Broken Condom - HIV Scare

[clemsonmike]

Hello,

A week ago I had an encounter where I was engaged in protected receptive anal intercourse.  I asked the insertive partner if he was HIV negative.  He assured me that he was, and that he always practices safe sex and gets tested on a regular basis.  

During the act he pulled out and I heard a "pop" sound.  He said that the condom had broke.  I inspected it and sure enough it did.  I started becoming very anxious and asked him if it had ripped while inside of me.  He assured me that it did not rip inside of me.  He said that he felt the condom stretching like it was going to rip inside of me, and when he pulled out, I did hear a "pop"sound and there was a small tear in the condom right at the head of his penis.  This gives me some solace, as I would think if it had ripped while during intercourse, the tear would not remain small and at the head of the penis, but it would have ripped completely?

My main questions here are -  1.  What do you think my risk of possibly catching HIV is?  Should I have gotten PEP?  The insertive partner is a homosexual african american male - therefore in the upper echelon of risk.  However, he assures me that he is HIV negative and he always practices safe sex and gets tested regularly.

2.  I have a partner that I have unprotected anal intercourse with.  We have both been tested and are both negative and remain monogamous (except for this slip up!).  In your honest opinion, can I safely continue unprotected anal intercourse with him?  I plan on getting tested at 4 weeks and then again at 6-8 weeks.

Thank you for your time and insight.

[Edward W Hook, MD]

Agree, at 2 weeks antibody test detect about 50% of infections.  EWH

[clemsonmike]

Dr. Hook -

I took the OraQuick take home rapid HIV test 15 days after exposure.  I am happy to report that the result was negative.  I will test again at 6-8 weeks.  

I'm guessing at 2 weeks, rapid HIV tests would detect around 50% of newly acquired infections?

Thank you again for your insight.

[Edward W Hook, MD]

You and I expect the same outcome.  Please do not worry.  EWH

[clemsonmike]

Will do.  Thank you.  Please pray that I do not have HIV.  I honestly believe I don't.  I will test at the 4 week mark.  Take care.

[Edward W Hook, MD]

Thanks.  Please feel free to provide any follow-up that occurs.  We al learn from each other.  EWH

[clemsonmike]

Thank you Dr. Hook.

[Edward W Hook, MD]

Welcome back to the Forum. I will be pleased to comment.  Your condom mishap is unfortunate. FYI, this occurs about 1% of the time condoms are used.  You are also correct, this was a high risk encounter and if your partner had not assured you that he did not have HIV, then you should have taken PEP. He did indicate that he gets tested regularly and if that is correct, then your encounter becomes low risk.  Most people do tell the truth.  With regard to your specific questions:

1.  What do you think my risk of possibly catching HIV is?  Should I have gotten PEP?  The insertive partner is a homosexual african american male - therefore in the upper echelon of risk.  However, he assures me that he is HIV negative and he always practices safe sex and gets tested regularly.

You can settle this if you can talk with him.  Depending on when his last test was, this is likely to be low risk. As I indicated, most people do tell the truth. If he has had a number of new partners of unknown status in the interval since his last test, then there is a possibility that he could have been infected in the interval since his last test but as you note, he appears to regularly practice making this a low risk encounter.  If he is available and willing, the best thing you could do at this time is arrange for him to be tested (you could do the same for him).  If he is negative, then there is almost no risk form the exposure you describe.  On the other hand, if you cannot arrange for him to be tested, then you should arrange for testing with a 4th generation, combination HIV antigen/HIV antibody test at 4 weeks after the event.    

2.  I have a partner that I have unprotected anal intercourse with.  We have both been tested and are both negative and remain monogamous (except for this slip up!).  In your honest opinion, can I safely continue unprotected anal intercourse with him?  I plan on getting tested at 4 weeks and then again at 6-8 weeks.

The best and safest thing for you is to use a condom until your 4 week test.  I would also suggest that you get tested for other STIs as well (gonorrhea, chlamydia) at the same time as these infections are more common than HIV.

I hope these comments are helpful. EWH