Context is that I’ve added a new female partner, and I want to ensure I don’t spread any STIs to my primary female partner. 

For my new partner, we were both fully screened for STIs before engaging in any activity. All negative for both. 

We started our physical intimacy with some frottage (vagina on penis, but in places of contact, barrier of underwear), masturbation of the other (vaginal fingering, rubbing clitoris, handjob for penis), and unprotected fellatio (2x). 

From what I’ve read, the frottage and masturbation are basically zero risk. I’m guessing at most, HPV, but presume barrier reduces that risk? I realize that sometimes genitals get slightly outside of covered areas (e.g., from fly hole in boxers), so maybe some light risk? However, in any case, I got two shots of HPV vax recently, and this new partner told me her last Pap showed no high risk strains + believe she got one HPV vax shot too. 

Then for fellatio, she says that she hasn’t been sexually actively for over 2 years (including blowjobs)… so I have to believe that makes the risk of oral STIs essentially zero. Unless she is lying, but I know her personally, and really doubt that. 

Is my assessment of risk being zero-ish correct? Should I wait 10 days before engaging with my primary partner to ensure no symptoms? Any risk of NGU that I should consider in terms of my health or primary partner’s? Thx!

I applaud your decision to be screened and have your partner screened before engaging in sexual activity.  This will do much to keep you both safe.  As you point out, the was no risk for any STI from frottage or mutual masturbation.  Having been screened and given your partner’s limited recent sexual activity, the risk of getting any bacterial STI from receipt or giving oral sex is effectively zero.  Similarly there is no risk for HIV.  If your partner has HSV-1 and you don’t (or vis versa) there is a tiny risk of acquiring genital HSV-1 but no meaningful risk for HSV-2.  As you point out there is a minuscule risk for HPV but I would not worry about this, particularly given that you are both partially vaccinated.

Overall I see no reason to worry about your primary partner, your new partner, or yourself and no reason for further testing. EWH 

Just a few other questions... 

1. Im going to get my 3rd HPV shot in about a month. This was the one where I had to wait a few months after the 2nd shot. As a 30s male, how well does this confer immunity? When and for how long? Was there ever a study on how well it prevents men from acquiring and / or transmitting HPV?

2. I saw somewhere that it was only recommended for younger women. Why is that? Why shouldn’t everyone just get the vax? Including middle aged women and men?

Thanks for helping educate me on this one!

1.  Most people have developed a substantial degree of immunity to HPV infections after receiving two injections of the vaccine. The third injection increases the relatively small proportion of persons who have developed strong immunity and appears to prolong the duration of the response. You likely have partial protection at this time.

2.  As a policy matter, influenced by economic considerations, vaccination of females has been emphasized over vaccination of males because it is the women who most commonly experience the most worst consequences of HPV infection – cervical or vaginal cancer.  More recently appreciating the rather obvious fact that the women must get the infection from someone, vaccination recommendations haven’t been expanded to include men.

I hope these comments help. EWH

1. Just want to understand how to reconcile your statements on HPV vax. You said I likely have “partial protection”, but you also said after two shots, most people have “substantial immunity”. I have had two shots. Wouldn’t that mean it’s likely I also have more than just “partial protection”? I’m about to get my third shot early next month. 

2. How long does HPV vax last? Should I plan for future boosters?

3. Is non chlamydial NGU transmissible male to female? If so, by what sexual acts?

4. In my case, would you even wait 10 days to ensure no symptoms before engaging in sexual activity with another partner? It seems like you wouldn’t worry about that. 

Again, many thanks! Much appreciate you helping educate the masses, and trying to calm a lot of nerves (as I can see the stress it causes for many). 

1.  The level of immunity generated by the HPV vaccine appears to correlate with the magnitude of the antibody response. The vaccine gives higher levels of antibodies the natural occurring infection, therefore protects better. Similarly as I mentioned above, with the third injection antibody levels rise still higher then after the second shot. Protection is all relative- more is better.

2.  The duration of vaccine responses long-standing however there are no reliable data on the precise duration. There is no current recommendation for booster injections and, in my opinion, they’re probably will not be.3.

3.  There are no data to suggest that partners of men suffer problems or complications.

4. No, given the information you have provided I see no reason to delay in sex with your regular partner.

I hope the information I provided is helpful. As you pointed out above this conludes this thread. Take care. EWH