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Condom came off during anal sex
Sep 4, 2007

Dear Dr. Bob, Today, 4Sep07 my neg partner went somewhat soft during anal sex, but regained a full erection and ejaculated; much to my dismay the condom had not covered him. I'm HIV+, my VL is undetectable, CD4 is 560. WHAT MUST WE DO?

Please reply, soonest. ...from a very concerned Berkleley guy

Response from Dr. Frascino

Hi Berkleley Guy,

"Berkleley?" Hmmm . . . if that's anywhere near Berkeley, you could have just driven to Los Altos and seen us at the Frascino Medical Group. Condom failure does place your partner at some degree of risk. His risk, however, is mitigated somewhat by your undetectable HIV plasma viral load. PEP (post-exposure prophylaxis) would be recommended for this type of exposure, even with the reduced risk. The overall estimated per-episode risk for acquiring HIV from unprotected insertive anal sex with a poz partner is 6.5 per 10,000 exposures. PEP, when indicated, should be started as soon as possible and no later than 72 hours after an exposure. Your HIV specialist may be willing to expedite treatment for your partner. Alternatively an urgent care center, emergency room or another HIV specialist's office should be able to help.

Good luck. I'm here if you need me, OK?

Dr. Bob



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