Need advice fast

[downmtl]

Dear Dr.,

I met with a prostitue a few nights ago. She performed oral sex with protection twice and we had protected sex twice. I was careful not to go in deep as I was concerned about contracting something. The escort I was with specified that she always uses protection for both oral and regular sex. However she does allow men to give her unprotected oral sex, which I did not do. I did finger her.

I am of course concerned about STD's, AND PHV,  and want to know if I should get tested. I am married. This was my first and hopefully last time.

Please answer asap.

[H. Hunter Handsfield, M.D.]

Relax.  With condom-protection for both vaginal and oral sex, there simply is no realistic risk of any STD.  Herpes, HPV and syphilis can be transmitted by skin-skin contact above the condom coverage area, but the chance of that from a single exposure is very low.

Anyway, your partner probably was uninfected.  When CSWs insist on condom use, usually the main reason is not that they are infected and want to protect their customers.  The opposite usually is true:  they know they are not infected and want to stay that way.  In general, CSWs are at greater STD/HIV risk from their clients than the other way around.  STDs are rarely transmitted in either direction by oral-vaginal contact (cunnilingus).  That your partner permits unprotected cunnilingus does not increase her risk or yours for STD.

You don't need STD/HIV testing, but of course you could do that if you remain nervous despite this reassurance.  Gonorrhea and chlamydia tests can be done any time.  You need to wait 6 weeks for accurate blood tests for syphilis or HIV.  I don't recommend testing for herpes if you have no symptoms.  There is no test for HPV.

I hope this helps.  Best wishes-- HHH, MD

[H. Hunter Handsfield, M.D.]

I meant to add that fingering is zero risk.

[downmtl]

Why do you reccomend gonorrhea and chlamydia testing

also, we did kiss with tongue does this have risk?

[H. Hunter Handsfield, M.D.]

I did not recommend gonorrhea and chlamydia testing, only told you when to do it if you decide to be tested against my advice.

No STDs are transmitted by kissing.

[downmtl]

Thanks so much. Your job and this website are very important in todays world.

[H. Hunter Handsfield, M.D.]

Thanks!

[downmtl]

How long would it take to recognize any symtopms from herpes or other std's?

[H. Hunter Handsfield, M.D.]

STD symptoms usually appear within a week, sometimes 3 weeks.  But since your risk was zero from the exposure you described, you don't need to be on the lookout for sympomts.  And any symptoms you will be due to something else, not an STD.

No more comments on this thread, please.

[downmtl]

Hi Dr. H,

Thanks for your response to my earlier posts. I have since been tested for HIV after 1 month exposure and the results came back negative, although I understand it would take longer for most accurate tests to come back positive. I am on edge, not because of symptoms, other than anxiety which is giving me trouble to eat and in some cases giving me diarrhea.

I need to know if it is safe for me to have unprotected sex with my wife? What do you advise?

[H. Hunter Handsfield, M.D.]

There is no realistic chance you were infected and your negative test confirms it.  Of course I cannot guarantee someone isn't infected, but I do not believe you needed to stop having sex with your wife at all and that it certainly is safe to do so now.  But the decision is yours.

[downmtl]

Hi Dr.

I hope you are well.

I redcently, after having some dental work, noticed some bumps on the bottom part of my mouth, under my tongue below my lower teeth. The bumps have been here for a week and I actually had them a couple of days after my initial encounter, but since they went away, I didn't think much of them. Now I am concerned about Syphilis. Si this a risk from the exposure described? i did kiss this girl.

[H. Hunter Handsfield, M.D.]

Of course no risk for syphilis -- I can't even think why it would enter your mind.

You may not keep coming back with every anxiety-provoked question that comes to mind.  This thread is over. (And please don't start a new one with such a question.)

[downmtl]

I understand. Someone has to end the madness somewhere. I appreciate your patience and insight up to and including this point. Thanks.