[Question #7066] Clarification for Community

7 months ago
Hello Doctors:

Having had an issue and question regarding casual contact at Strip Clubs, and having read so many other questions here regarding the same issues, being licked, female hands on guy's genitals, etc, I did some looking in the archives and found the following from Doctor HHH:

3152 — I'm sorry you are having trouble believing or accepting the advice you have had. Cuts or sores on a stripper's (or anyone's) hands never transmit STDs. You are NEVER at risk for HIV or any STD unless your penis enters another person's vagina, rectum, or mouth. Period. There are no exceptoins.

and from Doctor EWH:

Condom protected sex is safe sex and neither French kissing, nor having your scrotum licked and sucked place you at risk for any STI.

If folks keep their contact to having scrotum licked, kissing, hand job, etc, that is, not putting your penis in the mouth, vagina and rectum of another person, can we assume we are not being put at risk of contracting STD or STI (herpes, gon, chlamidya, syphilis, HIV)?

I think if this rule is a good one to follow it would help a lot of the anxieties and concerns people have here.

Can you please comment here and let me / us here know if this is the gold standard rule to follow?
Edward W. Hook M.D.
Edward W. Hook M.D.
7 months ago

Welcome back to the Forum and, once again, thanks for your apparent commitment to safe sex.  It will keep you safe from STIs and HIV.  To rephrase your question, you are wondering if our opinions have changed in the intervals since we made these posts.  It is certainly reasonable to ask as for some topics, such as test performance, new knowledge has changed or recommendations.  This is not the case however for practices such as kissing, receipt of, or participating in masturbation, have your scrotum or other body parts licked without penetration. These remain no risk activities.  Over the past year, some investigators have suggested that persons with pharyngeal gonorrhea (and gonorrhea only) may transmit their infections to others through kissing however the topic remains quite controversial and most experts are skeptical that kissing (open-mouthed or "French" kissing) is a meaningful risk activity.  Certainly there is no known risk from closed mouth kissing.

I hope this reply is helpful to you.  I certainly would have no concerns related to the activities you mention.  EWH

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7 months ago
Thank you sir for your reply.

I think it is very clear, however, in doing the archives searching I did find a more recent post from Doctor HHH about some licking of body parts exposure someone had said and his answer which was he felt there was no risk did add this ==

But of course nobody can give a 100% guarantee that oral or saliva contact with intact skin carries zero risk of syphilis

The person posting had asked about Syphilis specifcally, but can we guess that Doctor HHH would have said the same about all STD/STIs?  And if so, is that different from your answer above ==

This is not the case however for practices such as kissing, receipt of, or participating in masturbation, have your scrotum or other body parts licked without penetration. These remain no risk activities.

I suppose maybe what he meant is that nothing is 100% certain?

IF you can clarify here I believe that would help me and others fully understand thank you!

Edward W. Hook M.D.
Edward W. Hook M.D.
7 months ago
Thanks for your follow-up.  I think you are right, in science and medicine, nothing is 100% certain or, in other words, stuff happens.   As I said above however, and as I am sure Dr. Handsfield agrees, there is no meaningful risk from the activities you list.  However, just as we cannot be sure that you will not be struck by a meteorite falling from space today, we cannot be sure that sometime, somewhere someone might become infected through the sorts of exposures you describe.  I would put the probabilities of STI or HIV infection from these activities as about the same as the probability of your being struck by a meteorite.  This is just not something to worry about.  EWH
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7 months ago
Thank you yes that is wonderfully clear.

Since I have one more question I will use it for others as well -- I have read in this forum regarding finger prick 4th generation Alere Determine Ag/Ab tests given at Planned Parenthood and other STD clinics:

All existing HIV AgAb (antigen-antibody) blood tests ("4th generation", "duo", "combo", etc) are conclusive by  6 weeks after the last possible exposure. This includes Determine® and other rapid, fingerstick tests

Does this remain true:  IF one takes this test 6 weeks or more since any kind of exposure, is a negative results 100% conclusive and as accurate as any other test?

Thank you
Edward W. Hook M.D.
Edward W. Hook M.D.
7 months ago

Yes, I would certainly have confidence in the 6 week test results for the Alere Determine finger stick 4th generation test and would not feel the need for further testing after getting a result from testing performed more than 6 weeks after an exposure of concern.

Hope this helps.  As you note above, we provide three responses to each client's questions.  This is my 3rd response.  Thus this thread will be closed shortly without further replies.  Take care.  EWH

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