Considering the artist gave her massive tits it's obvious she got all 3L through titjobs. Normally "sleeping with someone" is a euphemism for actual sex, not hand/blow/tit/etc jobs.
Sure its a euphemism, but its not a synonym. There may be no actual penetrating intercourse with BJs, hand jobs, or paizuri, but you or both got your rocks off by the actions of a sexual partner, not yourself. Hell, how many religious folks convinced themselves or their partners that anal isn't sex, so its OK in the eyes of their diety and "doesn't count"? Or if the hymen doesnt tear, it "doesn't count"? Or if you don't swallow, it "doesn't count"? Or best one I've heard, if you're using a condom, it "doesn't count"...
In the end, you're still having some form of sexual relations with your partner, whether you're actually getting it on trying to make a 5th kid, or hot dogging her buns cause she's on her period, you're still having sex.