Risk assessment

[keith486]

Hi,

I am a 29 y.o hetero male. First of all I will rehash a scenario that I have already asked an expert but believe the response to be unassuring as he did not respond to one of my follow up questions. As you can see from my previous posts I am not one of those people that continually ask follow up question after follow up question.

Scenario 1 - I received a protected ******** in the red light district in Amsterdam, and I know that this is quite safe, I just felt uncomfortable as it seemed to be a rather unhygienic atmosphere in the room and I believe I felt a bit of a ***** from something in the buttocks when lying down on the bed and am worried that it may have been a syringe or something.

I saw some csws later on in prague and again in amsterdam but it was all protected, however the girl in amsterdam did kiss me a little bit on the lips but it was fairly brief.

Scenario 2 - I went to a thai massage place in the red light district in amsterdam and received a handjob. I know that handjobs are safe, but I only worry because when I first walked into the room I saw a plastic glove lying on the floor. I did not hink much of it at the time because when I have had handjobs in the past the sex worker didnt wear a glove but then when she started to give me a handjob she put on a glove and I was worrying that it may have been the same glove that was lying on the floor from a previous customer.

Scenario 3 - I have just received an unprotected ******** from an asian csw for about 10-15 minsand now I am ver worried about getting HIV or herpes or some other std. My main concern is obviously HIV and also herpes. I am really kicking myself about it. I think I need help to stop seeing sex workers.

I am wondering what you make of all this. Do you think that I am at risk of anything from the exposures I have described.

Any thing at all?

Any help would be greatly appreciated.

[H. Hunter Handsfield, M.D.]

You had accurate responses from both from me on the STD forum 2 months ago and Dr. Cummings on the HIV international forum.  The latter covered scenarios 1 and 2 and I'm not going to repeat what he told you.  The "scenario 3" exposure involved unprotected oral sex, which is very low risk although not zero.  HIV is almost never transmitted that way, so that's no concern at all.  Herpes is rare after any single oral exposure and is unlikely to occur without obvious symptoms.  There also are slight chances of gonorrhea and syphilis, but these too would have caused symptoms.  If more than 4 weeks have passed an you have not had discharge of pus or mucus from the penis or penile blisters, sores, etc, then you can be quite certain you were not infected.  If you want still further reassurance, see a doctor or clinic and request an examination and STD testing.  You can expect the results to be negative.

All your questions concern low risk or zero risk exposures.  You're going to need to get a grip on real STD/HIV risks and stop asking for reassurance every time you have a sexual exposure.  If your bare penis (no condom) doesn't enter another person's vaginal or rectum, then there was little if any risk; and oral sex, even unprotected, is sufficiently low risk that testing is rarely necessary in the absence of symptoms.

Finally, I agree with your self-assessment about commercial sex.  As the saying goes, if you can't stand the heat, get out of the kitchen.

Try to make this your last question on any MedHelp forum about STD/HIV risks.  Even if you have commercial sex again, you have learned enough by now to know what is and is not risky.  Please do not return with more questions about ridiculously low risk scenarios.

Regards--  HHH, MD

[keith486]

Thankyou very much and I will make sure that this is my last post.

I was only concerned because, yes I know what is low risk and high risk. I was only unsure if it ever happens that people get pricked by syringes at brothels and acquire a dissease and also I have read that it is possible to contract diseases from unprotected blow jobs.

I am quite sure you can at least get herpes from unprotected blow jobs - so as far as that is concerned I don't know why that is considered to be low risk.

In the past I have been very happy with your responses, I just felt a bit dissatidfied with Dr Cummings response. Not yours. Your responses have been very reassuring and I highly appreciate it.

[keith486]

I am so sorry but I forgot to add but I did say it in my first post but scenario 3 just happened so obviouslu I would not have symptoms yet.