Dear Doc,

Thank you very much for this great forum. I had an incident 1 year ago tested negative and this forum helped me a lot during the tough times!

Now I made a second stupid mistake: I slept with a street girl in Bangkok and the condom broke. Now again I am worried sick and seek your advice here.

The soc told me that PEP in not needed although the FSW have a HIV rate of about 20% because of the low risk of transmission during condom breakage (he said its 1 in 100 and if I multiply that with the chance she was infected its less than 0.5%) so I didnt go on PEP - Was that the wrong decision? I caught chlamydia and now I read that if she had that and HIV the transmission risk increases heavily - Is that correct? BTW I noticed when I washed my "little" friend afterwards that he was "protected" from water due to some waterresistant stuff of the condom - Would that maybe also have prevented her fluids to come in contact with me, at least partially?

And last but not least I would like to know if there is a way to donate anonymously or with a fake identity - and how the data of the people donating is handled!?

Thank you very much in advance I hope you are continuing to do very fine and keep this great forum up!

Hello,

PEP is generally recommended only for significant HIV exposures. Although I do not have all the details of your cock-banging in Bangkok, it would seem that based on your potential exposure, HIV-transmission risk would be low, but not nonexistent. At this point, to PEP or not to PEP is a moot point, as it is not recommended to begin PEP beyond the 72-hours mark.

Regarding Chlamydia, yes, any STDs that cause increased white blood cells to collect at the infection site may increase the risk for HIV infection.

As for the water-resistant stuff on your Mr. Happy, I presume it was lubrication from the condom. Would that prevent vaginal fluids from coming in contact with the business end of your throbbing, probing tallywhacker? Well, I have no way of knowing, but you certainly can't count on that to keep you safe.

The bottom line is that you need an HIV test at the three-month mark and no amount of worrying or "what iffing" is going to change the results of that test. So there is absolutely no benefit for you to be driving yourself insane and becoming worried sick, especially when the statistical odds remain all in your favor that you are once gain a "worried well," OK?

Finally, certainly anonymous donations can be made to The Robert James Frascino AIDS Foundation. Merely include a note with your donation stating you want the gift to be anonymous and no records will be kept and you'll not receive any acknowledgement or thank-you notice. If you use a credit card or personal check, there is, of course, a paper trail that only you have access to. Cash can always be given completely anonymously.

Good luck. I'm sending you my good-luck karma that your definitive three-month HIV test will once again be negative and you'll be WOO-HOOing soon!

Dr. Bob