[Question #8899] Protected sex condom breakage

38 months ago

I had sex with a female from haiti I met in Miami. All 4 encounters were protected. But on fourth I did water test on condom after sex and the condom was spilling water towards the middle to lower shaft part. I have done the water test at least 200 times, and it has never leaked water until this time. Even though I wore a condom This was the driest girl I have ever had sexual intercouse with, which is why I believe the condom slightly broke. Also I wanna add that I have had condom breakages at least 15 times in my lifetime, and they always split up easy it’s super obvious. So that is my only saving grace, since I don’t believe the hole was towards the urethra, but We were drunk as well. Well long story short she texts me that she tested positive for hiv an hour ago, after telling me a week ago she was negative after she tested. And she calls me back 30 minutes later and says she was just kidding. At this point I have no time or games for what ifs, if she is indeed positive she is most probably in early infection since she just tested two weeks ago. So assuming she is positive I am going to ask a few questions. Also Oral to my penis was involved, and fingering to her vagina.

1) what are the chances I have hiv or any other stis from this encounter

2) should I take pep . Assuming the time I can actually go and by the time I can take them, the encounter would have been 64 hours after event If I can get them by 5 pm tomorrow

3)have you ever heard of a condom breaking like this instead

Of just completely wide open?

4) what are your opinions about the water test to check for condom breakage? Is it smart that I do it etc ?

H. Hunter Handsfield, MD

38 months ago

Welcome to the forum. Thanks for your confidence in our services.

If you saw a previous reply from me, please disregard it. Two questions came in close together, and I thought I was replying to the other. My apology for any confusion.

Condom protection is considered complete if the head of the penis and meatus (urethral opening) are covered, so I don't think the mid-shaft condom defect is anything to worry about. And while I can't judge which of your partner's statements about her HIV status is truthful, I'm inclined to guess she doesn't have it. I don't follow your reasoning about whether her infection is recent or chronic, if she is HIV positive. To your questions:

1) Even if your partner has new HIV with a high viral load, I would say this was a zero risk exposure for all practical purposes.

2) I would advise against PEP, based on what we know so far. In any case, you're almost too late for effective PEP anyway. Although 72 hours is the maximum recommendation, the effectiveness of PEP is believed to drop significantly after 48 hours. At this point, I would advise against it. But if it turns out your partner has a new HIV infection, implying a high viral load, some experts might recommend it. The best I can suggest is to see a local HIV-experienced health care provider in person and make a decision together. (If somehow I were in your situation, I wouldn't do it.)

3) I don't have any personal experience with patients with stories about condom leaks like you describe. But as I said above, I don't think it matters much. Which leads to my next reply....

4) In several other forum replies, I have commented on the condom "water test" -- to say it is more or less BS. Microscopic or small leaks that can lead to infection risk are an urban myth, with no supporting data. As I said in my opening comment above, a small hole or two is not likely to increase the risk of any infection. So a water test that finds a small leak probably is irrelevant. I would suggest you stop doing it. If no overt condom rupture, condom protection is as good as it can get.

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

HHH, MD

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