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Condom breakage, PEP and risks...
Nov 14, 2009

HI Dr. Bob, I've been able to find a lot of information in the questions you have already answered - thank you. I'm HIV negative and had a receptive anal sex with a guy yesterday. He pulled out while he was cumming. Afterword he told me there was a hole in the condom and that he was HIV+ with an undetectable viral load. In my small town nobody knows about PEP but I was able to get it within 2 hours at the emergency department and will continue for 30 days. I guess I want to hear that my risk is low and that this huge panic I have is unwarranted. The doctor here didn't know too much about it so we looked it up together and he told me to come back for an HIV test in a month. Is there anything else you can tell me? thanks.

Response from Dr. Frascino

Hi,

The CDC's estimated per-act statistical risk for acquiring HIV from unprotected (or broken-condom) receptive anal sex with a partner confirmed to be HIV positive is 5 per 1,000 exposures. Your estimated statistical risk would be less, because your exposure was brief and you began PEP within two hours. The post-PEP HIV testing guidelines recommend getting an HIV-antibody test at six weeks, three months and six months from the date of exposure. You can download a complete copy of the non-occupational post-exposure prophylaxis guidelines at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5402a1.htm. You can also read much more about HIV transmission risk and PEP in the archives of this forum. Have a look.

Good luck.

Dr. Bob



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