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Condom breakage has gotten me Worried

Jan 11, 2010

Doc I live in Thailand, and have regularly visited massage parlors here and engaged in sexual activities. I must have had atleast 50 such encounters.

I believe I have practiced safe sex always, Blow jobs with condoms only, penetrative sex with condoms & KY jelly applied on condom and kissing on lips and rest of the body.

Today I had an condom breakage when engaged in penetrative vaginal sex at a massage parlor, and has me worried. She was very tight and possible the condom was tight on my penis as well. I was not sure of how long we may have had sex with broken condoms, but on noticing the breakage, I pulled out I did find some white body fluid on my penis, possibly her vaginal discharge. We had a shower immediately after and washed my penis with water & soap.

I had not ejaculated at the time of breakage. Infact I was not at my usual best and my penis was loosing erection for some reason.

She was equally worried and immediately started confessing that she has been working for 1 month only in the business, she claims she was screened for VDRL and HIV before being recruited at this parlor about 1 month ago and tested negative. She has had only a few customers and always engaged in sex with condoms only, including oral sex. I have to take her word for it now and cannot verify this...!

We immediately went to a test center and tested, results due tmrw.

I have 1 questions for you. - Often times I have dry lips (chapped). Does this increase my risk of infection from kissing, which I have engaged with several of these women - Can I wait for the results of the test to know if she was HIV positive and assess viral load prior to starting PEP. The test results are expected within 36 hours of exposure. - I know I am at a risk, but what chances would you give me with this episode of broken condom

Response from Dr. Frascino


Dry lips would not significantly increase your risk of acquiring HIV from kissing.

Broken-condom sex does place you at some degree of risk for STDs, including HIV. If there was a significant HIV risk, I'd recommend beginning PEP immediately. You could choose to stop it when the laboratory results become available (assuming they are negative). PEP is most effective when begun as soon as possible after exposure. It's also worth pointing out that even if your rub-a-dub-dub gal tests negative, there is still the remote possibility she could be in her window period. Viral load testing is generally not warranted for routine HIV screening, due to the possibility of false-positive results. (Her viral load could be undetectable if she were on effective antiretroviral therapy.)

Good luck.

Dr. Bob

prolonged usage of antihistamine and window period

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