[Question #12726] CSW protected sex
5 months ago
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Hi Doctor,
On a holiday to Japan I had a sexual encounter with a CSW at an establishment (which tests CSWs once a month) that has left me concerned. The activities we engaged in include: sitting in a filled bathtub together, a body slide with gel (with body to body contact, mostly with me face down), handjob, protected oral and protected vaginal sex. No mouth to mouth kissing, no unprotected sex. The condom stayed intact as much as I could tell, it was on pretty tight and stayed on throughout sex, with no visible leakage after. It did not cover the full length of my penis, though, so I assume there was some skin to skin contact with my uncovered shaft.
What has me concerned is that when putting on the condom the CSW mistakenly pinched the tip of the inside of the condom, before realizing the correct orientation and putting it on my penis. She might have touched her genitals before this event, I’m not sure. Based on your assessment, what is my risk for contracting STIs? I am particularly worried about HIV, but also the other STIs such as syphilis, chlamydia, gonorrhea etc. Thank you!
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Edward W. Hook M.D.
5 months ago
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Welcome to our Forum. Thanks for your questions. FYI, your questions arrived while I was on the Forum so you are receiving a reply more quickly than is typical. Replies to any follow-ups may take longer.
Congratulations on your safe sex practices. There is certainly no risk for STI, including HIV, from sharing a tub, receipt of a body slide or masturbation, or receipt of condom protected oral or vaginal sex. Further, your partners were relatively low risk despite her profession- she is tested regularly, practices condom protected sex, and is more cognizant of her risk and measures to avoid infection that other more casual partners. The fact that she touched the inside of the condom before putting it on your penis is a no risk event, even if she had touched her genitalia prior to doing so, No STIs are transmitted through transfer of infectious material on a persons hand to another person, either directly (as might occur with masturbation) or indirectly as might happen in the situation you describe. I would not be worried in the least and in fact, see no medical or scientific reason for testing at this time.
I hope that this perspective is helpful. EWH
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5 months ago
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Hi Dr. Hook, thank you for this extremely helpful response! It has certainly helped put my mind at ease. Just two follow ups, if you wouldn’t mind:
1. I woke up today feeling a sore throat and perhaps a mild fever coming on. It has been less than 48 hours since the sexual encounter. Is this indicative of anything related to the encounter, or more likely a result of lack of sleep/a common cold coming on? (clarification: I did not perform oral sex on the CSW)
2. I’m curious as to why online resources seem to indicate that condoms are only about 90% effective in preventing HIV transmission - this seems to indicate a 1 in 10 chance, though I assume from other readings that this is not the case.
Thanks so much for your expertise and the work you do on here!
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Edward W. Hook M.D.
5 months ago
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Thanks for the additional information. Response is below:
1. 48 hours is too soon for the onset of symptoms due to any STI including HIV. Thus these symptoms are further evidence that your symptoms are unrelated to the encounter you described. As you know, flu-like illnesses are common in travelers.
2. The 90% figure rate for condom. Success relates to the fact that many people use them incorrectly, putting them on after they’ve begun to have sex or other errors and use. As long as you were a condom was worn throughout the encounter from beginning to end it did not break. You can be confident that it protected you from STI. Again that your partner touched the inside of the condom is no misuse.
Please don’t worry.
EWH
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5 months ago
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Thank you very much, Dr. Hook!