Condom Breakage

[strange]

Hi Doctor,

I am a Chinese living in Hong Kong. Just about 6 hours ago, I went to China and had sex with a commercial sex worker.

The condom broke just when I inserted my penis into her vagina. She realised the breakage and took out my penis from her vagina at once.  The condom broke at the tip with my penile head exposed.  I thought  my exposed penile head had a brief contact with her vagina for less than 3 seconds.  There was no ejaculation inside her vagina.

Although she said she is free of HIV, I am still in doubt and quite worry now.

I have a few questions ,
1. What is the chance of me getting HIV in this event ?
2. Do I need testing ?
3. Do I need PEP treatment ?

Thanks.

[Garfield68]

A related discussion, Condom broke was started.

[H. Hunter Handsfield, M.D.]

You are asking the same question I already answered.  Did you think I might have changed my mind?  You may not keep returning with every additional anxiety-driven question that comes to mind.  This thread is over.

[strange]

Hi doctor , I want to ask my last question.

I want to make it more clear that in the event mentioned above.  The condom broke at the tip  just after I inserted my penis fully into her vagina.  ( In case I may misled you that the condom broke before my penis was inserted  into her vagina). She realised the breakage and took out my penis from her immediately.

Would this change your opinion on my risk level ?

Thanks again.

[strange]

Thanks doctor.

Sorry I login in with the name of bbcc2200 in the previous posts.

[H. Hunter Handsfield, M.D.]

Are you the same person?  Please stick with one username, per MedHelp rules.

I never guarantee someone isn't infected and can safely have sex with their regular partner.  The risk seems to be extremely low, for the reasons discussed above, but you're going to need to make your own decision.

[bbcc2200]

Thanks for your reply which relieves my anxiety and worries.

I have one more question.

Is it safe for me to have unprotected sex with my wife now ?  Should I wait 6 weeks and get test before doing so ?

Thanks again.

[H. Hunter Handsfield, M.D.]

There is little risk for HIV in this situation, certainly not sufficient for PEP and probably not even for testing -- except for the psychological relief you will feel with a negative test result.

Most likely your partner did not have HIV.  I can't guess the exact odds, but although HIV probably is more common in some Chinese CSWs. the large majority are not infected.  That she believes she isn't infected is reassuring, and so is the fact that she apparently has her customers use condoms.  (When a CSW insists on condom use, it's usually because she knows she isn't infected and wants to stay that wa -- NOT because she is infected and is trying to protect her customers.)  Also, even completely unprotected sex -- i.e., with exposure for several minutes -- the average risk of transmission by vaginal sex, if the woman has HIV, is around 1 in every 2,000 exposures.

So your risk may not be zero, but it is extremely low.  As I said, it's probalby a good idea to have an HIV test in a few weeks, for the reassurance it will give you.  But definitely I do not recommend PEP.

I hope this helps. Best wishes--  HHH, MD