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Risk regarding life style
Hello, Doc, I have a few questions regarding the risk of certain life style. If a male person does not have a fixed partner, but go to visit CSW occationally (2~4 times per month). Each time he visits a different CSW. He correctly use a condom each time (but the condom may fail sometimes). He may perform unprotected cunlingus and falatio occationally (once per month). And he only engage in sex activities with a female person. He lives in a place with normal level of std prevalance (e.g. Hong Kong).
1. If he keeps this life style for three years, what do you estimate his risk of contracting at least one std within three years? Will the number change much if he does not perform oral sex, but only protected vaginal sex?
2. Same setting as the previous question, what about the risk of HIV, herpes, and HPV?
3. In your experence, among all the ppl coming to std clinic, what is the percentage of ppl catching std because of protected sex (considering occational condom failure) do you estimate? And what is the percentage of ppl catching std from CSW?
I know there is small risk having one epsisde of protected sex even with ppl with std, but I want to know the cumulative risk over a time period, because it should affect the choice of lifestyle. I know there may not be a quantitative data available to my questions. But if possible, please give me at least some kind of estimate. A rough estimate is better than nothing.
Thank you very much doctor.
1. If he keeps this life style for three years, what do you estimate his risk of contracting at least one std within three years? Will the number change much if he does not perform oral sex, but only protected vaginal sex?
2. Same setting as the previous question, what about the risk of HIV, herpes, and HPV?
3. In your experence, among all the ppl coming to std clinic, what is the percentage of ppl catching std because of protected sex (considering occational condom failure) do you estimate? And what is the percentage of ppl catching std from CSW?
I know there is small risk having one epsisde of protected sex even with ppl with std, but I want to know the cumulative risk over a time period, because it should affect the choice of lifestyle. I know there may not be a quantitative data available to my questions. But if possible, please give me at least some kind of estimate. A rough estimate is better than nothing.
Thank you very much doctor.
MEDICAL PROFESSIONAL
So I assumed; and I saw this before responding above.
MEDICAL PROFESSIONAL
Welcome back to the forum.
The STD risk is not the same for all female CSWs. Escorts (expensive CSWs by appointment), many of whom are well educated, get regular STD/HIV testing, and consistently have their clients use condoms for vaginal or anal sex probably are lower risk than most non-CSW women. If you choose such partners and consistently use condoms yourself, you'll probably be very safe no matter how often or how long such exposures continue. At the other end of the spectrum, inexpensive street walkers and bar pickups, especially those who don't use condoms (or can be talked out of them, e.g. for higher pay) can be very high risk. Others can obviously have various levels of risk. And geography is important. Far more CSWs have STDs in, say, tropical Africa than in most of Asia. I'm not aware of specific data for Hong Kong, but you could contact national public health authorities for information about it.
1,2) Assuming the frequency and practices you describe in your question, there will be some small STD risk from unprotected oral sex. Avoiding even oral sex will lower the risk still further. You can assume you will be infected with HPV (probably already have been), but HPV is unavoidable and occurs in all sexually active people -- and most infections remain asymptomatic and harmless. Assuming no condom breakage, there will be essentially no risk of HIV, and low risks for HSV-2. HSV-1 risk will be higher, due to oral exposure -- but still low.
3) Sorry, I can't give specific estimates on these questions. We don't always ask most STD clinic patients whether or not they used condoms for exposures preceding STD diagnosis. Your "cumulative" risk of HPV is probably 100%, but it's far, far lower for all others.
My advice is this: Accept that you simply cannot reduce the STD risk to zero, given the lifestyle you describe. Condoms fail, sometimes without notice. So you'll have to accept at least a small risk of all STDs, and therefore I would urge you to have routine STD testing (gonorrhea, chlamydia, syphilis, HIV) every year or so. I would not recommend testing for HSV in the absence of symptoms.
Regards-- HHH, MD
The STD risk is not the same for all female CSWs. Escorts (expensive CSWs by appointment), many of whom are well educated, get regular STD/HIV testing, and consistently have their clients use condoms for vaginal or anal sex probably are lower risk than most non-CSW women. If you choose such partners and consistently use condoms yourself, you'll probably be very safe no matter how often or how long such exposures continue. At the other end of the spectrum, inexpensive street walkers and bar pickups, especially those who don't use condoms (or can be talked out of them, e.g. for higher pay) can be very high risk. Others can obviously have various levels of risk. And geography is important. Far more CSWs have STDs in, say, tropical Africa than in most of Asia. I'm not aware of specific data for Hong Kong, but you could contact national public health authorities for information about it.
1,2) Assuming the frequency and practices you describe in your question, there will be some small STD risk from unprotected oral sex. Avoiding even oral sex will lower the risk still further. You can assume you will be infected with HPV (probably already have been), but HPV is unavoidable and occurs in all sexually active people -- and most infections remain asymptomatic and harmless. Assuming no condom breakage, there will be essentially no risk of HIV, and low risks for HSV-2. HSV-1 risk will be higher, due to oral exposure -- but still low.
3) Sorry, I can't give specific estimates on these questions. We don't always ask most STD clinic patients whether or not they used condoms for exposures preceding STD diagnosis. Your "cumulative" risk of HPV is probably 100%, but it's far, far lower for all others.
My advice is this: Accept that you simply cannot reduce the STD risk to zero, given the lifestyle you describe. Condoms fail, sometimes without notice. So you'll have to accept at least a small risk of all STDs, and therefore I would urge you to have routine STD testing (gonorrhea, chlamydia, syphilis, HIV) every year or so. I would not recommend testing for HSV in the absence of symptoms.
Regards-- HHH, MD
Sorry, doctor, there is one more factor I forgot to mention: he has no other sexual activities besides those described with CSW.
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
