What are my risks of any STD infection? AND Should I get Tested?

[FMG83]

Hello,  I did a very stupid thing 20 days ago. I was in a business trip and one Saturday night I drank a lot of alcohol and then called an escort service. I spent 1 hour with the escort where we had unprotected oral sex, then we had only a couple of minutes of protected intercourse (with out any kind of ejaculation). I was so drunk, that I even had a lot of trouble getting an erection. Afterwards there was some unprotected contact with her vagina and my penis, but with out any intercourse (since I couldn't get an erection at the time there was no unprotected vaginal intercourse). 5 minutes before the hour concluded, I finally had an erection and had protected intercourse until ejaculation 2 minutes later. The condoms never broke nor there was any kind of apparent leak.  I paid 500 for that hour. 24 hours later I developed a mild pharyngitis with NO FEVER, NO CHILLS, NO MALAISE, NO DYSURIA NO DISCHARGE FROM THE PENIS,  NO DIARREA (diarrhea) NO LYMPH NODES PALPABLE IN THE NECK, AXILA OR GROIN. The pharyngitis got better two days latter and I have not had any symptoms since then.   I have never done this before. I have been married for 7 years and I've had only 1 sexual partner my hole life. I am very worried about the risk of acquiring an STD (specifically HIV or hepatitis C). Am I in  high risk of infection? Right now  I am really anxious, and feeling tons of regret. I even contacted the escort service and they mentioned that they follow strict hygiene guidelines. Should I get tested? How much time should I wait in order before the test? Should I abstain from Sexual relations with my wife until I get any results back? Thank you very much for your help.

[Edward W Hook, MD]

You have posted on the wrong site for HIV questions.   Questions about HIV belong on the HIV prevention site.  I will do my best to answer your HIV questions with this reply but, if you have additional HIV questions or follow-up they must be on the HIV Prevention site.  Sorry, those are the rules.

Chances are that your partner did not have HIV or any STD.  This is the case for most commercial sex workers and the higher priced they are, the lower the risk of infection tends to be.  

The exposure you describe was very low risk for STD acquisition and no risk for HIV.  HIV and other STDs are not spread by masturbation, fondling or touching and there is virtually no risk for these problems when a person properly uses a condom which remains intact for vaginal sex.  Thus your only risk at all was from oral sex.   IT is not clear whether you were giving or receiving oral sex with your partner.  For HIV whether you were giving or receiving makes little difference.  The quoted figure for HIV risk, if one has oral sex with an infected partner is less than 1 in 10,000 and, in my estimation that is too high. The risk from receiving oral sex is even lower.  Some experts state there is no risk at all from oral sex.  Neither of us on this site have ever seen or reading the medical literature of a convincing instance in which HIV was passed by oral sex.  

Oral sex is also an inefficient way to transmit STDs.  Of the bacterial STDs only gonorrhea and nongonococcal urethritis (NGU) are transmitted through receipt of oral sex; chlamydia is not and without an obvious sore or lesion on your partner’s mouth, the chances of syphilis and herpes is likewise tiny.   If you had gotten gonorrhea or NGU you would have most likely developed symptoms of urethritis (penile infection).  Even if your partner had an STD (any STD and it is likely she did not), most exposures do not lead to infection.  In your case, your exposure was brief; I would urge you not to worry.

From performing oral sex, there is even low risk of acquiring STDs with the only STD of concern being gonorrhea and this is very rare.  

In my opinion, you do not need to be concerned or testing.  Hope this is helpful to you.  EWH