[Question #9971] Condom came off during an intercourse.

27 months ago

I'm 33 years old with no STDs so far. I reached out to expensive escort - charging $600 / hour and being selective about the clients. I met her yesterday. While we were having a sex, the condom came off (i.e condom was stuck deep inside her vagina), when she was on top of me. This period (of having unprotected sex with her) lasted 3 minutes. We then stopped the sex. She and I panicked. She panicked because this is the first time she had experience condom coming off completely. We asked about our STDs history and she was clean (she got tested regularly and her last test was a month ago). She has a real career in an industry and doesn't see clients often. My plan : get tested (1) Chlamydia and Gonorrhea in 4 - 5 days , (2) get HIV RNA Test in between 12 days and 14 days and (3) get HIV 4th Gen AgAB and Syphilis at 4 weeks. You mentioned there's a chance of 1 / 2,500 of catching HIV in my case and expensive escorts tend to have low risk of having STDs as it affects their businesses, I'm still anxious that I might have these STDs like HIV.

Edward W. Hook M.D.

27 months ago

Welcome to the Forum and thanks for your implied confidence in our service. I'll be glad to comment. It appears that you have looked at other threads on our site (thank you) and you have summarized the facts well. Several comments:

1. The fact that she was upset over the condom coming off is a good sign. It suggests that she indeed does take steps to avoid STIs, making it unlikely that she was infected. As you know, high end CSWs such as this women rarely have any STIs, including HIV.

2. Even if she was infected, which is unlikely, most single exposures to infected partners do not lead to infection. The likelihood of acquisition, if she was infected varies with the sort of STI involved- for HIV the risk if she had untreated HIV is less than one infection, on average, for every 2,5000 exposures. For gonorrhea and chlamydia the likelihood of transmission is higher (about 20% of exposures result in infection) .

3. I think your plan is a good one and agree with your plan and the timing you suggest. As an alternative, since you both have a vested interest in knowing whether or not the other was infected, if possible, you might contact her and agree to each get tested and exchange results. If her tests are negative, you were not exposed and can move forward without concern.

Thanks for your commitment to safe sex. I anticipate that you will have not gotten an STI of any sort from your condom mishap. Please don't let this keep you from using condoms in the future. EWH

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26 months ago

Dear Doctor Hook, thank you for your response and I hope you are well and healthy.

I just received a report on my HIV RNA test. Fortunately, the result was negative for both HIV - 1 and HIV - 2. Just to recap,

- Both Chlamydia and Gonorrhea were negative 4 days post exposure. I also had and still have no symptoms.

- Both HIV - 1 and HIV - 2 RNA tests were negative 15 days post exposure.

I'll get both Syphilis and Hiv 4th Gen AgAb test done at 4 weeks. I'm checking daily to see if I'm seeing any sign of Syphilis. So far, I don't see any sign of Syphilis yet.

Doctor Hook, you mentioned on this forum sometime ago that you haven't seen anyone with negative RNA test at 11 days turned positive later. That post you wrote was written ( I believe ) few years ago. Did you by chance see a case when a person tested negative on HIV RNA test at 15 days turned positive later? I'll still get Syphilis and HIV 4th Gen tests at 4 weeks. Thank you, Doctor Hook, for providing a probabilistic answer to calm down nervous people like myself.

Edward W. Hook M.D.

26 months ago

My previous response is unchanged. I have never seen an HIVPCR test which was negative at 11 days go on and become positive. Your 15 day HIVPCR is very, very strong evidence that you did not acquire HIV. While I still agree with your plans for testing at four weeks, I certainly would not be worried in the least. EWH.---

26 months ago

Good morning Doctor Hook, I just received test results for both Syphilis and HIV 4th gen Ab/Ag test. They were taken at 29 days after that encounter and they were negative ! Doctor Hook, should I get another HIV test done at 6 weeks or is it safe to believe that ,with HIV RNA tests at 15 days and HIV 4th Gen test at 29 days, I'm free from HIV and I can move on from this incident ? Thank you, Doctor Hook, for giving me a probabilistic reassurance that I have not gotten any STI from this condom mishap. For the past 2 weeks, I was very anxious and regret making this terrible choice of seeking an escort first time in my life. I don't think I would have had good sleep, if I didn't find this site where you and Doctor Handsfield are doing amazing work. Thank you Doctor Hook so much. I can't express my gratitude on this post enough for your service.

Edward W. Hook M.D.

26 months ago

Thanks for your thanks and for sharing your follow-up test results. The combination of your HIV PCR and 4 week test results provide conclusive proof that you did not acquire HIV from the encounter you described. There is no scientific or medical reason for further testing. I encourage you to move forward without concern.

This will conclude this thread which will be closed shortly. Take care. EWH

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