[Question #10930] STD Scare from Encounter with CSW

18 months ago

A few days ago I (32 M) went to a CSW for a sensual massage. Before the massage, I asked to limit stimulation to only her hands and body (no oral or vaginal) as I have a partner and wish to protect her. During the massage, I was lying on my back and the CSW was gliding her naked body over my own, and having me suck on her breasts. However, she rubbed her naked vagina on my penis several times. Each time, I moved our positioning to remove my penis from touching her vagina, but I find it hard to guarantee that none of her vaginal fluids got on my penis. In the end, she straddled my lap and manually stimulated my penis, but she licked her hand several times to use saliva as lubricant as she continued to use her hand to stimulate my penis. Now I really wish that I did not let her touch my penis after she got saliva on her hand. This continued until I climaxed, at which point she continued to rub her hands and saliva on my penis. Before I knew it she placed my penis in her mouth to clean up the semen. As soon as she did this I moved her away saying No. My penis couldn’t have been in her mouth for more than two seconds. I asked her some questions, and she said that she does provide unprotected oral sex to other clients, but always a condom for vaginal sex, and tests regularly – seeming to indicate she has not tested positive for an STI. I hoped to know how much of a risk this incident has of me receiving an STI, and if I am at any risk of exposing my partner. Thank you very much.

Edward W. Hook M.D.

18 months ago

Welcome to the Forum. Thanks for your questions. Ill be glad to comment. This was a close to no risk encounter.

STIs are not transmitted in the course of mutual masturbation which is where your encounter falls. Contact of the outside of your penis (or any other part of your body) with your partner's genital secretions or saliva does not put you at risk for acquistion of STIs. As a rule, no penetration, no risk.

Further, your partner, like most CSWs is statistically unlikely to have an oral STI and even if she did, most single exposures do not lead to transmission of gonorrhea, the STI most commonly acquired from receipt of oral sex. In your case, the brevity of the exposure makes your risk lower still. That said, the fat that your penis was in her mouth represents a very, very small risk for acquistion of gonorrhea. If you wish to be 100% confident you did not acquire gonorrhea, a urine test for gonorrhea (typically chlamydia testing is done on the same specimen) would provide assurance that you were not infected. Your risk is so low that the decision about testing should reflect your level of anxiety over this exposure- I do not feel strongly that you need testing. EWH

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18 months ago

Thank you so much for your reply Dr. Hook. I appreciate your time and am very relieved to hear I am at low risk.

Just to have complete certainty I will likely get myself tested for gonorrhea and Chlamydia. How long should I wait to be tested and have 100% accuracy?

Just to educate myself, do you mind if I ask what about my encounter limits my risk to just these two STIs and not any of the other major ones like syphilis, herpes, HPV, NGU, Etc? What would have had to occur for these to be at risk?

I'm so pleased to hear that saliva and genital secretions carry no risk of transmitting STIs. Do you have further readings or research you could provide that I could read to further educate myself on this matter? I want to understand the proper research because I was so surprised at how many online resources made it seem like these two fluids could easily transmit STIs, and indeed, make it seem that STIs are so much easier to catch than seems to be scientifically accurate.

Do you have any opinion on why so many online resources seem to indicate this? Is it emotionally driven to scare people from engaging in sex, rather than report on scientific data?

Thank you again for your time and response. This is a wonderful service you provide and greatly appreciated.

Edward W. Hook M.D.

18 months ago

Your follow-up questions are overly broad and encompass the entire field of sexually transmitted infections. I will try to answer the specific questions that are readily answered.

You can get a urine test for gonorrhea and chlamydia, anytime more than 3 to 5 days following your encounter and anticipate conclusive results

Risk for the more than 30 different organisms, which can be transmitted sexually very according to who the partner is, the sort of contact, and the type of exposure. Certain diseases like syphilis and herpes require exposure to infectious lesions. Fortunately, all sexually active adults already have HPV and HPV is rarely transmitted through oral sex.

The Internet is not your friend here. The Internet is not edited and so you can not be sure of the statements made there. Much of what is present on the Internet is inaccurate, either because it is out of date, taken out of context, or just plain wrong, representing misunderstanding of the facts.

EWH

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18 months ago

Thank you very much Dr. Hook. I received a urine test to check for gonorrhea and chlamydia 5 days after the encounter and received test results 3 days later: both tested negative.

I am so pleased to hear that the results were indeed negative and I was not at risk just as you had anticipated.

Just to confirm, since the test was taken 5 days after the encounter, they are 100% conclusive, correct? No restesting necessary? Also, these were the only two tests you felt were remotely necessary for my encounter and no other tests are thought to be needed? With these negative results, I am safe to have unprotected sex with my female partner without any fear of infecting her?

Thank you very much for all of your time and assistance. This is an invaluable resource and I appreciate the information and reassurance that you provide to visitors to the site such as myself. Have a great day!

Edward W. Hook M.D.

18 months ago

You know, we provided up to three responses to each client’s questions. As this is my third response this will be the final response.

I’m pleased to hear that your test for gonorrhea and chlamydia was negative although not surprised. These results are conclusive and should be believed. At this time I see no reason for you to abstain from unprotected sexual contact with your regular partner. It is time to move forward without concern.

Thanks again for your thanks. Take care. EWH.

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