condom broke during anal

[joeadam1970]

Dear Dr. i am a 42 years old male, i have been sexually active for the past 3 months -always protected sex except for oral sex-

4 days ago and -unfortunately- i had a sexual exposure with a CSW in Abu Dhabi, United Arab Emirates.

while performing anal sex on her  -insertive- the condom broke, it was about 2-4 minutes before i found out, no ejaculation happened and i had no open sores on my penis or any other cuts.

i am of a good general health, smoker and have never been diagnosed with any std or any serious disease.

right now i am freaking out because of the hazardous of HIV that i have put myself in.

i have asked her if this was the first time for her to have a condom failure indecent and she answered yes, she even had an HIV blood test for residency visa 7 months ago and she already has her visa stamped (which means she was a negative at the time) ,my questions are as follows.

1- i know that anal sex is considered a high risk action, is there any % that can measure that risk ? i mean am i at 50% for example or is it definite that i will get infected if she really has HIV ? i have read somewhere on the internet that the the risk of transmission to the insertive partner from a single encounter of unprotected anal sex is 0.065%, meaning that 99.935% do not get HIV, is that true ?

2- i am thinking of getting a PCR test to check myself, how long should i wait before getting tested (PCR) and how accurate and reliable is that test ?

3- Do you recommend that i go for the PCR test or should i go for the regular antibody test and how long should i wait as well ?

thank you in advance for helping me on this, i would really appreciate to hear from you as soon as possible as i am really freaking out.

[H. Hunter Handsfield, M.D.]

Welcome to the forum.

My understanding (by email from STD experts in UAE) is that few commercial sex workers in Dubai, Abu Dhabi, etc have HIV (for the same reasons your partner gave -- required HIV testing on arrival and mostly consistent condom use) and therefore that HIV infections are very rare in ex pats and foreigh workers there, if they occur at all.  To your specific questions:

1) Anal sex is higher risk than vaginal, but still low risk for any one exposure.  If the anal partner has HIV, the average transmission risk is said to be around 1 in 500 for anal sex, versus 1 in 2,000 for vaginal.  And as already discussed, it is very unlikely your partner had HIV anyway.

2,3) It would be a waste of money to have a PCR in this circumstance.  I wouldn't necessarily recommend HIV testing at all.  But if you do it, ask for a duo test (for both HIV antibody and p24 antigen) 4 weeks or more after the event.

I hope this has helped.  Best wishes-- HHH, MD

[joeadam1970]

Thanks a lot Dr. that really put my mind on ease :)

[H. Hunter Handsfield, M.D.]

Yes, that is the duo/combo test and your result is conclusive.

Take care and stay safe.

[joeadam1970]

Hi again Dr. I just got my HIV test results back, it reads the following

HIV 1/2 Ab + P24 Ag

Result:  0.199

Reference Range: Negative 1

i have taken the test 35 days after the exposure (5 Weeks)

is this the Duo Combo test 4th generation and is it conclusive ?

thank you in advance Dr.  

[H. Hunter Handsfield, M.D.]

See the thread linked below; or just use the search window to hundreds of other discussions on this forum.

http://www.medhelp.org/posts/show/1704700

[joeadam1970]

thank you very much doctor for your answer, i really appreciate that and that really helped put my mind at ease.

just one final question if you don't mind.

you mentioned 4 weeks window period for testing and a duo test, could you please explain in simple English -I'm not a doctor you know :)  -  what is the P24 test and how reliable is that test ?

thank you again for your help.