[Question #10161] Broken Condom with Escort
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25 months ago
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9 days ago I
saw a escort in Ohio. Alot of Colombian and Cuban girls are here. They charge 250 per hour in decent hotels.
Unprotected oral is a up charge that I did indulge in.When we got to sex I
supplied my own condom(she had her own as well), after the oral we started the
deed in doggy and as soon I as I entered her the condom popped and pulled out,
looked like my head was exposed(2-3seconds). Had to stop, She cleaned me off
with wipes right after. She required protection for sex and that she is
healthy. I have no symptoms at 7 days, went to urgent care and tested for
Gonorrhea/chlamydia/Trich by rapid urine test and all came back
negative. Worried about HIV. I am married and happy and we do have sex few
times a month with condoms. I asked the urgent care doctor if I should have started
PEP and said NO. Because this was a very low risk, he mentions 4 in 10k IF she
was infected. Should I get tested for HIV?
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Edward W. Hook M.D.
25 months ago
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Welcome to our Forum. thanks for your questions. I'll be glad to comment.
Overall this was a low risk exposure, both for STIs and for HIV. Most commercial sex workers, and in particularly those who charge higher prices, do not have STIs and get themselves checked regularly. Rates of HIV are very, very low. In addition, in the unlikely circumstance that your partner was infected, most single exposures do not result in infection- if exposed to a partner with gonorrhea or chlamydial a single time, the risk for infection is about 20% on average and in your case, given the brevity of the exposure, your risk is lower still. Similarly, in the unlikely circumstance that your partner had HIV, your average risk for infection from a single exposure is less than 1 in 1000. In your specific case, your negative urine tests are further strong evidence that you did not acquire a typical STI from the exposure.
Like the clinician who saw you, I would not have offered PEP to you following this exposure.
My advice at this time, considering the specifics of your exposure and your bacterial STI test results, I'd move forward without concern. Personally I also would not pursue testing for HIV either however, if your level of concern is high, you can get conclusive results with a combination HIV antigen/antibody test performed 6 weeks after your exposure. Should you test, I am confident that you will find that you were not infected.
I hope that his perspective is helpful. EWH
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25 months ago
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Thank you doctor for your response!
They did not mention being tested at all, there was a big language barrier with them(2 of them were there). But I did ask multiple times if they are clean, no HIV. They responded yes, they were sharing the hotel room.
Overall... what a mistake. First time doing this on my business trip and it will be the last. The stress this has done to me is insane, Ive lost 5lbs over the past 9 days. I have a small runny nose and here I am googling symptoms of HIV thinking I have it. Considering money isnt a issue for me, would a HIV RNA test be ok to take tomorrow since I'm home now? I would follow up with another test in 4 weeks as well. Also, is there any need for another test for the tests I did already? I know some of these can take more time to develop. Kinda need that peace of mind I suppose.
Again Doctor, thank you for your response and expertise.
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Edward W. Hook M.D.
25 months ago
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I would not expect them to mention testing. I mentioned testing as a generalization.
If money is not an issue, given your level of anxiety, an HIV RNA PCR test taken 11 or more days after your exposure would be helpful. A negative HIV RNA PCR at 11 days is considered a very strong indication that you were not infected. We have never seen or heard of someone who had a negative HIV PCR at 11 days go on any become positive although out of an abundance of caution we have seen some experts recommend still following a negative PCR test with a 4the generation, combination HIV antigen/antibody test at 6 weeks "just to be sure". This may well be overkill.
EWH
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