the Risk of Syphilis Transmission in Non-Penetrative Sex

The likelihood of contracting syphilis?

Hello Dr.
Lee, I visited a sex worker on July 8th of this year for a handjob service.
The process involved unprotected oil massage handjob and breast sex, and my genitals did not come into contact with her mouth or lower body (she didn't even take off her pants).
However, I recall that she might have licked my nipples for about a minute, as I had to think hard to remember this detail.
Afterward, I became very anxious about sexually transmitted infections (STIs).
I went to Far Eastern Memorial Hospital for blood and urine tests on July 11th and July 19th, and the results were approximately as follows: TPPA: Negative, RPR: Non-reactive, and both urine routine and culture results were sterile and normal.
Additionally, I completed the three doses of the nine-valent HPV vaccine two years ago.
Given this context, I have ruled out most STIs (such as HIV, gonorrhea, etc.), but I am particularly worried about syphilis, especially regarding the nipple licking.
Although outpatient physicians and various health education websites indicate that the likelihood of contracting syphilis is extremely low, with one physician stating, "Your nipples did not have any open wounds, so it is almost impossible for syphilis to infect you," I still feel very fearful.
Could you please provide some advice based on my personal situation and conditions? Thank you very much!

Niming, 20~29 year old female. Ask Date: 2022/07/21

Dr. Li Xinyi reply Urology

No one can guarantee that there are no issues, but your situation really does not seem like a syphilis infection.
What is certain is that you are overly worried, and only you know the reasons for that.
If you are still very concerned, it would be best to get tested again in three months.

Reply Date: 2022/07/21

More Info

When it comes to understanding the risk of syphilis transmission and other sexually transmitted infections (STIs) in non-penetrative sexual activities, it is essential to consider several factors, including the nature of the sexual contact, the presence of any open wounds, and the overall health of both partners involved.

In your described scenario, you engaged in activities such as manual stimulation and possibly some form of breast contact, with the additional concern of your partner licking your nipple. The good news is that the risk of transmitting syphilis through such activities is generally considered low, especially if there are no open sores or significant abrasions on your skin or your partner's skin. Syphilis is primarily transmitted through direct contact with syphilis sores, which are typically found on the genitals, anus, or mouth. If your nipple did not have any open wounds or sores, the likelihood of transmission through licking is minimal.

Your test results from the hospital, which showed negative results for TPPA and non-reactive RPR, are reassuring. These tests are used to screen for syphilis, and a negative result indicates that you likely do not have an active syphilis infection. Additionally, the fact that you received the nine-valent HPV vaccine two years ago further reduces your risk for certain types of STIs, although it does not protect against syphilis.

It is also important to note that while the risk of syphilis transmission through non-penetrative sex is low, it is not zero. The presence of any cuts, abrasions, or open sores on either partner could increase the risk. Furthermore, other STIs can also be transmitted through skin-to-skin contact, so it is always wise to practice safe sex and maintain open communication with partners about sexual health.

If you are still feeling anxious about the possibility of having contracted syphilis or any other STI, it may be beneficial to consult with a healthcare provider for further evaluation. They may recommend additional testing or counseling to help alleviate your concerns. Regular STI screenings are a good practice, especially if you engage in sexual activities with new partners.

In summary, while your situation does present some level of concern, the combination of your negative test results and the nature of the sexual activities you described suggests that the risk of syphilis transmission is quite low. However, if you have any lingering doubts or symptoms, seeking medical advice is always a prudent step. Remember that maintaining sexual health is an ongoing process, and being proactive about testing and communication can significantly reduce risks associated with STIs.

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