STDs Expert Forum
I'm an idiot. Protected sex with an escort. STDs risk?
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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I'm an idiot. Protected sex with an escort. STDs risk?

Good evening. I am writing you because, like an idiot, I had sex (protected) with a female escort 3 nights ago. I am a 30 year old male. Prior to this mistake, I was 100% certain that I was STD free. The woman placed a condom on my penis with her mouth, and used her teeth while performing oral sex. We proceeded to vaginal intercourse afterward. She did repeatedly check that the condom remained on me throughout the encounter. However, I guess, it is possible that the condom may have been damaged by her teeth. I am now terrified that I may have contracted an STD. I contacted the escort, and asked her if she knew her STD status. She said that she gets regular check ups, and that she is clean. She also said that she does not "work" but a few times per week (not sure if I trust that).
I am sure that you get this all the time, but what are the chances that I have contracted an STD (HIV, HPV, syphilis, chlamydia, gonorrhea, etc?). I did begin to get a discomforting sensation in my genitalia yesterday. I do not know if this is early symptoms of an STD or from stress. I also had some doxycycline left over in my house from when my dogs got sick a few months ago. I read that doxycycline can be used to treat the treatable STDs. I began taking 100 mg, twice a day, 2 days ago (got that from online as well). Could the discomfort in my genitalia be a side effect from the doxycycline? Should I continue to take the doxycycline? How long should I take it? Lastly, when is the earliest I can get tested for STDs and when would I start seeing symptoms that would confirm an STD? I have also read that the chances of contracting HIV is extremely low with protected sex. Is that true?
Thank you so much for your time. Please provide some advice as to whether I should pursue testing, or leave it alone. Have a great night. I look forward to hearing from you soon.  
239123_tn?1267651214
Welcome to the forum.  THanks for your question.

I guess I'll start by saying the title you chose for your question is an oxymoron, i.e. internally contradictory.  Sex with an escort?  Potentially risky.  Protected?  No risk for HIV and little or none for other STDs.

Even the escort part may not have been risky, even without a condom.  Many escorts -- i.e. expensive female sex workers by appointment -- probably have low STD rates, especially if they use condoms regularly (as yours seems to do).  They also tend to be selective in their clients (you're at low risk for STDs, right? -- probably the same for others), and many get tested regularly to assure they are disease free, which also seems to apply to your partner.  After all, they don't want bad health outcomes any more than you do -- and of course it would also be pretty bad for business!

The important thing, though, is that condom-protected sex is safe sex.  How the condom is applied makes little difference.  As for potential exposure to saliva by applying the condom with her mouth, even without a condom, unprotected oral sex is generally safe -- not completely free of STD risk, but low risk for all STDs and virtually zero risk for some, including HIV.

As for the genital discomfort you describe, there is no STD that causes such symptoms -- and anyway, it began too soon, since no STD can start to cause symptoms of any kind sooner than 2-3 days after exposure, and for most infections the incubation period is a week or more.  You're on the right track with your statement about stress.  This sort of symptom is typical for genitally focused anxiety following a regretted sexual choice.

Had you asked ahead of time, I would have recommended against taking doxycycline.  However, now that you have started, you need to take it in the present dose for a full 7 days.  It will prevent any infection with chlamydia, syphilis, and gonorrhea from taking hold.  But don't expect it to clear your genital discomfort (except maybe by placebo effect).  And don't bother to be tested for any of these 3 STDs:  if you in fact were infected, the doxycycline will eradicate them no test will ever be positive.  One of the downsides of self treatment is that there will never be any way for you to know for sure whether you actually caught anything.

So I don't advise any testing at all.  The risk for any other STD is nil, including HPV, herpes, viral hepatitis, or HIV.  And if you have a regular sex partner, I would advise you to continue unprotected sex without fear of transmitting anything.  That's what I would do if somehow I found myself in this situation.

I hope this has helped.  Best wishes--  HHH, MD
5 Comments
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Avatar_m_tn
Last question, doc, and I promise to let it be. Would your answer/advice be different if I told you it was a $40 prostitute vs. a $200 per hour "escort" (I had the latter for what it's worth)? Thank you so much for your time. Your forum has definitely helped me to start moving on. Have a great evening. I hope to hear from you soon.
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239123_tn?1267651214
No important difference, especially given condom use.

Thanks for the kind words about the forum.  I'm glad to have helped.
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Avatar_m_tn
Good morning, Doc. It has now been just over 4 weeks since I inquired about the possibility of contracting HIV. I thought I had moved on, but came down with an acute case of a sore throat that has me extremely nervous. Yesterday afternoon, my throat began to hurt, my tonsils are very sore, and this morning, I have a bright yellow phlegm. Normally, I would completely disregard these symptoms, however it is almost summer time, and strep throat / cold season has long past. If you would take a couple of minutes to let me know what you think, that would be tremendously helpful. I am worried that this may be ARS, or am I being completely irrational? Thank you for your time, Doc. Have a wonderful day.
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239123_tn?1267651214
This doesn't sound like HIV, which would not be likely to produce "yellow phlegm" -- either from the upper respiratory tract (nasal) or lower (cough with phlegm).  And 4 weeks is too long; ARS starts within 10-14 days.  Colds are half as frequent in the summer as winter -- still millions of colds per month nationwide.  You caught a cold, nothing more.
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