[Question #13124] Broken condom

2 months ago

Hello doctors,

I’m a 53 year old white male.

Had intercourse with a high end female escort in her early 30s in NYC, with a condom. After 4-5 minutes we adjusted ourselves and I noticed that the condom broke right at the tip of my penis, exposing my urethra.

She immediately said she’s tested every four weeks. Told her I hadn’t been tested in years, that I’ve had a few protected encounters with escorts over the last six months, and she said that I was a very low risk.

Wanted to get your thoughts on possible risks.

Thanks so much for all you do.

H. Hunter Handsfield, MD

2 months ago

Welcome back. However, this appears to be about the same event described in your question a month ago, no. 12596. Even if it's a different one, the circumstances seem the same, including the condom break. At that time, you also asked about possible irritation of your meatus (urethral opening). Here is my reply from that discussion:

Escorts -- upscale, expensive female sex workers by appointment -- are generally considered about the safest sex partners possible other than permanently monogamous ones. Most know the risks, use condoms consistently for vaginal or anal sex, get tested frequently, and their clients generally are low risk of having active STIs (men like you). The exposure itself sound entirely safe as well, with condom for vaginal and unprotected fellatio zero risk for some STIs (including HIV) and low risk for all. I suggest waiting a few days to see what happens with your meatus (urethral opening); my guess is you're just looking more closely than usual and likely nothing is wrong. Assuming these feelings clear up and no other symptoms, I would not advise testing for anything.

Do you have any other concerns about the situation?

HHH, MD

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2 months ago

Thanks for your reply, Dr. Handsfield.

With this encounter, the condom broke at the tip after 4-5 minutes of intercourse.

With the previous encounter, there was an irritation on the meatus due to prolonged oral sex, which resolved after a few days. The condom didn’t break during this encounter.

H. Hunter Handsfield, MD

2 months ago

So this is a new encounter? That wasn't clear from your message -- or I misunderstood. But if the condom didn't break, why did you choose the title "Broken condom" for this question? I'm sure you can understand why that was your concern. In any case, my reply the last time still applies. I don't have anything more to advise.

All OK?

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H. Hunter Handsfield, MD

2 months ago

There was no need and no point in starting and paying for a new question. It is being deleted and you will be reimbursed for that fee (after the weekend).

The new question you wrote was to reintroduce yourself and describe you new partner, just as you did above, and then:

After approximately 4-5 minutes of intercourse with a condom on, we changed positions and I noticed that the very tip of the condom was broken, exposing my urethra. This is the first time I have ever had a condom break at the tip.

The escort immediately shared that she gets tested every 4 weeks, which was reassuring.
I am, however, married with a family, and quite nervous about potential risks for STIs in general, and certainly HIV exposure, and wanted to get your thoughts on this encounter.

None of this changes my answer above. The only difference from your question several weeks ago is the possible exposure of the tip of your penis. That elevates the risk of infection somewhat, but this still was a very low risk exposure -- based on the nature of your escort partner and the evidence she is unlikely to have an active, transmissible STD -- and I do not advise testing. We rarely advise testing after only a single exposure, even entirely unprotected. But of course you are free to be tested if it would reduce your worry and anxiety. In that case, feel free to have a urine gonorrhea/chlamydia test (valid any time 4-5 days or more after expossure) and, after a few weeks, blood tests for HIV and syphilis. The risks of these are so minuscule that I would advise you to continue sex with your wife in the meantime.

Another option would be to speak with your escort partner and ask her to be tested again now, at your expense. (With respect and kindness -- you have no right to to insist.) If she testes negative for gonorrhea, chlamydia, HIV and syphilis, you'll know you were not exposed and could not have been infected. Honestly, I think this would be overdoing things given the low risks you describe, but it's an option you could consider.

That completes the two follow-up comments and replies included with each question and so ends this thread. I hope the discussion has been helpful. Best wishes and stay safe. Please note the forum policy against repeated questions of the same type or on the same topic. This was a different exposure than your previous question, but it was virtually identical in all respects, including the condom breakage. Let's make this one your last, with or without condom breakage and with or without meatal exposure. Thanks for your consideration.

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