damaged condom?

[iamworried333]

Hi.  A couple weeks ago I had sex with a prostitute.  I used a condom that she put on me but afterwards when taking it off I noticed that the condom felt dry and rough rather than smooth like usual.  It was not overtly broken, but my concern is that it was damaged somehow, maybe by her use of an oil-based lubricant or something like that.  I now have a sore throat and fatigue and so am worried about that encounter.  A couple questions...

Does a condom need to be overtly damaged for HIV to spread or could something like the use of an oil-based lubricant result in a condom that allows transmission?  Are there many cases of HIV spread despite condom use?  Does it sound like I have anything to worry about?

Also, I read a previous response that talked about sex workers in North America not being high-risk for HIV as people might assume.  But it specifically mentioned "high-class" escorts and this one was not really high-class.  She rents a really cheap motel room for the day and then advertises on craigslist.  She ended up being rather fat and not very attractive.  Does low HIV risk for sex workers still apply?

Thanks!    

[H. Hunter Handsfield, M.D.]

If the condom did not rupture in an obvious way, you were safe.  HIV and secretions do not penetrate microscopic defects to any appreciable extent, and even an oil-weakened condom is fully effective if it doesn't break.  Anyway, the feeling of the condom undoubtedly was a characteristic of the condom itself, not evidence of damage.

I cannot predict the likelihood of HIV for any particular commercial sex worker.  Generalizations about escorts, street walkers, etc cannot be applied to individual persons.  But the bottom line is that you had condom-protected safe sex and no worries about catching HIV.

Good luck--  HHH, MD

[eaman]

Condoms tend to break all at once and noticibly and not a just a bit.