[Question #5714] Condom broke will I get HIV infection

19 months ago
In my recent visit to India on July 3 rd , I had a sex with a girl and condom was broken in the end and I pulled out immediately and washed my self clean. The next day I met doctor and started the PEP TRUSTiVA and continuing the same. My HIV RNA blood work on 2 nd and 5th day came normal and not found anything. I am totally scared and panic how to deal this , since two small kids and a good family. I know I did not wrong what are the chance of HIV infection with broken condom with 10 sec of contact . 

Please advise. I am back to USA now and performed 5th day test here.
Please advise,
SS
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
Welcome to the forum. Thanks with your question. 

Even without a condom, if a woman has HIV, the average risk of HIV from a single vaginal sex exposure is about 1 chance in 2,500. And with only 10 seconds exposure, probably a lot lower chance than that. So the odds are strongly in your favor. But HIV RNA testing at 2 and 5 days after exposure was a waste of money:  the RNA tests cannot be positive sooner than 7-10 days after exposure, and generally are not recommended until 2 weeks after exposure.

If your partner is in an area where HIV is especially common or lots of single women are infected, PEP may have made sense. Unless the chance of infection was believed to be especially high, I would have recommended against PEP. However, now that you have started, you should finish the full month of treatment. However, you now will have to face the main downside of PEP:  if it doesn't work, PEP may delay the time to positive testing for HIV. Now that you're home, you'll need to see a doctor or clinic with experience in HIV/AIDS and its prevention, then follow their advice about follow-up testing. Probably they will recommend testing at roughly one month intervals (after the last dose of PEP) until 3 months or maybe 6 months after the exposure.

But in the meantime, I would recommend you resume sex with your wife. The chance you have HIV is extremely low, and if I were in your situation, I would take the low risk. But i'm not you and cannot decide for you. Once you get into care with an HIV doctor, follow his or her advice about it.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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19 months ago
Thank you for you response doctor. I have given blood today again for HIV RNA(11 th day after expose) . So you are saying taking PEP will not show correct results in RNA ? If so how soon i have see the doctor ? 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
19 months ago
It is pointless to be having RNA testing, or any HIV testing at all, while taking PEP. The negative result while on anti-HIV drugs is meaningless. See a professional for in-person advice -- the sooner the better, for sure before you complete the PEP regimen.---