[Question #11565] Upcoming SW visit concerns

13 months ago

Hi, I am going to have a session with two sex workers. Both are professional, serious about safety and independent. I was hoping to engage in oral and vaginal sex, all protected. I would like to kiss as well, but can keep it light. How much at risk am I for any STI if everything is protected and used properly? And if we kiss? Thank you

Edward W. Hook M.D.

13 months ago

Welcome to our Forum. Thanks for your questions, as well as your commitment to safe sex. Most commercial sex workers do not have STIs and even most unprotected exposures to infected partners do not lead to infection. Use of a condom throughout your encounters, as long as it does not break (and when condoms break, it is obvious, they rip wide open) reduces any risk you might have for all STIS- some more than others. It virtually eliminates risk for HIV, hepatitis, gonorrhea, and chlamydia. Risk for other STIs such as syphilis is reduced about 60% but when dealing with professionals as you indicate will be the case, that makes encounters VERY safe.

Kissing, even deep kissing with saliva exchange is likewise virtually no risk.

You can ask your partners if they test and when they last tested to be sure but as a generalization, as you explain it, it sounds like your risk for acquiring any STI is miniscule.

Personally, unless something untoward occurs, I would not worry about the sorts of exposures you describe and unless you need the assurance that a negative test provides, probably would not even bother to tests.

I hope this helps. If there are additional questions, please don't hesitate to use your up to two follow-ups for clarification. EWH

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13 months ago

Thank you. A few more questions. If I perform oral sex on them, how much protection does a dental dam offer and would you recommend it? And as far as herpes goes, which I know is skin-to-skin, if there is no visible shedding and a condom and/or dental dam is used, how much at risk am I still?

13 months ago

Hi Dr Hook,

I figured while I was waiting for the first response I might as well ask my second and then perhaps you could answer both in the same response.

I’ve spoken to both sex workers who say they get tested regularly and use protection for penetration. If I were to eliminate a condom for oral on me and/or not use a barrier for oral on one or both of them, how much more am I increasing my risk for any STI, including herpes to me from them? How much more am I increasing my risk by not using a barrier on one or both activities? I should mention over 10 years ago I had a girlfriend with genital herpes. We always used a condom for sex but I did perform unprotected oral on her. I have never been tested for herpes, but have never had any symptoms. Thank you.

Edward W. Hook M.D.

13 months ago

There are no good data on how well dental damms work for prevention of STI/HIV acquistion. It makes sense however that a barrier might reduce the risk for infection.

The risk of acquiring herpes from performing oral sex on a partner who has HSV-2 is low. For reason that are not entirely understood, HSV-2 very rarely infects the mouth and oral cavity.

Overall the risk of getting any STI from receipt of oral sex, or perfroming oral sex on a professional CSW is low. EWH

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