[Question #4190] Worried after encounter

33 months ago
Dear Dr Hook. Last night I made a mess by visiting a strip bar in Hong Kong. I received lap dance by two ladies from Philippines and they both then lightly licked my testicles. I was aroused and took one of them to a nearby small hotel. There she stripped and washed herself with a small shower head in the small bathroom in the room. I was naked by then and she went on top of me where her vagina made slight contact with my penis. However I was careful and was consciously avoiding any bare contact. She then made me wear a condom which covered all of my penis except an inch on the top  part near the pubic area. She then gave me oral sex. I then penetrated her in two positions. During sex she used a vibrator on the top of her clitoris. I ejaculated inside the condom. During sex I was trying to particularly avoid slamming hard so to avoid the contact with her vaginal secretions on to my pubic area and testicles however i must have had these contacts in the heat of the moment. Please note that a day earlier I got a cut on my testicles while zipping my pants and I bled for a few minutes. However, a day later during this encounter there was no bleeding and the cut looked fairly normal. After ejaculation,  I withdrew my and slid down the condom using a tissue. Whilst removing, her secretions on the condom must have made contact with my penis or hand which is how it normally would be after any encounter with anyone. I held up the condom and my sperm was intact inside and I didn’t notice any leak. I did not test by filling it with water as I didn’t suspect any leaks. Thereafter, she cleaned herself again by spraying herself on the vagina with the shower head. She left the shower head in the basin. I then went in and used a soap she had to clean my penis using the same showerhead. 

I am worried sick if I am running a risk of contracting HIV or any other STDs. I asked her after dressing up if she has been tested. Using broken English she told me not to worry as she was tested a week ago in Philippines before coming to Hong Kong. She also said that she always uses condoms for encounters with customers but sometimes gives oral sex without protection. I didn’t know if she was able to explain well what she wanted to and how far was she truthful.

I await your advice.
Edward W. Hook M.D.
Edward W. Hook M.D.
33 months ago

Welcome back to our Forum.  I'll be glad to comment.  In preparing to reply, I reviewed your earlier exchange with Dr. Handsfield and I agree with all that he said, including that "With rare exceptions, STDs require penetration for transmission. The bacteria and viruses that cause them are not simply infections that happen to primarily involve the genitals. These organisms evolved to require penetration for transmission. In addition, saliva or oral contact is rarely a source of infection. Among other things, saliva kills HIV and also is toxic to most STD bacteria and viruses".   Thus the non-penetrative activities you describe including having your scrotum licked (even with a cut on the scrotum), possibly contacting her genital secretions during sex or in removing your condom or in using soap that she had used did not put you at any meaningful/known risk for STI acquisition.  Further, for your penetrative sex, condoms remain the most effective means for preventing infection is such situations and since your condom appeared to be intact, it almost certainly was (FYI, the so-called "water test" is a waste of time, condoms do not leak a little, when they fail there is no doubt that they have failed as they break wide open. 

I would also add that is is statistically unlikely that your partner even had an STI.  I doubt that she did as most CSWs do not.

My advice is not to worry.  As you may be anxious, I realize that you may choose to test for STIs but if I were you, given the situation you describe, I really would not even feel the need to test.  I hope that you find my response reassuring.  EWH
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33 months ago
Dear Dr Hook. Thanks for the reassuring response. I have described the encounter in the best possible manner. There is nothing that I have to add to this. Therefore, should I assume that there is zero risk for HIV transmission based on the description I have given? Can I have unprotected sex with my wife going forward? 
Edward W. Hook M.D.
Edward W. Hook M.D.
33 months ago
Yes, I would say your risk for HIV is effectively zero.  I see no reason related to the events you described to not have unprotected sex with your wife.  You should be in the clear.  EWH---
33 months ago
Thanks Dr Hook for your advice! God bless!