[Question #2923] STD/STI concern after protected sex with escort

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93 months ago
I am a male who had Protected vaginal sex with a female escort.
After sex, she removed the condom and started using her hands on my penis to have me finish.
She then took the used condom and put it on her finger and started rubbing my anus. There was no anal penetration.
My concern is that this condom had her vaginal fluids that touched my anus. 
And I am not sure if she turned the condom inside-out (so as to not expose the side with vaginal fluids) before she wore it on her finger.
Am I at risk of any STDs/STIs?  
And is it recommended that I get tested?  If yes, how long should I wait after the incident, and what should I get tested for?
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H. Hunter Handsfield, MD
93 months ago
Welcome to the forum. Thanks for your question.

I really don't think you need testing for anything on account of these events. In general, we STD experts rarely recommend testing after any single exposure unless the risk is especially high, such as a known-infected partner. (And in that case, we usually also give treatment, without waiting for test results.) First, the odds of any infection from any single sexual exposure are low. Second, most escorts -- i.e. expensive female sex workers by appointment -- are believed to have low rates of STD. They usually know the score and take steps to protect themselves, as your partner apparently does, given the way you describe her condom use; get tested frequently; and mostly select clients who are themselves low risk, i.e. mostly sexually inactive or monogamous (i.e. men like you). Third, there is nothing in your description of her condom use that concerns me, whether or not she turned the condom inside out for the anal fingering.

So all things considered, I don't recommend testing and think it is fine to continue your normal sexual practices with your regular parnter, if you have one. That said, there are no guarantees and I cannot say the risk is zero, so it's up to you whether you would like the additional reassurance of negative testing. Also, if you have had other sexual exposures and have not had STD testing in the past year or so, perhaps this is a good time, when it's on your mind. If you decide to do it, I recommend a urine gonorrhea/chlamydia test (valid any time more than 4-5 days after exposure) and blood tests for HIV and syphilis at 6 weeks.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

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