Paid sex and sexually transmitted infections: What you should know
Paid sex is a socially taboo topic that nevertheless affects many people and is frequently used. It takes place in brothels, escort services, private apartments, massage studios, or in the context of street prostitution. At the same time, sexually transmitted infections (STIs) pose a serious health risk. But what are the risks, and how can one effectively protect themselves? In this blog, you will learn about the risk of contracting an STI through paid sex, the measures that effectively prevent infection, and when regular testing is advisable.
Table of Contents
- What is a sexually transmitted infection (STI)?
- Paid sex: How high is the risk of contracting an STI?
- How can I protect myself from STIs during paid sex?
- Are condoms sufficient to prevent STIs during paid sex?
- How often should I get tested for STIs if I engage in paid sex?
- Summary
What is a sexually transmitted infection (STI)?
Sexually transmitted infections (STIs) are infections primarily transmitted through sexual contact. These infections are caused by bacteria (chlamydia, gonorrhea, syphilis), viruses (HPV, herpes simplex, HIV, and hepatitis B), or parasites (trichomoniasis) and often affect the genitals, but can also impact other body areas such as the mouth, throat, or rectum. STIs can affect anyone who has unprotected sexual contact—regardless of age, gender, sexual orientation, or professional background. The myth that STIs only affect sex workers is false and stigmatizing (WHO, 2024).
How are STIs transmitted?
STIs are usually transmitted through direct contact with bodily fluids or infected skin. Understanding the transmission routes not only helps protect oneself but also protects sexual partners and enables the implementation of appropriate preventive measures. The primary transmission routes include:
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Sexual contact: Includes all forms of intercourse (vaginal, anal, oral) where pathogens can be transmitted.
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Close skin contact: Some STIs can be transmitted through direct skin-to-skin contact, even without penetrative sex.
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Bodily fluids: Transmission through contact with infected fluids such as semen, vaginal secretions, blood, and, in some cases, saliva.
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Blood: Transmission through blood, for example, through shared use of infected needles or (very rarely, and only under poor hygiene conditions) through blood transfusions.
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Mother-to-child transmission: STIs can be passed on during pregnancy, childbirth, or breastfeeding.
Source: Msdmanuals, 2023
Further and more specific information on transmission routes—such as oral transmission, kissing, fingering, rimming, and body massages—as well as information on how STIs cannot be transmitted, can be found in our blog category "Sexually Transmitted Diseases" on our website.
Paid sex: how high is the risk of contracting an STI?
The risk of contracting an STI during paid sex depends on various circumstances and behaviors, including irregular testing, unprotected intercourse, lack of healthcare access, or insufficient awareness among sex workers.
The following table provides an overview of factors that can increase or decrease the risk—focusing on aspects influenced by the behavior and preventive measures of the person engaging in paid sex:
| Factors that Increase Risk | Factors that Decrease Risk |
|---|---|
| Unprotected sexual intercourse (vaginal, oral, anal) | Correct and consistent use of condoms and dental dams |
| Frequent engagement in paid sex | Reduction in the frequency of paid sex |
| Frequent change of partners | Limiting the number of sexual partners |
| Knowingly or unknowingly existing STIs and the presence of wounds that facilitate pathogen entry | Regular STI testing |
| Sharing sex toys without protection | Use of condoms on sex toys |
| Lack of knowledge about safer sex practices | Good understanding of transmission routes |
| Alcohol or drug use during sexual contact | Clear communication about sexual health |
| Lack of access to medical care | Medical check-ups and early treatment of infections |
Source: Mayo Clinic, 2023; Hopkins Medicine, 2024
IMPORTANT: STI tests are especially important because many STIs are asymptomatic and can be transmitted unnoticed. Regular testing enables the early detection and treatment of STIs, protects personal health, and helps prevent the spread of infections—particularly for individuals with frequent sexual partners.
How can I protect myself from STIs during paid sex?
A look at the previous table of risk and protective factors highlights which measures are essential for effective STI prevention. Seeking services from professional providers who prioritize health and hygiene can be beneficial. However, personal responsibility remains the most important form of protection. Three key aspects should be prioritized:
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Consistent safer sex practices: Always use condoms and dental dams to avoid direct contact with bodily fluids and mucous membranes.
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Regular testing and preventive care: Get tested for STIs regularly to detect infections early and prevent transmission.
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Education and open communication: Learn about transmission routes and discuss protection and prevention with partners.
Source: NHS, 2025
Are condoms sufficient to prevent STIs during paid sex?
Condoms provide a high level of protection but are not 100% effective in preventing STIs during paid sex. They prevent the transmission of many infections such as HIV, chlamydia, and gonorrhea through bodily fluids. However, they are less effective against STIs transmitted through skin contact, such as herpes, HPV, or syphilis.
To maximize protection, condoms should always be used correctly and complemented with additional measures, such as the use of dental dams, regular STI testing, and vaccinations against HPV and hepatitis B. If you notice symptoms in yourself or your partner, avoid sexual contact and seek medical advice (CDC, 2024).
How often should I get tested for STIs if I engage in paid sex?
If you engage in paid sex, you should ideally be tested for a wide range of STIs, as many infections are asymptomatic. Be aware of the diagnostic window—the period in which an infection is present but not yet detectable by tests, which can lead to false-negative results. The frequency of testing depends on several factors, such as the number of sexual encounters and the use of protective measures. The following guidelines apply:
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Every 3 months:
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If you have frequent changing sexual partners.
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If you belong to a risk group, such as people who offer or engage in paid sex, men who have sex with men (MSM), or individuals with known STIs.
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After every risk exposure:
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If you had unprotected sexual intercourse.
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If you experience symptoms such as unusual discharge, burning or pain during urination, lower abdominal pain, or skin changes such as redness, blisters, or sores.
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At least twice a year:
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Even with consistent safer sex practices, regular check-ups are advisable since some STIs can be transmitted through skin contact and often occur without symptoms.
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Source: CDC, 2024
Want to get tested?
In Germany, STI tests can be conducted at health departments, by general practitioners, or using home testing kits. Home tests offer the advantage of not having to visit a doctor initially—an aspect that often discourages people from getting tested. Homed-IQ provides fully discreet home tests, offering a simple, private, and secure way to diagnose STIs. All samples are analyzed in ISO-certified laboratories used by clinics and medical practices.
Summary
Paid sex is a socially sensitive topic that may involve health risks, particularly through sexually transmitted infections (STIs). These infections are primarily transmitted through unprotected contact with bodily fluids or infected skin. Regular testing and safer sex practices, such as consistent condom use, are essential to minimize risks. Since many STIs are asymptomatic, early diagnosis through testing is crucial. Well-informed prevention protects both your own health and that of your partners.
