Escort Risks

[kenbay2005]

Hello Dr.,

I was with a several escorts over a period of a couple of years, but I had only two intercourse exposures. These two exposures were with the same escort. I used a condom both times, and as far as I could tell the condom remained in tact. The escort did kiss or lick the top of my penis on a couple of occasion’s very briefly, but no real oral sex. I also kissed her on the lips very heavily. I am rather nervous about these encounters and I would really like your advice about HIV testing and risks.

Thanks,

KEB

[H. Hunter Handsfield, M.D.]

HIV is rare in "escorts", i.e. relatively expensive commercial sex workers (as opposed to street walkers, brothel workers) in industrialized countries.  And you had only safe sex.  Further, when a CSW insists her clients use condoms, it usually is good evidence she is does not have HIV and wants to stay that way.  After all, such women are more at risk from their customers than vice versa.  And even overt oral sex rarely (or never) transmits HIV, so there definitely was no risk from the brief oral contact you describe.  And with respect to your follow-up comment below, HIV and STDs are never transmitted by hand jobs.

All in all, no significant risk for HIV.  From the standpoint of these particular exposures, you don't need testing.  On the other hand, all people who are sexually active outside mutually monogamous relationships should be tested routinely (e.g., once a year) for HIV and other STDs -- so this might be a good time, since it is on your mind.  So go ahead and have an HIV test if you will sleep better knowing the result is negative.  (This is not "code" that means I really think there was signficant risk; I do not.)

Best wishes-- HHH, MD

[kenbay2005]

Thank you,

KEB

[kenbay2005]

Sorry Dr.,

I also forgot to mention the other escorts I was with besides this one (perhaps 10 or so) I did nothing more than have them manually stimulate me "hand jobs," and I beleieve I used my fingers in one of them.

Thanks,

KEB