condom broke

[amanwithaQ]

Hello doctors.

You are doing a great job here i think.

Now last night i was going to a prostitued. This was very stupid of me as i have been very scared of hiv. Anyway she give me a condom on and i tried to penetrated her. It was not easy, and suddenly a heard/notice the condom breake and i pulled of immerterly. So i was in her for far less than a second. When i pulled out and saw the condom, my penis was still in the condom. What i mean is, that the condom was breaken on the side and not were my penis head was. Stil there is a possibillety that my penis had touched her vagina fluid. Now i am worried sick.

I tried to ask if she was infected but she could not understand my question. She was from thailand.

Now i have read that you said that time make no difference in getting hiv. But here it was really less than a second.

Should i getting pep?

[Edward W Hook, MD]

No, touching infected fluid does not lead to infection. EWH

[amanwithaQ]

Thanks for answering doctor

I will get testet again again:) Here in my country  we use the duo test. And they said its sure after 4 weeks. Still i find it very hard to wait that long, as im no felling well at all.

Some aids advicers in my country said that my accident was to short to get hiv, while it must going directly in the blood streem. I really hope that if she had hiv, that it must have been very hard to transfered it to me for no longer than a second.  Well my question is: Hiv virus is it like a bacteria were if your are very unlucky you can get infected just to touch the infected fluid?

[Edward W Hook, MD]

Welcome to our Forum.  PEP is a personal decision. I am sure that if you want PEP you can get it.  Decisions about PEP are a personal decision in which one should consider the likelihood that infection will occur, the likelihood of drug side effects, one's personal anxiety and the cost of the drugs (expensive, typically in the neighborhood of $1000).  I would not recommend PEP in your situation as my assessment is that your risk of infection is quite low.  Here is my reasoning on this:

1.  Your partner was probably not infected.  Most commercial sex workers are do not have HIV or even other STDs.  Thailand in particular has been very successful in reducing their HIV rates in commercial sex workers.
2.  Even though your condom broke, as you point out your exposure was quite brief. There are not good data on precisely how the duration of exposure effects the risk of getting HIV but common sense suggests that the shorter the exposure the less likely transmission is to occur.
3.  Even though your condom broke and therefore we must accept that there is some risk, you were also partially protected since part of the condom continued to cover the head of your penis. Again, there is no precise way to estimate how much protection a broken condom which partially covers the penis protects but it is probably at least a little better than no condom at all.

On the basis of these facts, I would not recommend PEP for you however, as I said, this is a personal decision  I would get tested in 6-8 weeks however.  I hope my comments are helpful to you.   EWH