Condom broke/vaginal cream

[Scott__1977]

Hello!

First, sorry for my english. I'm from Brazil.

I had sex with a friend on Sunday (08/26/2012). I obviously used a condom, but unfortunately it broke. I'm sure that this happened due to a vaginal cream she was using for treatment. Unfortunately, I did not realize that the cream could contain oil, which is bad for condoms.

I think the condom broke in the last few minutes of penetration, but I'm not sure about the exact time. I may have been unprotected for 3-5 minutes, I'm not really sure. I just realized what happened after I ejaculated.

Here are some facts:

1. She always uses condoms;
2. She did an checkup HIV test exactly one month before (on 07/26/2012). I saw the test and it was negative.
3. She said she did not have sex with anyone else besides me during her treatment with vaginal cream.
4. She said she had sex after the HIV test, but obviously it was always with a condom. And that there was no other problem with condoms during this period.

I have genital herpes (there was no sores when all this happened), and from what I've read on this forum, it doubles my risk, right?

My questions are:

1. I'm thinking of doing two HIV tests. At 4 and 8 weeks. This would be sufficient, or a third test at 12 weeks would be needed?
2. How much worried should I be, considering the facts AND the fact that I have herpes?

[H. Hunter Handsfield, M.D.]

Welcome to the forum and thanks for your question.  Your English is fine.

Based on your description, your partner is sexually very safe and very unlikely to have HIV.  Even if you had not used a condom at all, I would say you should not worry and do not need to be tested for HIV.  Probably she is telling the truth about her HIV tests; friends don't often lie about HIV status when asked directly.  And it is statistically very unlikely she has been infected since her last test.

Having HSV-2 roughly doubles the risk of HIV, but first you have to be exposed.  And the average risk of transmission from a single episode of unprotected vaginal sex, if the female is infected, averages 1 in 2,000.  Double that is still only 1 in 1,000.

To your specific questions:  1) I recommend against any HIV testing at all.  But if you feel aneed to be tested anyway, have either a single "combo" or "duo" test (for both HIV antibody and p24 antigen) at 4 weeks; or an antibody-only test after 6-8 weeks.  (See http://www.medhelp.org/posts/show/1704700)

2) You should not be at all worried.  The most important STD risk from this event was for your partner, i.e. your HSV-2.  Since you consider her a friend, I'm sure you made sure she knows abut your herpes.  If not, you need to tell her now.

I hope these comments have been helpful.  Best wishes and stay safe--  HHH, MD

[H. Hunter Handsfield, M.D.]

Yes, you can relax.  See the thread I linked above.

Thanks for the thanks.  Best wishes.

[Scott__1977]

OK, DUO test done after 29 days, and the result was negative. So I guess I can relax now, right?

Again, thanks for your help!

[Scott__1977]

Glad to know the info about fasting, I searched the forum but did not found anything related to this question. Anyway, my next (and final) post will be with the result of my test, and I'm very confident that it will be negative!

[H. Hunter Handsfield, M.D.]

There is no need to fast before an HIV test, either duo or otherwise.  I wonder whether you found a general instruction, intended primarily for people having certain metabolic tests, like blood sugar or cholesterol.  Don't worry about it.

[Scott__1977]

Doc, fortunately I found a laboratory in my city that does the DUO test (antibodies+p24 antigen). I will do the test at 09/24 (4 weeks and 1 day after the exposure). However, in their website, they claim that a 8 hours fasting is necessary before the test. Is that really so? I know for sure that fasting is not necessary for antibodies-only tests. There's something different in DUO tests that requires fasting? Also, drinking water is permitted during fasting before a blood test like the DUO test?

[H. Hunter Handsfield, M.D.]

Glad to have helped.  

[Scott__1977]

Well, I know that her HIV test was negative not only because she told me, but because I saw it myself. I even took a photo of the test - I know it's weird, but I have a very bad OCD with things related to HIV. And she already knew about my herpes before the intercourse.

Anyway, for my own piece of mind, I will do the antibody test at 8 weeks and I will post the result here.

Thanks, Doctor HHH. Your help was very appreciated.