Over the weekend, I had unprotected oral and protected vaginal sex with an escort from Colombia in the Dominican Republic.

We started having sex by me applying the condom and her getting on top.  She was grinding on me and it lasted for about 5-10 min.

I told her I wanted to switch positions, at which point she got off me and told me she needed to clean up and pointed to her vagina.  When I looked at the condom after she took it off, I noticed that it was covered in blood.  When I looked down at my penis, I noticed blood gathered at the base of my shaft where it was making direct contact with my skin.  I wiped it off where I noticed it.

We finished with her giving me oral and didn’t have penetrative sex after that.  I wanted to understand my risk of any STD based off this interaction.  I have someone I see in the US and we have sex without using protection.  Would it be safe to do that with her by this weekend?  It would put one week in between my escort and her.  I just want to make sure I am not putting her at risk for anything if we decided to have sex.  She is not my gf or wife, as I am single.

Thanks

Contact with vaginal blood -- whether menstrual or other -- does not raise the risk of any STI. The amounts of HIV or other STD viruses and bacteria is no higher in blood than in genital fluids themselves. Some people find sex during menstruation distasteful, but that's an emotional reaction and has nothing to do with STI risk or prevention. Further, you used a condom -- and contact with blood (or genital fluids) on the skin above a condom does not increase risk significantly; protection against most STIs is considered complete as long as the head of the penis and the meatus (urethral opening) are covered. Such contact is the main reason that condoms work less well in preventing infections transmitted skin to skin (syphilis, HPV, herpes) than those transmitted by fluids (HIV, gonorrhea, chlamydia). But the blood itself did not raise your risk any further.

In general, HIV/STI testing is not recommended after any single sexual exposure unless the risk is particularly high. Of course keep an eye out for symptoms, like discharge from your penis, painful urination, or sores of the penis, especially above the condom area. However, even without symptoms, some people are anxious enough to get tested after even a single low risk exposure, and you are welcome to do that. But most likely your regular partner is not at risk for anything -- and any existing risk was not raised on account of the blood contact.

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

HHH, MD

After a week, if no symptoms occur, realistically, what STD’s would I still need to be on the lookout for beyond that timeline? 

Thank you

Thank you sir.