[Question #7692] cunnunlingus and STD transmission

2 months ago
Over last year I gave cunnunlingus to two different high price massage girls. These girls are appointment only and I know full service sex is on the table for one but the other does not offer full service. It was a total of 5 times between the both of them as long as over a year ago and as recently as 3 months ago. I have no symptoms or any reason to worry, however I am anxious by nature. I am nervous of catching hsv2 or hpv. I have absolutely zero reason to believe that either of the 2 had anything let alone herpes or hpv. I know for certain, the woman that offers full service uses condoms diligently and is very concerned about her health.  I asked the other (whom I saw in December) if she has ever had any infections and she advised she was clean, just had an appointment with her doctor last week. Both woman are older early 40s, late 30's. I am worried because I am married. I have anxiety in my normal life, and this is just compounding it so I am trying to put my mind at ease. How concerned should I be about the potential of contracting herpes or HPV from these encounters? Should I get a herpes test with no symptoms? I know that the virus can lay dormant for some time as well as a likelihood for false positive/negative results.  Appreciate your help. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
2 months ago
Welcome. Thanks for your confidence in the forum.

Cunnilintus is very low risk for all STDs, for both the oral and vaginal partner. You're really not at sufficient risk for worry about it or for testing. If somehow I were in your situation, I would continue unprotected sex with my wife without any fear I woudl infect her, and i wouldn't be worried about my own health. I would not be tested for anything. I would give the same advice to my patients as well.

I hope this helps. Let me know if anything isn't clear.

HHH, MD
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2 months ago
I can't thank you enough for you quick reply.  Would the same apply for for analingus since it's in suck close proximity? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
2 months ago
There are no data on analingus and STD risk. (There's not much data for cunnilingus either, but at least a few studies.) Logically the same factors apply:  for anatomical reasons, transmission risk undoubtedly is low and I would estimate similarly low risk for the oral partner as cunnilingus. The main health risk for analingus is for gastrointestinal infections:  if the anal partner happened to have current or recent viral or bacterial gastroenteritis or colitis, or hepatitis A, for example, the oral partner would be virtually guaranteed to catch it.

For both cunnlingus and analingus, there also is risk of oral herpes if the anal partner has currently active genital or anal herpes -- which I didn't think to mention in my first reply. Both practices probably are extremely low risk for HIV.
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2 months ago
Thanks again, my big worry is herpes in my mouth from the cunnilingus. Just to be clear, the odds of me contracting herpes of the mouth from cunnilingus is low?  
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
2 months ago
The chance any particular partner has genital HSV2 averages 15-50%, depending on age and race/ethnicity (whites & asians lower, AA higher, LatinX intermediate; rising chance from teen years through age 35). If present and no symptoms, roughly 1 chance in a thousand of transmission. HSV1 isn't an issue -- inherently low transmission risk, with genital HSV1 almost never being transmitted sexually.

Are you sure you don't have oral herpes? If you do -- even if asymptomatic, i.e. no past cold sores -- the risk of giving genital HSV1 to your partner is higher than your risk of HSV2 from her. I'm sure you agree your partners' risks are just as important as your own!

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe!
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