[Question #2296] What is the Risk and Reccomended Action?

44 months ago
Dear Doctors:

Hoping you can put my mind and ease and reccomend what I should do regarding a mistake I made.

I was stupid and did something I regret a few days ago.

I met with a prostitute I found online and had a brief encounter.   I had second thoughts and ended things after a short time but did receive  brief oral sex with a condom, then with a condom on started to have sex but never fully penetrated (started to) but stopped myself.  Pretty sure there was no contact with genitals not covered by the condom as my hand never left the base of the penis.

Normally I would think this was very low risk and not be worried but I did notice IV drug track marks on her arms ( this was one of the reasons i stopped things).

I am married and hate myself for cheating but want to be sure not to put my wife at risk.

So a couple questions?

1) was this low risk, despite her IV drug use?  Do you recommend testing?
2) if i have unprotected sex with my wife is she at any  risk for STDs or HIV?
Edward W. Hook M.D.
Edward W. Hook M.D.
44 months ago
Welcome to the Forum.  Your question caused me to reflect on how we tend to process things, realizing that after we've done something risky we worry about it more than when our perception of risk is lower, even if that risk is just a little bit lower.  You might not be as worried if she were not possibly an IV drug user even though she is still a commercial sex worker.  Interesting how our minds work, isn't it?

.Most women who use IV drugs do not have HIV, just as most commercial sex workers do not have HIV.  Presuming you are in North America somewhere, I would estimate the possibility that your partner had HIV as still being less than 5% and probably far lower than that.  More importantly for you however is that all of your penetrative sex (both oral and possibly rectal) was condom protected throughout and your condom did not fail (when condoms fail, they break wide open, leaving no doubt that they have broken).  In the same way, the condom will offer the best possible protection against all other STIs as well.  I see no reason for concern and no medical need for testing related to the exposure you describe. 

Put another at, the answer to your questions are:

1) was this low risk, despite her IV drug use?  Do you recommend testing?
Yes, this is low risk.  I see no medical need for testing.

2) if i have unprotected sex with my wife is she at any  risk for STDs or HIV?
There is no reason related to the encounter that you describe for you to worry about unprotected sex with your wife.

I hope my answers are helpful to you. EWH

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