What Are the Risks of Having Oral Sex Performed by a Prostitute?

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Question: What Are the Risks of Having Oral Sex Performed by a Prostitute?

Once a month or so, I receive an e-mail from a man who has visited a prostitute for a blow job. The e-mails always want to know about the risks of seeing a prostitute for oral sex. These questions are often from men who have visited high-risk prostitutes outside the U.S. However, that generally only changes the magnitude of the risk, not the nature of it.

Unprotected fellatio is may not be the riskiest sexual activity. That said, it is potentially risky for any man who receives it. That's not just for those who visit prostitutes and other commercial sex workers.

Risks Vary

The risks of oral sex are numerous. Unprotected oral sex can spread a variety of STDs. Major risks for unprotected oral sex include herpes, syphilis, HPV, and gonorrhea. Very rarely, an unprotected blowjob can also lead to HIV.

Men who visit prostitutes in the developing world and other high-risk areas are often particularly concerned about contracting HIV. HIV can be transmitted through oral sex, although these cases are rare. The risk of contracting HIV is much higher during other forms of sexual activity. Still, as oral sex does include a risk of HIV, it is always a good idea to use a condom during oral sex. That's particularly true with an untested partner or a partner who is high-risk, such as a prostitute.

Condoms are very effective at reducing HIV risk.

However, HIV isn't the main reason people might want to consider using a condom when getting a blowjob. Remember, HIV is not the only potential negative consequence of receiving oral sex from a prostitute or other partner. Syphilis and gonorrhea can both be transmitted during a blow job.

So can HPV and herpes. As with HIV, practicing safe oral sex will reduce your risk. However, condoms may not be 100 percent effective at preventing the diseases that can be spread from skin to skin.

Under no circumstances should you simply wait to see if you develop symptoms to determine whether your sexual encounter has exposed you to an STD. Many men with STDs never show any obvious symptoms. They can still suffer long-term health effects or pass the infections onto their partners. Fortunately, except for HPV, all of the above diseases can be screened for using blood or urine testing. That said, it may take several months to be certain that your results are reliable.This is because blood tests need to wait for antibodies to form before they can be detected. 

A lot of men want me to quantify their level of risk after they've received an unprotected blow job from a prostitute. The problem is that there's no practical way to do so. The most accurate answer I can give is that it is possible that they've been exposed to and infected with one or more of the STDs described above. Unfortunately, the only way to be certain is to get tested. Furthermore, since blood tests that are antibody-based can take a few months to produce reliable results, that's a long process.

Men who have taken a risk need to should consider the possibility that they are putting their sexual partners at risk during future sexual encounters. As such, they should discuss their risk ​and practice safe sex accordingly.

Note: Some commercial sex workers are extremely reliable about practicing safer sex and undergoing regular testing. In fact, in the U.S. commercial sex workers may be better about that than many people in the general population who simply have a lot of sexual partners without getting paid. That's why, unless you do your homework, you have to assume every sex partner is potentially a source of risk. It doesn't matter whether you're paying them or not. Someone who always has safe sex is probably going to be a lower risk partner than someone who only does so infrequently. If nothing else, consistently having safe sex shows that they are aware of the risks of sex. That's particularly true if they're also engaging in regular testing. 

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