[Question #5598] Risk of Exposure to STDs

21 months ago
Good afternoon doctors, 
About 24 hours ago I had an intercourse with a commercial sex worker.  I used protection during the encounter and  I saw no signs of  the condom breaking afterward.  I also engaged in brief unprotected cunnilingus. I did not engage in any other acts. Do you think I am at risk of STDs such as HIV? Should I seek PEP for HIV . When do you recommend I get testing?
Thank you 
Edward W. Hook M.D.
Edward W. Hook M.D.
21 months ago
Welcome to our Forum. Thanks for your confidence on our advice and congratulations on your commitment to safe, condom-protected sex.  The short answer to your question is that the encounter you describe did not put you at risk for HIV or other STIs and were I you, I would not feel the need to get tested for this exposure.  Further, if you came to me and asked for PrEP, I would not be willing to prescribe it.  I will list some of the many reason why I say thins below:

1.  First, your partner. Most commercial sex workers do not have HIV or STIs.  While rates vary from nation to nation, most CSWs are aware of their risk and get checked regularly for infection.
2.  If your partner did have an STI, even most unprotected exposures do not result in infection.  The risk of a single, unprotected vaginal exposure to an HIV-infected partner only leads to infection about once in every 1000-1200 exposures.  
3.  Condoms are the most effective means of preventing acquisition of infection upon exposure to infected partners, reducing the already low risk for infection by over 99%.
4.  There are no proven cases in which HIV has been acquired from performance of cunnilingus on an infected partner.  The risk for other STIs, even if the partner is infected is likewise very, very low.

I hope this information is helpful.  I would not worry.  EWH

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21 months ago
Thank you Dr Hook
Edward W. Hook M.D.
Edward W. Hook M.D.
21 months ago
I'm pleased I can help.  EWH---