[Question #958] HIV Risk - Broken condom

98 months ago

Dear Doctors,

I am a male living in Belgrade, Serbia. I divorced 6 months ago, and since then, i did not have sex at all.

Since I was very stressed at work in the past few months, i decided to relax a little bit, and i engaged in sex with an escort.

We had vaginal sex with condom - but condom broke. I believe that sex with broken condom lasted just for few mins.

I asked the girl about her health several times, and she sad that she is ok, and that she does regular check ups. She was very convincing.

She really did not look like a drug addict or something similar.

I immediately called my doctor and he told me, that the chances of catching HIV are quite low and that i do not need testing. He also added that Serbia is one of the safest places on earth regarding HIV (3k people out of 7 million are HIV infected).

He told me that even if she was HIV+ it does not necessarily mean that i will be infected. I was very surprised because i did not know that.

Based on this, do you believe i was at risk of catching HIV and do i need testing?

Thanks in advance,

Edward W. Hook M.D.

98 months ago

Welcome to our Forum. I'll be happy to comment. Certainly having a condom break during sex with a new partner can be worrisome but I agree with your doctor, the risk of infection with HIV, as well as other STIs, from this event is very low. Even when exposed to infected partners, and most people are not infected, most exposures do not lead to infection. As your doctor told you, most commercial sex workers do not have HIV and when people are asked about whether or not they have infection, most people tell the truth. Further, even in the unlikely situation that your partner did have HIV, your risk for infection from a single unprotected vaginal encounter is, on average, between 1 in 1000 and 1 in 2000.

It does make sense for you to be checked for other STIs such as gonorrhea and chlamydia at this time however. While infection with these bacteria is also unlikely, they are more common than HIV. Then, if you wish, about four weeks after your encounter, it would be reasonable to have blood tests performed for syphilis and for HIV using a 4th generation, combination HIV antibody/antigen test.

I hope you find these comments helpful. Your overall risk for HIV iOS for that matter, other STIs is low. EWH

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98 months ago

Thanks for such a quick response.

The doctor already did tests for the bacterial infections and all the results are ok.

The only thing is HIV (as i mentioned, i thought that if one partner is HIV+ s/he will inevitably infect other partner).

Taking in consideration the numbers (both you and my doctor) mentioned, do you believe there is a realistic threat for me to catch HIV from this event.

Just one question off the topic: if this is low risk encounter, how come so many people catch HIV?

Thanks a lot,

Edward W. Hook M.D.

98 months ago

Great, glad you been tested for other STIs.

Only a small fraction of exposures to HIV lead to infection. The reason there is a lot is because lots of people have lots of sex. I would estimate your statistical risk of HIV as being about 1 in 100.000. I consider this rather low risk. If I were you, while I would test at four weeks, I would not be particularly worried. EWH

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