Somebody I am close to, had a condom break in low in country with an high-class escort girl 12 weeks back. They started with condom but it was broken when pulled out. It seems the girl suggested that it might have happened while pulling out as there was no sound, but he is not sure and extreely scared.
Girl told she was negative and as per him did not look sick. He does not recall seeing any rashes etc on her. He was put up on PEP for 28 days after insistence which was completed in 31 days. (break due to travel across different time zones etc.) In this part of world - heterogenous transmission is higher and more prevalence of +ve in CSW compared to EU/US.
He is so worried he has been wearing gloves at house most of the time much to his wife's doubts and confusion. He confided in me and I want to get some of his doubts clarified as I can clearly see this is impacting his relationship with his wife and even some friends/colleagues he comes across as paranoid.
During PEP there was diarrhea and sore throat after a heated discussion session with loud talk. No rashes, fever. He did complain of some neck pain particularly when exposed to cold weather and occasiaonally of groin discomfort. As far as I remember, there were no conspicuous swelling in the neck. He had never checked his groin for swelling as the discomfort was like a dull mild ache from a muscle twist.
He did the following tests:
10.3(72 days) weeks post exposure - 5.4 weeks post PEP - Oraquick oral fluid - negative
10.5 weeks(74 days) post exposure - 5.6 weeks post PEP - Oraquick oral fluid - negative - (validate the first test)
10.5 weeks(75 days) post exposure - 6 weeks post PEP - finger prick blood draw rapid third generation sandwich test at clinic setting (unigold) - negative
11.6 weeks(83 days) post exposure - 7 weeks post PEP - oraquick oral fluid (negative)
He is in travel and does not have access to 4th gen test for next few weeks. He is anxious to know:
1. if he can safely assume himself to be -Ve at this stage? Is there any probability of third generation rapid test post 6 weeks of PEP turn + ve at later date? (he will only be able to test again in 98th day when he is back from official travel)
2. Can the Oraquick OF negative tests on day 82 post exposure (7 week post PEP) be relied on?
3. Is it safe to have sex with his wife with condom? When can he safely get rid of condom?
4. Is there anything specific he needs to do avoid transmission to people who are in his close proximity and co workers(non-sexual contacts)?
5. Can he continue to have normal behavior with his 3 year old daughter (like dropping to pre-school, occasianally preparing breakfast, share dinner table etc.) until confirmed negative?