[Question #9364] Unprotected sex with escorts.

Avatar photo
33 months ago
Hi,

I have been seeing escorts for years and have done almost all protected sex except for some oral sex. I have had a few unprotected sex occasions with escorts (maybe 5 times or so). I found out one may have been positive with Hep C and Syphilis. I haven't had unprotected sex with her for a few years and it was only a couple of occasions. I'm going for testing next week but am extrememly nervous now of course. I am just wondering the posibilty of contracting these and also others like HIV.

Thanks,

BEK

Avatar photo
H. Hunter Handsfield, MD
33 months ago
Welcome. Thank you for your confidence in our forum.

We can dismiss your concerns about hepatitis C virus (HCV). Many online and other resources describe HCV as sexually transmitted, and testing is included in many or most "comprehensive" STD testing panels. In fact the only documented sexual transmission scenario is between men who have potentially traumatic anal sexual practices with other men, often meaning blood exposure. The heterosexual partners of HCV infected persons have no higher frequency of infection than anyone else. In Denmark, a study based on interviews of HCV infected persons and their regular sex partners calculated that the transmission risk by unprotected vaginal sex with an infected partner to be one in 190,000. That's equivalent to unprotected sex with infected partners once daily for 520 years before transmission might be likely. In other words, zero:  you were not at risk of HCV from the escort you believe to be infected (or any of the others).

As for syphilis, most people with positive blood tests have longstanding infection that can no longer be sexually transmitted. (After a year, syphilis is non-transmissible.) So those exposures may not have risked syphilis. That said, anyone who is sexually active outside a mutually monogamous relationship should be tested from time to time for the main potentially serious STDs, regardless of consistent condom use and relatively safe exposures like oral sex. That testing should include urine for gonorrhea and chlamydia and blood tests for syphilis and HIV. So I certainly endorse your plan to be tested -- but not only because of your possibly infected partner. But please include gonorrhea/chlamydia and an HIV test too. In the absence of symptoms both now and in the past, you definitely can expect negative results -- but better safe than sorry!

And feel free to include HCV if you wish, but if positive it won't be from your escort adventures. If somehow I were in your situation, I would save my money! I would also recommend against any other tests offered by many labs in "comprehensive" (but largely unnecessary) STD test panels.

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

HHH, MD
---
---
---
Avatar photo
33 months ago
Thanks, and I was also just wondering the chances of getting HIV and the other STD's as well with these encounters. 

Thanks.
Avatar photo
H. Hunter Handsfield, MD
33 months ago
My advice and accompanying comments imply the answer -- i.e. the few tests I recommend and that you can expect negative results. You're going about your sex life with superb protection, both by the kind of partners you have had and consistent use of condoms for vaginal (or anal) sex. The chance of HIV is zero or very close to it, and it is very unlikely you have acquired any other STD, with the possible exception of HPV (because condoms are not highly protective). However, everybody gets HPV anyway, and your risk probably is no higher on account of your escort exposures than it would be without them. And anyway, no reliable HPV testing is available for asymptomatic males. ---
Avatar photo
33 months ago
So I decided to test for just about every STD since my insurance pays for it, and all was negative. My final question is that I had my last unprotected sex on 10/13/22 and completly protected sex on 10/31/22. Both with escorts. My STD tests were done on yesterday 11/16/22. Should I be tested again or would these STD tests cover these? 

Thanks. BEK
Avatar photo
H. Hunter Handsfield, MD
33 months ago
All your tests are conclusive, with the likely exception of herpes if blood tests were done for HSV1 and HSV2. It takes up to 3 months for HSV blood tests to become positive, and 30% of people with HSV1 never get positive results. However, combining the low risk of STD in general as discussed above, and assuming you have had no typical symptoms of genital herpes, there was little or no chance of herpes anyway and you really didn't need those tests. But if you feel you need the additional reassurance of a negative test result, you could have another test for HSV2 around the end of January. If personally I were in your situation, I wouldn't feel the need.

That completes the two follow-up exchanges included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe (as you have been).
---