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Should I start PEP?
Jul 17, 2009

Dear Dr McGowan: I have a question that's bothering me.

I was about to have sex with a woman of unknown status (let's just assume she is risky). I put on the condom and as I was inserting we heard the condom pop so I pulled out immediately. I cleaned the whole thing with soap and water. I was so scared we didnt go ahead to have sex.

Specifially here is how the condom breakage looked like:

1. When I pulled out I found that my penis was fully covered with the condom but there was a small hole at the tip of the condom.

2. Based on my observation when I pulled out, it would appear there was no skin to skin contact. My penis head was some distance away from the hole since the penis head does not go into the reservoir.

Based on your expertise do you think I should take PEP?I have a doctor appointment for tomorrow, 24 hours after the fact.

The woman claims she had negative tests in January and last month but I have no way of proving that.

Response from Dr. McGowan

Sorry for the delay in getting back to you.

I do not think that you have had a significant exposure to HIv and would not recommend prophylaxis based on they scenario you described. As you mention, there was no direct contact, intact skin, minimal time before you washed and (?) a possible recent negative HIV test in your partner.

I am glad you are taking precautions and thinking about HIV prevention.



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