HIV risk - worrried

[Rocketman79]

Hi Doctor, three days ago I met up with a guy I met on a gay dating app (first time I've done this). He went down on me, we had mutual masturbation and then we had sex using a condom. I was the top. The condom stayed on the whole time and I checked it afterwards and it looked intact. I filled it with water to check and didn't notice any leaks. What I want to know is can a condom have small gaps that wouldn't be obvious when you checked it? And if so, could some fluids get through and cause an HIV infection? I'm really stressing about this at the moment and any advice you could give about my likely risk would help a lot. I asked the guy about his HIV status and he said negative but it seemed like he'd been meeting people from this app a lot so could be pos and not know. Also, how soon can I get a reliable test to hopefully put this behind me?

[Rocketman79]

Thanks doctor. I take your point, but I am just trying to understand whether, if this is syphilis, that would change the risk factor for HIV transmission from this event.

[Edward W Hook, MD]

I cannot make a diagnosis over the Internet.  Syphilis is a rare disease and is rarely acquired from oral sex.  My advice would be to seek evaluation by a trained clinician who can assess the lesion and test as is appropriate.  EWH

[Rocketman79]

Hi Doctor, may I ask your help one more time please. It's 21 days after the above experience and I have noticed a small round sore on my penis. I am freaking out because the timing and the sore match the online info about syphilis. I am adamant that the condom stayed on the whole time and did not rupture. Is it possible that I could have contracted syphilis from oral sex or some other way, or does this indicate that the condom failed and I was at risk for hiv transmission? I'm thinking of getting a 4th generation duo test and a test for syphilis on Monday (24 days after). Would that be pretty reliable if that came back negative for hiv? I don't know what to think about this. Your opinion would really help me at this difficult time. Thank you.

[Edward W Hook, MD]

Glad to help. Take care.  EWH

[Rocketman79]

Hi Doctor, thanks very much for your quick response. Your explanation of the risks really helps. Think I'll still get a test at the 4 week mark but I feel a bit less anxious about things now

[Edward W Hook, MD]

Welcome to our Forum. I'll try to help.  We often hear of clients who fill condoms with water following sex to check for leaks.  this is a messy waste of time.  condoms do not "leak a little".  When condoms fail, they break wide open leaving no doubt that they have failed.  If your condom appears intact following sex, it is and has done its job and there is no need for additional “testing”.

You are doing things right.  While in all probability a small proportion of persons do lie, most tell the truth.  if yur partner said he was negative, he probably was.  The combination of asking and correct and consistent condom use will almost certainly assure that you do not get HIV as long as condoms do not break.

If you wish to check for HIV to assure yourself that you were not infected, my advice would be to be tested using a 4th generation "DUO" (combination HIV p24 antigen/HIV antibody) test 4 weeks after exposure.  Relative to the exposure you mention above, when you do, I am confident it will be negative.

I hope these comments are helpful to you. EWH