[Question #3215] Condom Broke

37 months ago
Friday evening I went to a massage parlor Whittier, California. She was Hispanic and approximately 22-27 years of age 

The CSW used condom immediately without hesitation. She started with oral and then vaginal sex. we stopped twice to put on lubricant. I Had drank earlier but was aware. having slow sex and she orgasmed, stopped to check the condom. pulled the tip of the condom forward that's when it broke off. did not hear or feel it pop while in the act. unaware how long my exposure was or if there was exposure.
When I told her the condom broke she said what a scare. I peed and washed off with water. She asked me if I ejaculated in her and I had not. She went to the restroom and said she cleaned herself out. Asked if she had any diseases and she stated no and when was the last time she was checked, approximately 3 months. she stated she would get tested right away. She was much calmer than I was.

was very anxious in front of her, she stated the way your are acting makes me feel better that you possibly don't have anything. I gave her my number so we could talk. She did not give me hers, but did tell me her name.

asked  if this had ever happened to her before, was the first time. 

she had an orgasm which means she would have more vaginal fluid in her, higher risk?I am a husband and father. 
I check my condoms by filling them with water after sex to check for leaks.

Can you provide some advise and guidance on my type of exposure. Should I use pep? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Welcome to the forum. Thanks for your question.

My first reaction is to congratulate you on having safe sex for extra-marital sexual encounters. The condom may have failed this time, but it is obvious that you intend to be safe -- and also select partners who are careful about their own health (or at least you did so this time).

Your risk of HIV was nearly zero and most experts would not recommend PEP in this situation. It is rare that partners like yours have HIV, and it sounds like the chance she is infected is especially low, given recent testing and the care she apparently takes in protecting her health, such as regular testing and probably consistent condom use. And even if she did have HIV, unprotected vaginal sex has a risk of HIV transmission around once for ever 2,500 exposures. Further, the period of unprotected contact apparently was brief. (I'm a little confused by the story. Did you resume sex after she pulled at the condom and it broke?) Whether or not you ejaculated in her, whether she had an orgasm, or the amount of vaginal fluid present make no difference in risk.

The chance of other STDs was somewhat higher. Even careful sex workers with fairly frequent testing can have chlamydia, gonorrhea, or syphilis (although syphilis is quite rare in this situation). But even here, the chance you were infected is very low. She probably wasn't infected.

What to do now? Assuming your partner follows through and gets tested, and tells you the results are negative, you probably don't need testing. If you don't hear from her, or for additional reassurance, you could have a urine gonorrhea/chlamydia test, which will be valid in a few days (4-5 days after exposure). And you could also have HIV and syphilis blood tests 6 weeks after the event. However, I do not suggest you wait that long to have sex with your wife. The chance you have acquired either HIV or syphilis is extremely low, almost zero.

I hope this information is helpful. Let me know if anything isn't clear. Best wishes and stay safe--

HHH, MD
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37 months ago
Thank you Dr. Handsfield, we did not resume sex, it ended , we got cleaned up and then we spoke briefly and That's when she provided me with what She said was her real name.  

If i don't hear from her I will visit her to see what she can advise.   Surely hope she is clean and everything turn out good. I know you've said in other posts that there has never been a person that comes back and states they were infectsd from this type of exposure in the 14 years that you have been working on similar posts. I truly hope I'm not the first. 

I had something like this happen 20 years ago. Very scary situation. 
37 months ago
Just for clarification. Not sure if the condom broke inside, i am assuming it did. when I pulled on the front the tip of the condom broke of easily as if it already had a tear. I also would asume my urethra was exposed It was dark and everything happened so quickly and the andrnaline kicked in.  

We were having sex for about 10 minutes and break in between to lubricate. Last 3-4 minutes I would say we're very unclear.  When she started saying It felt good was the moment I said ok let me check.   ugh 

Do you think she would she have a reason to lie about her status of being disease free. Is it a good sign when someone gives you their real name?  

Very annoyed at myself right now. Thank you again. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
That's what puzzled me. If you didn't resume sex after the condom broke (as she was removing it), why are you concerned? It sounds like you were covered and protected during penetration. If so, I don't recommend you be tested, regardless of whether she gets tested or informs you of the results.

If and when someone reports on this forum they actually acquire HIV after an exposure they asked about, I'm sure it will come from a truly high risk exposure, such as a guy having unprotected anal sex with another male. Such exposure account for 90% of HIV infections in the US. After anal sex in men having sex with men, shared drug injection equipment is the second most common exposure resulting in HVI. Hetersexual exposure remains among the most rare kinds of events resulting in new HIV infections. It will be very surprising if the first event on this forum is from a vaginal sex exposure. And it sounds like you didn't even have that!

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37 months ago
Hi Dr.handsfield,

I had to limit the amount of words on my first message therefore it sounded like she had pulled on the condom. 

Clarification. I was on top and stopped  to check the condom,  I am assuming that there was a tear in the condom while in the act. We were not finished, I stopped to check the condom and then would have continued, if It remaind intact. When I pulled on the tip it broke off like butter, leads me to believe there was a tear. I  cannot recall if the sensation was different so I am assuming there was a tear on the tip of the condom and therefore there was exposure to my urethra. Sorry for the Confusion. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
OK -- but it really makes no difference. My reply wouldn't change significantly even if you had never used a condom at all. Note the figure I gave above for entirely unprotected vaginal sex if the female partner has HIV, around 1 transmission for ever 2,500 events. (That's why many spouses of HIV infected people often go years before they become infected, and some never do -- even if they never take precautions against it. HIV is hard to transmit!)---
37 months ago
Thank you for your time 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Thanks for the thanks. I hope the discussion has been helpful.

That concludes the two follow-up comments and replies included with each question, so this thread is being closed. Best wishes and stay safe.

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