Last week I had an encounter with a female CSW in London, UK.

There was no penetrative sex, but we both performed unprotected  oral sex on each other and also rimmed each other.

I’m wondering how much risk I exposed myself to and what testing (when) is appropriate. I am in a relationship with a woman and of course aside from the guilt/shame, I am wanting to make sure I wouldn’t expose her to any risk from my stupid mistake.

The CSW did say she had recently received a set of negative STD tests, but I don’t feel I can take any comfort in that.

Many thanks

Jim

Of course now I find myself asking how recent are they and also that it wasn’t a comprehensive set of tests to include the more serious ones...

There is a similarity between these questions and the ones in your preivious ones a couple of years ago. The main theme from those discussions (with Dr. Hook) is that oral sex is safe sex -- not completely free of risk, but far lower risk than vaginal or anal sex for all STIs and zero risk for several of them. Oral-anal contact (rimming) is also low risk. Very few if any cases of gonorrhea or chlamydia are ever acquired by either kind of exposure. Even if your partner's negative test results are not recent or were faked, the chance you caugth anything was very low. The biggest health risk from this event, by far, was for a non-STI gastrointestinal infection, like viral gastroenteritis. Syphilis is theoretically possible, but is so rare as a heterosexually transmitted infection (in the UK and much of North America) that it's not a realistic concern. Herpes could be possible, but also very unlikely. And HIV has never been documented to be transmitted by the exposures described.

Is the risk zero? Probably not -- but it was extremely low. Testing for STIs is optional:  really not necessary from a medical/risk perspective, but many anxious persons are more reassured by negative testing than by professional opinion, no matter now expert. If I were in your situation, I wouldn't be tested and would continue unprotected sex with my wife without worry. But I'm not you, and you'll have to make your own decision about it.

If you decide to be tested, I would recommend urine for gonorrhea/chlamydia, and both throat and anal swabs for the same; these will be valid any time more than 3-4 days after exposure, i.e. OK this week. Blood tests for syphilis and HIV can be done 6 weeks after the event. However, the chance of either of these is so low -- zero for all practical purposes -- that I would advise you to not wait that long to have sex with your regular partner. (For all testing, I would recommend your nearest NHS GUM clinic -- although other options, including excellent provate sexual health clinics (e.g. London's Freedom Health) also are available.

I hope these commetns are helpful. Let me know if anything isn't clear.

HHH,MD