I am new to the forum but I read many of your replies to others.

I made a regretful decision of seeing an escort two days ago. I had protected oral sex and protected vaginal sex. She was on top of me and after I ejaculated I continued to thurst and when she got off me, I noticed the codom was only covering the tip of my penis and semen was already out from the condom on me and assuming some of it got in her vagina too.

When I was taking shower there, I noticed a little blood speck on the towel I used to wash my private area. I dont know whether it is from potential lesion or infection she had. I have not looked at her vagina well since there was no enough light in the room. I failed to ask her too.

Now I am really concerned of STIs espcially herpes and syphils!! I have a fiancee at home and I have been abstaining from having sex with her lest infecting her with something. How likely am I at risk? Should I wait avoiding sex with my spouce until I get tested in few weeks?

Thank you, I hope to get a good answer. I am worried and disturbed!

First, congratulations on your attention to sexual safety. You used a condom, including oral sex, generally considered unnecessary; and you chose a very low risk partner. You're overreacting to a generally safe sexual exposure, with very low chance of any STI. "Escort" usually means an expensive female sex worker by appointment (in contrast to brothel workers, bar pick-ups, etc). If your partner was a typical escort, probably she understands the risks, works to protect her health, gets tested frequently, uses condoms for vaginal or anal sex, and has mostly low risk clients (men like you). In most geographic areas, such women have low frequencies of the common STIs. The possibility that she had syphilis probably was particularly low. And even though genital herpes is very common, HSV transmission from any particular sexual exposure typically is under one chance in many thousand, even if one partner is infected. The partial condom slippage raised the risk somewhat, but that's not very worrisome when the risk is very low anyway. If some of your semen "got in her vagina", that potentially elevates her risk of being infected, not yours. Blood exposure -- presumably from your partner, if you were not obviously injured -- does not significantly raise the risk.

Despite your concern for syphilis and herpes, you probably were at more risk for gonorrhea and chlamydia, given the condom slippage. But for the reasons just discussed, it's pretty unlikely she has either of these. HIV always is a consideration since it's the most serious of all STIs, but HIV is exceedingly unlikely in this situation, both because your partner probably doesn't have it and because of a near zero risk of transmission if she did. A final consideration is human papillomavirus (HPV). There's a good chance your partner has HPV and you were exposed, but that really doesn't matter very much. As sexually active persons yourselves, you and your fiancé probably have HPV anyway -- and it's so common that any single exposure generally does not significantly raises the risk of someday being infected or having an adverse HPV event (warts, abnormal Pap smear, etc).

What testing is advised? None; your risk really isn't high enough. If somehow I were in your situation, I would not be tested and would continue unprotected sex with my wife without worry. That said, I understand that negative test results might be more reassuring than statistics or professional advice, no matter how expert. (We don't take it personally!) If you decide to be tested, I would advise waiting a couple more days (4-5 d after the event) and having a urine gonorrhea/chlamydia test; and after 6 weeks, syphilis and HIV blood tests. But the last two are so exceedingly unlikely that I definitely do not suggest waiting that long to resume sex with your fiancé. Do not get tested for HSV:  the tests aren't nearly good enough to be reliable after a single exposure, and it takes up to 3-4 months for conclusive results anyway. And there is no test for HPV in this situation.

All in all, you really shouldn't be worried. This really was no big deal as STI risks go.

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

HHH, MD

Can gonorrehea and chlymedia be asymptomatic? It has been a third day since the exposure and I only feel occasional burning sensation around my tip of penis and the testicles. I also feel muscle shooting on my upper thighs around my genitals. I dont have pain or burning sensation while urinating though.

Thank you for the priceless advices!