[Question #10217] Advice please
24 months ago
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Hello Dr’s.
First thank you for providing this service it is a great help. I tried just reading some other posts and they where helpful but would still like your opinion and advise on my situation as I’m unsure what I should do.
Two weeks ago against my better judgment I hired an escort, fairly expensive and by appointment only. We ended up doing almost nothing, not even kissing, except I did receive unprotected oral to completion from her. I thought by limiting my exposure to that I would be ok but I’m having a hard time believing I’m ok. I have no symptoms as far as pain urinating or discharge or discomfort. But wanted to ask if there is anything I should be concerned or on the continued look out for? I do have a significant other and have been avoiding sex or intimate contact with her because I’ve been worried. The only thing that I’m noticing is a severely upset stomach and a weird rash red patch on my arm. What would your advice be to me in this situation. Thanks
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H. Hunter Handsfield, MD
24 months ago
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Welcome and thanks for your question.
We get many questions similar to yours; you should be able to find several by searching for "escort" or similar terms. By "escort" we mean exactly the sort of partner you describe: expensive female sex workers by appointment. There is consensus among most STI and sexuality experts that such persons typically are health aware, often are well educated, take care to protect their health, use condoms, get tested frequently and mostly have low risk clients (men like you!).
The other main aspect of your question is oral sex. In general, it's low risk for all STDs. There have been very few well documented cases of HIV ever being transmitted mouth to penis -- to my knowledge, maybe not even one scientifically documented case. That doesn't mean it's entirely risk free, but clearly it can be considered zero or close to it. Other STDs are possible, but not many serious ones. Chlamydia is essentially no risk -- it doesn't take well in the throat, is rarely found there, and when present often is transient and in low amounts -- and thus almost never transmitted by oral sex. Herpes due to HSV1 is a risk, but uncommon after a single exposure. Nongonococcal urethritis can occur, perhaps due to entirely normal oral bacteria, but appears to be harmless.
With no symptoms two weeks after the event, I think you can be very confident you are uninfected. I would not advise testing for anything and would consider it safe to resume sex with your regular partner. That's what I would do if somehow I were in your situation. Of course you could still be tested if the anticipated negative results would add to the reassurance I have tried to provide. If so, you can have a urine gonorrhea/chlamydia test any time; and blood tests for HIV and syphilis 6 weeks after the event.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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24 months ago
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Dr HHH-
To clarify you feel it was low risk and you would not feel the need to have me test for anything being symptom free for 2 weeks- ( to elaborate I have never had an STD but assume the symptoms would be obvious as well as painful and uncomfortable and not something you need to look for.. correct? But if I did want testing as reassurance I could get the urine test now … but would have to wait 6 weeks for hiv and syphilis, but you still feel that the single instance of oral sex would not warrant any of this? But if some one where to go down the testing route for their own piece of mind would you then advise them to hold off any sexual contact with anyone else until all results are conclusive?
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H. Hunter Handsfield, MD
24 months ago
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"you still feel that the single instance of oral sex would not warrant any of this?" Correct.
" if some one where to go down the testing route for their own piece of mind would you then advise them to hold off any sexual contact with anyone else until all results are conclusive?" No, I would not necessarily advise that, especially with a regular partner. If it were me, I would take the nearly zero risk that I had HIV and could infect my wife, and face the consequences later if I were wrong. But I'm not you and cannot make that decision for you. It's entirely on you.
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24 months ago
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Dr HHH-
Got it and sounds good.
I want to thank you for providing this invaluable service. It allows people like me who have made a regrettable and embarrassing choice a place to come to be able to seek advice from someone like yourself as opposed to trying to find it searching google( which never ends well) or in person which isn’t easy. So thanks again it’s greatly appreciated.
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H. Hunter Handsfield, MD
24 months ago
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Thanks for the thanks. That's why we're here. ASHA, the forum sponsor, is the nation's leading nonprofit agency in support of sexual health. Dr. Hook and I are former ASHA Board members. Perhaps you'd like to consider a donation -- www.ashashexualhealth.org.
Best wishes and stay safe.
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