[Question #6230] FKK Clubs in Germany

17 months ago
Hello Doctor,
I would like to ask questions about brothels in Germany or generally with escorts. Most of the prostitutes came from Romania in that area and they now require to have a condom for oral sex. I am wondering the following,
1.  I understand that the correct use of condoms during vagina sex and oral sex can protect HIV and other STDs, but some STDs can still spread even with the protection. What are these? I remember this is related to the skin to skin contact. How can I tell before someone want to have sex with them?
2. Is there any way to protect against the skin to skin contact during the vagina sex? Or how to practice safe sex in the brothel?
3. Is ORAL sex with condoms the safest way if someone wants to go brothel except the handjobs? Is this way risk-free with the correct use of a condom?
4. What condoms do you recommend for oral sex? Thank you!
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago

Welcome to our Forum and thanks for your questions.  Your questions really have to do with the general concept of the risk for STI from having sex in a German brothel.  For this reason, before I answer your specific question, I will make a few more general comments.  In general your risk for an STI is related to the likelihood that your partner has an STI, the sort of sexual exposure you have, and whether or not a condom is used.  In Germany, most brothels are legally regulated and workers are required to get checked for STIs on a regular basis and to use condoms.  As a result, the risk of getting an STI at a German brothel tends to be low.  Obviously, it would be bad for repeat business of clients were getting STIs when they go to brothels.   Few CSWs in German brothels have STIs, including HIV.

In answer to your specific questions:

1.  Theoretically, STIs that cause lesions can be transmitted even when a condom is used.  These STIs include syphilis, herpes, and HPV.  In fact however, condoms typically greatly reduce risk for these STIs as well because the condoms cover the part of the penis where lesions are most common. This, in combination with the fact that most exposures to infected partners make condom use a good way to dramatically reduce risk for all STIs.

2.  See my comment above.  I really would not worry at all about STIs when having sex at a licensed German brother an when a condom is used.  This is true for all sorts of sexual exposure, up to and including vaginal sex. 

3.  If your partner has an STI, oral infections are less efficiently transmitted than genital infections although, in general, as noted above, I really would not be worried about STI risk related to any sort of condom-protected sexual activity in a licensed German brothel. 

4.  All condoms made of synthetic material (latex, polyurethane, etc.) are highly effective and can be used with confidence. 

I hope that this information is helpful.  Take care.  EWH

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17 months ago
Thank you for your answer. Dr. Hook. There is one recent article (published in 2016) entitled "STI tests and proportion of positive tests in female sex workers attending local public health departments in Germany in 2010/11" shows that Chlamydia trachomatis is about 6% among prostitutes in Germany, syphilis is about 1.1%, gonorrhoea about 3.2%, Trichomonas vaginalis 3% and HIV about 0.2%. 
1. Since the Chlamydia is quite high, 6%, so 1 in 16 prostitutes may carry the virus. Does that mean I can catch that quite easily? How does it spread? Can condom protect me enough?
2. Although German Brothel is regulated, the prostitutes are thought of as independent, so they may require to do the test, but may not be regularly and many of them come from foreign countries. So I suspect that the rate of STD can be slightly higher than your expected. 
3. It seem to me that appropriate use of condom is the best way to go against STDs in the brothel, right? If I want to be super save, then oral sex with condom is even better? Thank you!
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago
1.   The prevalence of chlamydia that you mention is somewhat high although there are many populations in which the likelihood of infection is much higher. Given your condom use and the fact that your exposures were receipt of oral sex you are not at any meaningful risk for chlamydia infection.   Going forward, as long as condoms are used throughout sexual encounters of any kind, I would not be very worried about chlamydial infection. 

2.  This is a statement, not a question.  Obviously the likelyhood of infection will vary depending on who your partner is.  You can always ask partners when they were last checked.

3.  Correct.  The best way to reduce STI risk in brothels is to always use condoms.  The risk for STI acquisition will be lower following oral sex than with vaginal sex.  EWH
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17 months ago
Thank you for your answer, Dr. Hook. Lat question, how safe is the oral sex or french kissing without any protection? Any STDs concern? Thank you!
Edward W. Hook M.D.
Edward W. Hook M.D.
17 months ago

There is no meaningful risk for HIV from receipt of unprotected oral sex.  similarly, there is no risk from French kissing/


This is my 3rd reply. Therefore, as per Forum guidelines this completes this thread which will be closed at this time without further replies.  EWH

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