[Question #11742] Protected sex with Massage Sex Worker

12 months ago

What are my STD risks/odds/percentages give. The circumstances?

2 days ago I had protected sex with a female massage worker. I received oral and vaginal sex with the same condom. I did not see visible sores or lesions, although it was dim and I wasn’t necessarily inspecting closely. Duration of sex was 5-10 minutes. Location was in Las Vegas. I am a male.

During sex I did pull out briefly, held my penis, and re-entered. The condom never broke and was used the entire time. I ejaculated in the condom inside her. She pulled the condom off with a paper towel, gave me a wet wipe to clean myself.

I immediately got DoxyPep (14 100MG capsules) and Azithromycin - taking my first Doxy dose 16 hours after sex and the one time Azithromycin dose roughly 18 hours after. Doxycycline prescription is a 7 day plan at 100MG taken twice a day.

If you need anymore information I am happy to provide. Thank you!

Edward W. Hook M.D.

12 months ago

Welcome to our Forum. Thanks for your questions. Thanks as well for your commitment to safe sex. Overall I see the encounter you describe as being virtually no risk. Here are some of the factor and factors that contribute to this assessment:

1. You don't say much about your partner but CSWs in Las Vegas tend to have relatively low STI rates. Mid-to higher in CSWs like repeat business and STIs are bad for business. As a result they tend to take precautions and get checked regularly.

2. You used a condom throughout. Condoms are highly effective for prevention of the most common STIs (gonorrhea, chlamydia) as well as highly effective for HIV as long as they are worn throughout the encounter.

3. Further, even most unprotected encounters with infected partners do not result in infection of the uninfected partners. Thus if there was a condom mishap (doesn't sound like there was) the likelihood of infection remains low.

4. Doxycycline- you took more antibiotics than recommended as doxy-PEP. The recommended dose is a singe 200 mg dose within 72 hours of a risky encounter. Your antibiotics are overkill but effectively reduce ANY risk for chlamydia and syphilis and lower your risk for gonorrhea

Bottom line. This was a very low risk exposure for which you lowered risk even more with the antibiotics you took. Testing at this point has little to offer. My advice is to not worry and move forward. EWH

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12 months ago

Thank you so much Dr. Hook

I guess to add context, it was at an Asian Massage Parlor in Vegas that is known for offering sexual services.

My concern was STIs that can be triggered by skin-to-skin contact (Syphilis & Chlamydia). Google has of course amplified my anxiety.

And I guess the exposed base of my penis/pelvic region that could have rubbed on her pubic region during intercourse, as well when she used her hands (with paper towel) to take the condom off, and also my hands to wipe.

I understand that I am overly paranoid because I know that she likely has sex with multiple people a day. And the immense guilt as I am in a long term relationship. This is something that I’ll never do again.

I am avoiding sex with my spouse until the 7-day doxyPep is complete (I read that syphilis needs a 14 day doxy cycle.. debating on getting another week’s worth?)

Thanks again

Edward W. Hook M.D.

12 months ago

The massage parlor you describe is the sort of place I characterized in my original comment. They are less likely to have STIs than someone less cautious who you might of picked up in a bar

Google is not your friend. It is misleading. Your risk for chlamydia and and syphilis is virtually zero for the reasons outlined above

You misunderstand about doxycycline - single dose doxycycline (200 mg) is more than 80% PREVENTATIVE. It takes more to TREAT established infection- 14 days. Even 7 days of doxy is overkill.

EWH

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12 months ago

I’m virtually in tears. Thank you so much for addressing everything in detail and specific to my circumstances.

So I’m understanding correctly, 7-14 days of 200mg doxy is for STIs that “matured” or had time to incubate? Should I still avoid sex until finishing the cycle?

Other than that, this pretty much answers everything.

Edward W. Hook M.D.

12 months ago

Your summary is right on target. You do not have established infection and do not need two weeks of doxycycline.

I see no need to abstain from unprotected sex with your regular partner related to the encounter you have described.

As you know, we provide up to three responses to each client’s questions. This reply will complete the thread. There should be no need for further questions. EWH

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