I have been a fan of your services since med help and I will like to thank you for all you do. Last night around 1:30 am, I made a huge mistake and visited a transsexuals escort. This was really out of my character and I have never done this before. I was under the influence of alcohol. I know my risk is high because of the type of partner ( Biological a male). She started with oral sex and it was protected, I refused a few times to do anal but at the end I gave in and we had protected sex for about a minute maybe 2.  I made sure that was not really that much contact between the base of my penis and her butt. At the end I regret my mistake and left quickly. I did not asked her about her status or anything. I just left. A little bit about me: a healthy 39 year old male. I tested negative for all stds about 9 months ago and I have not been with anyone. This was my first sexual encounter in the last 9 months. I always practice safe  sex and my sexual partners always have been female till this encounter. I am a little bit worry about my risk here, mainly HIV and HSV2. 

Thank you! 

As just implied, I would not advise any treatment at this point -- indeed your risk is low enough that even testing for any STIs and HIV is optional. You might want to get checked out just for reassurance, however. If so, I would advise a urine test for gonorrhea/chlamydia 4-5 days after the event; and for HIV and syphilis in 4-6 weeks. The chance of HSV2 in this situation is very low -- regardless of whether there was skin-skin contact above the condom. Just be on the alert for typical symptoms (penile blisters/sores); if none after ~5 days, you're probably home free in regard to herpes. (Rarely symptoms can be delayed up to 3 weeks, but with stress on "rarely".) The blood tests for HSV2 are far from perfect and I would not advise testing in absence of symptoms.

In summary, yes -- this was a lapse in judgment. But you were wise enough to use a condom. If somehow I were in your situation, I probably wouldn't even be tested for anything and would continue unprotected sex with my wife, with no worries about infecting her. Your choice to be tested or not is for its reassurance value, not because of serious risk you were infected.

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

HHH, MD