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Condom Broke
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Condom Broke

Hi there,
I had an experience with a massage parlor girl last Thursday (In western Canada).  We planned for intercourse so she rubbed my penis with baby oil at first then put on a condom for oral.  We then had sex.  When I pulled out the condom was broke and I panicked.  We had sex for about 3 minutes is my guess maybe 5 at most.  I am of course concerned like everyone else that seems to be going or has gone through this.  Now she seemed cautious enough (ie, covered oral) I did not perform oral on her and her hygiene seemed good.  There were no open sores on my penis either.  Now, after this happened I asked her if she was clean and she said yes, she replied with "I should be asking you that".  My mind is running away with me now of course and I am thinking she used the baby oil on purpose to break the condom, something I did not know was not a good thing at the time.  I have read the many posts asking the same questions about what are the risks of exposure here.  My question is why is it hard to aquire HIV?  Just how hard is it?  The public, such as me, feels it is like catching a cold.  I have read circumsized males are at lower risk for some reason and I am circumsized.  I am also 36yo very healthy NEVER had relations with another man and NEVER used injection drugs.  I do no t even drink smoke or do drugs at this point and have not for many years.  

So if I could ask, what makes it hard to aquire HIV?  I understand it is thru a man
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Your commercial partner is right:  In general, commercial sex workers are at higher risk for HIV from their customers than the customers are from them.  In any case, it sounds like she isn't infected; most people don't lie when asked directly.

Transmission of most infectious diseases is not an all-or-none phenomenon.  As an example, consider the intestinal disorder shigellosis (bacteria dystentery) and the other called salmonellosis, often a food borne infection.  You have to swallow 50,000-100,000 salmonella bacteria to get sick, but only 50 shigella.  Similar disease, similar organisms, but one is 1000 times more infectious than the other.  Also consider the differences between HIV and the hepatitis B virus (HBV).  The chance of HBV from injury with a contaminated sharp instrument is 100 times higher than for HIV, even if the amount of virus in the contamined blood is more or less the same.

To catch HIV, "just one virus" simply isn't enough for the infection to take.  It takes large amounts of virus that have to be exposed to certain kinds of cells that generally are deep inside (in the blood, the deeper layers of the skin, etc).  Such cells come to the surface if there is another infection, like herpes or other STDs.

Even if your partner had HIV, the chance you got infected from a single exposure of unprotecte sex is around 1 in 2000.  And since she probably wasn't infected, your risk probably is zero.

I don't know how much oil it takes for latex condoms to break or how often it happens.  Your partner clearly needs education about oil based lubricants and condoms.  However, your speculation about her intentionally wanting a condom to break is wild paranoia and not worth further comment.

Regards--  HHH, MD
13 Comments
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Avatar_n_tn
This is the first I've heard of the transmission details.  I think a lot of people believe it's "all or none" and that if one virus makes it in you are done for.  I have some follow up questions to the transmission details if you could please address them:

1.)  Can HIV make it into the body and be fought off if it's a small enough load?  
2.)  Can a small viral load of HIV make it into the system and still trigger a response from the body which would resemble ARS symptoms, even though the amount is easily fought off by the body?
3.)  If any of the above questions are true, could this be why people seem to have ARS symptoms but end up testing negative months later or is it a fact that if you make it to ARS symptoms phase then you definitely have been infected enough to produce antibodies and seroconvert?  

I have donated and posted a similar thread a few days ago which addressed questions just like this and this just follows up on those if you could please find the time to respond.  

Thanks Dr. H
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Avatar_n_tn
I went for the standard tests today and nurse I was speaking to said, interestingly enough, that in his 26 years of doing this he has never seen a positive HIV case in a hetero male.  Other things, such as herpes and warts, yes, but not HIV....interesting.  He also said he has seen many many guys travelling the world and having unprotected sex (why I don't know) and they are tested and have nothing....wierd....very wierd.

He was not sure why she would use baby oil either and said she should have known but he said he did not feel she was doing things on purpose especially if she used a condom for oral.!  He did say they do not do ELisa tests here because they are not 100% and I need to wait 3 months to 6 to know for sure.?  But he did say wait for the current test results and then if negative get on with my life, as you usually seem to say Dr. H.  He also said he could not test for herpes or warts and you pretty much have to wait to see what happens with that....I thought you could have tests for this?

Still nervous but hopefully it will work out.

thanks for the reply.
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Avatar_n_tn
Hello all,
I am the same guy that posted under cougar in crisis. After so much of reassurance and support from Dr HHH I finally took HIV test. Last 24 hrs were longest in my life....my result came today and I am HIV negative. I am finishing this chapter of life forever. To all the people here plz plz plz go and get tested before judging yourself based on your symptoms. I see many post here with few to  no risk. When I went for testing the doctor was very understanding and she correctly explained the nature of epedemic. Her lines are very similar to DR HHH. If you are not IV drug user or involving in Unprotected anal sex then chances are in your favor. So freinds just muster some courgae ,get yourself checked and take the vow that you will not do anything silly like that. If you turn HIV positive then accept the fact and trust me there is nothing that you wont achieve being HIV positive. HIV positive or HIV negative everyone will die, but its question of how responsible we are towards ourself and our society. Thank you all and Thank you very much DR HHH.
San221
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Avatar_n_tn
Doc, thats funny you say that.  Today I called the public Health dept where I live and asked if they get many heterosexual guys testing pos.  She said, "Let me put it to you this way.  If we ever do, we get a call back by the state to do further investigation on the matter."  Wierd.
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239123_tn?1267651214
AD:  Despite working for 30 years in a busy STD clinic, I also have never had a male patient who apparently acquired HIV by heterosexual exposure.  There is no test for HPV/warts.  There is a blood test for herpes, but the risk is too low for that to be recommended after a single exposure such as yours.  (Even if positive, it probably wouldn't be from that particular exposure.)  Search this forum for "time to positive HIV test" for lots of discussion as to why you need do not need to wait 3-6 months for reliable testing, despite what your provider says.

JJ:  There is some evidence of some people developing partial immunity to HIV, not measurable by antibody tests, perhaps from repeated exposure to low doses of the virus.  But this is always totally asymptomatic and does not explain ARS symptoms with later negative HIV testing.

san:  Thanks for the testimony.

HHH, MD
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Avatar_n_tn
What does that comment mean?  That they are saying it is unusual and they want more of a history on that person or something?
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Avatar_n_tn
It means it's unusual.  Very.
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Avatar_n_tn
Thanks for the info.  I really hope it all works out.  

I am wondering how it works in the US.  If someone tests positive, do they "track" that person somehow?  I know that here in Canada they have a central database but it really does no good for the general population.  But, say if someone is infected, and they are a known prostitute, do they keep a close eye on that person, ie, such as where they frequent, how often etc...?

I am still freaked out but when I look back at my youth in the 80's I did much crazier things and seemed to survive, not that that makes much impact here today but still...
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239123_tn?1267651214
In the US and most industrialized countries, when a supposedly straight guy turns up HIV positive by testing (or is reported to the health department with a new case of AIDS), the near universal response is to re-interview the patient to find out what his real risks were--i.e. what behaviors he denied at the time of testing.  Almost always this turns up a history of sex with other men, injection drug use, or sex with known positive persons; or sometimes multiple unprotected heterosexual exposures in other parts of the world.  It is rare to document true heterosexual acquisition of HIV by a male, and I am not aware of a single case following the sorts of exposures described by most questioners in this forum.

Often it is not possible to find such persons for repeat interview; and some such men deny all other risks despite evidence to the contrary.  For example, if he is a never-married guy who has had syphilis (rare in heterosexuals, common in gay men) but denies sex with men, it is classified as a heterosexually acquired case. Keep these things in mind when you look at official statistics.  Many (most?) cases in men classified as heterosexually acquired were not actually acquired that way.

Ideally, all HIV positive persons should be contacted by the health department to identify their partners and assure those persons get tested; and to help the newly diagnosed person with referral to health care, if that hasn't yet been arranged.  However, in most areas of the country, this actually doesn't happen much. But that is changing and hopefully will become the norm.

HHH, MD
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Avatar_n_tn
Interesting you should mention that if a hetero male is reported to get HIV, that further investigation shows they have not submitted an accurate history.  I had this exact conversation with a nurse when I received results for Chlamidia, and Syph. just minutes ago (whic were negative).  The nurse I spoke to was different than the one I saw Monday, and she said she has seen a hetero male get HIV before, but I mentioned your experience and even that of the nurse I saw Monday (30 years exp. and 20 respectively) how both of you mention you have never seen a case of a true hetero male aquiring HIV, and that maybe the person did not give accurate history and she agreed with that statement.  

I am of course still worried and waiting for the gonorrhea test results hopefully Monday, and then I am not sure if I should take the advice of the nurse I saw Monday to get on with my life or continue worrying......what are the stats that a person with HIV has multiple STD's associated, especially if the other STD's are much more common? I swear I have never ever touched another man ever in that way.....nor have I used IV drugs.....ever, so it seems my risks are low from what I read here.

I, and others I am sure, truly appreciate your real world writings.  The nurse I spoke to today said to stay away from the internet, far away, and i agree with that but this site seems to have logical and accurate info.

Thanks very much.
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Well I don't know if anyone is reading or not but I went in to get Gonnorhea (Gonorrhea) results today and were negative.  Goon, syph, and chlamid. negative at this point.  Although they said I may need to re test for syph as it takes about 4 weeks to show but they did say it is rare anyway.  This was a different nurse this time and he reiterated the same thing as I have read here and was told previously by another nurse that without open lesions on my penis, without presence of a urethra inflammation / infection (chlamidya. gonnor. etc) which I dont have then I am at minimal (if not zero) risk and not to worry about it.  I was honest with them and I have never had male encounters ever nor IV drugs etc, they say I am worrying over nothing.  It will still be in my mind but now maybe not as much.

hope this helps others here.
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Yes, it helps!
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