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Condom broke on "dipping" in Thailand
Dear Doctors,
As everyone else I am writing you with most respect for your knowledge and efforts.
My incident relates to a Thai csw in Bangkok. She was picked up in an establishment, as opposed to being a street walker.
I decided to try protected anal sex. As I tried to push in the condom broke. I pulled away immediately, not entirely sure if I actually penetrated or not. I have pondered this and even discussed it with the csw who didnt really think of it as much of a penetration. Honesty, I felt what I have seen referred to as "a snug feeling around the head of my penis", which is what causing worries. Sorry for adding excessive detail, but the events of the potential condom protected entry, the break and the pull-out literally happened within a second. Therefore, I decided to call it a brief dip with a condom that broke leaving my head exposed for half a second max. I wanted to relay the event without trying to "un-riskify" it, and leave the risk assessment to you (not sue that worked out).
I recently tested conclusively neg for HIV, experiencing that I am one of those having difficulty accepting a negative result. That is why I am "reluctant" to go onto that band wagon every time there is a dubious exposure.
The csw correctly picked up my worries, and quickly assured me she was okay, asking me whether I was okay as well. I pursued this topic of conversation, and she told me about her testing routines, the policy of her establishment, that she in fact did not do this too often, even that she had a son and was quite concerned herself. At this point she even warned me about street walkers. I was welcomed back to see her if there was anything else.
Hopefully, this can add value to others and not just me as I think (although I am probably not) addressing some kind of a gray zone in a country (undeservingly lately?) infamous for HIV.
Thank you very much for your time.
As everyone else I am writing you with most respect for your knowledge and efforts.
My incident relates to a Thai csw in Bangkok. She was picked up in an establishment, as opposed to being a street walker.
I decided to try protected anal sex. As I tried to push in the condom broke. I pulled away immediately, not entirely sure if I actually penetrated or not. I have pondered this and even discussed it with the csw who didnt really think of it as much of a penetration. Honesty, I felt what I have seen referred to as "a snug feeling around the head of my penis", which is what causing worries. Sorry for adding excessive detail, but the events of the potential condom protected entry, the break and the pull-out literally happened within a second. Therefore, I decided to call it a brief dip with a condom that broke leaving my head exposed for half a second max. I wanted to relay the event without trying to "un-riskify" it, and leave the risk assessment to you (not sue that worked out).
I recently tested conclusively neg for HIV, experiencing that I am one of those having difficulty accepting a negative result. That is why I am "reluctant" to go onto that band wagon every time there is a dubious exposure.
The csw correctly picked up my worries, and quickly assured me she was okay, asking me whether I was okay as well. I pursued this topic of conversation, and she told me about her testing routines, the policy of her establishment, that she in fact did not do this too often, even that she had a son and was quite concerned herself. At this point she even warned me about street walkers. I was welcomed back to see her if there was anything else.
Hopefully, this can add value to others and not just me as I think (although I am probably not) addressing some kind of a gray zone in a country (undeservingly lately?) infamous for HIV.
Thank you very much for your time.
MEDICAL PROFESSIONAL
Glad to have helped. I was referring to "I felt what I have seen referred to as "a snug feeling around the head of my penis", which is what causing worries." I don't even know what that means. It has never been described to me as a symptom by patients in the STD clinic. Anyway, I wouldn't worry about it.
MEDICAL PROFESSIONAL
Welcome to the HIV forum.
This sounds like a low risk event. I wouldn't worry about it, for several reasons. First, although HIV used to be quite common in Thai sex workers, that's no longer the case. Thailand has had one of the world's most effective HIV prevention campaigns, based on universal condom use, and HIV is now uncommon in Thai CSWs (probably well under 1% on average, maybe more like 1 in 1000). Second, people rarely lie when asked directly about their HIV status; your CSW partner's reassurance should be taken at face value, and she seems like a knowledgeable person who knows the ropes about sexual safety. Third, if she says you didn't penetrate her anus before the condom broke, almost certainly you didn't: she should know! Fourth, even if there was penetration, and even if she had HIV, the transmission risk from under a 1 second exposure is miniscule, probably zero or close to it. Finally, your vague symptoms don't sound like any STD and certainly cannot be due to a new HIV infection.
So from a risk assessment or medical perspective, there is no need for testing for HIV or other STDs. Of course you can always do that if this reassurance (and hers) doesn't completely settle your nervousness about it. But if I were in your situation, knowing what I know, I wouldn't be concerned and would not feel a need to be tested.
I hope this helps. Best wishes-- HHH, MD
This sounds like a low risk event. I wouldn't worry about it, for several reasons. First, although HIV used to be quite common in Thai sex workers, that's no longer the case. Thailand has had one of the world's most effective HIV prevention campaigns, based on universal condom use, and HIV is now uncommon in Thai CSWs (probably well under 1% on average, maybe more like 1 in 1000). Second, people rarely lie when asked directly about their HIV status; your CSW partner's reassurance should be taken at face value, and she seems like a knowledgeable person who knows the ropes about sexual safety. Third, if she says you didn't penetrate her anus before the condom broke, almost certainly you didn't: she should know! Fourth, even if there was penetration, and even if she had HIV, the transmission risk from under a 1 second exposure is miniscule, probably zero or close to it. Finally, your vague symptoms don't sound like any STD and certainly cannot be due to a new HIV infection.
So from a risk assessment or medical perspective, there is no need for testing for HIV or other STDs. Of course you can always do that if this reassurance (and hers) doesn't completely settle your nervousness about it. But if I were in your situation, knowing what I know, I wouldn't be concerned and would not feel a need to be tested.
I hope this helps. Best wishes-- HHH, MD
Thanks again, Dr.
The "snug feeling" was actually a reference to the (very brief) sensation I felt when I tried to penetrate, sorry for not being clear. It lead me to think I managed to insert the head a little bit. If you see no (medical) reason to follow up on this because your advice does not change, please do not (I´ll take your silence as an indication this thread is over). I am very happy with the help you have provided.
Last but not least, congrats on the Thomas Parran award. I think there is zero risk than anyone would disagree with me in saying well deserved! :)
The "snug feeling" was actually a reference to the (very brief) sensation I felt when I tried to penetrate, sorry for not being clear. It lead me to think I managed to insert the head a little bit. If you see no (medical) reason to follow up on this because your advice does not change, please do not (I´ll take your silence as an indication this thread is over). I am very happy with the help you have provided.
Last but not least, congrats on the Thomas Parran award. I think there is zero risk than anyone would disagree with me in saying well deserved! :)
Thank you very much for that clarification, and for putting it all into perspective, it really is greatly appreciated that you give timely and accurate advice within such short deadlines.
I do not want to come off as being difficult, but you mention my vague symptoms. I did actually not mention any symptoms, and the fact that you do I guess is just due to answering a lot of posts - which is great in itself.
Especially when the reply has been very helpful and other than symptoms was straight (!) to all the points I wanted to raise with you.
I will leave it at that as I tend to use too many words for everything :)
I do not want to come off as being difficult, but you mention my vague symptoms. I did actually not mention any symptoms, and the fact that you do I guess is just due to answering a lot of posts - which is great in itself.
Especially when the reply has been very helpful and other than symptoms was straight (!) to all the points I wanted to raise with you.
I will leave it at that as I tend to use too many words for everything :)
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