[Question #4781] Risk of STI from sex with CSW
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80 months ago
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Dear Doctor.
I am a white heterosexual male from Sydney Australia aged 48. I have been in a long term relationship for many years. On 6 January I made an error in judgement after drinking an excessive amount of alcohol.
I went to a local brothel and ended up seeing a young Japanese commercial sex worker who had recently arrived from Osaka Japan three weeks earlier.
Details of what occurred:
- I fingered her in a warm spa for about 15 minutes (my hands were water logged and wrinkly from being in the spa so long)
- We got out. She put a condom in her mouth wetting both sides with her saliva and then put in on my semi erect penis with her mouth and gave me protected oral sex for around 5 minutes
- We then attempted somewhat partially successfully to have sex but I was not really hard enough for the whole time (I was probably inside her vagina for less than 10 minutes. The condom covered about 3/4 of my penis only.
- I then gave up on sex and she vigorously rubbed my penis by way of a hand job for another 10 or 15 minutes before I came.
- I then showered and applied hand alcohol gel to my penis and scrotum (it hurt like hell) when I used the bathroom and left.
After arriving home a couple of hours later I showered again and in the next 24 hours took the following antibiotics that I had at home:
- 4 x 875 mg Amoxicillin and 125 mg Clauvanic acid
- 4 x 500 mg Cefelexin
Can I get any STI like herpes/syphilis/HPV?
I am particularly concerned about herpes and even more over Syphilis. I am aware that Syphilis is common among gay men but there has been a major spike in cases in young females in Japan particularly around Tokyo and Osaka over the previous 3 years especially in commercial sex workers (over 6000 cases in 2018). Japan doesn't have penicillin G apparently and treats with tablets. Can I get syphilis infection on my fingers which were wrinkled or around the base of my penis/scrotum? Should I be tested before I have sex with my partner? Do I need to tell her?
Thankyou. I will tr
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80 months ago
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Sorry the last part was: I will tell my partner if needed and try not to repeat this mistake. Also the hand job was without a condom.
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Edward W. Hook M.D.
80 months ago
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Welcome to our Forum. I'll do my best to help. Forget about syphilis! The antibiotics you have taken would have prevented syphilis in the unlikely circumstance that you were exposed to syphilis. As for HSV, your risk is tiny- your exposures were very low risk and your exposures were relatively low risk since transmission of HSV is so very unlikely on a purely statistical basis.
As for HPV, there is simply little reason for concern. Most sexually active, unvaccinated persons already have HPV and vaccinated persons are not at risk. Most sexually active women in Australia are vaccinated against HPV making it not a consideration.
Bottom line, all things considered, this was a low risk exposure. Unless you develop symptoms, I really would not worry. EWH
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80 months ago
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Thank you Dr Hook. I was really worried about Syphilis when I read an article that it had spiked in female CSW from Japan - when the young lady told me she was recently from Japan I then worried and took the antibiotics. I'm assuming from what you said the short course of Amoxil 3.5 g (875 mg x 4) one tab per 6 hours over 24 hours would have protected me if I was struck by lightning? I wasn't sure. Can I resume normal relations with my partner without testing or waiting for a symptom free period? Last questions. I really appreciate your advice and assistance. I am considering attending psychological counselling. This is not my first slip up and I have been prone to stupid and impulsive behaviour despite being fairly well educated. If I was single the risk wouldn't be an issue but putting others at risk is another matter.
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Edward W. Hook M.D.
80 months ago
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Yes, the antibiotics you took would protect you in the unlikely circumstance that you were exposed to syphilis. You can certainly resume normal, unprotected sex with your regular partner without testing or waiting to see if you develop symptoms.
I should also add a comment about the article you read. Syphilis is a rare disease and so a doubling or even tripling of a very rare disease still leaves it as a rare occurrence. Please don't worry. I'm confident you are in the clear in terms of the exposure you described. EWH
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