Dear Doctor Greetings.  I am a male.  32 years old, uncircumcised, Hep B immune. 

I paid for sex two times in my life with a Gypsy Romanian CSW in the UK.  She charged me £100 per hour.  1st date I had sex three times with her at end of june.  2nd date I had sex 3 times with her 4 days ago.  All sex was unprotected vaginal sex and unprotected oral sex. French Kiss also. 

 She did fresh botox on lips last time I saw her. She is 34 years old, mother of 3 children and said she tested some months back and does not have HIV.  

She had condoms but we bonded with each other and one thing led to another and led to unprotected sex.  Each sex session was 20 minutes or so.   I don't know if I should believe her.  I tried to contact her to get her to test but she is unreachable.   I read on internet that my risk is high and I am worried.  I have never had sex with a stranger like this before.  I was in a monogamous relationship for 12 years until my fiancé passed away last year in a car accident.  I feel really stupid now and am ashamed.  I never dated outside and never had any STD.  

The CSW said she does not use hard drugs and is healthy.  She has asthma she told me but smokes.  She got a couple chesty cough when smoking which i heard.  She said I am only client she had unprotected sex with.  It was more like making love for her and she bonded with me.  I don't know if she is telling the truth or if its just to get my money.  She said she did not have unprotected sex with other clients but I am very scared and don't know if she is lying.  The fact she is a Gypsy Romanian and all that are just making me worried if my risk is really high, especially HIV.So I had sex with her 6 times in two occasions for 20 - 30 minutes each sex session.   We talked a lot and she said she is disease free but I am very scared.  I am planning to test for all STDs.  

When should I test to be 100% sure?  What are my odds?  Will I survive?  I am really worried.

With regard to other STIs, the absence of symptoms is a good sign although asymptomatic infections do occur.

I would not worry that the recent bite on the inside of your cheek change your risk for HIV or other STI’s meaningfully.

At this time, with no evidence of infection I see no reason for taking medications of any sort. Get tested in order to rule out the low possibility that you were infected.

I agree with your plans to seek testing.  Testing for chlamydia, Gonorrhea and most other traditional STIs will be reliable at this time.  Testing for HIV and syphilis will not be completely reliable until about six weeks after your last exposure.  

Going forward, as you begin to date or perhaps see this partner again I would consider periodic testing for STI’s as a good sexual health activity. For most people routine testing, even in the absence of symptoms (screening) is appropriate about once a year. Persons with larger numbers of partners or particularly risky partners may wish to be tested more often.

I hope this information is helpful. If there are further questions or any part of this reply is unclear please don’t hesitate to use you were up to two follow-up questions for clarification. EWH

If I test negative for all STDs including HIV after 6 weeks, can I put this behind me?  Im just really worried.  I am no longer in contact with the CSW and she has moved away I guess.  I am not seeing her again.