STD/HIV worry - condom slip and blood

[VictorSP]

Hello,

I have recently started a relationship with a new girlfriend. We have had (protected) sex half a dozen times. Last night, we were having sex for 10 minutes or so when I noticed the condom had slipped completely off - I was checking for the ring, but it had disappeared. I withdrew and she had a search around (!) and found the whole thing inside her. I am guessing we were having unprotected sex for a minute or two. It was only at this point that I discovered blood on the retrieved condom. It turns out she was on the last day or so of her period. I went to the bathroom and peed and washed my penis - never know if that does anything! Then we put on a new condom and finished sex.

I would like to know what risks I have been exposed to, and what testing I should do.

I am her only her third sexual relationship. She is Chinese (we live in China).

Thank you…
Victor

[Edward W Hook, MD]

Absolutely not.  EWH

[VictorSP]

Thanks! Final question. Would you ever consider recommending PEP treatment in a case like mine?

[Edward W Hook, MD]

Particularly in men, the absence of symptoms is certainly a good sign. the longer you are without symptoms, up to about 2 or perhaps 3 weeks, the less the likelihood that infection is present. Symptoms in women are often absent however and infections occasionally occur without symptoms in men as well.  Further, I think testing will provide both of you with confidence if your relationship goes forward.  EWH

[VictorSP]

Many thanks for your thoughts, Dr Hook. As a follow up question, would the absence of symptoms in both of us after a certain amount of time - say 14 days days - be reassuring in terms of infection. Obviously, I will follow your advice on testing... but that may take a while to organise given where we live.
Thanks!
Victor

[Edward W Hook, MD]

Welcome  back to the Forum.  In reviewing your previous posts over the past few years, I note that you are cautious about your health and the possibility of STIs.  That's a good thing.  I also congratulate you on your commitment to condom protected sex, that too is a good thing.  Let  me address your question.

Unprotected sex is unprotected sex and the role of the duration of exposure on risk for infection is unknown but probably relatively small.
since your condom slipped during sex, you were exposed, IF she had any STI.  Your partner sounds to be rather low risk however and most single unprotected exposures to infected partners do not lead to infection.  Further since you mentioned the presence of a small amount of blood, I should mention that the presence or absence of blood does not change the risk for getting any STIs. For STIs that are in the blood (like HIV), there is often as much or more virus present in genital secretions as in an infected person's blood.

So, what are your risks.  Probably low for all STIs.  The best way to address the possibility of exposure, as well as to move forward with your relationship with this woman if you both choose to do so it for you both to be tested for STIs.  If she is negative , then she is not infected and therefore does not pose a risk to you. If you test, you can reassure her that you were not a risk for her either.

The main STIs I would test for in both of you are gonorrhea, chlamydial syphilis and HIV.  She should also be tested for trichomonas.  There is no benefit to either of you to test for herpes using a blood test- you have already been tested and without a lesion there is little risk for infection. Finally, you are immunized against hepatitis B so you are not at risk for this either.

I hope this comment is helpful to you.  EWH