Question for Dr Handsfield please

[pahbwe]

I have been taking advice from your postings for a while now.. I try to maintain as safe an attitude to sex as possible but I have a question please.

I will occasionally visit an escort but only ever engage in hand relief (often covered) or breast relief...
I have started engaging in covered oral and bare breast relief but it worries me...

Is there a risk of HPV etc from covered ** or from skin to skin during breast relief... my understanding is that there are theoretical risks but that there is a wealth of evidence from the field that there is actually no risk at all from these activities?

I never engage in sex as even with a condom the risk is still too much for me, am I correct in that position?

Even if the risk is tiny of any STD the risk to my sanity is probably too high for me anyway...

Thanks for your excellent advice in the past.... Keep up the good work.

[Edward W Hook, MD]

You are correct. Take care.  EWH

[pahbwe]

I'd also note that I stated I avoided genital sex because the risk seemed higher... I note from your reply that you also suggest that is the case...

[pahbwe]

Thanks... I understand that and don't wish to guarantee but do wish to base my decisions on evidence, experience and advice...

I ask merely to confirm my understanding that the activity mentioned is low risk based on the understood body of evidence.

I shall continue with caution and likely avoid oral in future

Thanks for your time and advice

[Edward W Hook, MD]

Welcome to the Forum.   Dr. Handsfield and I take questions as they appear. As it happened, I happened to pick up your question and will be answering it.  FYI, the reason that we share the Forum is because that while I personal verbal styles vary a bit we have never differed in the facts of our advice to clients.

There is no meaningful risk for acquiring any STI, including HPV from receipt of masturbation from another person (covered or uncovered) or from what you refer to as breast relief.  As far as receipt of condom protected oral sex, we do know that some persons have HPV present in the oral cavity  and thus there is some very, very tiny chance that a person could acquire HPV through condom protected oral sex however the event would be so rare as to nearly be zero.  The chance of getting HPV from condom protected  genital sex is somewhat higher than the chance from oral sex.  In both instances however, the risk is very, very low.

Your statement about your inability to tolerate any risk of getting HPV from your interactions with a commercial sex worker however has led me to past part of a reply I made yesterday to another person in below.  I have little patience with persons who want to have sex with commercial sex workers but state that they cannot take any possible chance of getting an STI- this is simply not a healthy or appropriate perspective and suggests that you have an unrealistic attitude towards STIs.  The excerpt is below:

"Now let me take a moment to provide a qualification since you, like at least some of our other clients are seeking a guarantee that they cannot acquire an STI from contact with others. The qualification is that in life, other than the certainty of death at some time in the future, there are no guarantees. In truth, science does not deal in facts but in probabilities and estimates because knowledge does not stop accumulating. As evidence and experience accumulates, the precision of our estimates improves but they are still estimates. Thus, although there are no cases of HIV known to be transmitted by masturbation, this does not mean that tomorrow or the next day someone, somewhere will acquired HIV through the sorts of exposures you describe above despite the millions and millions of times before when this has not occurred. This generalization extends to most of the other STIs you mention as well. Thus in the same way that I cannot promise you that you are not going to be struck by a meteorite falling from space while reading this, I cannot and will not guarantee you that you could not get an STI through the sorts of exposures you describe."

The same holds for your question about HPV.  Thus, while the measures you take to avoid HPV and other STIs are highly protected, they are not perfect.  I hope that this makes sense to you and that you understand why I say this.  EWH