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single anal insertive exposure
May 14, 2009

Hello, your site and ways to aproach the HIV reality are both professional and friendly, and I feel compeled in congratulating your efforts.

My question: Im a 38 happily married man, 3 small daughters, "succesful" as some would say. I hanged out with a client celebrating a court victory (lawyer), got real wasted and ended up having both insertive vaginal and anal sex with a prostitute (unknown seropositive status). Initially wore a condom, however, the condom broke,and immediately removed broken condom from penis and put a brand new one and continued until the act was concluded. As the effects of alcohol wore down, I freaked out, and been that way since 1.5 months ago. I asked a close friend about PEP, and he told me I was way out of the period it would have been effective. My anxiety is driving me nuts, Im avoiding my wife without any good explanation. I've been tempted in going straight with her, but am quite convinced that would put an end to our marriage. I undestand I have to wait the 3 month window period in order to be sure about my status. I would greatly apreciate your input, since managing my anxiety is becoming very difficult.

Thank you in advance,

Response from Dr. Frascino

Hi,

PEP (post-exposure prophylaxis) when warranted should be started as soon as possible and no later than 72 hours after the exposure.

Your HIV-acquisition risk is brief unprotected insertive sex with an HIV-status unknown pro (due to a broken condom). Overall your risk is very low but not completely nonexistent. A three-month test is warranted.

Your anxiety and guilt are the major problem at this time. The best way to deal with these is to level with your wife. It's also the right thing to do. She may well be angry, but hopefully she will realize this was an alcohol-induced lapse of judgment. Use condoms with your wife until your three-month test reconfirms your negative HIV test. The odds are astronomically in your favor that you did not contract the virus form this indiscretion.

Good luck.

Dr. Bob



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