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Condom Breakage, worried about possible exposure.
Hi Doctor,
About a month ago, I was engaged in a vaginal sexual intercourse with a chinese prostitute in China. Before the intercourse, I applied the "delay" cream at the location where the penis head and the shaft meets. I've put on condom. However, I only realized that the condom broke after I ejeculated and pulled out. The condom breaks near the ring, along the side about 2-3Cm cut. However, I'm quite certain the head of my penis and my urethra is still covered with condom because of the fact that the sperms are ejeculated and well collected at the tip of the condom (no leakage of sperms). I don't really know how long the condom was broken for while my penis is inside her vagina, or it broke while I pulled my penis out.
At 24th day post exposure, the lymph node at the back of my neck (occipital node) was swollen. So, At 26days post exposure, I decided to take ECLIA test and it came back Negative.
These are my questions:
1. In a manner of how my condom broke, Am I at risk of contracting HIV assuming she is a HIV+ ?
2. Is it possible that the vaginal fluid enters into the condom through the broken hole on the side of the condom, and the fluid has come into contact with my urethra. Is it possible for HIV to transmit in this manner? Please explain.
3. Does the application of the "delay" cream on my penis further increase the risk? (The delay cream has a burning sensation effect on my penis, I'm afraid it will causes damages to my penis)
4. I took the test, it came back negative. Can I say my swollen lymph node is not due to HIV?
5. How reliable is my result with the test taken at 26days after exposure?
About a month ago, I was engaged in a vaginal sexual intercourse with a chinese prostitute in China. Before the intercourse, I applied the "delay" cream at the location where the penis head and the shaft meets. I've put on condom. However, I only realized that the condom broke after I ejeculated and pulled out. The condom breaks near the ring, along the side about 2-3Cm cut. However, I'm quite certain the head of my penis and my urethra is still covered with condom because of the fact that the sperms are ejeculated and well collected at the tip of the condom (no leakage of sperms). I don't really know how long the condom was broken for while my penis is inside her vagina, or it broke while I pulled my penis out.
At 24th day post exposure, the lymph node at the back of my neck (occipital node) was swollen. So, At 26days post exposure, I decided to take ECLIA test and it came back Negative.
These are my questions:
1. In a manner of how my condom broke, Am I at risk of contracting HIV assuming she is a HIV+ ?
2. Is it possible that the vaginal fluid enters into the condom through the broken hole on the side of the condom, and the fluid has come into contact with my urethra. Is it possible for HIV to transmit in this manner? Please explain.
3. Does the application of the "delay" cream on my penis further increase the risk? (The delay cream has a burning sensation effect on my penis, I'm afraid it will causes damages to my penis)
4. I took the test, it came back negative. Can I say my swollen lymph node is not due to HIV?
5. How reliable is my result with the test taken at 26days after exposure?
MEDICAL PROFESSIONAL
Last answer:
tThe calculations you use are mathematically correct HOWEVER they are too conservative. Your calculations would be accurate if your exposure was unprotected and if your partner had HIV. Your encounter however was not unprotected and it is statistically unlikely that your partner had HIV.
That will be it for this thread. Take care. EWH
tThe calculations you use are mathematically correct HOWEVER they are too conservative. Your calculations would be accurate if your exposure was unprotected and if your partner had HIV. Your encounter however was not unprotected and it is statistically unlikely that your partner had HIV.
That will be it for this thread. Take care. EWH
Dear doctor, I've one last question. I've read some old archives post saying the risk per vaginal intercourse exposure is 1/2000 (If circumcised?, I am). At 4 week of ECLIA testing, would detect 90% of recent infection that means 10% of false negative. 10% of 1/2000, that would be 0.005% risk. Is this why you're saying my risk is minimal? Thank you a lot for your time and your patience.
MEDICAL PROFESSIONAL
You are over reacting. As I said before, "If fluid had entered the side of the condom it would have also likely caused the condom to come down along the shaft of the penis, and or caused the condom to come off. " EWH
Thank you a lot for your explanation Doctor.
However, I have one question regarding your answer. You said "however most evidence suggests that as long as the condom covers the tip of the penis and that genital secretions do not come into contact with your urethra, there is no risk for HIV".
Now I got myself imagining it would very very easy, for the genital secretion to enter that hole from the side, like most liquids, and slip down to my urethra. So I found this a little contradictory. Sorry, I am not by any intention trying to disprove you. I'm just under a lot of stress and need to seek further answer. I hope you can help me.
However, I have one question regarding your answer. You said "however most evidence suggests that as long as the condom covers the tip of the penis and that genital secretions do not come into contact with your urethra, there is no risk for HIV".
Now I got myself imagining it would very very easy, for the genital secretion to enter that hole from the side, like most liquids, and slip down to my urethra. So I found this a little contradictory. Sorry, I am not by any intention trying to disprove you. I'm just under a lot of stress and need to seek further answer. I hope you can help me.
MEDICAL PROFESSIONAL
Welcome to the Forum. Congratulations on your commitment to safe sex. I'm sorry to hear of your condom failure- this does happen about 1% of the time condoms are used. I hope it will not keep you from continuing to use condoms.
If the condom continued to cover the tip of your penis and the urethra during sex, as seems to be the case, it still is likely to have done its job of preventing you from getting HIV. As you might imagine, there are no studies to help evaluate rare events such as these however most evidence suggests that as long as the condom covers the tip of the penis and that genital secretions do not come into contact with your urethra, there is no risk for HIV. As it turns out, HIV is rather hard to spread.
As for your questions-see below.
1. In a manner of how my condom broke, Am I at risk of contracting HIV assuming she is a HIV+ ?
I would start by pointing out that it is unlikely that your partner had HIV- most commercial sex workers do not. if she did however, as mentioned above, your risk for getting HIV should be minimal.
2. Is it possible that the vaginal fluid enters into the condom through the broken hole on the side of the condom, and the fluid has come into contact with my urethra. Is it possible for HIV to transmit in this manner? Please explain.
If fluid had entered the side of the condom it would have also likely caused the condom to come down along the shaft of the penis, and or caused the condom to come off. As I said above, I would assume that your condom did its job.
3. Does the application of the "delay" cream on my penis further increase the risk? (The delay cream has a burning sensation effect on my penis, I'm afraid it will causes damages to my penis)
Unknown. There are no data to help evaluate this. I do not know what is in the "delay" cream however if it is petroleum based, it may have weakened the condom, leading to the failure. As for the burning sensation, these creams are meant to decrease sensation (that's how they accomplish the delay). Typically before the sensation is decreased by such creams there is a burning sensation as they have their effect. Little is known about what sort of side effects such creams might have.
4. I took the test, it came back negative. Can I say my swollen lymph node is not due to HIV?
It certainly makes it unlikely. further the fact that your only symptom was the swollen lymph node, if that is what it was, also makes HIV less likely.
5. How reliable is my result with the test taken at 26days after exposure?
26 days is almost 4 weeks. At 4 weeks current tests, including the ECLIA detect about 90% of recent infections. At 8 weeks your results will be definitive.
Summary. In all likelihood your condom, despite its partial failure did its job and protected you from HIV and other STDs. Your swollen node is unlikely to be due to HIV. For definitive assurance, you should re-test for HIV at 8 weeks following exposure. I anticipate that the test will be negative if you choose to test at that time. EWH
If the condom continued to cover the tip of your penis and the urethra during sex, as seems to be the case, it still is likely to have done its job of preventing you from getting HIV. As you might imagine, there are no studies to help evaluate rare events such as these however most evidence suggests that as long as the condom covers the tip of the penis and that genital secretions do not come into contact with your urethra, there is no risk for HIV. As it turns out, HIV is rather hard to spread.
As for your questions-see below.
1. In a manner of how my condom broke, Am I at risk of contracting HIV assuming she is a HIV+ ?
I would start by pointing out that it is unlikely that your partner had HIV- most commercial sex workers do not. if she did however, as mentioned above, your risk for getting HIV should be minimal.
2. Is it possible that the vaginal fluid enters into the condom through the broken hole on the side of the condom, and the fluid has come into contact with my urethra. Is it possible for HIV to transmit in this manner? Please explain.
If fluid had entered the side of the condom it would have also likely caused the condom to come down along the shaft of the penis, and or caused the condom to come off. As I said above, I would assume that your condom did its job.
3. Does the application of the "delay" cream on my penis further increase the risk? (The delay cream has a burning sensation effect on my penis, I'm afraid it will causes damages to my penis)
Unknown. There are no data to help evaluate this. I do not know what is in the "delay" cream however if it is petroleum based, it may have weakened the condom, leading to the failure. As for the burning sensation, these creams are meant to decrease sensation (that's how they accomplish the delay). Typically before the sensation is decreased by such creams there is a burning sensation as they have their effect. Little is known about what sort of side effects such creams might have.
4. I took the test, it came back negative. Can I say my swollen lymph node is not due to HIV?
It certainly makes it unlikely. further the fact that your only symptom was the swollen lymph node, if that is what it was, also makes HIV less likely.
5. How reliable is my result with the test taken at 26days after exposure?
26 days is almost 4 weeks. At 4 weeks current tests, including the ECLIA detect about 90% of recent infections. At 8 weeks your results will be definitive.
Summary. In all likelihood your condom, despite its partial failure did its job and protected you from HIV and other STDs. Your swollen node is unlikely to be due to HIV. For definitive assurance, you should re-test for HIV at 8 weeks following exposure. I anticipate that the test will be negative if you choose to test at that time. EWH
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