I went through lots of other questions on this forum and I think I know what answers you going to give me but, since I may present different details I decided it was worth to get a personal opinion. Please note that until this encounter I had no other encounters outside my marriage. 

Exactly 4.5 days ago, I rang a CSW here in the south of Spain and went to her apartment where she receives her clients. I walked in her room and straight away noticed 4 condoms on the bed table and everything seemed cleaned. We started by kissing for a little bit and I then performed oral sex on her. Until here I know that there is no risk.

After, she used a wipe to clean my penis and gave me unprotected oral sex for around 5 minutes. Then, she used one of the condoms to put on me and followed around 15/20 minutes of protected intercourse. We stopped once I ejaculated and I did see the semen inside the condom - so I think it is fair to believe that the condom was intact throughout the whole period.  I then left and panicked a bit once I got home. Messaged her and asked about STDs to which she replied "you have nothing to worry about - relax".

I think I understand that my risks are basically close to zero, but with some risks given the oral sex performed on me. Please note that in the area that I am now I'm unable to seek testing and I will only be back to my home country in 20 days.

1- If after 10 days I have no obvious symptoms, may I believe that this was risk free and I can procede to continue unprotected sex with my wife?

2- I already had HPV in the past so I'm not worried about this or even other skin-to-skin stds (from what I read syphilis given this exposure is vanishngly rare).

Thank you for your time.

It sounds like you indeed have preducted what we would say. Cunnilingus (oral-vaginal contact) is low risk for both partners:  STD transmission is very rare, and there are no scientifically documented cases of HIV transmission. Unprotected fellatio is somewhat riskier, but still with low chance of STD and also no proved cases of HIV transmission oral to penis. There also is a calculation from CDC that estimated the chance of HIV transmission, if the oral partner is infected, is around 1 in 20,000. That's equivalent to recieving oral sex by infected partners once daily for 55 years before transmission might be considered likely.

As for condom protected vaginal sex, of course that also is very safe. As you understand, the main risk is for infections transmitted skin-to-skin like syphilis, herpes, and HPV -- but these also are very infrequent after any single condom-protected exposure. And it seems clear the condom remained intact, and small leaks that raise transmission risk are mostly an urban myth.

1) Your risk of HIV from this event definitely is zero or very close to it. Other STDs are a bit more likely, but still low risk -- and you are correct that absence of symptoms .after 10 days is reassuring. If I put this in personal terms, if somehow I were in your situation, I also would continue unrpotected sex with my wife and would not be tested for anything.

2) Of all STDs, probably you were at highest risk of HPV. Having had previous HPV makes no difference in that risk, however:  there are over 100 sexually transmissible HPV types; you are immune only to any types with which you were infected previously. Still, your overall risk of having genital HPV -- or sharing an infection with your wife -- is no higher from this event than it was based on your and her past sexual lifestyles. I really wouldn't worry about it at all.

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

HHH, MD

Thank you so much for the fast response. Indeed I expected a similar response to the one you have just given. So, from your response I think I'm going to wait another 6days and see if I develop any symptoms. If I do not develop any obvious penile symptoms, it is fair to say that I should just put this episode in the past and keep going with my normal life with my wife including unprotected intercourse. Would you agree with this statement?

Meanwhile, I will await your response and then will not post for another 6 days and make my final comment then. Thank you so far.

I'll be happy to comment further if you would like to post your test results. Assuming no symptoms, testing is optional in my opinion, but if you do it, I would advise a urine gonorrhea/chlamydia test at any time, and blood tests for syphilis and HIV 6+ weeks after the sexual exposure. 

Has now been 16 days after the described exposure and I have not had any discharge or pain urinating. Because of covid my trip had to change and I will have to wait even longer before I get back to my home country.

Given the 16 days after the exposure and the lack of symptoms, perhaps I can just let it go? I'm aware this is the last comment and thank you for your advice.

Thanks for the thanks. I'm glad to have helped. Best wishes and stay safe.