[Question #3337] Protected vaginal + unprotected oral sex with escort

38 months ago
Hello,

I made a huge mistake.  I had protected vaginal sex and unprotected oral sex with a private escort.  

I received unprotected oral sex from her, followed by brief protected vaginal sex where I lost my erection slightly due to nerves/guilt.  She then proceeded to perform oral sex on me while the condom that was used during intercourse was still on my penis.  After a short time, she removed the condom and continued (unprotected) oral sex on me.  She then put on a new condom and we finished protective vaginal sex.

Should I be concerned about the fact that the condom that was used during intercourse was in her mouth right before she performed unprotected oral sex on me?  Should I abstain from sex with my partner until I am tested?  What are my risks for various STDs/STIs?

Absolutely freaking out and totally filled with regret, thanks for you help.
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
Welcome to the Forum.  I'll be glad to comment.  By way of background, I should remind you that, as professionals, most commercial sex workers, particularly those that are more upscale, do not have HIV or other STIs and get checked regularly to make sure that they are not infected.  Further, I would add that your vaginal exposure was condom protected and therefore no risk.  That brings us to your receipt of unprotected oral sex following contact of your partner's mouth with the outside of a condom that had her vaginal secretions on it.  Thus, were she infected, you could have been infected if she had a pharyngeal infection or if she had a vaginal infection and got infectious vaginal secretions in her mouth from contact with your used condom, followed by transfer to you.  The latter situation is very unlikely to lead to infection - biologically for a variety of complex reasons, it is not likely that she got infected secretions into her mouth from the used condom that then were transferred to you.  On the other hand, from the sounds of things, performing unprotected oral sex is something that she may have done with other clients so there is a chance that she had oral gonorrhea or very improbably, oral chlamydia.  If she were infected, there is also a small chance that she could have then transmitted an infection to you.  Thus there is a small (I would guess less than 1 or 2%) chance that you were infected from your unprotected exposure. 

You don't mention how long ago this occured and I am going to presume that you do not have symptoms at this time but want to be sure.  The absence of symptoms, particularly if it has been a few days since your exposure, makes it still less likely that you were infected.  Thus, in summary, for the reasons I mentioned above, chances are low, probably less than 1% that you acquired an STI from the exposure you have described.  That said, there is still a small chance.  If you want to be entirely sure that you were not infected, you could have a urine test for gonorrhea and chlamydia which, if negative, would indicate that you were not infected and need not worry further.  Personally, I would not be worried.

I hope this comment is helpful.  if there are further questions or any other the rather complex explanation above is unclear, please feel free to use your up to two follow-up questions to seek clarification.   EWH
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38 months ago
In your professional opinion, did her performing oral sex with the used condom increase my risk of contracting anything - most notably HIV?  Do I have any tangible risk for HIV?  Would you, personally, abstain from sex with a partner after such an incident occurred?  How long should I wait before being tested?  I do not have any symptoms but it only happened 24 hours ago or so, thanks again for your help.
Edward W. Hook M.D.
Edward W. Hook M.D.
38 months ago
No, I see no realistic risk for HIV from having received oral sex after she had had a used condom in her mouth.  I see no reason for concern or for HIV testing related to the events you have described.  Nor would I abstain from sex with my regular partner if I were you. 

Testing will be accurate at any time 3 or more days after your exposure.  EWH
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