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STD risk
Situation: Intercourse with escort 30 hours ago, oral and vaginal with condom. At end of encounter mutual masterbation with lube without condom in which I used the same hand with which I touched her genitalia. I had MC six years ago. Physical scheduled for Wednesday. In a long-term relationship.
Questions: 1) For which STDs am I at risk and what is the probability I have contracted them? 2) What is probability of contracting HPV or HSV on areas not covered by condom (base of penis, scrotum, stomach)? 3) For which STDs am I at risk through the genital to genital contact without the condom via my hand? Is this adequate tissue messaging for contraction? 4) I read some HSV tests are spurious/inconclusive. For which should I ask my PCP to conduct at physical? 5) Is Wednesday too early for testing? 6) Will MC in blood distort results? 7) If I have HPV or HSV when should I expect symptoms? 8) What is risk factor of escort compared with average woman? 9) When it is safe to have sex without condom with girlfriend? Sorry for number of questions. Scared and thinking irrationally. Please respond candidly and clearly. Thank you for your service and compassion.
Questions: 1) For which STDs am I at risk and what is the probability I have contracted them? 2) What is probability of contracting HPV or HSV on areas not covered by condom (base of penis, scrotum, stomach)? 3) For which STDs am I at risk through the genital to genital contact without the condom via my hand? Is this adequate tissue messaging for contraction? 4) I read some HSV tests are spurious/inconclusive. For which should I ask my PCP to conduct at physical? 5) Is Wednesday too early for testing? 6) Will MC in blood distort results? 7) If I have HPV or HSV when should I expect symptoms? 8) What is risk factor of escort compared with average woman? 9) When it is safe to have sex without condom with girlfriend? Sorry for number of questions. Scared and thinking irrationally. Please respond candidly and clearly. Thank you for your service and compassion.
MEDICAL PROFESSIONAL
Welcome to the STD forum. As many regular readers know, often the very first line of a question (or the title of the question itself) provides almost everything I need to know to respond accurately -- in which case I give an initial reply before I read anything else. In that spirit: "Intercourse with escort 30 hours ago, oral and vaginal with condom": there is almost no chance of any STD. No other kind of sexual contact (e.g., hand-genital contact, kissing, etc) carries any STD risk; and most escorts (meaning high-priced commercial sex workers) are at pretty low risk for STD/HIV transmission, especially in the US and other industrialized countries. So unless there is very surprising information when I read the rest of your question, it is unlikely you have any STD worries from this encounter.
Now I have read the rest. I nailed it! The hand/lube/genital contact carries no measurable risk of any infection of any kind. To your specific questions:
1) None. I recommend you not be tested for any STDs.
2,3) Nobody can say the risk of HSV or HPV transmission is zero from this sort of event. But if so, it is literally lower than the risk of getting struck by lightning.
4) Don't be tested at all. If you insist on HSV testing despite this advice, just make sure the lab does a type-specific IgG antibody test and insist that an IgM HSV test not be done -- too much risk for false positive results (use this forum's search link for more information).
5) There is no test for HPV. HSV testing cannot be done reliably until 3-4 months after the exposure. The only STDs that could show up this soon are chlamydia or gonorrhea, and you definitely were at zero risk for them. Any and all STD testing in this setting would be a waste of money. If you get tested despite this advice, be absolutely clear on this: if positive for any STD, it will be from some exposure other than the one with the escort. So why bother?
6) Molluscum contagiosum does not get into the blood and your past infection has no bearing on any of this.
7) Usually a few days for HSV, a few weeks for warts.
8) Probably about the same STD risk for escorts versus the average woman of similar social class -- especially when the escort routinely has her customers use condoms, as yours apparently does.
9) Since you had no risk, there is no reason to not continue unprotected sex with your regular partner. If I were in your situation, knowing what I know, I would continue unprotected sex with my wife and would not be tested for anything.
Let's not get into any "yes but" or "what if" questions. If the exposure information is accurate, there is nothing more you could say that could possibly change my opinion or advice.
Regards-- HHH, MD
Now I have read the rest. I nailed it! The hand/lube/genital contact carries no measurable risk of any infection of any kind. To your specific questions:
1) None. I recommend you not be tested for any STDs.
2,3) Nobody can say the risk of HSV or HPV transmission is zero from this sort of event. But if so, it is literally lower than the risk of getting struck by lightning.
4) Don't be tested at all. If you insist on HSV testing despite this advice, just make sure the lab does a type-specific IgG antibody test and insist that an IgM HSV test not be done -- too much risk for false positive results (use this forum's search link for more information).
5) There is no test for HPV. HSV testing cannot be done reliably until 3-4 months after the exposure. The only STDs that could show up this soon are chlamydia or gonorrhea, and you definitely were at zero risk for them. Any and all STD testing in this setting would be a waste of money. If you get tested despite this advice, be absolutely clear on this: if positive for any STD, it will be from some exposure other than the one with the escort. So why bother?
6) Molluscum contagiosum does not get into the blood and your past infection has no bearing on any of this.
7) Usually a few days for HSV, a few weeks for warts.
8) Probably about the same STD risk for escorts versus the average woman of similar social class -- especially when the escort routinely has her customers use condoms, as yours apparently does.
9) Since you had no risk, there is no reason to not continue unprotected sex with your regular partner. If I were in your situation, knowing what I know, I would continue unprotected sex with my wife and would not be tested for anything.
Let's not get into any "yes but" or "what if" questions. If the exposure information is accurate, there is nothing more you could say that could possibly change my opinion or advice.
Regards-- HHH, MD
Hello Dr Hook
I'm terrified please help. Last night I had protected Vaginal intercourse and oral sex with an African American csw who had piercings in her mouth. She sucked on my testicles for awhile but the rest was with a condom. But there seemed to be some blood on the condom. What is my risk for HIV/STD from this exposure? Can HIV/STD be transmitted from pierced mouth to testicles? Please tell me candidly what my risk is.
I'm terrified please help. Last night I had protected Vaginal intercourse and oral sex with an African American csw who had piercings in her mouth. She sucked on my testicles for awhile but the rest was with a condom. But there seemed to be some blood on the condom. What is my risk for HIV/STD from this exposure? Can HIV/STD be transmitted from pierced mouth to testicles? Please tell me candidly what my risk is.
MEDICAL PROFESSIONAL
You may not start a new discussion about a new exposure on an existing thread. I deleted it. However, you should have learned from my response above that there was no risk from this new exposure. Therefore, please do not start a new thread. Just use a little common sense and move on.
Thank you, Dr. Handsfield, for your clarification on this topic. You have been very helpful during a troubling time.
Thanks again and good luck to you sir!
Thanks again and good luck to you sir!
MEDICAL PROFESSIONAL
There are no data on the risk of warts transmission during any single exposure. But in general HPV infection is believed to require microscopic abrasion, which is why warts are most frequent at the sites of maximum friction during sex -- i.e. the penis, vaginal opening, labia minor, or anus. They are much less common at the sites you name, probably because they don't get much frictional contact during sex.
That is definitely the end of this thread.
That is definitely the end of this thread.
Hello Dr. Handsfield,
Thank you for your reply and words of wisdom. I apologize if my question was not clear. I meant: what is the risk of infection of warts to areas not protected by the condom during condom protected sex (scrotum, groin, pubic area)? Could you please answer this? Not only for me of course, but for other readers as well.
Thank you for all of your work on this site. I will put this behind me and move on. Thank you.
Thank you for your reply and words of wisdom. I apologize if my question was not clear. I meant: what is the risk of infection of warts to areas not protected by the condom during condom protected sex (scrotum, groin, pubic area)? Could you please answer this? Not only for me of course, but for other readers as well.
Thank you for all of your work on this site. I will put this behind me and move on. Thank you.
MEDICAL PROFESSIONAL
I don't understand the question about condoms and HPV. HPV risk is lower with a condom than without, because most of the exposed skin surface of the penis is protected. But protection is not perfect, and condoms work less well against HPV than say gonorrhea, chlamydia or HIV, because there is some skin contact above the condom. What's the mystery?
Warts do not have to be present for transmission. If you don't develop visible warts within 2-3 months, probably you were not infected. However, there will never be a time when you can be 100% certain you didn't catch HPV, since most HPV is asymptomatic and stays that way. But it really doesn't matter much, since most infections are harmless for both men and their partners. As a non-virgin, you can assume you have been infected with HPV before and probably will be again someday. You'll never know when it happens. Don't worry about it. If I were in your position, knowing what I know, I would never stop having unprotected sex with my wife (or with other partners if I were single and dating).
That will have to be all for this thread. Work to put this episode behind you. Nothing bad will come of it.
Warts do not have to be present for transmission. If you don't develop visible warts within 2-3 months, probably you were not infected. However, there will never be a time when you can be 100% certain you didn't catch HPV, since most HPV is asymptomatic and stays that way. But it really doesn't matter much, since most infections are harmless for both men and their partners. As a non-virgin, you can assume you have been infected with HPV before and probably will be again someday. You'll never know when it happens. Don't worry about it. If I were in your position, knowing what I know, I would never stop having unprotected sex with my wife (or with other partners if I were single and dating).
That will have to be all for this thread. Work to put this episode behind you. Nothing bad will come of it.
Hello Dr. Handsfield,
Could you please explain why HPV risk is low for condom-protected sex when there are areas not covered by the condom that could be exposed or are such areas generally not infected? Must there be actual warts present for transmission to occur? Also, what percent of males develop symptoms? Finally, is there a certain time when, if I don't have symptoms, I should consider myself safe in my relationship?
Thank you again very much
Could you please explain why HPV risk is low for condom-protected sex when there are areas not covered by the condom that could be exposed or are such areas generally not infected? Must there be actual warts present for transmission to occur? Also, what percent of males develop symptoms? Finally, is there a certain time when, if I don't have symptoms, I should consider myself safe in my relationship?
Thank you again very much
MEDICAL PROFESSIONAL
Besides helping individuals with their own questions, a main purpose of the fourm is education for other readers. Therefore, In general threads are not deleted. Users are responsible for selecing usernames that guard their identities.
Thank you Dr. Handsfield for all of your help and info on such a great forum. P.s. Could you please delete my accounts/threads for privacy issues? Thank you!
MEDICAL PROFESSIONAL
As already discussed, the risk of STD is low for condom-protected sex. The risk is the same for any particular encounter. It's a good idea for all people who are sexually active outside mutually monagamous relationships to have routine STD testing from time to time, like once a year. On that basis, consider doing it -- but not because of these particular events. There is no test for HPV, however.
My final comment is the old phrase "If you can't stand the heat, get out of the kitchen". In other words, if you're going to be this anxious about STD risks after encounters with commercial sex workers, I suggest you stop doing it.
That's all for this thread. I won't have any further comments.
My final comment is the old phrase "If you can't stand the heat, get out of the kitchen". In other words, if you're going to be this anxious about STD risks after encounters with commercial sex workers, I suggest you stop doing it.
That's all for this thread. I won't have any further comments.
Hello Dr. Handsfield,
Last night while drunk I had protected sex with two escorts making my total of incidences
of exposure within the last month at three. With each exposure are my chances of contracting HSV or HPV increased, or am I safe simply because it was protected? Do you suggest I get tested? In other words, is the likelihood of infection the same as the first incident, or is it increased?
Thank you for your time and I will not bother you again
Last night while drunk I had protected sex with two escorts making my total of incidences
of exposure within the last month at three. With each exposure are my chances of contracting HSV or HPV increased, or am I safe simply because it was protected? Do you suggest I get tested? In other words, is the likelihood of infection the same as the first incident, or is it increased?
Thank you for your time and I will not bother you again
MEDICAL PROFESSIONAL
I guess it makes sense that an escort who "forgot" to bring her own condoms might be less likely to use them consistently. But the salient facts are that you did use condoms and hand-genital exposure (including the details you provide) carries no measurable STD risk. So this additional information does not change my opinion or advice.
Hello Doctor H. Sorry, I just wanted to clarify my description of the encounter in one respect: Concerning hand/genital, I "fingered" her then used that very same hand on myself without a condom. I hope that makes sense. I apologize if you already gathered that. Thank you again, and I promise I will not bother you again. Cheers.
Thank you so much for sharing your knowledge. You have alleviated much apparently undue stress. Please forgive me if the following falls in line with "yes but" or "what if" questions - but I think it is a qualification on the exposure info. She mentioned that she was glad that I had condoms in that she forgot hers. Now this may be more of a psychological or sociological question rather than medical, but in your experience, do you believe that is indicative of not using condoms routinely, and therefore she is of higher risk? Or if, for that matter, we even assume she had an STD, does your opinion remain the same simply because I wore a condom?
This is my final question in this forum. Thank you very much again, Doctor, for your time, knowledge, and compassion.
This is my final question in this forum. Thank you very much again, Doctor, for your time, knowledge, and compassion.
You are reading content posted in the STDs Forum
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STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
