[Question #6065] Licked the semen

17 months ago
Hello, dear experts!
First I would like to thank you for all the amazing job you’ve done. It has been saving my nerves so much! 

Now I would like to ask a question regarding my situation:

Recently I had a protected sexual intercourse with a guy. He was top. Nothing happened, condom was fine. 
After we finished, I filled up the condom with water to check whether it stayed intact. But when I was holding it, I felt something slippy on the end of it (like lube). 
I decided to check it first with my finger, then with my tongue. 
I guessed it was the lubricant we used. But then my partner explained that it was HIS own lube, produced by him (cause he turned out the condom while taking it off). 

My question is:
Am I at risk for any STD because of licking (tasting) his pre-cum? 
If yes, what tests should I make?

Thank you in advance for your answer!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
17 months ago
Welcome to the forum. Thanks for your confidence in our services.

I'm assuming that "intercourse" means anal sex, right? If so, I guess I don't understand how your partner's pre-ejaculate fluid (pre-cum) or semen would be on the outside of the condom. It seems that any moisture on the outside of the condom had to be lubricant or your own anal fluids. Either way, I see no significant HIV risk, even if hte fluid was your partner's sexual fluids or lubricant.

Oral exposure to HIV always is low risk; the mouth is not easily infected with HIV. Performing oral sex to completion, i.e. with ejaculation in the mouth (and even if semen is swallowed) rarely transmits HIV. One estimate is that this activity has about 1 chance in 10,000 of transmitting HIV. That's equivalent to giving BJs to infected men once daily for 27 years before transnission might be likely. If it's that low from oral sex to completion, obviously the risk is far lower than that for the possible minor exposure you had. Finally, if the fluid was lubricant, there would be even lower chance:  most lubricantls contain perservative chemicals that would be toxic to HIV.

Similar comments apply for all STDs. This was not an exposure to worry about. I do not recommend any testing at all. That said, all people having sex outside mutually monogamous relationships, and especially men who have sex with men, should be tested for HIV and STDs from time to time, e.g. once a year (HIV, syphilis, gonorrhea, chlamydia). If you haven't been tested recently, this probably is a good time, while it's on your mind. But not because of this particular event.

A minor point:  It isn't necessary to inspect condoms after use by filling with water. There is no such thing as microscopic leaks that allow sufficient contact to risk transmission of HIV or STDs. If the condom doesn't break wide open, protection was complete.

And now my final advice:  do you know your partner's HIV status? If not, I strongly suggest you get into the habit of always asking about HIV status with potential partners, and sharing your own, before having sex -- even when safe sex is planned. Avoid sex, or be especially careful about condom use, for those who are HIV positive (and not on effective anti-HIV treatment), those who don't know, and those who are evasive or won't answer. Mutual knowledge of HIV status is an extremely important component of safe sex.

I hope these comments are helpful. Let me know if anything isn't clear.

17 months ago
Doctor Handsfield, many thanks for your detailed answer!
Just to explain: when my partner was taking off the condom, it turned the other side. So everything what was inside got out.

And according to your answer: you DO NOT recommend any testing including HIV after this particular event (licking the pre-cum so it got into the mouth), right? 

Also I got to say thank you one more time for your education regarding the periodicity of routine testing. I do it every half a year.
Thank you
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
17 months ago
Thanks  for the clarification -- sorry I misunderstood the condom reversal. But no change in my opinion and advice:  little or no risk of HIV or any other STD and no testing recommended on account of this event. I'm glad to hear you have routine STD testing annually -- Поздравляю!---
16 months ago
Doctor Handsfield, hello!

Unfortunately recently I had an unprotected receptive anal intercourse due to the condom failure :(
We talked with a guy about his HIV and STI status. He said he's fine. That calmed me down
But as it's often said: trust, but verify.

That said, I'd like to make a full check-up. Could you help me to find out which tests are necessary?
My plan looks now like that:

-HIV ab/ag at 6 weeks after exposure
-Syphilis RPR at 6 weeks
-Anti-HCV at 6 weeks

-Gonorrhea rectal (needed?) and urethral swab PCR at 2 weeks 
-Chlamydia rectal (needed?) and urethral swab PCR
-Mycoplasma genitalium rectal (needed?) and urethral swab PCR
-Trichomoniasis urethral swab PCR

I'd be really thankful if you could check that list and add/remove tests.
Please, let me know if this question should be asked in a separate discussion.

Thank you! Спасибо!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
16 months ago
The first thing you might do is speak with your partner to assure he isn't infected. (You should have asked about HIV status before having sex, even with intended condom use.)  If he doesn't have HIV, or is infected but on effective treatment, no HIV testing is necessary. Same for other STDs if he has been recently tested.

Assuming that doesn't happen, I would recommend anal swab testing for gonorrhea and chlamydia, which is valid any time more that 3-4 days after exposure and an HIV AgAb test and syphilis blood test at 6 weeks. (You could also have an HIV test at 4 weeks, which would be 98% conclusive.)

I do not recommend any other testing at all. M genitalium is not known to cause any rectal symptoms or disease, indeed causes little if any health problem at all in men having sex with men. Trichomonas is exclusively a heterosexual STD, not known to occur with any measurable frequency in men having sex with men. And hepatitis C is essentially zero risk after any single exposure. If you from time to time have traumatic (bloody) rectal sex, then it would be reasonable to have an HCV test once every few years, but not after any single exposure. 

That completes two follow-up comments and replies and so finishes this thread. I hope the discussion has been helpful.