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Undetectable HIV+ partner (bottom) I am HIV- (top) condom broke. I pulled out after less than a min and there was blood on my glans. What should I do?
Jul 28, 2010

I was recently having sex with my positive/undetectable bf he was bottoming and I was/am the HIV- top. The condom broke due to my size and the sex was rough. I pulled out before I felt it break and there was no blood. Checked a second time everything was ok. When I checked the third time when I felt it break I pulled out and there was a small, yet decent amount of blood on my penis, circumcised foreskin, and glans/head. We freaked out. I ran to the bathroom washed it off with soap ASAP and peed three times immediately. I called my doctor, Aldo my partner's within an HR and received PEP (Combivir) 1.5 hrs after the incident. He also prescribed me claritin to take to make sure there is no allergic reaction to the PEP. I am taking both twice a day at the same times, antihistamines first than an HR after that the PEP.

I am really scared and will be taking this for a month. What statistically can you tell me about our situation given the expoosure & his undetectable status? Any experience like mine that you can relate this to? Anxiety and panic are setting in and I could use you advice regarding all of this. Many thanks

Response from Dr. Frascino

Hello,

Broken-condom or unprotected insertive anal sex with a partner known to be HIV infected does place you at risk for HIV. However, your risk of acquiring the virus has been mitigated by three factors:

1. Your exposure was very brief.

2. Your partner is on combination antiretroviral therapy that has driven his HIV plasma viral load down to undetectable levels.

3. You began PEP quickly (1.5 hours).

Taking all these factors into consideration, your HIV-acquisition risk is very low. You will need to be followed by an HIV specialist during your 28-day course of PEP and then have post-PEP HIV-antibody testing at four to six weeks, three months and six months from the date of exposure. You can learn much more about PEP in the archives of this forum. You and your partner should also peruse the information in the archives chapter devoted to magnetic couples.

Good luck to you both. I'm here if you need me, OK?

Dr. Bob



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