Dear Love Goddess,

I have been diagnosed today with primary syphilis.  I'm still waiting for my lab results, but my doctor says that he is pretty confident it is the case.

Over the last 2 years,  I had only a single sexual encounter, and it was with a provider less than three months ago.  So I kind of know where and how I contracted this.

Here is my dilemma....

The lady in question is an active member of TER, highly reputable, and highly sought after.  I would assume that a lady of this caliber would be responsible enough about her health to get tested regularly.  Moreover, we have developed a connection after the encounter and we have been in email contact every couple of days for the past 3 months.  I would assume that she would have enough ethical responsibility to let me know if she has a positive result.  Apparently, either (a) she is not responsible enough to get tested regularly, or (b) she cares more about her business reputation than the health and well being of the people she has seen.

The funny part is that we have been already working on the details of a repeat visit in the very near future.  I'm obviously going to cancel and probably stay out of the hobby for good -- at least that's the plan.  However, I'm having a moral dilemma right now: should I tell her the real reason why I'm cancelling so that she would check herself (if she hasn't already) or should I treat her using her own "code of ethics" and just forget about her and move on?  

I would really appreciate some input and thoughts on this, especially the ethical and moral responsibility of such a situation from the hobbyist and/or provider point of view.

I don't have VIP status on this account, so please no PMs.

Good God, ShouldITellHer,

I am really sorry for you that this happened! On the other hand, why are you even thinking twice about telling her? OF COURSE YOU SHOULD TELL HER! If she were just some girl you found in a bar and had a one-night stand with, wouldn't you call her and tell her that she contaminated you with syphilis? Why is this case somehow special? In fact, it's WORSE! She is a professional sex worker and she is in intimate, contagious contact with people for a living!

Moral dilemma? There IS no moral dilemma here - at least not for you. YES, you should call her IMMEDIATELY and tell her that you are not coming and the reasons why. She will probably freak out, mostly out of shock, but so what?!? Actually, you'll be doing her a favor - at least she'll go check herself out now and can get some treatment before her nose falls off (yep, 2nd stage syphilis, "saddle nose," common in the 19th century). As for you, I think we would all love to hear the circumstances - did you go bareback or was this from oral or what?

Luckily you caught it in time and now you're being treated. But to think that there's some sort of special "moral code of ethics" for prostitutes and their clients when it comes to public health issues - fuhgeddabout it. The only code to have is her area code, plus her number, and a phone that really works. And then give her a ration of good-sized verbal horsemanure while you're at it.

I really feel for you on this one, but no exceptions for anything or anyone must be made,
The Love Goddess

Dear LG,

Of course I DIDN'T go bareback! To add insult to injury, the oral was even covered. Talk about being unlucky, huh?

I do see your point... I think it was my anger and confusion resulting in irrational thinking...

Thanks

Good grief, ShouldITellHer,

You have now become an unfortunate statistic in the game of risk - yes, it's possible to contract syphilis, even through covered oral sex. The only thing to do now is go ahead and dial that phone number and brace for impact.

Sorry for her, but more sorry that you have to endure all this,
The Love Goddess

The incidence of syphilis transmission through an intact condom must me extremely small.  I would like to know the actual statistics and mechanism of this type of transmission.

It's notable that when reading literature about STD prevention, it is always termed "can reduce" the incidence of transmission rather than "eliminate" transmission.

You bet you should tell her!  You'll be doing the right thing for her and her next 'victim'.

After reading this, I think I may never enjoy a BBBJ or CIM again! If you got something with a cover, then God only knows how I have managed to stay so lucky. I actually am going to thank you now for sharing your story, it is an important eye-opener to us all, and for me, a reminder that I am rolling the dice every time I get a BBBJ from a sex worker. As with any woman, in any circumstance, man or woman, yes anyone who has something has a right and a duty to inform the person they got it from, and anyone they may have given it to.

Hi LG, I take an annual HIV test.  Once when I ask my MD for everything...herpes, syph, etc., He asked me "Is there any reason you need to check for all those".  Of course, I said no...just curious.  I know about patient confidentiality, but we are both acquainted with some same civilians, I'm worried he give me the Evil Eye in public gatherings if I told him I frequent providers.

I know there's some clinics in my city, but I work with the public, if someone recognized me in/going to these sex clinics I could lose my job.

On a legal note, if you lie to a civilian that you don't see providers but end up giving her a STD you didn't know you had, are you liable?

Dear orbiter10,

As far as I know, we don't yet live in a police state to the degree that you are "liable" for something if you give someone an STD.

Now as far as the physician, HE HAS A LEGAL OBLIGATION TO KEEP YOUR REQUESTS CONFIDENTIAL - with the exception that he has to report any diagnoses and treatment interventions to the insurance company if you have decided to claim services on your policy.

You definitely don't have to discuss your sex life with him. If he asks you again, simply say that you "are not obligated to discuss your sex life with him in detail." Also tell him that if he is not comfortable testing you for STD's, could he please recommend a lab for such purposes? Legally, he has to refer you if he doesn't want to administer a certain kind of treatment for personal reasons (and even that's touchy these days.)

So just tell him that you want to do a complete STD panel. Do not discuss providers with him unless you want to tip him off to TER - that's your private business. On the flip side, as a clinician I can tell you that I sometimes move in the same circles as my clients and the last thing I want to do is discuss them with other people. I could care less about their private lives - who they consort with, what they wear, how they vote - none of that is really a concern to me. I have enough in my own life to keep me busy, and I suspect the physician does too. So don't worry, but be firm in your requests. No one should prevent himself/herself from having important medical tests done from fear of the health care practitioner!

There, go get your test now,
The Love Goddess