Concerned condom broke

[Matbp]

Hi Drs. Im pretty much concerned about the possibility of cought HIV. Im male, heterossexual, 25yr old, uncircumcised.

Last sunday i had protected vaginal sex with a girl that i met in a bar. Unfortunately the condom broke and i continued the intercourse couple of minutes without noticing it. I do not know her hiv or others STDs status.

At the exactly minute i notice condom broke, i took a shower, washing my penis with water and soap.

Anyhow, i got so anxious and concerned, i went to a medicine center and started PEP treatment 33hrs after the exposure. 

Even though I read in this forum that regular vaginal sex chances of a male catch HIV from female is really low, this role episode drove me crazy, i cant stop thinking about the possibility. Please, i would appreciate very much if you answer some questions, and help me to calm down (if applicable).

1)  Assuming that she is HIV+, even though my chances are very low? Close to zero? What if she had an Internal cut that i couldn't saw?
2) the fact i washed my penis with water and soup right after helps to decrease risk anyway?
3) how effectivy PEP treatment is? Im taking 4 diferents antiretrovirals. Does this treatment will significantly reduces my risks? Even being started 33 hrs after expusure?
4) due to all i explayned and told, how would you consider my case? Should i stell be worried? Can i relax? would you recomend HIV testing? How many  weeks should i wait to do the test (if applicable)?

Thanks a lot for your time and patience.

[Edward W Hook, MD]

Yes, a 4 week test will provide useful preliminary information.  EWH

[Matbp]

Thanks a lot doctor. I'm much more calm now.
I have just one last question. Although i'm pretty much less concerned, i'm shure this role episode will bother me a lot and disturb me at work and personal life until get tested. My question is, even following your recomendation of geing tested 8 weeks after end of PEP, can i also have a test 4 weeks after PEP to calm down even more? How accurated would it be? Maybe 95-98%? Thanks a lot.

[Edward W Hook, MD]

Welcome to our Forum. You are correct, I would judge the exposure you report to be rather low risk and would not have recommended PEP in your situation.  Now that you are on it however, this, when considered along with the low risk nature of your exposure virtually assures that you will not get HIV.  You should not worry.

1)  Assuming that she is HIV+, even though my chances are very low? Close to zero? What if she had an Internal cut that i couldn't saw?
The average risk of infection IF she had HIV and that is unlikely, is 1/10th of 1% (1 in 1000) and it is unlikely she had HIV.

2) the fact i washed my penis with water and soup right after helps to decrease risk anyway?
There is no proof that washing after sex in any way reduces risk for HIV.

3) how effectivy PEP treatment is? Im taking 4 diferents antiretrovirals. Does this treatment will significantly reduces my risks? Even being started 33 hrs after expusure?
PEP is highly reliable any time it is begun less than 72 hours after an exposure.  Taking PEP probably reduces your already low risk more than 90%.

4) due to all i explayned and told, how would you consider my case? Should i stell be worried? Can i relax? would you recomend HIV testing? How many  weeks should i wait to do the test (if applicable)?

My advice is not to worry.  You should test for HIV 8-12 weeks AFTER you complete your PEP. At that time I am confident you will find that you did not get HIV.

Take care.  EWH