So my exposure was an unprotected oral and protected vaginal sex which lasted 2-4 minutes. 

Condom (Durex Extra Safe) was on from the start till finish and seemed to be intact as far as I know. 

We stopped the act because I wasn't feeling anything - it is a bit ticker condom. 

On 34. day after the act I went to my local lab and performed full panel STD tests from urine and also a blood from vein test for syphilis and HIV. Test for syphilis was combo test with VDRL / RPR TEST and TPHA test.

Hiv test was a abbott architect CMIA 4th gen anti-HIV 1, 2, p24Ag test. 

Everything came back negative. 

1. If you were somehow in my shoes, would you pursue any additional testings or would you move on with your life and accept your 34. day test results?

2. Would you continue to have unprotected sex with your wife?

4. I wanted to confirm this with you before moving on with my life because I know the CDC recommendation is 6 weeks, while still some other entities like BASHH say 4 weeks for most of the exposures, so I was a bit confused and wanted to make sure I am good.

You went about this event with excellent safety. In all honesty, I would not have recommended any testing at all after such an exposure. Female escorts (expensive, working by appointment -- just like your partner) are generally believed to be at low risk for STDs in general and especially for HIV. Most are aware of the risks, use condoms, have relatively low risk partners (men like you), and get tested frequently. Second, condoms are highly effective in preventing HIV and most STDs, and oral sex is inherently low risk -- and probably zero risk for HIV (there have been few or no proved cases of HIV transmission oral to penis, ever). Finally, your test results are conclusive for all practical all purposes. And I agree exactly with your doctor's advice (more about that below), and would further comment that it appears s/he has a sophisticated understanding of HIV risks and testing. To your specific questions:

1,2. As implied above, I would not have been tested at all. If I were in this situation (pertinent to my distant past!), if I had such exposures from time to time, just to be extra safe I would have syphilis and HIV blood tests and urine tests for gonorrhea and chlamydia from time to time, maybe every 6-12 months, but not after each such exposure. During that time I would continue unprotected sex with my wife, without worry. For sure you can accept your results and move on without worry.

3. No:  See above.

4. Public health agencies are inherently risk averse and their guidelines basically assume the worst case scenario, and that worried persons generally want absolutes, not probabilities. It is true that on rare occasions the AgAb (4th generation) HIV blood tests can take up to 45 days to become positive. But if someone's risk of HIV is say one in a million (yours probably was even lower)* probably a fair guess for an exposure like yours)*, then a negative result at 34 days -- probably 99% reliable -- lowers the possibility of HIV to one chance in 100 million which, I hope you agree, is zero for all practical purposes. But if the baseline risk is a lot higher -- say unprotected sex with a known infected partner -- that 99% reliability might not be quite what is needed, and testing at 6+ weeks is reasonable. Undoubtedly your doctor understands all this, even if s/he hasn't necessarily gone through the analysis in the footnote below. 

The statistics for syphilis testing are similar, so you also can rely on that result. Urine gonorrhea/chlamydia testing actually isn't as good, missing maybe 5% of infections. On the other hand, condoms remain highly effective, absence of symptoms (urethral discharge, painful urination) is a good indicator, and in any case these are rarely as serious as HIV or syphilis.

So all is well. If like many you're not completely comfortable with a probability analysis, feel free to have repeat HIV and syphilis tests at a time when the tests alone are 100% conclusive -- i.e. 6+ weeks after exposure. But as already implied, if I were in your shoes, I wouldn't do it.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

Thanks for the thanks. I'm glad to have helped. Let me know if anything else comes to mind.