i need advice

[Advice105]

Last night i had sex with an asian escort, stupid yes i know. I am worried that i am at risk for something. I am married 42 years old.the encounter was protected oral and vaginal, i am worried because the condom slipped and when i puled out it was covering the head of my penis, we then switched condoms and she gave me oral sex (protected). I am worried that my indiscretions have me at risk.

should i get tested for HIV?

do i have a risk for contracting an STD based on the condom slipping?

can i continue unprotected sex with my wife?

your advice is greatly appreciated

[Edward W Hook, MD]

No, absolutely no risk. Not only was the exposure no risk but the ARS typically does not begin until at least two weeks after an exposure.  EWH

[Advice105]

Hi dr. Hook

I'm sorry to bug you I really appreciate everything you have told
Me along with the reassurance of really no risk. I honestly thank you
For what u do. I have not had any symptoms of penile
Infection or herpes after 6 days. I have had a fever and sore throat do you think this has anything to do with ARS or can I move forward and not think about this again.

[Edward W Hook, MD]

Yes, this would be considered condom protected sex.  EWH

[Advice105]

Dr. hook thank you very much for your professional help,

I have one last question

You say as long as the condom didn't come off i was protected against HIV and std's

the condom was at the tip of my penis when i pulled out and rolled it back down would this be considered full protection against HIV?

this is my last question i thank you for your professional answers and for giving me peace of mind.

[Edward W Hook, MD]

Yes, you are safe.  I see no reason for you to abstain from unprotected sex with your wife.  EWH

[Advice105]

thank you Dr. Hook you have made my worries decipate, knowing what you know do think in my situation you would continue unprotected sex with my wife with no worries?

since my encounter was protected would you say i am close to 100% on not acquiring an STD like chlamydia or gonnorea?

thanks again Dr. Hook i really appreciate it

[Edward W Hook, MD]

Welcome to the Forum. I'll be pleased to comment on the questions you ask.  The encounter you describe was associated with no meaningful risk for HIV or for that matter, other STIs.  Please remember that most persons, even commercial sex workers, are not infected and even when they are, even most unprotected exposures do not lead to infection- your exposure was protected further reducing the risk dramatically.  

I would not worry that the condom slipped partially off as you exited your partner- as long as the condom covered the head of the penis you were protected from the most comment STIs.

From a medical perspective, there really is no reason for testing related to the exposures you describe.  If you feel that testing is important for your peace of mind, that is a slightly different issue.  You can test for the most common STIs- gonorrhea and chlamydia at any time more than 2-3 days after the exposure.  Testing for syphilis should wait until at least a month after the exposure and testing for HIV with a standard HIV antibody test is not completely reliable until at least 8 weeks after exposure.  We do not recommend testing for HSV in the absence of lesions (too many false positive results) and there is no recommended test for HPV.

I hope these comments are helpful. EWH