Aa
Risk assessment
History: I had sex with a commercial sex worker in london 7 days back and am now in the US. This is the first time I had such sex outside of marriage. I used a condom and both the worker and me used gloves. I had oral and vaginal sex both with condoms. I used a plastic barrier to lick her genitals for 10 seconds or less. We had anal penetration (both ways) only with gloved fingers - we both wore gloves. The condom did not break during sex. I also had a bath cleaning and washing genital area and anus 30 minutes after sex. To date I have no symptoms.
As follow up I had asked via email to the organization email pretending to be a future customer seeking an appointment whether they could provide any assurances that the sex worker I had sex with was free of STD. They replied that if that is my concern I should search someplace else implying that the girl has some form of STD.
I was an idiot for doing this as now I feel so guilty and am extremely worried about the risk of acquiring and transmitting STD to my wife who I have not had sex with since the incident. My whole life would be ruined if this came out.
Questions:
1) What STDs am I at risk for if the sex worker had some sort of STD? Is it possible to give me a % of risk?
2) If the sexworker has normal risk levels (if person on email was insincere) of having STDs what is my risk? Is it possible to give me a % of risk?
3) Should I be doing tests to be at peace? If yes which ones? I need the test to be anonymous through an organization such as tSTD. However I read some other post where you talked about the possibilities of false positives. Are false positives a high risk (% if possible)? If I get a positive result I would have to tell my wife and get real medical help.
4) Also can std be passed through hand contact with gloves on? For example if her vaginal fluid came in contact with my anus through her hand. I do not think this happened but is possible.
5) Does bathing reduce my risk?
As follow up I had asked via email to the organization email pretending to be a future customer seeking an appointment whether they could provide any assurances that the sex worker I had sex with was free of STD. They replied that if that is my concern I should search someplace else implying that the girl has some form of STD.
I was an idiot for doing this as now I feel so guilty and am extremely worried about the risk of acquiring and transmitting STD to my wife who I have not had sex with since the incident. My whole life would be ruined if this came out.
Questions:
1) What STDs am I at risk for if the sex worker had some sort of STD? Is it possible to give me a % of risk?
2) If the sexworker has normal risk levels (if person on email was insincere) of having STDs what is my risk? Is it possible to give me a % of risk?
3) Should I be doing tests to be at peace? If yes which ones? I need the test to be anonymous through an organization such as tSTD. However I read some other post where you talked about the possibilities of false positives. Are false positives a high risk (% if possible)? If I get a positive result I would have to tell my wife and get real medical help.
4) Also can std be passed through hand contact with gloves on? For example if her vaginal fluid came in contact with my anus through her hand. I do not think this happened but is possible.
5) Does bathing reduce my risk?
MEDICAL PROFESSIONAL
You can relax. It is hard for me to imagine safer sex than you had, regardless of the fact that your partner was a commercial sex worker and regardless of what infections she might have had. (Indeed, I think this is the first time I ever heard of someone using condoms, gloves, and barriers for oral sex all during the same exposure event!)
To your specific questions:
1,2) I cannot see any plausible STD risk here, even if your partner had every STD there is.
3) I recommend against STD testing at all. The only plausible reason is for reassurance, if my own reassurance isn't sufficient; from a medical or risk assessment perspective, no testing is necessary. And it may not be wise, and you state one of the reasons: the risk of a false positive test result probably is greater than the chance you were infected. Or testing might reveal a previous infection that you would just as soon not know about, like an HSV infection.
4) No STD can pass through latex, polyurethane, etc. It just doesn't happen.
5) I doubt bathing made any difference. You can't make zero risk any lower than it is to start.
Please let this go. Don't let your guilt or anxiety about your infidelity cloud your judgment about the infection business. But if you do test, please do not do it online, without professional advice. See a health care provider and follow that person's advice about whether to be tested and which tests to have.
Regards-- HHH, MD
To your specific questions:
1,2) I cannot see any plausible STD risk here, even if your partner had every STD there is.
3) I recommend against STD testing at all. The only plausible reason is for reassurance, if my own reassurance isn't sufficient; from a medical or risk assessment perspective, no testing is necessary. And it may not be wise, and you state one of the reasons: the risk of a false positive test result probably is greater than the chance you were infected. Or testing might reveal a previous infection that you would just as soon not know about, like an HSV infection.
4) No STD can pass through latex, polyurethane, etc. It just doesn't happen.
5) I doubt bathing made any difference. You can't make zero risk any lower than it is to start.
Please let this go. Don't let your guilt or anxiety about your infidelity cloud your judgment about the infection business. But if you do test, please do not do it online, without professional advice. See a health care provider and follow that person's advice about whether to be tested and which tests to have.
Regards-- HHH, MD
MEDICAL PROFESSIONAL
The additional information doesn't change my opinion or advice. This isn't a counseling service and I won't have any further comments. Feel free to take the discussion to the HIV community forum, but any additional comments on this one will be deleted.
Dear Doctor,
I apologize in advance for my paranoia but the thought of me potentially transmitting an STD to my wife is worrying me so much. Even though you point out the risk is very small, details of the encounter haunt me -
a) I did not check the expiration date of the condom and even though I can be sure there was no significant breakage I am unsure if there was a hole or tiny tear at some part of the condom. I did not check the condom in detail while I was disposing it.
b) Also the woman put on the condom I did not. I think she did a good job though holding the tip and rolling it down. This was put on before any oral or genital contact but after hand contact.
Because I am still losing sleep over this I though I should get a test for "reassurance" as you put it. The unfortunate part is that almost all local STD testing centers/health dept clinics ( I checked over 5) are booked for several weeks and the few with walk-ins typically have lines outside the door for entry before the opening time. Both factors could compromise my confidentiality.
I know you are completely against online testing centers. But they could setup the test for me by tomorrow and provide results in 2 days.
The quick timing more than anything else does help maintain this confidential for me. I was hoping you could give me 2 answers:
1) Do the additional details of the encounter change your recommendation of not getting tested?
2) Is the risk of a false positive the same whether I do the test with an online service such as TSTD (which uses local Quest Diagnostics centers for the tests I mentioned in my first post) or in a public health department? (I understand the professional care aspect is vastly different)
Doctor I apologize for being annoying - I just have no one else to talk to regarding this. I would really like a quick way to get the reassurance and the local health departments here don't seem to offer that. I am hoping the risk of a false positive even through an online test organization is significantly low relative to the chance of a clean result that provides me reassurance, peace of mind and confidentiality.
I apologize in advance for my paranoia but the thought of me potentially transmitting an STD to my wife is worrying me so much. Even though you point out the risk is very small, details of the encounter haunt me -
a) I did not check the expiration date of the condom and even though I can be sure there was no significant breakage I am unsure if there was a hole or tiny tear at some part of the condom. I did not check the condom in detail while I was disposing it.
b) Also the woman put on the condom I did not. I think she did a good job though holding the tip and rolling it down. This was put on before any oral or genital contact but after hand contact.
Because I am still losing sleep over this I though I should get a test for "reassurance" as you put it. The unfortunate part is that almost all local STD testing centers/health dept clinics ( I checked over 5) are booked for several weeks and the few with walk-ins typically have lines outside the door for entry before the opening time. Both factors could compromise my confidentiality.
I know you are completely against online testing centers. But they could setup the test for me by tomorrow and provide results in 2 days.
The quick timing more than anything else does help maintain this confidential for me. I was hoping you could give me 2 answers:
1) Do the additional details of the encounter change your recommendation of not getting tested?
2) Is the risk of a false positive the same whether I do the test with an online service such as TSTD (which uses local Quest Diagnostics centers for the tests I mentioned in my first post) or in a public health department? (I understand the professional care aspect is vastly different)
Doctor I apologize for being annoying - I just have no one else to talk to regarding this. I would really like a quick way to get the reassurance and the local health departments here don't seem to offer that. I am hoping the risk of a false positive even through an online test organization is significantly low relative to the chance of a clean result that provides me reassurance, peace of mind and confidentiality.
MEDICAL PROFESSIONAL
Nope.
Doctor - one last detail. I had a 2 boils on my skin about 3 inches below my navel and about 2 inches above the base of my penis in my pubic area. I dont think they were open or cut in any way. I also do not think they were exposed to any sexual fluid but cant be 100% sure. Does this change your recommendation of not getting tested?
MEDICAL PROFESSIONAL
Millions of people world wide get health care from their physicians using payment systems that preserve confidentiality. If nothing else, you probably can visit your local public health STD clinic for the most expert care available anywhere, at no cost or only a token fee, and hyper-confidential.
Even with no protection, if one person has genital herpes and the other does not, the average risk of transmission is once per every 1000-2000 episodes of sex. It's too low a risk to worry about.
Even with no protection, if one person has genital herpes and the other does not, the average risk of transmission is once per every 1000-2000 episodes of sex. It's too low a risk to worry about.
I am sorry for the multiple posts. However I read online that herpes can be spread even with condoms. Just wanted to make doubly sure that I am not at risk for this either.
Thanks so much for the reassurance.
I could not have a previous STD because my wife or I had no other sexual contact.
The problem with going through professional advice is that it would involve insurance, credit cards and may result in my wife knowing.
tSTD does chlamydia, gonorrhea, hepatitis B, hepatitis C, herpes 1, herpes 2, syphilis, and HIV tests as a package for $250. I only thought of doing the tests to be super sure. I would not seek any medical advice from them.
But I think your assurances are sufficient for me to go on with my life, block this out forever and cherish my wife and my life and never do this again. I thank you for your medical advice.
I could not have a previous STD because my wife or I had no other sexual contact.
The problem with going through professional advice is that it would involve insurance, credit cards and may result in my wife knowing.
tSTD does chlamydia, gonorrhea, hepatitis B, hepatitis C, herpes 1, herpes 2, syphilis, and HIV tests as a package for $250. I only thought of doing the tests to be super sure. I would not seek any medical advice from them.
But I think your assurances are sufficient for me to go on with my life, block this out forever and cherish my wife and my life and never do this again. I thank you for your medical advice.
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
