Broken Condom with CSW

[bg57104]

I had unprotected oral and what started out as protected vaginal intercourse with a prostitute. After several minutes of intercourse (probably 5-10 minutes), I noticed that the condom broke wide open, and my penis had her vaginal fluid all over it. From what I've seen on the forum, this was a no-risk activity up until the condom broke. How concerned do I need to be about acquiring HIV from this encounter?This woman said she was/is disease free. She's been "in the business " for 7 years, and has been with her steady boyfriend for 10 years. She lives in Iowa, but "tours" all over the US. She also said she gets tested for std's every 3 months. Do I need to get tested in 6 weeks to know for sure? Can I have sex with my wife?  What can you tell me to (hopefully)  ease my mind?

Thanks.

[Edward W Hook, MD]

No change in my opinion or advice, This does not suggest the ARS. EWH

[bg57104]

Thanks for your advice. I've had no symptoms until last week. I know symptoms are never a good way to diagnose ars or HIV. However, due to my risk/exposure, I have to ask... at 3 weeks and 6 days post-exposure, I developed a sore throat, which I think was probably due to sinus drainage. I might have had a slight fever (99ish) as well, but no rash. I now have no fever or rash, but my sore throat is now worse and now only on the left side of my throat. My left tonsil is swollen, but no white spots. Doctor's office tested for strep, but it came back negative. I assume you're going to say that my symptoms are not consistent with ars, but I want the peace of mind of hearing it from you.

Is it true that lack of high fever and no rash probably rules out ars? Is it also true that if you get ars, all symptons will occur at the same time? If one were to get an "ars rash", what would it look like?

Thanks

[Edward W Hook, MD]

The longer you go without symptoms the less likely it will be that you have acquired an STD.  The decision about when to have sex with your wife is yours.  EWH

[bg57104]

Thank you Dr. Hook.  You said that if it were you, you would not get tested for HIV or any other STD's (unless symptoms develop).  If I take the "wait and see" approach and wait a week or so to see if any symptoms develop for chlamydia, gonorrhea, genital herpes, syphilis, etc, I assume you would say it is then OK to resume having unprotected sex with my wife if no symtoms develop?

[Edward W Hook, MD]

Personally, I would probably not test but this is, of course, your call. If it was on my mind, I would test.  EWH

[bg57104]

I'm honestly not as freaked out about this as I thought I'd be. Is a week long enough to wait and see about symptoms developing for chlamydia,  gonorrhea, and genital herpes?  Would you recommended testing for hiv at all?

[Edward W Hook, MD]

Welcome to the Forum.  Congratulations for your commitment to safe sex and sorry to hear of your condom breakage. FYI, this does happen about 1% of the time that condoms are used.  

Most commercial sex workers do not have HIV or, for that matter, other STDs and most exposures do not lead to infection.  Further, from what you say, your partner sounds to be rather low risk for infection.  Nonetheless, you have had a single, unprotected exposure to a new partner who has had other partners.  The risk for other STDs (gonorrhea, chlamydia in particular) is far higher than your risk for HIV but there is some, very small risk to have acquired an infection.  I would calculate your risk for HIV as being less than 1 in 10,000 and probably closer to 1 in 100,000.  In terms of risk for bacterial STIs, there are several approaches to what you can do now.  These include:

1.  Don't worry, wait to see if symptoms develop.  This is a roll of the dice. Chances are that you are not infected but I suspect you'll worry about this if you take this course.

2.  Go get tested.  You can go for testing for gonorrhea and chlamydia at any time more than 2 days after your exposure and anticipate accurate results.  The tests are easily done at lots of places and are available on a confidential basis lots of places including your local health department.

I hope this is helpful. Again, let me emphasize, your risk from this exposure is low. EWH