[Question #12874] Broken Condom STD Transmission Risk
4 months ago
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I recently had condom-protected sex with a woman in her 40s. During the encounter, I wasn’t certain whether there was any penetration of her vagina or rectum. At one point, I heard a sound that seemed like the condom breaking, so I immediately withdrew. Upon inspection, I noticed the condom had torn near the base, but the tip covering the head of my penis remained intact. The woman assured me that there was no vaginal or anal penetration and said she gets tested for STDs annually and is currently STD-free. Given this situation, what is the risk of STD transmission, and should I get tested?
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H. Hunter Handsfield, MD
4 months ago
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Welcome back to the forum. Thanks for your continued confidence in our services.
Your previous two questions and this one all suggest you overestimate the risks of STI. Even after entirely unprotected sex with a female partner -- including sex workers -- the large majority of exposure do not result in STIs. With the condom breakage, your risk was a little higher than it would have been, but protection is considered complete when the head of the penis and the urethra (penile opening) are covered. And you describe a partner who is aware of STDs and unlikely to be infected. I would not advise testing for anything on account of this single event. Rather than testing after any single sexual exposure, a smarter plan is to get tested periodically -- maybe after 6-7 such events, but not every time.
I hope this information is helpful. Let me know if anything isn't clear.
HHH, MD
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4 months ago
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Thanks Dr. Handsfield
I was told that time matters during exposure to genital secretions, so if the exposure was short like lasted for seconds or few minutes the risk is very low and I shouldn’t worry about it. Do you agree with this even if the penis was uncovered?
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H. Hunter Handsfield, MD
4 months ago
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I agree that duration of exposure is important. That it was so brief after the condom broke is one of the reasons I consider this event to be very low risk.---
4 months ago
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Thanks Dr. Handsfield. What regular tests do you recommend and the appropriate waiting timeline? I read in the forum that you should wait 28 days or 6 weeks for an hiv combo test.
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H. Hunter Handsfield, MD
4 months ago
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I don't recommend any testing at all after a single exposure of such low risk. Even you had used no condom at all, I would not advise testing. Rather than looking for STD after any single exposure, a smarter plan is to be tested at regular intervals, e.g. once every 6-12 months or after several exposures -- maybe 5-10 events? As for HIV, your risk was zero for all practical purposes.
All that said, testing can have reassurance value even when the risk is zero. If that applies to you, consider an AgAb (4th generation, "combo") blood test and a syphilis blood test 6 weeks after the event. A urine gonorrhea/chlamydia test can be done any time 4-5 days or more after exposure. If somehow I were in your situation, I wouldn't be tested for anything and would be continuing unprotected sex with my wife without worry.
That concludes this thread. I hope the discussion has been helpful.
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