[Question #9858] Condom broke during sex with a escort

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28 months ago
Hello, im very scared because today earlier i had sex with a escort and the condom broke, the tip of my penis was all uncovered, i didn’t notice it after around 2 minutes of penetration then i clean my self and we stop the service also I asked her if she had HIV but she said no, i can’t trust and im freaking now. I wanna know what are the probabilities that i got HIV and any recommendations for my situation. Is a PEP a good prevention? What about the secondary effects?
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28 months ago
I just wanna add this information if is important: im 27 years old, country Peru, i dont have much sexual life activity but im really worried for what happened me today, also i forgot to ask after how much time i can get a HiV test that i can trust 100% in the results? Thank you Dr, i apologyze if my english isn’t good enough to get understood.
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Edward W. Hook M.D.
28 months ago
Welcome to the Forum.  Thanks for your question. Your English is good, your questions are clear.  I'll do my best to help

I'm sorry to hear of your condom mishap.  Condoms break about 1% of the time they are used.  Most commercial sex workers in Peru do not have HIV but there is some small risk. That your partner said that she had been tested and did not have HIV is also good new as most people do tell the truth when asked.  If your partner had HIV, there is about a more than 99% chance that you did NOT acquire HIV- HIV is transmitted from untreated, HIV infected persons on average less than once in every 1000 sexual encounters.  It is more likely that she had one of the more common STIs such as gonorrhea or chlamydia.  I would advise you to get tested for these STIs any time more then 4-5 days after your encounter.  As for HIV, if you were exposed you can substantially further reduce your risk for HIV by taking medications to  prevent HIV, often referred to as PEP or post-exposure prophylaxis.  PEP must be started within 3 days of an exposure and in general, the sooner the better.  PEP is often prescribed for 30 days.  In general the PEP medications have relatively few side effects but if you do decide to take PEP, taking PEP will delay how soon you can be sure that you were not infected.  Testing for HIV is entirely conclusive and reliable at any time more than 6 weeks after an exposure or, for persons taking PEP, more than 6 weeks after the last dose of PEP.

In summary, there is a much less than 1% chance that you have acquired HIV from the exposure you describe.  Taking PEP is a personal choice.  Alternatively, if you can find your partner and arrange for her to be tested, if her test is negative you can be confident that you were not exposed.  Either way, I would also suggest testing for STIs.

I hope this information is helpful.  EWH
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28 months ago
Thanks for your answer Dr, i have more mental peace now.
Do you recommend me do to the PEP according to my situation? 
As you told me, im in risk to get other STIs like chlamydia or gonorrhea, what symptoms should i experience during first days?
Should i expect negative results for HIV test after 6 weeks of exposure?

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Edward W. Hook M.D.
28 months ago
Whether or not to take PEP is a personal choice.  If you choose to take it, you should do so soon.  There is a more than 99% chance that you will not be infected, if you were even exposed.  No matter what you choose. I anticipate that at six weeks your tests for HIV will be negative.

EWH 
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