worried about risk

Hello Doctor, I recently had protected vaginal sex with a CSW. I was very careful with the condom, she performed protected oral sex on me and I asked her to give me another condom before we switched to vaginal sex. During vaginal sex the condom did not break but it slipped up so half of my shaft, or at least part of it was not covered by the condom. I don't know if I have genital herpes, but if I do, would my risk for HIV be high in this encounter? I am very anxious about all of this.

[Edward W Hook, MD]

Welcome to our Forum.  It is not unusual for condoms to slip partway down during vaginal sex. Despite that, as long as the head of your penis was covered there really is no reason to worry about HIV and no reason to even test for HIV.  

Had the condom slipped completely off, your risk for HIV would still be low, both because most commercial sex workers do not have HIV and because even if one has sex with an infected partner, the risk of HIV infection is only one infection in 1000 acts of intercourse.  

Try not to worry.  As I interpret your note, there is no risk. EWH

[worriedguy68]

Thank you so much for your response Doctor, I am breathing a little easier. The reason why I am a little worried is because I didn't test for STDs prior to the encounter. If, hypothetically, I had acquired HSV-2 before my encounter with the CSW, but it had been asymptomatic (or I hadn't noticed it), would my risk still be low from the encounter as described?

[Edward W Hook, MD]

Your risk would be slightly higher but not dramatically so.  Having provided this answer, I would urge you no to get too far into the "what if" situations of the sort you have just asked. EWH

[worriedguy68]

Would you recommend testing for HIV in that scenario?

[worriedguy68]

If someone had contracted HSV-2 prior to the event I described, would you recommend HIV testing as well?

[Edward W Hook, MD]

No, even if you had herpes, I would not see a medical indication for HIV testing related to the exposure you described.  EWH