Broken condom with ejaculation, vaginal sex

[scaredandworried300]

Hi Doctor,
I posted a question not too long ago about a few instances of unprotected sex I had and I obtained a negative result.  Prior to getting that result back, I started dating a new guy.  I was afraid to have sex with him, even with a condom, without being sure I was fine.  A few days after I got my negative result, we had sex.  We've had sex numerous times now, and we've ALWAYS used condoms.  Unfortunately, one time, the condom broke and he ejaculated inside of me.  I was really worried; I think the universe is against me or something...I try to have safe sex and this is what happens!  I asked him about his history and he asked me about mine.  I told him I was recently tested for everything and I'm fine.  He was recently married [divorced less than a year ago] and says he hasn't had many partners since, and that he doesn't like picking up "random girls."  He is heterosexual, doesn't do drugs, white, British, 22 years old, and is very wealthy [I don't know if any of this makes a difference, just giving you as much info on him as possible].  
Do I need to test for this?  I have a gyno appointment this week anyway so I'm planning on getting tested for other STD's just in case, but do I need to worry about HIV or even test?  I am so sick of this constant worry and I feel like I can't do anything right, like I'm doomed or something...help!

[H. Hunter Handsfield, M.D.]

All assessments for the chance of any disease are "numbers games".  In your case, the numbers work out to well under 1 chance in a million you caught HIV.  And no, I have never had a patient with a history like yours who turned out to have HIV.

This is your second "just one more question", so that will have to be all for this thread.  Don't worry about your upcoming test -- and if your HIV fears continue after that, please seriously consider my opening advice about counseling.  It isn't normal to continue with fearful thoughts after such strong evidence and repeated, reasoned reassurance.

[scaredandworried300]

Thanks Dr...even though I know, rationally, that you're not lying to me and wouldn't tell me that I don't need to get tested if I was actually at risk, I still can't stop thinking about it.  I might just go get tested after 8 weeks so I can be sure 100% that I'm fine.  Can I ask though, if you don't mind, why is it that you're so confident to say that I don't need to be tested?  Have you never seen or heard of someone getting HIV from a situation similar to mine?  Is this disease really that much of a numbers game?

[H. Hunter Handsfield, M.D.]

I agree with your doctor.  I rarely tell people not to get tested for HIV, unless they have been tested with negative results.  If there is any plausible risk for HIV, even if nearly zero, I generally advise that testing isn't necessary from a risk assessment standpoint, but that testing still may be a good idea for emotional support -- i.e. for those who are just going to keep worrying about it until they have a negative test to bolster their confidence.  Testing on those grounds is a personal choice; only you can decide whether it applies to you.  From a risk standpoint there defnitely is no need.

[scaredandworried300]

Just one more question, if thats ok. I got my results back for common stds and everything was negative. my dr didnt even  suggest testing for hiv, and when i asked her about it, she said to not worry, that it wasnt necessary after only 1 time with a low risk partner and to just test once annually as a part of regular health care. Do you think i should stick with this advice? is this ok? ive seen you tell others, especially men, in my situation not to test, does this apply to me as well?

[scaredandworried300]

Thanks, I understand now. Ill get tested for common stds in that case, and I guess Ill hold off on the hiv test (since I need to wait 6 weeks anyway, right?) since, rationally and based on what Ive seen you  tell others, its probably not necessary that I worry about it. Thanks.

[H. Hunter Handsfield, M.D.]

All sexually active 22 year old persons who are not in committed, mutually monogamous relationshipa EW at high risk for common STDs like chlamydia, herpes, and HPV.  As for testing because of a single episode of (unintentional) unprotected sex, it's a personal choice.  The chance you caught an STD is low, given nearly universal condom use with your new partner.  On the other hand, all non-monogamous sexually active persons should be tested for common STDs from time to time.  On that basis, if you haven't been tested recently for gonorrhea, chlamyia, syphilis and HIV, this would be a good time, since it is on your mind.  Most likely the results will be negative, but better safe than sorry.

[scaredandworried300]

I understand. And I am seeking professional help for this actually. From a medical perspective tho, do I need to test? Also, why do you say my partner is at a high risk for other stds?

[H. Hunter Handsfield, M.D.]

You describe a partner at little or no risk for HIV.  As for other STDs, this is always a possibility; it sounds like your new partner probably is at fairly high risk for things like chlamydia or herpes.  But speculating is silly -- since you're concerned, and since you're about to see your gynecologist anyway, you should be tested for common STDs.

Both this question and your discussion with Dr. Hook are loaded with cries for psychological support:  "I literally can't sleep at night, I've been suffering from panic attacks" from your thread with Dr. Hook; plus "I am so sick of this constant worry and I feel like I can't do anything right, like I'm doomed or something...help!".

Everybody with such feelings needs professional mental health care.  I suggest it out of compassion, not criticism.  However, this is not a counseling service, so that's all I will say about it.  Good luck--

HHH, MD