Serious Exposure

Hello Dr.

I am a 30yr old male and have had serious high risk exposure about a year ago with 3 prostitutes at nevada brothels year. Initially I thought this is a low risk exposure based on what I read on the Internet and a brief conversation with the brothel manager. I was told that these girls are safe and that they are being checked every week for STDs. Now after searching through your archives, I noticed that you consider brothel workers as very high risk.

I did not have any symptoms of any STDs for the past year. I know that the chance of HIV is close to zero since the girls used condoms consistently for every activity.  However, I am pretty sure that I am infected with HPV and very likely to have asymptomatic HSV-2.

I am going to get tested for all STDs on Wednesday, however, I'd like to know my chances of having any STDs and what precautions I should start taking...

Thanks in advance...

[H. Hunter Handsfield, M.D.]

As indicated by monkeyflower before my response (below), you have misinterpreted something I wrote.  The rates of HIV in commercial sex workers in unregulated brothels probably is higher than in some settings, such as higher-end CSWs (e.g., escorts).  But in regulated settings, like the Nevada brothels, the risk probably is low.  Anyway, you had condom protected sex, apparently including condoms for oral sex.  You can't get any safer than that, other than being in a permanent, mutually monogamous relationship.

It's a good idea for people who are sexually active outside monogamous relationships to have routine STD and HIV testing from time to time, like once a year.  But if you are always as safe as you describe above, you can expect negative test results.

HHH, MD

[needAdvise15]

Additional info which I forgot to include in my original message:
The exposure consisted of protected oral and intercourse.

[monkeyflower]

"I noticed that you consider brothel workers as very high risk. "

Who does? I don't think you mean Dr. Handsfield--I've never gotten that impression from any of his responses. Protected oral and intercourse is about as safe as you can get while still having another partner, sex worker or no. And in a place where sex work is legal, well, it's pretty safe to say the workers are tested so regularly and frequently, they're probably a million times safer than the average partner :-)