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Unprotected Vaginal Sex with CSW in Singapore
Dear Doctors,
I've read through a lot of the questions and responses on this forum and feel that the two main questions relate to i) probability and ii) anxiety thereof.
Well, my situation is pretty simple. About 5 days ago I went drinking with a buddy in Singapore and went back to my hotel with a high-end ($300+/night), relatively youthful (19-21) commercial sex worker (probably Vietnamese or Chinese). Apparently we did not have sex over night, b/c we could not find a condom and she did not want to get pregnant. After I expressed my gladness that we didn't have sex in the morning, she played around with me (probably b/c she was afraid she would not be paid) and before I had a chance to object she jumped on my erect penis and we had sex for something like 20 seconds before I threw her off.
Before this time I have always had negative test results (last test for HIV, hepatitis and other STDs was in October 08), and my last exposure (except for my girlfriend) before was over a year and a half ago. The CSW did not appear to have any open sores or anything like that, but I can't be sure. What are my chances of contracting HIV or other STDs? I also hear that sex workers in Singapore are very rigorously tested (at entry and periodically), but I want to be very sure since my girlfriend and I have unprotected sex (she's on the pill). I'm going to get tested when I get back to the States (and a few weeks thereafter to make sure), but it'll be difficult to change my sex patterns with my girlfriend before I get tested. Please give me the straight scoop, b/c although I am willing to live with the consequences of my stupidity I want to make sure I don't hurt my girlfriend. Thank you so much for your invaluable service.
I've read through a lot of the questions and responses on this forum and feel that the two main questions relate to i) probability and ii) anxiety thereof.
Well, my situation is pretty simple. About 5 days ago I went drinking with a buddy in Singapore and went back to my hotel with a high-end ($300+/night), relatively youthful (19-21) commercial sex worker (probably Vietnamese or Chinese). Apparently we did not have sex over night, b/c we could not find a condom and she did not want to get pregnant. After I expressed my gladness that we didn't have sex in the morning, she played around with me (probably b/c she was afraid she would not be paid) and before I had a chance to object she jumped on my erect penis and we had sex for something like 20 seconds before I threw her off.
Before this time I have always had negative test results (last test for HIV, hepatitis and other STDs was in October 08), and my last exposure (except for my girlfriend) before was over a year and a half ago. The CSW did not appear to have any open sores or anything like that, but I can't be sure. What are my chances of contracting HIV or other STDs? I also hear that sex workers in Singapore are very rigorously tested (at entry and periodically), but I want to be very sure since my girlfriend and I have unprotected sex (she's on the pill). I'm going to get tested when I get back to the States (and a few weeks thereafter to make sure), but it'll be difficult to change my sex patterns with my girlfriend before I get tested. Please give me the straight scoop, b/c although I am willing to live with the consequences of my stupidity I want to make sure I don't hurt my girlfriend. Thank you so much for your invaluable service.
MEDICAL PROFESSIONAL
She "jumped on my erect penis" and you just couldn't help that it slipped inside her? And you couldn't get it out for 20 seconds? Hmm... why am I skeptical? I don't mean to be critical -- I just don't accept that the event was so involuntary on your part!
OK, so you had brief unprotected sex with a partner who may or may not be at high risk for HIV and other STDs. Clearly she intends to use condoms routinely, which is a sign she isn't infected and wants to stay that way. On the other hand, she obviously doesn't follow the condom rule consistently. All things considered, the possibility she was infected certainly is there. On the other hand, even among CSWs (in Singapore or elsewhere), the large majority don't have HIV. And if it is true that CSWs are "rigorously tested" in Singapore, that also is reassuring.
But most important, the risk of exposure doesn't matter. Test results always outweigh risk assessment in determining the chance someone has HIV or other STD. For reassurance and common sense, you should have blood tests for HIV and syphilis and a urine test for chlamydia and gonorrhea. Since you have had no symptoms and the overal situation suggests low risk, you can expect negative results. In this situation I do not recommend testing for anything else, like herpes, hepatitis, etc.
I hope this helps. Best wishes--- HHH, MD
OK, so you had brief unprotected sex with a partner who may or may not be at high risk for HIV and other STDs. Clearly she intends to use condoms routinely, which is a sign she isn't infected and wants to stay that way. On the other hand, she obviously doesn't follow the condom rule consistently. All things considered, the possibility she was infected certainly is there. On the other hand, even among CSWs (in Singapore or elsewhere), the large majority don't have HIV. And if it is true that CSWs are "rigorously tested" in Singapore, that also is reassuring.
But most important, the risk of exposure doesn't matter. Test results always outweigh risk assessment in determining the chance someone has HIV or other STD. For reassurance and common sense, you should have blood tests for HIV and syphilis and a urine test for chlamydia and gonorrhea. Since you have had no symptoms and the overal situation suggests low risk, you can expect negative results. In this situation I do not recommend testing for anything else, like herpes, hepatitis, etc.
I hope this helps. Best wishes--- HHH, MD
Point taken doctor. I know I shouldn't have even put myself in that position in the first place, and I had ample opportunity to stop even the initial penetration.
At any rate, I'll get tested in the coming weeks and will stop unprotected exposure with my girlfriend during that time. Thanks again for the advice.
At any rate, I'll get tested in the coming weeks and will stop unprotected exposure with my girlfriend during that time. Thanks again for the advice.
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