[Question #1814] Busted Condom

78 months ago
Good Morning Doctor,

On Feb 5th I had protected sex with a CSW in Panama, unfortunately somewhere during our last act the condom ruptured completely, leaving my entire Penis  exposed, it may have been 5 seconds or 5 minutes, I'm not sure.

On Feb 6th she took an  hiv 1/2 test (blood draw) 3rd gen I assume, that returned negative. 
After 14 days and 9 hours I took a HIV duo test that also returned negative for hiv 1/2 ab/ag.
I freaked out immediately after the act and took 500mg of Azythromicin each day for 3 days in case she had a bacterial infection, since that time my stomach has been a mess, no appetite at all and in 26 days I've lost 10 pounds. 

My tongue has a white coating on it, I'm hoping just from the change in eating habits or antibiotic and the weight loss are the only symptoms I've had since the event. I've had no fever or anything else.

I've seen in other posts that you estimate a 14 day duo test as 80-90% accurate but those where several years ago on another forum, do you still feel that confident?

I plan on taking a final duo test this Monday which will be 29 days, I know you say that will be definitive.
I guess I'm looking for a little reassurance to get me through the next few days, I know I need to eat but the thought of food right now is not appealing and sleep is hard to come by right now.

Could you please give me your thoughts on my exposure and any testing you recommend I get done.

Thank you.
Edward W. Hook M.D.
78 months ago
Welcome to the Forum.  The odds that you got HIV from the exposure you describe are minuscule.  Most Panamanian CSWs do not have HIV and the fact that your partner's test was negative make that chance that she was infected close to zero.  Your own negative 4th generation test makes your infection risk essentially zero.

I suspect the white coating and GI upset you are experiencing are related to the azthromycin you took.  Personally, at this time, I really see no medical reason for further testing (or concern) about STIs from the exposure you describe, including HIV.  EWH
78 months ago
Thank you for the reply.

Just to follow up on your answer,

1. Do you mean no reason for further testing now or after my test on Monday?
2. The joint and muscle pain people describe during ARS, is it fleeting brief pain or is it sustained and very  noticeable?
3. Last night I developed a tender throat with phlegm and raspy cough, it is also associated with a stuffy nose, any cause for concern?

Thank you, I will post my results after I receive them.
Edward W. Hook M.D.
78 months ago
1.   Given the fact that your partner has already been proven to not have HIV with a test performed after you had contact with her there is little reason for further testing at this point. You were testing Monday will just provide you with added assurances. 

2.   The symptoms of the ARS are quite intense including the muscle aches and joint pains. The symptoms are not transient but sustained often for several days.   Cough mild sore throat and cold symptoms are not a typical part of the ARS. 

3.   Please see my comment above. 

 I hope my comments have been helpful and anticipate that when you post your results in the future we will find that you are negative and did not acquire HIV.
78 months ago
Good Morning Doctor,

I took an STD panel on day 29 post incident,

FYI  (I also took a duo test on day 26 just to ease my fears).

All tests where sent to a lab:

HIV 4th Gen: negative ( both the one on day 26 and the one on day 29).
Hep B and C : negative
Herpes 1/2: Both under the limit and indicate negative
Syphllis: negative
Gonorrhea negative 
Chlamydia: negative

Would you be happy with these results at this time and seeing as I took the 500mg per day of Azythromicin for 3 days starting within 1 hour of the incident, do you see any need for further testing? 
I haven't noticed any symptoms of STD's.

Thank you for your help and professional opinion,

Kind regards.
Edward W. Hook M.D.
78 months ago

Your test results show that no STI is present and that you can safely assume that you were not infected from your condom mishap.  There is no reason for further concern related to that incident and no need for further testing.  you can move on with confidence. 

This is my third reply to your questions.  therefore, later today, as per Forum guidelines, this thread will be closed.  Take care.  EWH