[Question #722] encounter with TS CSW

53 months ago
Hello Drs,

I recently went to Amsterdam for a bachelor party. During this time I had sex with a transgender csw in the red light district.   A condom was used for oral sex, both giving and receiving, followed by condom protected brief anal sex ( I received).  There was no ejaculation by the CSW.  She then took off  my condom to finish me by hand. It was during this time she rubbed both of our uncovered penises together (frottage?) briefly.   Once I finished I asked her if she  definitely used a condom when she entered me and she said "of course I'm not crazy". I tend to believe her since she used condoms for everything else. 

I get tested yearly for all STD's. My next appointment is not until Aug. should I schedule a full panel around 4 weeks, with a 4th gen HIV test for this encounter?

Thanks!
Edward W. Hook M.D.
Edward W. Hook M.D.
53 months ago
Welcome to the Forum.  I'm pleased to provide some information.  In general the exposures you describe constitute safe sex with minimal risk for acquisition of STI, including HIV.  Irrespective of the site of exposure, condom protected sex when the condom is used throughout sex and does not break is safe sex with no meaningful risk for infection, even if your partner was infected.

I say "even if your partner was infected" because most CSWs do not have HIV or other STIs.  This is particularly true in Amsterdam where many of the CSWs are licensed and with their registration are required to regularly get checked for STIs.  In addition, as indicated by your partner's response to your question, because they are aware of their profession-related risks,  most CSWs take precautions to avoid infection and get checked regularly.

As long as you have no reason to think that she did not tell the truth, I see no reason for testing for HIV or other STI before your regular check up in August.  If you have concerns, then both a test for STIs at this time and a 4th generation, Duo test a four weeks after exposure might be a good idea.

I hope these comments are helpful.  Congratulations for your commitment to safe sex.  Take care.  EWH
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