What are the chances that I have an STD?

[stupidandscared451]

I hope this question finds a professional, because I need one. Last Saturday night, I was at a Bachelor Party and became very, very inebriated. I ended up at an Asian Massage Parlor, and participated in sex acts with a worker. She placed a condom on my penis and performed 1-2 minutes of oral sex on me before we then engaged in about 5 minutes of vaginal intercourse. I stopped due to how intoxicated I was. She laid me on my back, removed the condom, and stimulated me manually until completion. She did not use gloves, nor do I recall any type of sterilization tools being present or used. Due to how drunk I was, I have no idea if the condom slipped off at any time, or if it broke. I do not think either happened, but I cannot be totally sure. I made a stupid mistake, and am now terrified that I have an STD that I will give to my spouse. I have felt fatigued all week, and haven't had much of an appetite either. I do not know if these are STD symptoms or if they are the result of guilt and anxiety. Should I be tested? And if so, how soon? Everything I have read online says to wait at least 2-3 weeks, or as long as 3 months for some of the more serious STD's. I do not think I could stand not knowing for that long. How at risk do you think I was?

[Edward W Hook, MD]

Your assumptions are demonstrating your level of paranoia.  The fact is that most commercial sex workers do not have an STD. Further, there are NO STDs for which the risk for infection followins a single exposure is higher than 1 in 3 and in most cases the risk is far lower.  Finally, most STDs do cause symptoms.  

Putting all of this together, you need to stop worrying. EWH

[stupidandscared451]

Thank you for your reassurance, Doctor. A follow-up question, if I may. My main concern right now is the anxiety I am getting over whether or not the condom remained on or tore at all during the encounter. I was probably the most intoxicated I've ever been, and was not paying much attention. I seem to remember the condom being removed as I previously explained to you, but now I am having bouts of second-guessing my memory. What are the odds of contracting an STD unprotected? Of course, I am assuming that the worker was infected with anything at all. I will say odds are, she was. In which case, what are my chances of infection from a single episode? Some of what I read online says that I would be very susceptible to transmission, while other sites claim that my risk would still be very low. Which is more accurate, and is it true that most STD's have no symptoms, so I really wouldn't know if I was carrying anything without being tested?

[Edward W Hook, MD]

Welcome to our Forum. I'll be happy to provide some guidance.  As I understand it both your receipt of oral sex and your vaginal sex were condom protected and it was not until you received manual masturbation that the condom was removed. If this is the case, there is no risk for an STD.  Condoms are highly effective for prevention of STDs.

As for testing, there is no medical reason for you to be tested. At the same time, as you point out, you are feeling quite guilty about this event and thus you may want to get tested for your peace of mind. If you choose to get tested, the main things you need to be tested for are the most common STDs, gonorrhea, chlamydia and NGU.  This can be done with accuracy within 3-4 days of exposure, at the outside.

I hope this is helpful. You need not worry about STDs from the exposure you describe. EWH