condom broke during anal sex

Dear Doctor,

I am  very worried ...in panic really....and need your help and advice. I am a gay man , active  (TOP) and a week ago I had anal sex with a married man . I put a condom on, but because either there was not sufficient lubrication or the guy was really tight , the condom broke - leaving the upper part of my penis exposed. The BOTTOM guy realised, he told me,  and I immediately pulled out. I must have been exposed only for seconds really !!!

I was shocked and went to the bathroom and put my penis under the light to check it. There was no blood on it and had no visible "wounds" or "cuts"  either.  There was no blood or anything visible on my penis apart from some of the lubricant which was in the condom. I washed with water. The other guy was really cool, he did not seem to worry at all. I asked him  lots of times if he was healthy and said he was. In fact he looked really healthy. A bit overweight  and certainly not a drug addict. I kind of calmed down put a new condom on and continued sex (anal) with him.

From the next morning onwards I have been living with great worry and anxiety.I feel miserable and deeply depressed because am having negative thoughts that maybe the guy was infected with HIV and therefore I am at risk.
How great is my risk ? Should I really worry?

I know that even if I get tested the window period is three to six months? Until then I will go crazy.The idea of a test at any  moment after this "accident" scares me so much....

Please give me your advice and comments. Life seems to have lost its meaning for me since then....

[H. Hunter Handsfield, M.D.]

Good for you for using condoms for anal sex.  Your reaction to the condom failure suggests a strong dedication to safe sex, which is excellent and will save you a lot of grief.  Nevertheless, it seems you neglected another important safe sex strategy -- but more about that below.

Most likely there was no serious risk of HIV transmission.  From your discription, I infer that the head of your penis remained covered with the condom, i.e. it apparently was only your penile shaft that was exposed.  It isn't possible to catch HIV through intact skin; the risk to the top partner in anal sex is from exposure of the urethra (penile opening).

Now the lecture.  That your partner looked healthy says nothing about his HIV status.  You don't say whether or not you asked him directly about HIV or his response.  I assume that means you didn't ask.  Big mistake.  There simply is no excuse for any man to ever have sex with another man without first asking about and sharing HIV status, and avoiding sex (at least avoiding anal sex) with those who are HIV positive or who seem evasive about it.  I call it "do ask, do tell", and it applies even when  condoms use or only low risk practices (e.g., oral sex) are planned -- because condoms break and intentions for safety are easily forgotten at the height of arousal.  In the long run, "do ask, do tell" is just as important as consistent condom use for anal sex.  Of course it isn't 100%, but most people don't lie when asked directly, and few people are in the window period since their last negative test.

If you followed this and just didn't say it, congratulations.  I take the opportunity to say this, for the benefit of all MSM forum users, whenever I can; it's that important.  And if you didn't share HIV status, please take that habit away from this experience.  It's really important as an HIV prevention strategy for all MSM.  If you are able to contact your partner and ask now, please do that.

As a sexually active gay man, you should be having routine tests for HIV and other STDs from time to time, at least once a year.  If you haven't been tested recently, this would be a good time.  But the chance you were infected during this particular event seems low, even with the condom breakage.

I hope this helps.  Best wishes-- HHH, MD

[iason40s]

Doctor, I am so worried that may be I did not explain well.

1)By upper part of penis I meant the head. The head was exposed for seconds.

2)regarding the hiv status of the other guy, I asked him before sex and after the incident with the condom whether he was healthy and exactly whether he was HIV negative and he said he was Negative and healthy. I really asked him many times.

Aftet I clarified these 2 points what do you really think? Is my risk really high?

[H. Hunter Handsfield, M.D.]

I'm glad to hear that "do ask, do tell" is part of your safe sex program.  Good show!  You didn't need the lecture, but I hope other readers will benefit.

That the head of your penis was exposed, presumably including your urethra, increases the risk.  Still, it seems very unlikely your partner has HIV; and even in the slight chance he is wrong (or lying), such brief exposure should be pretty low risk.  So I really wouldn't lose sleep over this event.  Still, 6-8 weeks after the event probably is a good time for your next routine HIV test, not so much because of this event in particular but to help reassure you. In the meantime, I really wouldn't worry much about it.  You can expect a negative result.

[rulcelt]

A related discussion, Gay man; anal sex condom breakage was started.