Did I fall foul of misinformation?

[ManekiNeko]

Hello there,

Thank you for your attention and for providing this resource.

I was hoping you could help to improve my understanding regarding a series of mistakes I made in my only sexual interaction.

I’m a gay male who recently had my first sexual experience with another man and am worried I went about it the entirely wrong way. I did some research beforehand which left me with the (mis?)understanding that manual sexual is entirely risk free. Please see here for example:

https://www.askexpertsnow.com/wp-admin/ ... et_id=7837

I therefore decided to experiment in what was supposed to be receipt of a handjob from a stranger I connected to through Grindr (I don’t know any other gay people personally). This was one of several mistakes as he immediately propositioned me for sex, so is likely very promiscuous and high risk for STIs, but I'd been led to believe that by limiting our interaction to hand-genital contact I was not putting myself at risk of anything. Unfortunately said individual masturbated briefly while I was there. At the time I did not perceive any risk in this (he didn't get secretions on his hands) but to go over and above I had him use hand sanitizer before he touched me. A few weeks after this incident, I was confused and distressed to find some sources, including your website, citing several STI risks from manual sex in contradiction to the sources I'd found previously. The one that continues to concern me is HPV, since the hand sanitizer would have killed herpes or syphilis in the unlikely event that those had gotten on his hands (it would not have killed HPV). Yet a recent Canadian study suggests that HPV isn't a risk from hands?

https://www.google.com/search?q=hands+d ... e&ie=UTF-8

I’m very confused and don’t know what to believe anymore. I’m also despondent that as a man, I can’t be reliably tested for HPV to know my status. I guess I'm just looking for some advice on whether I ought to be worried about this incident?

[Carly]

Hi ManekiNeko -- unfortunately there is a lot of contradicting information available on the internet, as it hosts everything from personal opinions to hard, proven facts. It's very easy to find information that is willfully incorrect or misinformed. As our site states, manual sex is not entirely risk-free; there is a chance of contracting HPV, genital warts, chlamydia, herpes simplex virus (HSV) 1 and/or 2, and syphilis. The keyword here is that manual sex is low risk, meaning it is possible but unlikely or rare. The link to the Canadian study you posted directly links to a Google search of "hands don't spread hpv," not a specific study. Several results say it is unlikely, aka low risk. I don't think you need to be worried about this incident, but any person that engages in sexual contact should keep an eye out for any changes in their body, like a foul smell or discharge, that could indicate an infection. You can find information about STIs here.

You mentioned this was your first and only sexual interaction - how do you feel about your experience? You referred to making mistakes throughout your post which is indicating to me that there might be some shame or guilt. I also noticed that you made an assumption about the stranger who gave you a handjob - what made you think he was very promiscuous and high risk for STIs?

[ManekiNeko]

Hello Carly,

Many thanks for your thoughtful reply.
My apologies, I noticed I posted the wrong link in my prior post but wasn’t sure how to correct it afterwards. Here’s the actual link to the study I mentioned: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6404546/

I feel lousy about my experience because with retrospect I came to it with a false sense of security and it was studded with red herrings. I considered the aforementioned source credible as he has strong credentials and extensive experience, plus what he said was backed up by the study I’ve linked above so I thought I was on sound footing. In other words, I fear my good faith was misplaced and I wouldn’t have engaged in the encounter if I’d suspected there was any STI risk.

As for my mistakes, well, hindsight is a wonderful thing but they were manifold. The hand sanitizer I asked the other guy to use was labelled as killing viruses, but if I’d looked closer I might have seen the asterisk excluding nonenveloped ones (such as HPV). Sodium Lauryl Sulfate, a common surfactant found in soap, ostensibly kills HPV as well as the other skin-contact germs, so if I’d used that instead I would probably feel a bit better about it all. High-risk (carcinogenic) HPV is also known as mucosal HPV, so I figured if there was no contact with mucous membranes, directly or indirectly, I could not be exposed to high-risk HPV. As it turns out this was also mistaken as high-risk HPV can infect regular skin, including the penile shaft.

If I’d engaged in this encounter with someone as inexperienced as myself, that would have been another failsafe, since their risk of carrying HPV would have been near-zero. Besides that gay men have higher rates of STIs than other demographics on average, the stranger immediately propositioned me on the app, no questions asked, and seemed a bit careless about his health in general. He declined a mask when I offered one (for Covid) and had next-to-no personal hygiene items in his shower room. He wasn’t a bad fellow so far as I could tell, but he was slovenly. After I’d touched him for around a minute, I only had access to water to clean my hands so I doused them with sanitizer afterwards for good measure. Since he tried to make out with me near the start, I remembered that he breathed on my face and it condensed inside my mask, so I rubbed hand sanitizer inside my nose in case he had Covid (it seemed a bright idea at the time). Unfortunately the nose is a mucous membrane so if I had some residual HPV on my fingers, I could have infected my nose. In-all it was quite a catalogue of mistakes.

I feel cheated since the rules of safe play as I saw them changed after-the-fact. I’m also sad because as a complete virgin, STIs weren’t a worry of mine before, but I seem to have unwittingly jeopardized that. I’m particularly afraid of HPV because it’s nigh-undetectable in men, can incubate for decades, and it’s potentially deadly. I am regretful

[Mo]

My understanding is that HPV transmission through manual sex is unlikely, but not impossible. We really can't know the STI status of this guy, and even if he did have HPV that doesn't mean you would have contracted it. Ultimately this isn't something we can know for sure, and I know that's stressful, but I agree with Carly above that you likely don't need to worry too much about this situation.

What I would encourage you to do is think about what you are and aren't comfortable with when it comes to safer sex (or things like Covid precautions, which are important right now as well) in the future, and make a plan for the kind of conversations and boundaries you want to have moving forward.

[ManekiNeko]

Hello Mo,

Thanks for weighing in. Yes, I think that’s what aggrieves me most about this situation. If it had been most other STIs I could just go to a clinic, get a test, deal with the result and put it down to experience. There are a couple of companies offering male DNA tests in England but the tests don’t catch dormant infections and since such tests aren’t routinely done on men, even the providers cast doubt on their accuracy.

Your practical advice is gratefully received. Thing is, I’ve lost interest in exploring my sexuality further. With respect to HPV at least, it seems there’s next to nothing you can do with anyone else which is truly safe. For instance, if I’d asked him to wear gloves, but he touched himself with them, the virus could have just gotten on the glove as opposed to his hand. I should have insisted on condoms, but if he’d touched himself before he applied it, or didn’t wash his hands properly afterwards, or touched his scrotum/some other exposed area, he could still have HPV on his hands. Even if I’d clarified his sexual history with him beforehand, it would not have been conclusive. Some people have exposures they only semi-remember such as from being drunk etc., others lie and apparently even total virgins can have HPV (albeit very rarely) because they can contract it from their parents, e.g. while passing through an infected birth canal? It feels inescapable.

[Nicole]

Hi ManekiNeko, I hope it's okay that I'm stepping in here. I completely understand what you are going through and your concerns are entirely valid. You mentioned that you lost interest in exploring your sexuality further. My biggest advice there is to have a direct, clear line of communication with any future sexual partner. For instance, the concerns about HPV contraction from manual sex that you mentioned here--please make sure to mention this to any sexual partner in the future. While the risk for contraction of HPV through manual sex is low, it is still something to watch out for, and it is excellent that you are being proactive about this. For any future sexual interactions, make sure it is with a trusted and open individual. It is extremely important for them to address the questions you have in regards to STIs, as it is clearly something that is holding you back from exploring your sexuality further. Your worries are valid, so please try to make sure that your sexual partners are aware of that and respect them.

In case if you haven't taken a look into our articles, here is the information we have on HPV: The STI Files: Human Papillomavirus (HPV).

Here is another article about safe sex that focuses on HPV: HPV & Herpes: Why Safer Sex Isn't Always Safe Enough.

Please let me know if any of this helps!

[ManekiNeko]

Hi there Nicole,

I certainly appreciate your kind advice. I’ve read the sources you’ve shared and found them helpful. Might I propose one correction? In the first link, it says:

'The strains of HPV that are sexually transmitted only cause infection in mucus membranes – like in the mouth and throat, rectum, genitals, and urethra.'

With respect to high-risk (“mucosal”) HPV, this was one of the assumptions I had going into my encounter. Unfortunately it isn’t true. Both high- and low-risk HPV can infect regular/cutaneous skin as well as mucus membranes. My understanding is that high-risk HPV types have tropism for mucosal tissues, i.e. they infect them more readily, but not exclusively. The penile shaft, for example, is not a mucus membrane, but is commonly infected with high-risk HPV, and of course low-risk HPV/genital warts can appear anywhere on the genitals.

Certainly I should have communicated better with the other guy, but I'd believed that doctor's advice about manual sex's safety because of his credentials (Emeritus Professor) and experience, plus I didn't see what he had to gain by being untruthful. I think you're right in that exploring my sexuality with someone I trusted would have been better. Is that enough though? If I’m not mistaken, the reason mutual testing is considered best practice amongst new couples is because you’re not relying exclusively on trust or your partner knowing what infection(s) they have. While trust is a worthwhile auxiliary to negative test results then, I don’t necessarily see it as a substitute for them. With HPV however, and for men in particular, the facility for accurate testing doesn't exist. That’s why I'd rather eschew sex going forward.

[Carly]

Hi again ManekiNeko -- I took a look at your response to my post and the discussion you're having with others. I'm noticing that you seem fixated on STIs, specifically HPV. Can explain why this is has been as distracting and souring as its been for you? Health and safe(r) sex is absolutely something to be concerned about, of course... but can you pinpoint why this is something that would stop you from exploring your sexuality, especially if you experienced a low-risk activity? Considering that all sexually active people face the risk of contracting an STI, what do you think of people who do have sex still knowing the risks? Does that ever bother you? I know these seem like really strange questions that may have simple answers, but I'm very interested in understanding your view of your sexual health along side your sexuality.

[ManekiNeko]

Hi there Carly,

I don't find your questions strange. Correct, this has been souring for me. Apart from that I was naïve enough to believe this was a no-risk activity, I suppose I also believed (and hoped?) there were things you could do with others without risk. I recognize that sexual compatibility is important in relationships, so I’d much rather there was scope to test the waters without putting yourself in harm’s way. It seems that’s not really the case.

As for people who are fully aware of the risks and still choose to be sexually active, I cannot rationalize with them, at least where it's done casually. I understand wanting to be loved, but is any empty endorphin rush worth putting your life at stake? I would say, no.

[Sam W]

Hi ManekiNeko,

So, it may help to know that there are ways of being sexual with another person that pose low or no risk of STI transmission: Can I Get Pregnant, or Get or Pass On an STI From That?. That means that, if you're most comfortable with low to no risk activities, there are still ways of exploring sexual intimacy with another person.

Too, I think it may help to remember that the vast majority of STIs are not life threatening. Bacterial STIs can be cured with antibiotics, and viral STIs can be managed in different ways. Even for something like HPV, contracting it doesn't automatically mean the worst case scenario, and there are preventative measures like the HPV vaccine that can reduce the risk of it becoming a problem if it is contracted. Like most things in life, STIs and sex is a matter of risk assessment and risk reduction; for some people, knowing how to reduce the risk of transmission and what their options are if transmission occurs allows them to comfortably take what risks are present. Too, sometimes it helps to remember that most things in life come with some risks, and that we can sometimes treat certain risks as being more likely or more severe than they really are; for instance, statistically something life threatening is more likely to happen to me in a car than during sex.

[ManekiNeko]

Hi there Sam,

The no-to-low risk sexual activities you’ve linked to are appreciated, thanks. For me, with respect to the ones which are no-risk (talking, petting over clothes, using sex toys), I would rather just masturbate, but at any rate even these activities would probably be reclassified as risky for the time being, with Covid circulating.

Viruses phase me much more than the bacterial STIs, since like you say, bacterial STIs are readily curable. I’m not so worried about gonorrhea or chlamydia (except for the antibiotic resistant types).

From what I understand there’s nothing you can do if you’re one of the unlucky few with persistent HPV. Women can have their cervical dysplasia treated, but most men only realize its effects after a cancer diagnosis (anal pap smears are currently unavailable in Scotland). I’ve already taken the vaccine, which I’m very grateful for. It protects against the most common strains, but does nothing for the others. Provided any partner has a type included in the vaccine, you’re safe But maybe they have another type, and if they’re male you have no real way of knowing ☹ It feels like Russian Roulette, which personally would bleed the enjoyment out of anything I might do with them anyway.

I take your point with the driving analogy. You’re right, we’re statistically much more likely to die on the road than from sex. I don’t drive personally, but I would say that sex strikes me as more elective than other day-to-day risks, including motor travel, which in a lot of cases is essential to livelihoods. I can forego sex and the risks it entails without impediment to my daily life. I don’t think I could say the same for motor travel, but maybe that's just me.

[Sam W]

I'm glad that article had some useful info! Looking back at this thread, I have a few other things I wanted to ask. For starters, prior to this incident, were you excited to be exploring your sexuality with a partner? Or was it something that was already anxiety inducing for you?

I think it's also worth asking yourself why HPV in particular seems so inescapable to you. As we've noted in this thread, there a preventative measures like barrier methods, communication with a partner, or the vaccine that can significantly reduce the risk of transmission. But what I've noticed is that you go very quickly to all the what-ifs, including unlikely ones, that would mean HPV got through all those preventative measures AND resulted in the worst case scenarios, when in reality most cases of HPV, including of high-risk strains, go away on their own.

[ManekiNeko]

Hi Sam ,

Yes, prior to this incident I was excited to be exploring my sexuality, or at least I was when I thought hand-genital contact was safe. I was overcome with trepidation during the experience because I sensed that something was amiss, but I overruled that instinct in favour of advice from people I thought knew better. I wish I'd listened to my gut.

I know that high-risk HPV rarely causes problems, but when it comes to cancer I’d rather address the possibility than the probability. Maybe I ought not to be so worried, but it scares me. I really want for an accurate test in men but could be it’s just not technically possible.

I will certainly take onboard the advice kindly given by you all should I decide to return to this field of life. I think probably the best way for me to go about it would be with someone who is equally inexperienced.

[Michaela]

Hi ManekiNeko,

Since you were feeling excited about exploring your sexuality but the risk of STIs has been causing you some anxiety, I am wanting to chime in with a few other thoughts for you echoing what Mo mentioned earlier. As I understand the situation, this was with a person who you had just met and there were some things that made you feel uncomfortable (COVID precautions and hygiene), even before sex entered the equation. Sex can be vulnerable not just health-wise but emotionally too and so setting boundaries or having discussions with a partner beforehand can help you feel more comfortable exploring your sexuality in a safe way. You mentioned only wanting to be involved with someone inexperienced, however, that still does not completely absolve the risk. It may be more beneficial to think about the types of boundaries you want to have in place if you do decide that you want to continue exploring your sexuality. In an earlier post of yours you mentioned things like washing hands before applying condoms, wearing gloves but being careful what comes into contact with them, and maybe changing them between sexual acts etc. How would you feel about talking with a future partner about these things beforehand to help alleviate some of your fears so that you can have an enjoyable experience? Are there others that you would want to add?

I also was wondering if you find yourself jumping to these worse-case scenarios in other areas of your life too, or is it specific to HPV risk?

[ManekiNeko]

Hi Michaela,

That’s right, I didn’t know this person. It was my first experience so I had no frame of reference and I didn’t think anyone would entertain the trouble of having me over for something less stimulating than they could do themselves. Hygiene was kind of irrelevant to me going in since I didn’t think I could get anything from hands not carrying fluids or having touched mucous membranes, especially not sanitized hands. Prior to the experience I saw an extract from this page reposted on a sexual health message board, specifically the part about handwashing being unnecessary during mutual masturbation (although it addresses HSV specifically):

https://www.medhelp.org/posts/STDs/Mutu ... how/289855

With respect to the safeguards you’ve mentioned, I agree this is what it’d take to make me feel safe. I guess that’s why I resent HPV, because it makes safe sex impractical if not impossible. Not only would I feel little if anything through gloves, but I’d also need to change them between touching myself and my partner, or even different areas of their body. There comes a point where it’s just more trouble than it’s worth. Do you mind if I ask whether you know any people who do this? What do you all do personally to stay safe within your sex lives, or what would you do if you aren’t currently sexually active?

As regards worst-case scenarios, I know I don't sound like fun at parties but I hope I’m just like this with HPV. It made me feel stupid and vulnerable because I didn’t even see the risk and the safeguards I did take (no mucous membrane contact, sanitizer) weren’t really safeguards at all.

[Nicole]

Hi ManekiNeko,

I'm glad Michaela's comments have been resonating with you! I understand that these safeguards may seem troublesome and tedious to you, but any respectful partner will understand their importance and do whatever it takes in order for you to have a safe and comfortable experience. Personally, I do not know many people who follow these specific safeguards. Mainly of my MLM friends get the HPV vaccine and use barriers like condoms. I know your existing concerns with contracting HPV even while using condoms, but that is what the people close to me rely on. The vaccine is extremely effective but I know you have some concerns with protection against certain strains. For me, I am a woman in a monogamous relationship, so I am not sure if I can entirely relate to your situation. Regardless, anything is possible, so getting tested frequently and utilizing contraceptives is extremely important for me and my partner. Do you have any friends that you can reach out to and ask about their use of safeguards or their thoughts on your specific safeguards?

Also, I just want to let you know that you are not stupid! You are bringing up a very important concern that many people really do not take into account when getting into sexual relationships. I am glad you reached out to us and are really considering our advice!

[ManekiNeko]

Hi there Nicole,

Nice to hear from you again. You sound very mature for a 20-year-old (I hope that doesn’t come across as condescending as it’s meant as a compliment).

Thanks for your kind words. I feel stupid because I’ve saddled myself with trepidation over a risk I didn’t even see and would much rather have avoided.

I appreciate you sharing your insights. Within my social circle, nobody I know uses the safeguards we’ve discussed either, although on the other hand I’ve found that most don’t know much if anything about HPV. That’s not necessarily a reflection on them but probably more on our sex education, or perhaps reflects progress in scientific understanding since we left school (all I remember being taught was that HPV causes genital warts). Sometimes insisting on condoms and changing gloves was met with ridicule, i.e. that I'd be as well approaching sex in a hazmat suit.

If you don’t mind me asking, would you feel comfortable having a sex life if you didn’t have access to pap smears or HPV testing, i.e. if you were solely reliant upon the vaccine like your MLM friends? Being mindful that condom users still transmit HPV given enough exposures (because of skin contact around the condom), would you resort to the safeguards we’ve discussed, forego sex or do you think it wouldn’t affect your sex life at all? I realize these are personal decisions but I’m interested to learn about other people’s perspectives and practices.

[Carly]

Hey ManekiNeko -- to answer the question you posed right before this post, yes, I would personally still feel comfortable having a sex life if I didn't have access to pap smears or HPV testing (also keep in mind there was a point in time no one had those period). This is because I view my sexual expression, exploration, and pleasure as a part of my overall wellness and it's important to me. I'm personally willing to take informed risks because of that. Another example of this is would be pregnancy risk. Though I take measures to prevent pregnancy and trust their effectiveness, the only way to 100% guarantee that I won't get pregnant is abstinence... but that's not fulfilling for me. Even though there are ways to prevent these outcomes that make them less likely to happen, being some percentage at risk for pregnancy and STIs is just the reality of being sexually active in the way I want to be.

I'm asking this again because I'm not sure we got to the bottom of it -- why are you concerned about HPV specifically? Is there something about it that feels particularly triggering or inescapable to you? I could be totally off-base and too arm-chair-psychologist here, but I'm wondering if the risk for HPV is a stand-in for another anxiety you're feeling about sexual activity or a more generalized anxiety. In my experience of anxiety, it's often around what I anticipate will happen in the future rather than what the current situation is. It's usually calmed by predictable situations or feeling like I'm adequately prepared for something, and if I did not end up being prepared for something I tend to get very upset about it. I'm wondering if this has had such a big impact on you because you felt safe and prepared enough to make a huge step towards being sexually active, only to feel like you didn't have all the information and now you're feeling the need to retreat big time. Am I on to something here? Does any of this resonate?

Also, I want to bring up the comment you made about Nicole's maturity for a moment. I know this was done with no harm intended, but just keep in mind that the sentence structure of "you're very [blank] for a [blank]" can come off as condescending even if the compliment is genuine like this was. I'm not intending to speak on behalf of Nicole by any means, nor am I hoping this makes you feel bad for expressing your appreciation to her. I'm just highlighting this as something to look out for in the future!

[ManekiNeko]

Hi Carly,

Thanks for that. It’s honestly enlightening for me to have these kinds of discussions and I trust it’s equally so for other users of this site. I am grateful for all your time. Apologies to Nicole for my clumsy turn of phrase. I had it in my head that adulthood only begins (legally at least) in the UK at 21, but that’s since been changed to 18. At any rate I see that’s not only an outmoded but an unconsidered way of thinking. It wasn’t meant in a backhanded manner but unfortunately it carries those undertones. Probably when you have to postface anything with ‘I hope that doesn’t come across…’ you’d better just not write it. Lesson learned.

For being an ‘armchair psychologist’ I couldn’t have expressed myself better than you have in your second paragraph.

The impression I’m getting from this thread is that I ought to be braver with respect to HPV and other STIs. I’m not brave actually so it’s something I might have to work on. (´。＿。｀)

Also for what it's worth there's a new vaccine in development: https://journals.asm.org/doi/10.1128/jvi.00566-22

[Nicole]

Hi ManekiNeko,

It seems like your keeping up with the research and news on the HPV vaccine and STIs in general helps ease some of these anxieties that you’ve been having, is that right? I am glad that you have been internalizing our advice and working with us to find some closure in your concern. Again, the way you are feeling is entirely valid and proactive. I feel like this conversation might be wrapping up, but I just want to extend our availability to any other questions or concerns that you have. Please let us know your thoughts!

[ManekiNeko]

Hi there Nicole,

I'm glad to hear from you again. I'm always pleased to learn news of medical advancements, be they in the field of STIs or any other. I sense we might share a similar outlook. I don't have any other questions or concerns to be honest, in fact I didn't expect any reply when I said I was suspending sexual exploration although I appreciate those I received both before and after. I'd like to extend my thanks to each of you for having weighed in on this thread. I've read and considered all you've said and feel wiser for it. As well as sex being new to me, my anxieties were largely borne out of not having the right information and interacting with more knowledgeable people has proven a good antidote. Take care! (。・∀・)ノ