoms like you describe. Anal area itching/irritation is among the most common symptoms of all, experienced by all humans at least some of the time. Can I imagine a transmission scenario like you describe? Sure. I can also imagine you being struck by a meteorite. I hope neither happens, but they're probably both just as likely and I would not advise taking special precautions against either one. As I said in my initial reply, you should not be tested for HSV or any STD and should be continuing your normal sexual life with your partner.

That concludes the two follow-up comments and replies included with each question, and so ends this thread. I hope the discussion has been useful.
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