condom breaks in red light district amsterdam

[xtothez3423]

Hello Doctor

So I have been a regular at the red light district when I come here for vacation. Only playing around with beautifull or what I consider beautifull woman and always protected both oral and vaginal never anal.
This one night I had vigourous protected sex with a bulgarian girl for about 30 minutes. 20 minutes after finishing with the bulgarian girl, I couldnt take my eyes off of this really beautifull but very busy Italian red light girl.

After walking around 10 more minutes I decided to play with her. She performed protected oral sex and then protected vaginal intercourse with her on top. Following we did doggy style and after 15 minutes of vigorous sex I pulled out my penis for reinsertion to see the condom had broke. NO EJACULATON on my part and she did use lube.

I became very worried as I am a disease freak and have caught chlamidia twice and urinary tract infection once from sexual intercourse. I am not circumcicesd and in my late twenties.

I asked the red light girl if she was safe. She said she gets tested every 3 weeks and that she is clean and has papers to prove it becuase she wouldnt be able to work in the red light wothout them. She said she would get tested again in 2 days by her doctor which wont let me know much about recent exposures she may have had.

Worst case scenario doc is that my entire upper part of my penis including the glans penis, prepuce, and urethal opening may have been exposed for a minute or so. Other scenario would be that the m iddle part of my shaft was only exposed. Dont really remember how the condom broke as I panicked. This is my 1st condom breakage and I know that the red light girls are tested and fairly clean due to union rules here in amsterdam but what do you think?

What are the stats for STD and or HIV contraction with condom breakages for both infected and non infected partners?
Should I be worrying and can I enjoy the red light 1 more time before I leave in 3 days?
THX

[Edward W Hook, MD]

We get this question fairly often.  Neither STDs nor HIV typically cause abnormalities on general blood screening panels.  There really is no substitute for having the specific tests performed.  Since you have your blood drawn regularly, you could have syphilis and HIV tests done at that time (they are blood tests).  The other STDs (gonorrhea, chlamydia and NGU) can be tested using a urine specimen which you probably also give at that time.    
ewh

[xtothez3423]

Thanks again EWH
Appreciate it.

I do a complete blood panel testing usually once a year since I am on narcotics for chronic pain and is mandatory. They check everything as you know even glucose and cholesterol.

My final questions for you is would infection of an STD or for god sakes the HIV virus cause any of the numbers within  a complete blood panel test to be elevated or decreased?

What would those numbers be besides the neutrophils, eosoiphils, basophils, lymphocyte, monocytes (WBC count)?

Furthermore will this work or are the specific tests needed to properly diagnose teh various STD's or Hiv virus?

I guess what Im really asking is could I bypass the specific STD tests and or HIV tests unless specific numbers on my next blood panel are either elevated/decreased?
.
Thanks again and dont work to hard

[Edward W Hook, MD]

If her test is negative you do not need to be tested.

On the other hand, you need to try to get over your fear of testing.  Having a test does not change whether or not you are infected.  Rather it gives you knowledge to do something about it if it turns out you have been unlucky enought to get infected.  I have seen far too many people who are "selective" about their partners who have become infected to suggest that being selective assures you that you will not get infected with something, sometime.

As a matter of personal protection, we recommend annual testing for anyone who has had two or more sex partners in the past year (we consider this to be health maintenance- we also recommend you get your blood pressure and cholesterol checked regularly). Take care.  EWH

[xtothez3423]

Thanks EDH MD.

I apprciate the timely response.
I took an HIV test only once in my life and hate them. I never have unprotected sex and am very selective about who I sleep with in the states but when in holland do as the dutch do I guess.

If the girl shows me papers that she is negative on monday from her md would it be necessary to even do an STD/ HIV test if I do  not develop any symptoms of either?

I just hate the waiting period with the tests and always fear the worst. Its like my only fear in life.

THX and this is the first time something like this has happened and I shouldnt worry like you said but I guess u just cant halp it. I bet having some condom protected sex with another beautifull girl could help.

Take care and let me know

[Edward W Hook, MD]

Sex with Amsterdam's Red Light District commercial sex workers is, in general, safer than sex with commercial sex workers in many other parts of the world.  As you were informed, most of the Dutch CSWs are licensed and, as a condition of their licensure, they are required to be regularly checked for STDs including HIV.  Studies of these persons indicate that their STD rates, including HIV  are relatively low.  Thus, while this exposure is not as low as if your condom had remained intact, it remains relatively low.

There are no data or studies on STD rates following condom breakage.  We do know that condoms break about 1% of the time that they break.  We also know that, logically, when a condom breaks the unprotected part of the exposure is briefer than if no condom had been used and common sense tells us that the duration of the exposure probably contributes to the probability of infection with briefer exposures being less likely to result in transmission.  Finally, we know that most exposures to infected partners do not lead to transmission of infection.

Putting all of this together, your chances of having gotten infected as a consequence of a single episode of condom breakage are very low.  I would not worry.  It may be in your best interest to get yourself checked for STDs at some point in the future but in the interim I would not worry.  Similarly, it may be worthwhile to get checked for HIV at some point more than 4 weeks beyond the exposure (on a statistical basis your risk of HIV is far lower than your risk of acquiring another STD).  Please be aware that I say this in the spirit of providing conservative advice and again, not because you are at particular risk.

As far as having further sex with other CSWs in the Red Light District, I see no reason for you not to have further condom-protected sex.

Hope this helps.  EWH