[Question #13244] Unprotected sex with sex worker
 |
1 months ago
|
I am a male who recently met a female sex worker in London whom I met previously. During the previous encounter, all sexual activities were performed with a condom. The second time however, we engaged in unprotected oral sex both ways, and around 5 minutes of unprotected vaginal sex. I did not ejaculate inside of her but as mentioned did have unprotected sex for around 5 minutes. After the encounter she told me she was clean, though obviously I do not know this to be true for sure. I am writing this message on the same day as the event in question, so there has been no time for symptoms to develop. My question is therefore threefold.
1. What are the chances I have contracted an STD? I am specifically worried about HIV and syphilis.
2. What would your recommendation be regarding which STDs I should get tested for, and what should the timeframes be?
3. I have a partner. If you were me, would you wait until I have received negative tests to continue sexual activity with her, or are the risks too small to be worried about it?
Thanks a lot
 |
Edward W. Hook M.D.
1 months ago
|
Welcome to the Forum. Thanks for your questions. I'll be glad to comment. Your partner was probably telling the truth. Most commercial sex workers do not have STIs and most single encounters do not result in transmission of STIs when present. In the future, I might suggest that you ask partners not only if they were tested but when that happened. In response:
1. What are the chances I have contracted an STD? I am specifically worried about HIV and syphilis.
See above. Among the STIs your CSW partner might have, the risk of HIV and syphilis is far lower than the risk for far more common STIs such as gonorrhea or chlamydia
2. What would your recommendation be regarding which STDs I should get tested for, and what should the timeframes be?
Testing is a personal choice and is not essential however many clients choose to test for the reassurance that a negative test provides. Should you choose to test, tests for gonorrhea and chlamydia on a urine specimen and throat swab performed more than 4 days following your encounter will provide conclusive results. Testing for HIV using an HIV RNA PCR test would be conclusive any time more than11 days following the encounter and testing for syphilis (and HIV if you choose to test using a 4th generation, combination HIV antigen/antibody test) would be conclusive at any time more than 6 weeks following the encounter.
3. I have a partner. If you were me, would you wait until I have received negative tests to continue sexual activity with her, or are the risks too small to be worried about it?
The risks are quite small. I certainly would not worry about waiting until tests for HIV and syphilis are negative and do not feel strongly that waiting for negative tests for gonorrhea or chlamydia is essential
I hope this information is helpful. EWH.
--- |
1 months ago
|
Hello Dr Hook
Firstly may I thank you for your swift reply. I do have a couple of follow up questions if you don't mind.
1. I appreciate it might be tricky but are you able to put a rough probability in terms of a fraction when it comes to the chance of contracting HIV or syphilis from the described encounter? This may go some way to setting my mind at ease.
2. I have not heard of an HIV RNA PCR test before - I will look into this but if I do have a negative result after a test at 11 days would you recommend testing again at the 4 and or 6 week period or is the negative result at 11 days with the RNA PCR test sufficient evidence to dismiss all further need for testing.
3. I just want to thank you for all the work you and your colleagues do on this forum, it clearly helps a lot of people
|
Edward W. Hook M.D.
1 months ago
|
1. I would estimate that your risk of HIV or syphilis is substantially less than 1%
2. If an HIV RNA PCR test taken after 11 or more days, no further testing is needed. Results are conclusive at that time.
3. I’m glad my comments have been helpful. EWH
--- |
1 months ago
|
Thanks again for the swift response Dr. One final question, I have read online since your response that there are two types of HIV that can be tested for - HIV 1 and HIV 2. Do you believe it is worth being tested for both? As far as I can work out, it seems that HIV 1 is the only one worth being tested for as HIV 2 is prevalent only in the region of West Africa. Is this in line with your understanding?
|
Edward W. Hook M.D.
1 months ago
|
You are correct. HIV-2 is quite rare unless your partner was from EST Africa or perhaps India. Even then it is relatively uncommon and I would not worry.
This thread is now complete and will be closed.
Take care. Please don’t worry. EWH
---