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What we did when condom slipped off
Sep 10, 2007

Dear Doctor Bob,

I'm the Berkeley guy who wrote you last week when the condom slipped off.

Just so you know, your quick advice was followed, and within 22 hours, my partner was given Atripla for PEP by our local emergency room.

Please know we greatfully appreciate how you gave such sage advice.

THANK YOU, with Hugs!!

the guy born in Berkeley

Response from Dr. Frascino

Hi,

Thanks for your thanks and the follow-up. Good luck to both you and your partner. I'm here if you need me.

Dr. Bob

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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