[Question #6122] STD Risks

16 months ago
Good Afternoon,

I had an exposure where i met a CSW and had the following types of activities happen:
- Oral sex safe on me - Saliva was spat on the condom but some saliva did touch my scrotum and inner thighs as well as possibly gone within the condom
- Oral sex on me was safe at all times however her mouth may have touched the back of my penis that was not fully covered 
- she kissed me on my lips a few times but no Deep kissing rather light kissing but she did kiss me multipe times
- She gave me some lap dances while she was naked and i was wearing the condom 
- When i ejaculated - i took the condom off and her saliva came in contact with my hand which then came in contact with my penis 

In terms of risks 

a) I never received any oral sex un-protected but i am aware that it still not a no risk - can you let me know from an STD lense what risk i am possibly exposed to from an Oral sex action - not worried about HIV more so Syphilis and Gonorrhea 

b) From kissing i am reading that gonorrhea is now a risk? I was not aware of this - am i at risk and do i need to be tested?

c) The lap dancing is there risks associated with this ? - i did not notice any sores but i am aware it can be hidden. 

d) Prior to ejaculating I took off the condom and her condom on the saliva came in contact with my hand which then went on my penis - what are my STD risks here 

e) Am I at risk here for anything and if so what should i target testing for? 

Thank you kindly,
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
16 months ago
Welcome to the forum. Thanks for your confidence in our services.

This was an entirely safe exposure, and I see no need for testing of any kind. Salival rarely if ever transmits STDs, and potential contact of your CSW partner's lips on your penis above the condom, or saliva there, is risk free. If there was direct gential contact during the lap dance -- i.e. genital apposition without penetration -- in theory there could have been slight risk for one of the STDs transmitted skin-to-skin (HPV/warts, herpes, syphilis), the actual risk is very low, even if you had not been wearing a condom. To your specific questions:

a) Even without condom protection, oral to penile transmission of gonorrhea or chlamydia is pretty infrequent after any one exposure. With a condom, the risk is zero. Nothing to worry about.

b) Kissing and gonorrhea currently is controversial. One Australian research group has published several papers expressing the belief that gonorrhea in men who have sex with men may be transmitted frequently by kissing, and more frequently by oral sex than previously believed. Their research and conclusions have had considerable media attention, but they are controversial; the large majority of STD experts are very skeptical. There are no data to suggest it's an issue among heterosexuals. As it happens, I was the scientist recruited to debate the leader of the Austraila group on this topic at the main international STD research meeting, which occurred in Vancouver, BC last June, so it's something I know a lot about. He and I disagreed on the conclusions from his data, but agreed with one another about the importance of additional research, and several research groups are reexamining old data and starting new research to confirm or refute the Australians' conclusions. As a scientist, I am prepared to alter my views if convicing data emerge. In the meantime, you should consider the kissing to be extremely low risk probably zero, and I do not recommend testing for oral gonorrhea.

c) Even if she had sores you didn't see, the lap dance carried little or no risk. See my comment above.

d) Saliva does not transmit STDs, certainly not by simple contact with intact skin.

e) Answered above:  I don't recommend any STD testing at all.

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

16 months ago
This helps me understand alot.

In terms of Oral to penile - during that time frame her lips did come in contact with inner thighs which obviously was unprotected and my neck as well . From a risk prespective would that be cause for concern

During the lap dances my pants were off but the condom was on is there risk from maybe her thighs touching my thighs which were u covered except the condom being on?

Lastly during the kissing on the lips - our kiss was multiple pecks vs heavy deep kissing would this lower my risk if there was which i understand you there was minimal

Thank you and that will be all
Appreciate your responses

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
16 months ago
Brief oral contact with intact skin anywhere on the body is safe, with little if any risk of transmisison of any STD. For infection to take hold, either susceptible (non-skin) tissues must be exposed, e.g. HIV, gonorrhea or chlamydia introduced into the urethra; or, for skin-to-skin STIs (herpes, syphiils, HPV), the germ needs to be massaged into the tissues. That's why genital warts, newly acquired herpes, and the chancre of syphilis almost always occur at sites of maximum friction during sex:  the head of the penis, labia minor or vaginal opening, anus, etc. Brief contact of the mouth (or genitals) with intact skin is risk free -- including possible contact of your partner's mouth with your inner thigh (or anywhere else on your body).

It is conceivable that prolonged sexual kissing could transmit STDs; we discussed the controversies about gonorrhea and kissing above. However, you are focusing on minutiae. The fact is that even the busiest STD clinics never see infected patients whose only exposures were like the exposure you describe. Virtually all patients have had vaginal, anal or oral intercourse; we simply never see patients whose only exposure was kissing, genital-genital contact without penetration, hand-genital contact, etc.

Try to accept the reasoned, science based reassurance I have tried to give. This event really was nothing to worry about, and there are no other details of the events that would possibly change my assessment and advice. Do your best to move on without worry!

16 months ago
Thank you for this.

Lastly if she had licked my genitals which is unprotected by geintals i am referring to my balls as my penis was covered at all times

Is there risk she had licked my balls heavily for about 20 seconds.

That would be all. 

Thank you kindly
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
16 months ago
As I said above, "Brief oral contact with intact skin anywhere on the body is safe, with little if any risk of transmisison of any STD." I haven't changed my mind! That includes the skin of the scrotum. If there were strong contact or nipping, e.g. if a bleeding wound or bruise (hickey) develooped, there might have been slight risk. Otherwise no risk at all.

As I also said previously, don't overthink this. In my 40+ years in the STD buisiness, I've never seen a case of STD transmitted to intact skin by oral conact.

That completes the two follow-up comments and so concludes thsi thread. I hope the discussion has been helpful and reassuring, as intended. Do your best to move on without further worry.