[Question #1950] Risk from sexual encouter with sex worker

48 months ago
I went to a massage parlour for an erotic massage. Both me and the lady had been drinking alcohol in the spa for about 2 hours. She gave me unprotected oral sex a number of times and then gave me a body slide on the massage table with her vagina rubbing up against my genital area but no penetration. We also French kissed deeply several times. I then attempted to have sex with her using a condom but was unable to have sex with her due to anxiety/nerves and probably the drinking. I then had a shower and left. In the light of day I realise that this was a huge mistake, I have a female partner and I'm worried. What are the risks of contracting any STD and can I get cancer causing HPV in my mouth/throat from this encounter - she seemed perfectly OK to give unprotected oral so I am guessing she may have oral HPV? Do I need testing before I sleep with my partner?
48 months ago
sorry - I must also add that my fingers (and hers) at times were in her vagina and both of us then rubbed my penis - i.e. there would have been vaginal fluid on my penis
Edward W. Hook M.D.
Edward W. Hook M.D.
48 months ago
Welcome to our Forum.  Overall, in the absence of penetrative genital sex, this was a relatively low risk encounter.  Your partner was a commercial sex worker (CSW).  Despite their vocation, most commercial sex workers do not have STIs and even when they do, most exposures to infected partners do not lead to infection, particularly following receipt of oral sex..  Your other exposures, mutual masturbation, body slide massage, genital rubbing without penetration have no meaningful risk for STIs.  Contact with vaginal fluid without penetration does not transmit STIs.  Thus your only exposure of concern was oral sex and oral sex only relatively rarely leads to infection.  When it does, the most common problems are either gonorrhea of non-gonococcal urethritis NGU) caused by mouth organisms introduced in to the urethra during sex.  This sort of non-chlamydial NGU is not clearly and STI in the traditional sense, is not readily transmitted to sex partners like other STIs, and in not associated with complications. There is almost no risk for chlamydia and there has never been a case of HIV proven to be acquired from receipt of oral sex.  Similarly, syphilis is almost never transmitted by oral sex.  You do not mention when this exposure was but if you do not develop symptoms within 5-7 days of your exposure you it is still less likely that you acquired an STI from your dalliance.  If you wish to test, testing for gonorrhea and chlamydia can be done using a urine specimen any time more than 2-3 days after your exposure. 

As for HPV, this is not a concern.  Overall about 80% of sexually active adults have HPV so you may well already have HPV, whether or not you know it.   Oral HPV infections are less common than genital infections and most single exposures do not lead to infection.  I would not worry about HPV and even if you are, there are no recommended tests for HPV for men.  I would urge you not to worry about HPV related to this encounter.

I hope these comments are helpful. If anything is not clear, please don't hesitate to ask for clarification regarding this low risk encounter.  EWH


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48 months ago
Thankyou Dr Hook. This encounter was one day ago - would it be safe to say that if I don't develop symptoms over the next week or so that I can avoid the need for testing? What symptom should I look out for?
Edward W. Hook M.D.
Edward W. Hook M.D.
48 months ago
The symptoms to look for would be a discharge from your penis or burning on urination.  If these do not occur, not testing is probably OK although the safest approach is to test.  This is easily done with a simply urine test. these tests can be done confidentially at public health STD clinics through your health department.  EWH
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48 months ago
Thankyou for your advice. The service you provide for invaluable - this will be a one time event for me, it has been a somewhat painful learning experience.