This is an unusual type of condom failure; mostly they break wide open or not at all. It is difficult to judge the exact risk from this. It is true that the risk of HIV and some STDs (e.g. gonorrhea, chlamydia) is low as long as the head of the penis, and the urethral opening, are covered. However, it sounds like the tear was near the head of your penis, and it seems possible that genital fluids could have gotten inside -- and since the penis often slides inside the condom, fluids could have come into contact with susceptible areas. Also, if you are uncircumcised, you should assume the inside of your foreskin was exposed -- which is highly susceptible to HIV. Having said that, even without a condom, the chance of HIV and other STDs is always low for any one exposure, and certainly you can consider this sexual exposure as largely protected, if not quite perfectly.

I agree with the helpline advice about the abrasion. It doesn't signfiicantly elevate the risk of HIV.

As for sex with your wife, it is impossible to give any kind of guarantee and the risk is not zero, so you probably should be tested for HIV and other common STDs. I recommend a gonorrhea/chlamydia urine test, which you can do at any time (the test is valid any time more than 3-4 days after exposure); an HIV 4th generation (antigen-antibody, "duo") test at 4 or more weeks; and a syphilis blood test at 6 weeks or more after the event. If I were somehow in your circumstance, once the gonorrhea/chlamydia result was known to be negative, I would resume unprotected sex with my wife -- i.e. the risk of HIV and syphilis is low enough that I would not feel a need to waiting for those test results. 

If you are able to contact your CSW partner and ask her to be tested for syphilis and HIV (perhaps helping her, e.g. paying for the tests?), you could stop all worry if she has negative test results.

I hope this information is helpful. Let me know if anything isn't clear.

Best wishes--  HHH, MD

No reason at all for you to be "sorry" about all this. You haven't done anything unusual, and wisely used a condom, and with a partner who seems to be relatively low risk. Don't beat yourself up over normal behavior or a bit of bad luck.

 

"when a condom breaks she's more nervous about catching something then transmitting it":  I didn't say that, but it's certainly possible she is more concerned about protecting herself than worried about infecting her clients. That's why most people use condoms, including sex workers.

"she might be lying":  What I said is that most people do NOT lie about this when asked directly. Of course I have no way of knowing for any particular person.

"if i dont have chlamydia or gonorrhea i can have sex with my wife":  I did not and cannot tell you whether and when to resume sex with your wife. If you want 100% assurance, you'll have to wait until your HIV and syphilis tests also are negative, i.e. 4-6 weeks from now. Even then, there are no good tests for herpes and HPV, so the STD risk in this situation can never be zero. As I said, I would have sex with my wife once the gonorrhea/chlamydia tests were negative. But I'm not you, and you'll have to make your own decision.