clarifications on what is safe sex

[iamworried333]

Hi.  I have a habit of frequenting massage parlors and escorts.  I would like to clarify what activities are safe if I want to ensure that my risk of contracting an STD is essentially non-existant.

I am fairly certain that these activities are all ok…

- french kissing
- sucking nipples (even if woman is lactating?)
- my fingers in her vagina or anus (assuming no obvious fresh cuts on fingers)
- receiving a handjob WITHOUT a condom (even if her hands are not washed and previously in contact with her own or previous client’s body fluids?)
- receiving oral sex WITH a latex condom

1) Am I correct that all those are essentially non-existant risk?  

2) I would like to be able to add protected vaginal intercourse (WITH a latex condom) to that list but since I have seen data that condoms break 2% of the time even when used properly I am not sure if I can add this and still maintain essentially non-existant risk.  Given the fact that condoms can break, do you consider vaginal intercourse WITH a latex condom to be essentially non-existant risk or does it have to be considered a risk for acquiring an STD?

3) I assume that receiving oral sex WITHOUT a condom and performing oral sex on her (no protection) are no-go’s if I want to maintain non-existant risk?  Do they carry non-negligible risk for any of the serious STDs or just for the easily curable ones?

Thanks for your help!

[H. Hunter Handsfield, M.D.]

Safe sex means choosing low-risk partners and using condoms for vaginal or anal sex.  That's pretty much it.  By definition, you are foregoing the first.  But if you use condoms for vaginal or anal intercourse, you are pretty much home free; the safety issues you cite go beyond the standard recommendations, because oral sex is extremely low risk even without condoms; and contact of sexual secretions or saliva with hands, skin (including nipples), and so on is no risk at all.  If you follow all the things you describe, you could visit your parlors and escorts daily for the rest of your life and never expect to get HIV or most other STDs.  You would retain a certain risk for HPV and herpes, however.

HHH, MD

[anxious7]

I had a conversation with a person on an HIV Hotline [phone]. There are 4 bodily fluids that transmit HIV.

1. Blood
2. Semen
3. Vaginal Fluid
4. Breast Milk

Just FYI!

[iamworried333]

Thank you Dr. Hansfield.  In terms of the risk for genital herpes, I just did some reading and appears to me that even with condom use the potential of acquiring genital herpes from frequenting escorts would be high due to the prevalence of the disease (i've seen as high as 1 in 4 women and probably higher for escorts) and that condoms are less than 50% effective at preventing transmission of herpes.  Is that correct that genital herpes would be a significant risk or would it be very low risk if condoms were used?  Thanks and I promise no more follow-up questions.

[H. Hunter Handsfield, M.D.]

HSV is low risk with condoms but not zero.