[Question #709] Unprotected Sex w/Stripper

53 months ago
Got jacuzzi dance from stripper at club in Memphis, TN.  Stripper, without asking first, she put my penis inside of her, I didn't realize it at first due to warm water, had to ask her, she confirmed and then asked me not to cum inside her.  Continued for probably no more than 2 minutes, pulled out, no ejaculation.  Very vigorous hand job the given, to point of discomfort, before she again used her hand to reinsert me into her.  Pulled out again within 30 sec to a minute.  Again, no ejaculation.  Stripper 23 year old white females, admitted bisexual and into BDSM.  When asked, said she didn't do that all the time but she was "attracted to me."  Also said she was clean of any diseases.  Ashamed to admit but I am married with pregnant wife, only went to strip club because been feeling lonely lately because wife got promotion to another city and I haven't been able to transfer yet with my job.  I was not looking for or expecting sex, obviously feel very guilty and do not want to put her at any risk.  Based on your expert opinon(s,) what is my risk level for STD infection, and what, if any steps, do you recommend from here.  Needless to say, I will not be revisiting that strip club.
Edward W. Hook M.D.
Edward W. Hook M.D.
53 months ago

Welcome to the Forum.  I'll try to comment.  Assuming that some of what she said to you was a "sales pitch" let's distill this as unprotected vaginal sex with a commercial sex worker in a hot tub.  This was a relatively high risk exposure but, nonetheless, there is a good chance you were not infected because even most CSWs do not have STIs and your risk for infection may have been slightly reduced due to occurring in the hot tub.  The STIs she would be most likely to have gotten are chlamydia, gonorrhea and trichomoniasis.  Herpes is a possibility but lower risk.  Syphilis and HIV are lower still.  That said, you need testing.  Testing within 24 -48 hours of exposure will be of little help.  Thus, assuming you do not develop symptoms (and please don't spend a lot of time looking- if you develop symptoms, they should be obvious.  Hyper vigilance is a mistake) I recommend:

1. Testing for chlamydia, gonorrhea and trichomonas using a urine test sometime more than 2 days after the episode, irrespective of the presence or absence of symptoms.  If the tests are negative, I would not worry further about these STIs.

2. There is little value to blood tests for herpes.  False positive are common, some people already have HSV and do not know it, and the tests can take up to 6 months to be positive.  Rather, you are stuck with being vigilant for an outbreak.  no outbreak within two weeks of exposure, it is safe to assume you did not get HSV from this encounter.

3.  Testing for HIV - it is very unlikely you were infected but a 4th generation, HIV antigen/antibody test at 4 weeks will provide you with definitive results and assurance that you were not infected.

4.  Syphilis blood test.  Also at 4 weeks.  books will say that persons can develop positive tests as far out as 3 months but this is virtually unheard of and with your low probability of being infected (far less than 1%), 4 weeks is highly reliable and should be believed.

5.  PLEASE do not let anyone give you antibiotics "just in case".  This is only likely to confuse things and could possibly lead to side effects.

I hope these comments and suggestions are helpful.  EWH

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53 months ago
Thank you for the response.  So, assuming no herpes outbreaks within 2 weeks, and all tests clear at the timeframes you specified, would you consider it safe to resume unprotected sex with my wife?  With her pregnancy and living in separate cities most days of the week, we haven't been having sex very frequently, anyway, but as guilty as I feel now, I would never forgive myself if I were to infect her or do anything to jeopardize the health of the baby.
53 months ago
Also, should I be worried about hepatitis B or C from this encounter?  I believe my wife has been vaccinated against hep B, but I also know no vaccine exists against hep C
Edward W. Hook M.D.
Edward W. Hook M.D.
53 months ago

Yes, I agree that if negative tests as outlined and no HSV outbreak, I would not be concerned about unprotected sex with your wife

Hepatitis C is almost never transmitted through vaginal sex.  Hepatitis B is now quite rare because nearly everyone born after 1992 and many others are vaccinated against hepatitis B.  EWH

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53 months ago
Ok, one last follow up  since I know I'm limited on responses.  For an event that happened Tuesday (yesterday,) would Friday be too close to the 2 day testing window for gonhorrea, chlamydia and trich, or would it be better to wait longer.  Along those same lines, what's you opinion of the early RNA HIV testing that some websites are saying can be done 9-11 days after potential exposure?
Edward W. Hook M.D.
Edward W. Hook M.D.
53 months ago
Friday would be a good time for gonorrhea, chlamydia and trich testing and would provide accurate results.  

While a negative RNA test at 9-11 days after exposure would represent very strong evidence that you were not HIV infected, we continue to recommend a 28 day 4th generation HIV antigen/antibody test for definitive results.

I hope this information is helpful. EWH
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