STDs from sex with escort

[tj_no]

I had sex yesterday with an escort (I'm male, escort female). I kissed her briefly, not deep. I sucked her breasts. I inserted my fingers in her vagina. She gave me unprotected oral. We had intercourse with a condom which stayed on the entire time. Of course, I am worried SICK about the whole thing.

1.  What are my risks? Some STDs from the unprotected oral I'm sure. What about other STDs? Herpes? Lice? Scabies?

2.  Kissing. Is there anything I could get from the kissing? Hepatitis A? I know she had sex with someone else earlier in the day. Probably same situation as me:  unprotected oral.

3.  Any danger from inserting my fingers in her vagina? I did have a small cut on one finger near the nail.

4.  She seemed fairly clean, fairly well kept. What are my risks from lice & pubic lice & scabies? She was mostly shaved around her vagina. Does that make any difference? I was at her apartment, which was stupid to say the least. It wasn't the cleanest place. But she lived alone (well, two cockatoos that weren't the cleanest).

5.  I want to get tested for EVERYTHING. How soon? What can I reliably test for now vs later?

6.  I am worried sick that I can transmit something to my family members. Obviously, no sex with wife, but that isn't a problem. But transmission from casual contact, clothing, bed linens, etc.? What about my kid? I"m scared to hug my kid or handle the laundry. I probably need Xanax more than penicillin! :-)

7.  I'm going to my doctor next week. Can I wait until then to do anything about this stuff? Is there something I should do now?

[Edward W Hook, MD]

Your risks are low. there is no risk from kissing her mouth or her breasts.  Protected vaginal sex is likelwise safe.  Your only risk is receipt of oral sex and your risk of infection from that is low.  Oral sex is an inefficient way to transmit STDs.  Of the bacterial STDs only gonorrhea and nongonococcal urethritis (NGU) are transmitted through oral sex; chlamydia is not and without an obvious sore or lesion on your partner’s mouth, the chances of syphilis and herpes is likewise tiny.   If you had gotten gonorrhea or NGU you would have most likely developed symptoms of urethritis (penile infection).  Herpes can be tranmitted b oral sex but is likewise uncommon unless she had an obvious cold sore and even then would not be expected.  Even if your partner had an STD (any STD and it is likely she did not), most exposures do not lead to infection.  As for your specific questions:

1.  See above.
2.  No, hepatitis A is not spread by kissing or oral secretions.
3.  No.  this is masturbation.  Masturbation is safe sex.
4.  Unlikely.  
5.  Tests for gonorrhea, chlamydia and nongonococcal urethritis will be accurate after 2-3 days, testing for HIV should wait till at least six weeks.  Syphilis is so uncommon that any test after a week or two will be sufficient.  I would not get a blood test for herpes but would watch for lesions.  If you have a blood test and find it is positive, unless you have been tested in the past, you will not know if the infection is newly acquired or long standing (HSV-2 is present in 20% of the adult population, only 10% of whom are aware that they are infected).
6.  No risk of transmission through casual contact, towels, etc.  You are over reacting.
6.   the best thing to do is calm down.  Over all your risk is low.  EWH

[steve6410]

A related discussion, Protected sex at massage parlour was started.

[tj_no]

Thank you very much for your answers and reassurances. It is very stressful dealing with the likelihood of STDs. Again, thank you for this site and your answers to my questions. :-)

[Edward W Hook, MD]

I do not debate with other internet sites. I told you above, hepatitis A is not tranmitted by kissing. If you wish to believe otherwise, that is your call but do not expect me to argue or change my statement.

Chances of getting lice form a US escort- minimal.

Space does not permit the detailed answer to my statement other than to promise you that thereare NO STDs that are transmitted at rates of more than 40% per exposure and for most the figures are far, far lower.  This is the case for rectal, genital and oral sex and for viral and bacterial STDS.  EWH

[atg4073]

When you say that even if a partner does have an STD, most exposures do not lead to an infection, what do you mean?  Do you mean from receiving oral sex?  What about unprotected vaginal?  If a partner had herpes but no symptoms and I had unprotected vaginal with her, what is the chance that I will catch it?

[tj_no]

Two follow-up question if I may:

As you know, the Internet has tons of info on STDs. On one reputable site, the info suggests that Hep A can be acquired via kissing assuming a partner came in contact with feces via some type of anal sex play. Sounds far fetched to me, but I thought I would check that out with you. Any chance of that happening?

Also, since my mind is still racing with stupid questions and you are a definite expert in communicable diseases:

Concerning lice in general:  what is the likelihood of getting regular lice from an escort? I'm guessing the same as pubic lice and scabies. I guess the big question:  if for some crazy reason I did acquire lice, is there really anything that can be done until the symptoms become obvious? I know of the treatments, but there seems to be no reason to worry about that until lice are detected or nits are detected.

Dr Hook, I think it is fantastic that you and the other doctor agree to answer people's questions like this. I can tell from reading this forum that people are worried and scared about all the stupid things we do sexually, and they (and me) really do appreciate all the help, support and reassurance that we get from the two of you. Again, I am very grateful. I can tell you that here in Ohio there is nothing that is as helpful as what you guys are offering.

[tj_no]

Thank you so much for your comments. It is too easy to worry myself sick over a stupid mistake.

I was most worried about crabs or lice or scabies, then I read a comment you made in this forum about never seeing scabies from sex workers.

I'm guessing crabs is the same, quite unlikely? Every itch on my body for the past 48 hours has been a cause for worry.

I'm seeing my MD next week. I will get the tests I can get now. I will get the rest in 6-12 weeks as you suggested and I've read elsewhere. I've been tested for Herpes before, so I might get the blood test done just to be sure.

Again, much thanks.