Broken condom - freaking out

[darren333]

Hello all

So this morning I had protected sex with an escort and somewhere during the last 2 minutes the condom ripped and I ejaculated inside her, the tip was unfortunately exposed.

She says she gets tested every month, always uses condoms for sex etc and whilst I don't have reason to disbelieve her, it still has shaken me up. I tested negative a few months ago and have never had unprotected sex since.

I will of course get tested at 4 weeks and 3 months but does this sound like a high risk exposure to you? My gut feeling is that PEP would probably be a step too far.

Thank you
Darren

[Jim Allen]

The odds for any sexual exposure leading to a HIV infection is statistically low, yet globally its the most common transmission route in adults and we tell people to protect themselves for good reason.

Now the condom broke and so you had a risk. The women's line of work or history don't even factor into this, HIV effects people from all walks of life and if she tested today all it means is she was negative some 3 months ago - No good to you at all.

All in all you had a risk and so testing is indeed recommended as you point out yourself.  Also test for easier to transmit STI's whilst you are at it.

Now regarding taking PEP this is up to you, and PEP has an excellent track record of preventing HIV post exposure when taken correctly and started within 72 hours post exposure.  So note that if you are considering PEP you should start taking this as soon as possible after exposure starting no later than 48-72 hours post exposure. It's up to you at the end of the day to decide to take PEP for this incident.

If you do take PEP than test at 6 weeks and 3 months post finishing the PEP course.

Here's what you need to know in order to avoid hiv infection:
Use condoms for anal or vaginal intercourse, correctly and consistently, every time, no exceptions. Consider starting PrEP in the future as an additional layer of protection against HIV

Keep in mind that some sexual practices which may be described as ‘safe’ in terms of HIV transmission might still pose a risk for transmission of other STI's, so please do get fully 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.

More information on HIV Basics, PEP, TaSP and Transmission can be found through the links in my signature to our POZ pages, this includes information on HIV Testing

Kind regards

Jim

Please Note.
As a member of the AM I Infected 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.

[Jim Allen]

PS.

You have 2 free posts renaming so, if you do have follow-up questions make them count.

Jim

[darren333]

Just a little update,

The GUM consultant wouldn't even consider PEP after I asked his opinion. Claims I'm too low risk and that most sex workers are better than most at getting themselves tested. No different than me having unprotected sex with a woman from a nightclub.

Been told to test at 4 weeks and 3 months but to expect negative results.

Might pay for a private RNA test which is pricey but can apparently pick up after 10 days (however having read about it's percentage of false positives and questionable accuracy I might skip that one)

Will post my results in 3 months time

Darren

[Jim Allen]

 No different than me having unprotected sex with a woman from a nightclub.

Correct and this is how HIV is acquired. As said the odds for any sexual exposure leading to a HIV infection is statistically low, yet globally its the most common transmission route in adults and we tell people to protect themselves for good reason.

Now the condom broke and so you had a risk. The women's line of work or history don't even factor into this, HIV effects people from all walks of life and if she tested today all it means is she was negative some 3 months ago - No good to you at all.

As for the RNA testing, indeed its no shortcut due to the false results. Save your cash for a night out and simply test with the approved antibodies test at 4-6 weeks and confirm the result at 13 weeks.

Jim

[darren333]

Hello again,

So my 4th gen test came back negative at 4 weeks but this is obviously to be confirmed at 3 months as right now it means nothing. Jim, I know you tend to tell people to test initially at 6 weeks but was following "doctors orders" as they say.

Do you think it would be overkill to test at 6 weeks too or should I just wait it out?

I'm aware this is my last free post I'll let you know in 2 months whatever happens. Think the least I can do is pay and contribute somewhat. I'm very grateful as I'm sure hundreds if not thousands of others are.

[Jim Allen]

You tested at 4 weeks, well the results you have are highly unlikely to change when you do test at 3 months post exposure, in other words no need to repeat at 6 weeks now, just test at 3 months.

The 3 months mark is really just to capture outliers.

I'm aware this is my last free post I'll let you know in 2 months whatever happens.

When people don't return as full members I presume it's negative result and I'll do the same for you

Jim

[darren333]

When people don't return as full members I presume it's negative result and I'll do the same for you

Jim

Sorry what was that?

But yes, I am negative at 13 weeks.

[Jim Allen]

Glad to hear it.

Jim

[darren333]

Thank you.

Since I'm here I may as well get my money's worth (I'm Scottish after all) so I have another question if you don't mind. HIV1 and HIV2, what are the differences between the two viruses other than the latter being much less common?

[Jim Allen]

Hiya

That's a very broad question...

In short the two HIV are separate, yet related species of Lentivirus that have widly speaking similar effects on the human body,

So there are genetic difference between them.

On a treatment side, most of it is geared towards HIV 1 although treatments for HIV 1 are generally effective for HIV 2 . Example thought NNRTIs inhibit reverse transcriptase, an enzyme that controls the replication of the genetic material of HIV, stopping or inhibiting this process works very well with HIV 1 however not so for HIV 2 simply due to the difference between the two viruses.

Treatments are simply put based on stopping the different steps in the lifecycle https://www.poz.com/basics/hiv-basics/hiv-life-cycle

Both viruses are fragile, highly limited to the point of being infectious but not contagious and both are aquired through the same activities. That said HIV type 1 has an easier time/way to attach itself to target cells (CD4's) in the human body, probably this is also why HIV 1 is more wide spread than HIV 2 and has generally a faster progression rate.

Jim

[darren333]

Interesting reading, thanks Jim.

[Jim Allen]

You're welcome