Condom ripped during insertive anal

[scareshitless]

Hello Doctor,

On 1/18/13 I topped a transexual, at one point he/she said the condom may have broken so I pulled out immediately to find that the condom was still covering my penis and my penis head, at first I thought it was ok but then I moved the tip of the condom on my penis head and found a rip maybe about half inch so I ran to the bathroom and ran water tru it and it ran tru it. I asked him if he has HIV and he said no he got tested 3 weeks prior to this incident but my fear consume me so I kept on asking and he got mad, then I kept on texting and he texted me back to say he's 100% STD and HIV free but who knows. A week after I went and got tested for all STD and HIV and everything came back negative. My great concern is that could my uretha been exposed and if exposed what are my chances of catching HIV and could HIV have entered the rip. My questions are:

1. Can HIV enter the rip and got into my uretha?
2.. Can the rip on top of the condom stayed the same size with prolonged anal sex, I am asking this because I fear that the rip may have not rip further and been rip for the whole duration of the anal sex ~15 minutes?
3. How risky is this exposure and my chances of catching HIV?

Thank you

[Edward W Hook, MD]

While the RNA test you had is not recommended for testing for HIV in most cases, your negative test is strong evidence that you were not infected.  Between now and futrue testing, I would not worry if I were you.  EWH

[scareshitless]

Hello Dr. Hook,

Thank you so much for your help. I went in to do an RNA HIV test done on 1/30/13 which is 12 days after potential exposure,just got the result right now from my doc and it is negative! I did the test from Kaiser Permanente, do you know if they are good with doing the RNA test? Can this test give me reassurane that I was not infected? I am also planning on testing at 7 weeks and 3 month to make sure, what is the likeliness this test will change on the antibody test? From what I read, the RNA test after 12days after potential exposure should give me about 90% accuracy, is this accurate, I just need your opinion so I can breathe a little better. Thank you!

[Edward W Hook, MD]

Welcome to the Forum.  I'll try to help.  I read your interactions on the HIV Community site and agree with what has been said.  Like them, I wonder if and when the condom broke.  When condoms break it is typically wide open leaving no doubt that a break had occurred and leaving the head of the penis uncovered.  That does not seem to be the case for you.  

In addition, in one of your comments you note that your partner wanted you out as soon as he was aware of the breakage.  This suggests to me that he is concerned that you might infected him, thereby indirectly reenforcing the idea that he was not infected as he stated when you asked.  

Putting all of this together, I doubt that it was a meaningful exposure.

As for your specific questions:

1. Can HIV enter the rip and got into my uretha?
See above- most unlikely.

2.. Can the rip on top of the condom stayed the same size with prolonged anal sex, I am asking this because I fear that the rip may have not rip further and been rip for the whole duration of the anal sex ~15 minutes?
As you might imagine, given the relative rarity of condom breakage and the impossibility of studying the time course of such events, there are no data on this subject.  Typically however, when condoms break the condom is off and the penis exposed VERY quickly.

3. How risky is this exposure and my chances of catching HIV?
Low.

I hope this helps.  It occurs to me that since both you and probably your partner are concerned, you might both go together to a site where you can get rapid tests.  If you are both negative, then your risk is truly miniscule and not something to worry about.  EWH