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Condom Breaking
Jun 4, 2010

I am Hiv + and my bf is HIV-. He is usually the top and I am usually the bottom. But sometimes we switch. We were having sex and I was using a condom, and after I ejaculated I pulled out and pulled off the condom but noticed it had broke. My levels have always been undectectable and he has always tested negative. I can count the numbr of times he has been the bottom and I have always used a condom but they have never broke. I know he should get tested, just wondering how high the risk of him getting HIV would be considering my viral load is undectectable?

Response from Dr. Frascino

Hi,

Broken-condom (or unprotected) receptive anal sex with a partner confirmed to be HIV positive is always risky business. The CDC's per-act estimate for acquiring HIV from unprotected receptive anal sex with an HIV-positive partner is 50 per 10,000. Being on effective combination antiretroviral therapy that drives the HIV plasma viral load down to undetectable levels significantly decreases the risk of HIV transmission, but does not eliminate it. PEP would be recommended if it could be started soon (and no later than 72 hours) after such an exposure. HIV testing at both the three- and six-month marks is recommended.

I'd recommend you and your partner read through the chapter in the archives of this forum dedicated to magnetic couples. Review the harm-reduction techniques. I also recommend you review proper condom technique, as condoms only rarely fail (break) when used properly.

Good luck to you both.

Dr. Bob



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