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help, condom slipped off with HIV+ boyfriend
Aug 31, 2006

I am a 23 year old guy who is daying a 28 year old HIV+ guy. We pratice safe sex, and have never had a problem until now. Last night he was having sex with me (i was on the bottom) and the condom he was using slipped off. We had been drinking so I didnt notice right away, but did within 45 seconds or so. He didnt cum in me, and i got rid of the condom (it went inside) as soon as i realized. he precums a little, and this is my main concern, should I go see a doctor, and go on a PEP program? He is a very healthy guy who is on a combivir/sustiva regimen, and has an undetectable viral load. Still Im concerned, what should I do here?

Response from Dr. Frascino

Hello,

To PEP or not to PEP, that is the question! On the "not to PEP" side would be:

1. very brief exposure

2. no ejaculation

3. Your Top Gun boyfriend is on HAART with non-detectable plasma viral load.

On the "to PEP" side would be:

1. Losing the condom during backdoor action does qualify as unprotected receptive anal sex.

2. You were drinking, which may have impaired your memory of exactly what happened.

The proper decision here is for an HIV specialist to "offer PEP," which means we don't strongly encourage it because we realize the risk is small, but we don't discourage its use either because the risk, although small, remains real. If you are genuinely concerned and worried, you should take PEP for 28 days, starting as soon as possible and no later than 72 hours post-exposure. If you aren't all that concerned, despite realizing there was indeed some degree, albeit small, of risk, then you would skip PEP, but in either case you'll need HIV testing at three months.

Good luck! I'm here if you need me.

Dr. Bob



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