Short term dating and sex

[jdo192]

Dear Medhelp

Thank you for your services. They are very useful.

I have a question. I understand that the best approach to avoiding STDs is to use protection and have a trusting relationship with the person who you have having sex with.

I am a man, who enjoys short term dating with women and I don’t really get into long trusting relationships.

I enjoy for example meeting a woman and going on a couple dates with her, maybe I have sex with her a couple times and that’s it, I dont see her again. And then I meet another woman etc.

I never lead the woman on, but this type of short term dating doesn’t allow me to get to know the woman enough to trust her properly.  

I want to know what risks of STDS and/or HIV I as a man am running in the following circumstances :
- Protected sex (not anal) with a condom
- Receiving oral sex (*******) from a girl – no condom
- Receiving oral sex (*******) form a girl – with a condom
- Giving a girl oral sex (going down on her) – no protection
-       Mutual Masturbation involving vaginal fluids - no protection

Thanks your assistance is greatly appreciated.

[H. Hunter Handsfield, M.D.]

You describe a diverse set of partners, with varying levels of STD risk.  I think the main thing is that you seem to mostly date women who are willing to have sex with you right away, either the same night or within a couple of dates.  All men and women who behave in this manner should be considered high risk for STDs.

Therefore, if you continue your current sexual lifestyle, you can expect to have one or more STDs as the years go by, with HPV and herpes perhaps the most likely.  (Probably you already have had one or more genital HPV infections.)  On the other hand, consistently using condoms for vaginal or anal sex would keep you at low risk for serious ones, like HIV, syphilis, hepatitis, gonorrhea, and chlamydia.  With only kissing and mutual masturbation, you will not be at risk, but limiting yourself to these practices doesn't sound very satisfying or practical.

[jdo192]

Dear Doctor

Thank you for your responses, they are a real eye opener.

I would like to clarify that the women I have sex with, I meet them through friends, work, university, bar pick ups, salsa clubs and normal dating sites. Does your advice remain the same?

I get a bit paranoid about STDs/HIV, if I stick to kissing and mutual masturbation, am I at no risk of stds/hiv?

Regards

[H. Hunter Handsfield, M.D.]

Welcome back to the forum.

You don't say where and how you recruit your sex partners.  If most are very casual, such as bar pick-ups or commercial sex workers, the STD/HIV risk is inherently higher than with partners introduced by friends, at work, etc.  In any case, you can assume that most women willing to date men with your sexual lifestyle are at pretty high risk for having various STDs.  If they're willing to have short-term flings with you, it is likely they do the same with other partners.

For those reasons, my replies to your questions assume your partners are at high risk and that even with safe sex, you are at continuing risk for STDs, especially in event of a condom failure during vaginal sex.  Therefore, I would encourage you to be tested for common STDs (HIV, syphilis, chlamydia, gonorrhea) from time to time, like every 6-12 months -- even if there have been no condom failures or other apparently lapses in sexual safety.

To your specific questions:

1) Condoms for vaginal sex are virtually 100% effective in preventing gonorrhea, chlamydia, and HIV; but in the long run, only 50% protective against herpes, syphilis, or HPV.

2) Receiving unprotected oral sex is low risk for all STDs, and zero risk for some.  The most likely infections are gonorrhea, nongonococcal urethritis, and herpes due to HSV-1.  There are minimal if any risks for chlamydia, HIV, hepatitis, or HPV.

3) Oral sex with a condom is zero risk for all STDs.

4) Cunnilingus is zero to low risk; there are small risks for gonorrhea, syphilis, and herpes.

5) Hand-genital contact is exceedingly low risk for all STDs; it can safely be considered zero risk.

Regards--  HHH, MD