Condom broke during sex with stripper - Should I take PEP?

[UnsureWhatToDo]

Hello,

I'm a circumcised male in his early 30's, and almost 72 hours ago, it was my birthday and I went to a strip club in Miami, Florida.  I ended up having sex with a stripper who I was really attracted to.  I tore the condom wrapper open a little bit harshly, but the condom still appeared to be intact.  It was dark, so I couldn't really see, but I put it on very quickly and not exactly properly, as I only rolled it on probably about halfway down, and we began having sex.  Probably about 30 to 40 seconds into it, I realized that I didn't feel protected, so I pulled out and the condom was completely broken, meaning it was down halfway around my penis, with the top uncovered.  She asked me what happened, and I showed her.  She didn't speak very much English, but she started asking me if I had any diseases or was I clean, over and over, and I kept responding "yes", and trying to ask her.  She told me no repeatedly, and even made a gesture and said something like "On my mother in Cuba".  This is somewhat reassuring, but I know that if she had sex with me so easily she could very well be doing the same with lots of others.  Although she kept asking me if I was clean, her body language did not appear to be overly nervous.  She was more calm, and appeared to be a little bit drunk also.

I went to an urgent care facility yesterday and spoke with a doctor.  He told me that the chances of transmission were very low, and I could take PEP if I wanted to, but there are side effects and it is very hard on your liver and kidney.  I asked him if he would take it, and he didn't really want to tell me either way but said honestly probably not, but that it can help if you feel anxious.  I declined to get it just because I know it is a powerful antiviral medicine, that I would really prefer not to take.  He also said that he had never seen someone come in with a case of HIV contraction from vaginal sex in his practice.  I know the odds are low, but I am obviously worried about this.  He advised me to take a rapid HIV test for some reason,  even though he acknowledged that the test results are not that helpful this shortly after and I should get tested again in a few weeks.  The results were negative, Thank God.

I was pretty much set on not taking PEP, but I only have a few hours left in the 72 hour window and I am becoming very anxious.  It's a really hard decision for me to make and I would hate to look back with any regrets, god forbid.  If I wanted to, I could still go to an emergency clinic and probably get it.  I am more anxious about this than I have been about anything in a while.  I am somewhat prone to anxiety, and the thought of waiting four weeks just to get this over with is really bothering me.  From what I've read the odds are very low, but I don't want to be that one unlucky one.  I haven't had unprotected non-oral sex since 2012, specifically because I hate dealing with these feelings.  I know there are worse things to deal with than feelings, but I'm feeling very stressed right now.

I just wanted to get some thoughts from experts on this situation.

Thank You.

[Jim Allen]

Hi

The side effects from PEP are mostly none existent to a few days of mild discomfort as your body adjusts and as for the kidney stain its not a lasting effect as in once you finish the course its not a lasing effect if any.

Greatest benefit is possible HIV prevention as if you were to become HIV positive your would have to take the meds not for 30 days but for life.

That said the meds are so good that people living with HIV have a near normal life expectancy that's how good they are.

As for your risk, taking PEP or not is up to you but you need to start sooner and before the 72 hours post exposure. Test in 6 & 13 weeks post exposure for a conclusive HIV result.

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.

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.   

[UnsureWhatToDo]

Hi Jim,

I didn't get strong advice within the 72 hours that made me feel I should start on PEP, and now I am outside of the window.

Later tonight / early tomorrow morning, it will be 96 hours, is there any chance I should still try to take the PEP?

I am just really worried sick about this and if I had read a response like yours earlier I probably would have started on the PEP, but most of what I had read online combined with what the doctor said, lead me to believe that I would probably be better off not taking it.

What do you think my risk is for this exposure?  I am extremely anxious about this and it's hard for me to figure out what to do.

[Jim Allen]

I don't know what you read online but millions of people take the drugs daily without any issues whatsoever and people can live full and healthy lives taking them, that are the facts and I find that stories online are just that, stories nothing more and often  outdated and misleading.

96 hours is outside the 72 hours and taking PEP this late would most likely not be beneficial anymore.

You had a risk though the main transmission route of HIV, unprotected intercourse That said it would be highly unlucky for you to be infected from this 1 time exposure however it does happen and so testing is advisable at 6 weeks post exposure and 13 weeks to confirm the result. 

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.

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.

[UnsureWhatToDo]

I just took a finger prick HIV test at about 28 days since the incident, and I am incredibly thankful that it came back as negative.  My doctor told me that this is conclusive.

I'm thankful not only to you but to the other posters in other threads on this forum who provided information and some reassurance.

I hope that science is one day able to provide a cure for this virus.  Is there any links that you can recommend where I can make a donation?

[Jim Allen]

No donation needed, just remain HIV negative.

Look the rapid tests/finger prick test all have a window period of 3 months, so I recommend you retest at that time.

Jim