STDs Expert Forum
Very worried about stds due to liaising with prostitutes
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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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Very worried about stds due to liaising with prostitutes

Hi, I am a married man, who for the past eight years has had encounters with prostitutes. I have never had any diagnosed stds or std-like symptoms as a result of this, but I have recently started to become worried that I may have contracted an std. I have never had penetrative vaginal or anal sex without using a condom. I have never had unprotected oral sex with a prostitute apart on two occasions when the prostitute placed my unprotected penis in her mouth. The contact was not prolonged, and I did not ejaculate. I am also circumcised. The only unprotected contact I have had is the form of receiving rimming on a couple of occasions. I am now worried that I may be harbouring an std and that I may have passed it on to my wife. I want to break this cycle of addiction and am seeking some kind of counselling to help me change my behaviour and my life. I would like to gauge people's opinons on whether I need to get tested for stds - I am afraid of finding out that I do have one
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Thanks for your question.  I hope you will find my comments helpful.  It sounds to me as though most of your contact have been protected (all of the genital contacts and nearly all of the oral) and therefore your risk is very, very low.  Condoms are excellent for STD prevention and therefore it is unlikely that you caught an STD from protected genital sex.  Occasionally we see men who get non-gonococcal urethritis or even gonorrhea from oral sex but it is quite rare and your symptoms really do not match this,  Sometimes after an exposure that, in retrospect, one wishes they had not had, persons tend to examine themselves and be far more attuned to genital sensations than in periods when they are not concerned. Perhaps this was a contributor to your situation.  

I do however recommend that you get evaluated and tested,.  The reasons for this are that, given your history, you should be screened.  We recommend periodic STD "screening (testing in the absence of symptoms) because you have had multiple partners.  As a matter of personal protection, we recommend annual testing for anyone who has had two or more sex partners in the past year (we consider this to be health maintenance- we also recommend you get your blood pressure and cholesterol checked regularly).  There is no reason not to get tested, if you have a problem you can get treated or, more likely you will have negative tests allowing you to be confident that you do not have STD (the tests are very reliable).  To be nervous about testing is silly- testing does not change whether or not you are infected, it just allows you to get treated if you are infected and to know you are not infected if the tests are negative.

Hope this helps.  EWH
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H. Hunter Handsfield, M.D.Blank
University of Washington
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