Condom broke 2 nights ago, should I get PEP?

[nunya]

So two nights ago I met a trans woman, get profile said she was negative and on prep but obviously that isn't a definite.

She wanted me to fuck her bareback, but I wouldn't, I put on a condom and inserted my penis into her ass for 2 - 4 seconds, and pulled out to see the condom had broken and my penis was exposed.

I originally decided not to go for PEP because it didn't seem like it was very high risk, but now, 2 days later I noticed skin peeling on the glans of my penis and some small white bumps. I'm not sure if they were there before but could it be that the chance of infection was increased if these were present? I know I'm running out of time to get PEP and I don't know if the doctors in Ireland would even give it to me based on my story but I'm pretty worried

[Jim Allen]

Hiya,

Look her claimed status or PrEP usage means nothing.

Regarding the HIV risk from the broken condom incident, it is an HIV risk although the good news is that until the condom broke it would have been protecting you, also as you were the insertive partner it would be less risky than being the receiving partner as an example.

As it was a risk test at 6 weeks post-incident with a blood-drawn HIV antibodies test and a negative result at that time will rarely ever change. If you wish you can confirm the result at 3 months post-encounter.

Now about PEP, yeah time is running out at this stage. If you do decide to start PEP you might need to go down to the A&E considering the time as PEP is only effective when started no later than 72 hours post-exposure.

It's up-to-you to take PEP or not over this incident, if you do take PEP then test at 6 weeks post finishing the PEP course with a blood-drawn antibodies test, a negative result at that time would rarely ever change.

Not sure where you are in Ireland but please see the link below on PEP from St James hospital in Dublin.
http://www.guideclinic.ie/sti-clinic/hiv-testing-and-pep

Here's what you need to know to avoid HIV infection:
Use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions. Consider talking to your healthcare provider about PrEP as an additional layer of HIV protection

Keep in mind that some sexual practices described as ‘safe’ in terms of HIV transmission might still pose a risk for transmission of other STI's, so please do get tested regularly and at least yearly for all STI's including but not limited to HIV and test more frequently if unprotected intercourse occurs

Also, note that it is possible to have an STI and show no signs or symptoms and, the only way of knowing is by testing.

Kind regards

Jim

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[nunya]

Hi thanks for getting back.

I just really don't know what to do, I feel like it only having been inside for less than 5 seconds means it was quite unlikely, and I'm guessing they broken condoms happen a lot and don't usually prompt the insertive partner to get on PEP, but I'm worried anyway.

I know PEP has quite bad side effects and I don't really want to go through them for a month if there wasn't a realistic chance of infection. Plus I know doctors only give it on the basis of chance of exposure, so I'm not sure if they would give it to me anyway.

What would you be thinking if it were you?

[Jim Allen]

Hiya.

With modern HIV meds, asides from getting settled into taking the meds, people should not be expecting any major side effects and if you do end up living with HIV you will be taking them for life instead of just 28 days.

The rough guidelines in Ireland for the doctor would be to consider PEP. Page 4 https://www.hpsc.ie/a-z/EMIToolkit/appendices/app7.pdf

Ultimately the odds are in your favour even if you don't take PEP and it's up to you to seek PEP over this potential exposure or not. I do recommend testing.

[nunya]

I thought they were some pretty serious meds. Also with PEP not being 100% effective I'm wondering if it's worthwhile when the chance of exposure was so small to begin with. I'm only really worried because of the person, I never have this worry after unprotected vaginal sex

[Jim Allen]

I never have this worry after unprotected vaginal sex

Well, I am concerned to hear condomless vaginal intercourse does not concern you given the STI & HIV situation in Ireland.

Anyhow, look it's up to you. As said with modern HIV meds asides from settling in no issues should be expected, it's 2021, not the 90's. If you don't seek PEP then I do still recommend testing for HIV & STI's at the appropriate time.

You can test through the GP's however they will charge for the service. You can also test for free through HIV Ireland and the Clinics at St'James or Mater Hospital https://www.mater.ie/patients/sti/

There is also a new service that can offer free of charge home testing. https://mpower.hivireland.ie/

[Jim Allen]

Please Note.
As a member of the "Do I have HIV?" The forum you are required to only post in this one thread no matter how long between visits or the subject matter. You can find this thread by going to your profile and selecting show own post and it will take you here. It helps us to help you when you keep all your thoughts or questions in one thread and it helps other readers to follow the discussion. Any additional threads will be deleted.

Please don't post in other forums designed for people living with HIV.

Regarding your PEP. Relax, take the next scheduled dose as normal and pay closer attention for the remaining duration of the course.