[Question #11010] Escort

17 months ago

Three days ago, I met an escort. We kissed deeply for about 20 minutes, and I performed oral sex on her. I also licked and sucked her body. We did not engage in vaginal sex.

I am concerned because, during the encounter, I had severe canker sores in my mouth, which were and still are painful. Additionally, I sometimes experience bleeding gums.

Should I be worried about HIV?

H. Hunter Handsfield, MD

17 months ago

Welcome to the forum. Thank you for your question.

There are two main aspects of STI risk: the nature of the exposure, i.e. the chance of STI transmission if one partner is infected; and the nature of the partner and the risk that person has an active, transmissible STI. From the first perspective, this was a very safe exposure; and it probably was from the second as well.

You don't say where you are, but in industrialized countries -- and probably in most of the world -- "escort" is used for female sex workers who work by appointment (unlike bar pick-ups, brothel workers, etc) and charge a lot for their services. In general, such women are believed to be at low risk for active STIs: they know the score, use condoms for vaginal or anal sex with most or all clients, get tested frequently, and generally their clients are at low risk (men like you). If these features apply to your escort partner, probably she was not infected.

As for the contact itself, cunnilingus -- oral-vaginal sex -- is very safe, with very low chances of gonorrhea, chlamydia, syphilis, herpes, etc. And there has never been a reported and scientifically confirmed case of HIV transmitted by cunnilingus. Oral canker sores or other lesions in theory might raise the risk a bit, but not by much. Bleeding gums also might theoretically raise the risk. But since there have been no known cases of HIV transmission, and there must have been millions or even billions of such events in the presence of oral sores or gum disease, obviously the risk remains very low.

For those reasons, I see no need for you to be tested for HIV or any other STI. If you have a sex partner, you can continue your usual sexual practices without putting her (or him) at risk.

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

HHH, MD

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17 months ago

Thank you for your reply!

I would like to provide some additional details. Does performing rimming pose a risk for HIV transmission? I am concerned that during oral sex, my tongue might have come into contact with her anus, which means I may have performed rimming. Assuming that I engaged in prolonged rimming (with my tongue inside her anus), can I still be confident that I did not contract HIV?

H. Hunter Handsfield, MD

17 months ago

There's never been a case of HIV documented to result from rimming. Probably it is no more risky than cunnilingus, i.e. near zero. In addition, oral exposure to HIV always is low risk. For example, performing oral sex on a male and swallowing infected semen rarely results in HIV infection. Also, it is difficult for me to imagine your tongue entered your escort partner anus without you knowing. How could that be?

In short, this does not change my advice. No significant risk, no need for testing. Of course you're free to be tested anyway if you wish. Relief of anxiety and worry is a valid reason for HIV testing, in addition to actual risk.

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17 months ago

Thank you. I will consider testing. I have one final question. You didn’t mention anything about body licking and sucking. Are there no risks from licking and sucking someone’s body (nipples, breasts, etc.), even if I have canker sores and bleeding gums?

H. Hunter Handsfield, MD

17 months ago

STI bacteria and viruses are not like staph, strep and other skin bacteria. Those tend to simultaneously occupy much of the entire body surface and most body cavities (nose, mouth, ears, rectum, genitals). The STI pathogens don't do this at all. They are not present on body surfaces, except maybe in the immediate genital area. in addition, the oral cavity is not highly susceptible to infection with most STIs, which is why oral sex is much less risky than vaginal or anal sex. The kind of events you describe are zero risk, with or without cankers or other oral sores, inflamed gums, etc.

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe.

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