Concern after Condom Breakage

[rclicious]

Hi All,

I've been reading multiple posts on this website and this forum has been a great source of information for me. However, I would like to run this situation with you all.

I had anal sex with another man I've met yesterday and I was the top. However, during the intercourse, I didn't know the condom broke by the head of the penis until I pulled out. I did not ejaculate within him. I removed the condom, masturbated and came on his body instead. After everything, we both talked about our statuses and we are both negative. However I am still skeptical about it since I've only met him yesterday. I did an OraTest today at home and I am negative.

Should I be worried about being infected with HIV from the condom breakage and should I start on PEP meds? (It has been 20 hours since this incident as of now) Previously I have been on one round of PEP (Combivir) meds a year ago and I was wondering if this would be a risky enough scenario to go through a series of PEP again.

Thank you for all your advices in advance!

Cheers,
R

[Jeff G]

You are right for not trusting what a person said about their HIV status . You had a risk in this situation and will need to test , you can test at 6 weeks and again at 3 months to confirm the result .

There are things in your favor , its rare for the insertive top to test positive after a brief insertion ( if it was brief ) . At best you had a low risk situation for an HIV exposure and the decision about PEP is between you and your doctor .

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 STIs 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!

[rclicious]

Hi Jeff,

Thanks for the quick response!

That was definitely a brief insertion. The condom broke and the unprotected sex went on for about a minute.

With my situation, would it be advised to undergo the PEP treatment? Moreover, based on your experiences, how many insertive top cases have you seen test positive after a brief insertion due to a condom breakage?

Thanks for the help Jeff and I look forward to your reply!

Best,
R

[Jeff G]

Hi Jeff,

Thanks for the quick response!

That was definitely a brief insertion. The condom broke and the unprotected sex went on for about a minute.

With my situation, would it be advised to undergo the PEP treatment? Moreover, based on your experiences, how many insertive top cases have you seen test positive after a brief insertion due to a condom breakage?

Thanks for the help Jeff and I look forward to your reply!

Best,
R

I haven't seen any cases where the top went on to test positive . I cant tell you to get PEP or not too , if you talk to your doctor he may can advise you .

Condom breaks rarely turn into an infection and where your risk was low risk it was not no risk . Best of luck .

[rclicious]

Hi,

Thank you for providing me with the support I needed during this stage! I am eternally grateful to you all.

However, I would like to ask you some questions in regards to my current state.

1) I feel like I have a low running fever as of right now and I am concerned if this is a seroconversion stage as it has been 4 weeks since my possible exposure to HIV due to a condom breakage event. I was feeling fine a couple of weeks ago and tonight I felt a bit fever-ish. However, I am also considering the fact that I might have caught the cold due to the change in weather. Would this fever be an indicator that I am in the seroconversion stage?

2) Would it still be possible for me to undergo the seroconversion stage even though it has been 4 weeks since my possible exposure? When does the seroconversion stage normally occur?

3) Would a Rapid HIV test using Clearview HIV 1/2 STAT-PAK at the 6 week mark produce a trustworthy result as an indicator of HIV infection? If not, then when would it be the best indicator of HIV infection using Clearview HIV 1/2 STAT-PAK as the test?

Thank you for all your help and I look forward to your reply!

Best,
R

[jkinatl2]

Hi,

Thank you for providing me with the support I needed during this stage! I am eternally grateful to you all.

However, I would like to ask you some questions in regards to my current state.

1) I feel like I have a low running fever as of right now and I am concerned if this is a seroconversion stage as it has been 4 weeks since my possible exposure to HIV due to a condom breakage event. I was feeling fine a couple of weeks ago and tonight I felt a bit fever-ish. However, I am also considering the fact that I might have caught the cold due to the change in weather. Would this fever be an indicator that I am in the seroconversion stage?

2) Would it still be possible for me to undergo the seroconversion stage even though it has been 4 weeks since my possible exposure? When does the seroconversion stage normally occur?

3) Would a Rapid HIV test using Clearview HIV 1/2 STAT-PAK at the 6 week mark produce a trustworthy result as an indicator of HIV infection? If not, then when would it be the best indicator of HIV infection using Clearview HIV 1/2 STAT-PAK as the test?

Thank you for all your help and I look forward to your reply!

Best,
R

Hello!
 
I will try to answer your questions in order:

1) Symptoms of seroconversion range from absolutely nothing to raging fevers that leave people bedridden or in the emergency room. It really is all over the place. Considering the time of year, I would use Occum's Razor and assume it was perhaps a mild cold or allergies.

Especially given the insanely low level of risk. Like has been stated, were you to test positive over the incident you describe it would be the first time in over ten years of risk assessment on these forums.

2) Seroconversion almost always occurs within 22 days past exposure. We still use the three month gold standard because this is a global site - and even in the US older tests are used. Most advanced cuo tests will pick up infection at six weeks, though a new test is going to be rolled out that might bring it down to four. Anything less than that and you are looking for antigens (viral particles) instead of antibodies, and those tests are prone to false positive and not used much for diagnosis.

A six week test will be considered almost certain. We still advocate the three month test because, as I mentioned, the latest generations of tests (developed within the last four years or so) are simply nor available everywhere.

In two weeks you can test and get a pretty definitive result. In two months you can get the global gold standard all-clear.

And I fully expect you to come out of this negative. Like I said, ten years, tens of thousands of risk assessments, and not ONE SINGLE insertive partner has tested positive over a condom break. It's a low enough risk to test for peace of mind (or the next time an STD panel rolls around) - and low enough to make the level of anxiety you seem to be experiencing worth investigating.

[rclicious]

Hi All,

I would like to run through another situation with you all and hope you can shine some light on this.

I've met this guy a couple of times over the 2 years and we had sex about 3-4 times in the 2 years of briefly knowing each other. In all the previous times, we used a condom and had protected sex.

However, I just had sex with this guy again and he ensured me that he was on PrEP (Truvada) for 2.5 months now. He didn't like the feeling of condoms and persuaded me into barebacking. I was in the receptive role and he was in me for about 1 minute. He did not ejaculate and I did not see any pre-cum as he pulled out. Being the paranoid me, I immediately checked for tears and found no tears in and around the anus.

He seems somewhat trustworthy but we only meet up and have sex. That being said, I know that PrEP would reduce the risk but being the receiving end, I would have a higher risk in comparison to the Top.

Hence, I would like to ask experts if they can shine some light as to what my next steps should be. Should I go on PEP or is this considered a slightly lower risk that I can forego PEP and expect a negative result in 6 weeks?

Thank you in advance!

[Joe K]

Unprotected intercourse is a risk for infection, however the short duration is in your favor, but you still had a risk.  You cannot go by what others tell you about their health, as only testing can determine your status.  While the short duration of intercourse is in your favor, you should consult with your doctor to discuss PEP.  If you decide on PEP, remember that you can test 6 weeks AFTER you complete PEP and then at 3 months to confirm the result.

Joe

[rclicious]

What kind of a risk would you say it was? (small, medium, high)? And from your experience, should I go on PEP?

[Jeff G]

We cant give odds on transmission and can only advise that it was a risk and you need to discuss PEP with your doctor if you want to pursue it. You can read about PEP here ...
http://www.aidsmeds.com/articles/Transmission_17146.shtml