I have been practicing safe sex consistently but yesterday I had a situation that has me concerned.  I met with a female CSW in Toronto for a sexual encounter.  We decided to try anal sex using a condom.  She was very tight and I had some trouble entering her.  I finally got about half my shaft into her when I heard, and felt, the condom break.  I immediately withdrew and noticed the condom had indeed broken exposing my penis head.  The experience literally lasted 1-2 seconds as I withdrew immediately after the sensation of the condom breaking.  I had not even began thrusting as the break occurred while I was still trying to enter her.

She repeated several times that she does not have any STD's or HIV concerns and does get testing however I am very concerned about this encounter.  Should I get testing or is this anxiety getting the better of me?  

I'll start as Dr. Hook did in the past, congratulating you for your consistent safe sex. As this experience reveals, of course safe sex doesn't always work, as you found. However, people who use condoms consistently typically are otherwise careful as well, and I'm guessing you chose an escort service with some care (as opposed to a bar pick-up for example), and your partner's confidence she is free of STDs also is helpful and probably true, at least in regard to major ones like HIV, gonorrhea, chlamydia and syphilis. And even if she were infected, even without condoms, most STDs are not transmitted during any single exposure. Finally, the brevity of your exposure after the condom failed also reduced any potential transmission risk.

Should you be tested? Strictly from risk assessment, it really isn't necessary. Assuming such exposure occur from time to time, mostly without lapses in safe sex, presumably you're being tested from time to time (like maybe once a year?) for the STDs just mentioned, and I would recommend you continue to do so. This particular event need not change such a schedule. On the other hand, you're obviously nervous about it or you wouldn't have come to us. Many anxious persons are more reassured by negative testing than by professional advice based on probability and statistics, no matter how expert that advice. (We don't take it personally!) If that applies to you -- that is, if you're going to worry and wonder otherwise -- then by all means be tested for reassurance. Urine testing for gonorrhea and chlamydia is valid any time more than 4-5 days (maybe even 2-3 days) after exposure. Conclusive HIV and syphillis blood tests can be done after 6 weeks. Of course also keep on the lookout for symptoms like urethral discharge, painful uriantion, or penile sores of any kind, but I doubt anything will show up.

I hope these comments are helpful. Let me know if anything isnt' clear.

HHH, MD