sex with escorts

I am such an idiot, I have three situations that I would like to tell you about and could you please tell me your assesment also bear in mind that i am a white male 30 years and  i live in the state of ohio
1. in february of 2010 i had unprotected oral sex with a female ( white if that matters ) escort and protected vaginal sex.
2. in april of 2010 i had protected sex with a female escort, this time as we were finished there was blood on the condom mostly at the base of my penis which was very concerning to me, as far as i could tell the condom did not break.
3. july 7th 2010 i had brief unprotected oral and protected vaginal sex with a female escort, although this is in recent memory , so i may give more details, she performed unprotected oral sex on me then she sat on me for a couple of minutes with her genitals touching mine i did not have a condom on at this time , but before the penetration she produced a condom and put it on me then at that time we proceded to have protected vaginal sex

I must tell you that I had genital warts in the past, but I took care of that back in 2007, i believe that i acquired them from a relationship. furthermore i believe that these woman may have been into drugs in their past or currently, i am not being judgemental by saying that, that is just my opinion and am just wanting to make sure that i can tell you all the details, the other thing about the later two of these women is that they spent alot of time in south florida ( if that matters ).  i know you are very busy and i thank you for taking your time to read this but my biggest questions are these.
1. am I at risk for catching HIV or other STds?
2. i understand you and the other doctor run a large std clinic from what i've read on this site in your threads, what would you say the percentage of women that have HIV are csw's?

thank you for your time and by the way i think what you are doing on this site is great

[Edward W Hook, MD]

Welcome to our Forum. As I read your post I note that you have had sex with several CSWs.  Most CSWs are not HIV infected, thus it is unlikely that you were exposed to HIV.  As an occupational hazard, CSWs may have STDs.

You have had several episodes of condom protected vaginal intercourse which is no risk for HIV or other STDs.  Condoms work.

As for receipt of oral sex, the quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.   In your situation I see no reason to worry about getting HIV from the exposures you have describe either.  In terms of other STDs, oral sex is an inefficient way to transmit STDs.  Of the bacterial STDs only gonorrhea and nongonococcal urethritis (NGU) are transmitted through oral sex; chlamydia is not and without an obvious sore or lesion on your partner’s mouth, the chances of syphilis and herpes is likewise tiny.   If you had gotten gonorrhea or NGU you would have most likely developed symptoms of urethritis (penile infection) by now.  Even if your partner had an STD (any STD and it is likely she did not), most exposures do not lead to infection.  In your case, your exposure was brief; I would urge you not to worry. If you must, you could go to your local STD clinic or health care provider to be tested at this time.  

Finally, most CSWs do not have HIV and most women with HIV are not CSWs. Most women get HIV either through drug use or through sex with an infected male partner in the course of a non-commercial relationship.

I hope my comments are helpful to you.  Take care.  EWH

[ohio88888]

this is the same person i had to renew my name,( forgot password) just to be sure because I also had two other of the same situation( unportected oral and portected vaginal sex ) more recently with two different female csw's, you have said on this site that if I receive unportected oral sex the chances are 1 in 10000 IF the partener is infected?  I have read on some other sites that there has never been a documented case where someone was infected by recieveing oral sex. is that true? by the way i only engage in these activities when I have been drinking but thats a whole seperate issue, you have read my stories above and the same is true for the more recent too, although i always use a condom for intercourse, the one epidsode the oral sex was rather rough , my penis never bleed i don't think but it was quite irritated, these two events were just a couple of days ago,  i know that this is stupid to involve myself in and am most likely not going to do it again, i just want to be sure that i am safe, i am very worried still. should i be tested for hiv? .thanks for your help

[ohio88888]

sorry to bother, one more thing , when you say 1 in 10000, does that mean 1 in 10000 episodes or does it mean an hiv infected person would have to perform the act 10000 times on the same person for transmission to occur?  i know that sounds like a silly question but if the later is true then the odds would be more like 1 in 1,000,000? just a question. thank you again

[Edward W Hook, MD]

I cannot be sure if you are the same person or not so I will answer this question and then the thread will end.  If you are the same psoter you should be able to find out your passowrd from the MedHelp hosts.  The question asking if there has never been a well documented case of HIV pass through oral sex just repeats my original answer.  Read it again.

1 in 10,000 mean that, on average, an infection would occur once every 10,000 acts of oral sex with an infected partner. It could be the first of those 10,000 or it could be the last and it could be 10,0000 epsidoes with a single infected partner or 10,000 single acts with that many different infected partners.  That is what it means when it is said "on average".  EWH