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condom broke and ARS
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condom broke and ARS

Hi there Dr. I am a 40 years old male who live in Dubai (United Arab Emirates)
On the 3rd of March i had sex with a CSW in Dubai.
The condom broke while i was performing anal sex on her, it was  not more than 5 minutes before i saw the condom breakage, i did not ejaculate, i am circumcised and I had no cuts or open sores on my pines
I am really worried of the HIV risk that i would face. When the condom broke I asked her if this was the first time for her to have a condom failure incident and her answer was yes.
In the UAE it's mandatory to get tested for HIV before getting the residency visa to live here, she told me  she was tested almost a year ago, yesterday I started having a sever diarrhea,I am going to the bathroom almost 15 times a day, every time I eat or drink I have to go to the rest room within 10 min. max
10 days ago I started a herbal medication (Costus) which is beneficial for general health
I am an OCD patient but I am not getting any panic attacks like the ones I used to have when I was first diagnosed, no sweating for example.
My questions are as follows.
1-What kind of risk did I put myself in? Am I at high or low risk and if high or low how high or low is it, are there any numbers or percentages that you can please mention.
2-Taking in to consideration that I have no fever at all, does the sever diarrhea -I have- on its own qualify as an ARS? Could it be caused by the herbal medication I am taking or by anxiety (OCD patient) even though that I didn’t have any attacks for a while now?
3-What are the most common ARS that shows on an HIV patient? do they occur one at a time or all together at the same time.
4-What is the best test that I can take for a conclusive result within the shortest period? I have read about PCR, Duo Combo and the antibody test, which one is the most reliable test with the shortest window period.
Finally, , thank you in advance for helping me, I will be awaiting your answers impatiently.

1024580_tn?1331577721
Hello,
Thank you for your post, and apologies for the delayed reply.  here are your answers as follows:
1-What kind of risk did I put myself in? Am I at high or low risk and if high or low how high or low is it, are there any numbers or percentages that you can please mention.
THE ESTIMATED RISK OF HIV INFECTION THROUGH UNPROTECTED VAGINAL INTERCOURSE, ASSUMING THAT SHE WAS POSITIVE, IS LESS THAN 0.1%.  IN YOUR CASE, AS A CONDOM FAILURE, WOULD BE MUCH LESS, AND WE DO NOT KNOW THE STATUS OF THE LADY EITHER.  AS YOU CAN SEE, YOUR RISK IS LOW.
2-Taking in to consideration that I have no fever at all, does the sever diarrhea -I have- on its own qualify as an ARS? Could it be caused by the herbal medication I am taking or by anxiety (OCD patient) even though that I didn’t have any attacks for a while now?
DIARRHOEA IN ISOLATION IS NOT A SYMPTOMS OF HIV SERO-CONVERSION.  THEREFORE I DO NOT BELIEVE THAT IT IS RELATED TO HIV.
3-What are the most common ARS that shows on an HIV patient? do they occur one at a time or all together at the same time.
HIGH FEVER, SEVERE SORE THROAT AND A RASH, HAPPENING SIMULTANEOUSLY AT SOME STAGE BETWEEN 2 AND 6 WEEKS AFTER THE INFECTION AND LASTING 7-14 DAYS
4-What is the best test that I can take for a conclusive result within the shortest period? I have read about PCR, Duo Combo and the antibody test, which one is the most reliable test with the shortest window period.
I WOULD RECOMMEDN THE DUO TEST OF FOURTH GENERATION AFTER 4 WEEKS OF ANY POSSIBLE EXPOSURE.

Best wishes,
Dr José
17 Comments
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Avatar_n_tn
i have received an email saying that there was a response to my email, i came here and found nothing, is there a problem with showing the answers ?
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Avatar_n_tn
isn't this the doctors forum ? am i in the right place or not ?
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Avatar_n_tn
i didn't get an answer yet .. where are the doctors ?
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Avatar_m_tn
hey. sorry, let me tell you
this intenational forum, these doctor are in the UK, some timing is different, plus they take lil bit longer to answer, that the other expert forum, THEY WILL ANSWER, THEY WILL, THEY ALWAYS DO, BY it mas takes 1 or 2 days more, if u want  same day answer , posted in the other expert forum, they chek answer daily
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Avatar_n_tn
thank you very much for the clarification man, i will be waiting for the answer by the doctors (soon hopefully) :)
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Avatar_n_tn
its been 10 days with no reply, where are the doctors ?
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Avatar_n_tn
dear Dr. thank you for your reply, but my exposure was due to a condom failure during anal sex and not vaginal, so the question still stands, plus would you recommend that i take a test in the first place or not ?

thank you in advance for your reply  
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Avatar_n_tn
1 more question Dr. is the Duo test 4 weeks after the exposure considered conclusive ?
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936016_tn?1332769204
Hello Joey,

An HIV DUO is rated as being more than 99.89% accurate at 28 days so in practical terms, yes, it is conclusive.

kind regards,

Sean
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Avatar_n_tn
thank you doctor, yet still my first question stands regarding the ANAL encounter i had.
Dr. Jose answered my Question but he stated that -I quote- (THE ESTIMATED RISK OF HIV INFECTION THROUGH UNPROTECTED VAGINAL INTERCOURSE, ASSUMING THAT SHE WAS POSITIVE, IS LESS THAN 0.1%.).

Dr. Jose answer was about VAGINAL intercourse while my question was about ANAL intercourse, does the less than 0.1% probability apply to unprotected Anal Sex as well ?

thank you again Dr.
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Avatar_n_tn
Dr. please answer me as i am being really confused right now, my question was about Anal Intercourse while your answer was about Vaginal intercourse.

does the less than 0.1% apply for unprotected Anal or Vaginal intercourse ?
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Avatar_n_tn
HELLO , is there anybody out there ?
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Avatar_n_tn
Dr. Jose answered my Question but he stated that -I quote- (THE ESTIMATED RISK OF HIV INFECTION THROUGH UNPROTECTED VAGINAL INTERCOURSE, ASSUMING THAT SHE WAS POSITIVE, IS LESS THAN 0.1%.).

Dr. Jose answer was about VAGINAL intercourse while my question was about ANAL intercourse, does the less than 0.1% probability apply to unprotected Anal Sex as well ?

thank you again Dr.
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Avatar_n_tn
hello Dr. I just got my HIV test results back,  the result was as follows

HIV 1/2 Ab + P24 Ag, Result: Negative

i have taken the test 35 days after the exposure (5 Weeks)

is this the Duo Combo test 4th generation that the Dr. recommended ?and is the result conclusive ?

  
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936016_tn?1332769204
Dear Joey

The test you describe is a 4th generation HIV antibody and p24 antigen test. The result is good at 28 days or after.

With respect to your question about the risk of anal sex - the risk will be approximately 3 to 4 % per event. I note Jose has already described the risk rate for vaginal sex.

best regards, Sean
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Avatar_n_tn
thanks a lot for the answer doctor, when you say that the test is good at 28 days or after, that means that my result is conclusive and no further testing is required, is my understanding correct ?

thanks a lot Doctor
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