Should I be taking PEP?

[seeking advice]

My situation:  Male, HIV-, STI Free, Healthy

My partners situation:  Male, HIV+, STI Status Unknown.  Partner didn't reveal status until after engaging in sex.  After discussion, says he's undetectable, and has been regularly taking medication for 5 years.

The situation:

1   Mutual oral sex, without condom. Followed by:
2.  Penis to penis rubbing.  Followed by:
3.  Me as insertive partner in anal sex with condom. 
4.  No ejaculation by either partner.
5.  Removed condom after anal sex.
6.  Noticed small amount of blood on inside of condom, from small slice on skin on my penis.  Not sure how this happened.  Perhaps prior contact through friction, teeth during oral, or my penis rubbing against stud on a penis ring he was using prior to penetration.  No visual evidence of condom breakage at this point.
7.  Partner revealed HIV+ status at that point.
8.  Ended sexual acts.
9.  Tested condom with water the following day.  Found a small pin size hole, allowing water to leak. 
10.  Have since been to two doctors and followed up with testing.

My concern:

A.  Is there a chance that anal fluids from the positive partner were able to come in contact with the tiny cut on my penis shaft through the pin size hole.  If so, does this present a risk?

B.  I'm currently within the 72 hour PEP window.  I've seen two doctors.  At visit to doctor 1, I was unaware of the pin size hole in the condom and thus, that wasn't conveyed.  At that point, he recommended not taking PEP.  At visit to a second Doctor 2, after pin sized hole in condom was discovered, she seemed to say risks of contraction were outweighed by effects of PEP drug.  I'm not sure I agree...wouldn't I want to take any measure to reduce the chances of contraction?

Thanks in advance for your advice as I go crazy thinking about this.

[Jeff G]

Pep is not warranted in this situation and I agree with your doctor told you you do not need pep .

There have been no fewer than three separate serodiscordant couples studies (where one person is HIV positive, the other negative.) These couples were tracked for three. five and ten years. The couples used condoms for penetrative vaginal and anal sex, but NO BARRIER at all for oral sex. Any kind of oral sex. These studies yielded NO infections.

The small wound on your penis was covered by a condom is not a risk . Condoms are designed to leave no doubt when they fail and there is no need to check them for holes by doing the so called water test . In all likely hood you damaged the condom doing the test and the bottom line is intact condom = no risk for HIV .

ALTHOUGH YOU DO NOT NEED HIV TESTING AT THIS TIME for this incident , anyone who is sexually active should be having a full sexual health care check-up, including but not limited to hiv testing, at least once a year and more often if unprotected intercourse occurs.

If you aren't already having regular, routine check-ups, now is the time to start. As long as you make sure condoms are being used for intercourse, you can fully expect your routine hiv tests to return with negative results.

Don't forget to always get checked for all the other sexually transmitted infections as well, because they are MUCH easier to transmit than HIV. Some of the other STDs can be present with no obvious symptoms, so the only way to know for sure is to test.

Use condoms for anal or vaginal intercourse, correctly and consistently, and you will avoid HIV infection. It really is that simple!

Please understand that that HIV positive people who date people who are not have sex everyday and and the other remains HIV negative as long as condoms are used correctly and consistently for vaginal or anal sex . If you had a risk I would not hesitate to tell you but in this instance there is no need for concern .