[Question #12462] Escort encounter

7 months ago

Hi doctors,

Im a white male, late 40s, and three weeks ago had unprotected oral sex and protected sex with a high end female escort, white, late 40s.

Unprotected oral lasted about two minutes.

Approximately two minutes into intercourse, I noticed that the condom slipped about a third of the way down the shaft of my penis. I immediately pulled the condom back up when I noticed.

Three days before this encounter, I nicked the shaft of my penis with an electric razor while grooming.

I didn’t notice any bleeding or scabbing two days before we had sex, but I’m not sure if the area I nicked was exposed when the condom slipped. I wanted to ask about potential STIs/hiv from this encounter, and whether testing would be appropriate.

Thanks.

Edward W. Hook M.D.

7 months ago

Welcome back to the Forum. There was little or no risk for HIV or other STIs from the encounter that you describe. I say this for several reasons. Those include:

1. As a generalization, most people overestimate the risk for STIs in casual partners. The fact is most persons with multiple partners do not have STIs. This includes commercial sex workers and, especially :high end" CSWs.

2. Even when partners have STIs, most single sexual encounters do not lead to infection.

3. Among penetrative sexual encounters, oral sex is particularly low risk both because relatively few people have throat STIs and because the efficiency of transmission through oral sex is also relatively low.

4. Condoms, when worn throughout an encounter, provide virtually complete protection against HIV, gonorrhea, and chlamydia and reduce the already low risk for other STIs like syphilis and herpes by about 60%. When condoms slip down, as long as the head of the penis is covered.

That you nicked yourself while grooming does not change change this. I would not worry. I do not feel strongly that you even need to test although I understand that many of our clients appreciate the reassurance that a negative test provided.

I hope this information is helpful. EWH

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7 months ago

Thanks so much, Dr. Hook. I greatly appreciate your service.

With the condom slippage and nick while grooming, I was most concerned with hiv transmission.

It sounds like, as long as the condom is covering the tip of the penis during a brief encounter, even with a small nick from shaving (no blood or scabbing present), the condom is doing its job in terms of protection.

Thanks again for all your help and I’ll end my correspondence.

Edward W. Hook M.D.

7 months ago

You’re exactly right. There was certainly no risk for HIV from the event you described. I’m glad the information I provided was helpful.

Closing the thread now. Happy new year EWH.

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