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Brief Exposure from a Condom Break
Oct 13, 2010

Doc,

Last night, while having sex with my hiv+ (bottom) partner, me hiv- (top), the condom broke. Immediately after I felt the condom break, I pulled out. There appeared to be a very light red tint of blood on the condom. I jumped in the shower to further clean my penis and forced myself to urinate. Although this exposure was brief, I am concerned.

My partner has been undetectable for over a year, and our sex has always been protected following his diagnosis. We are both distraught.

Following last night's episode, we phoned our doctor this morning (7 hours after) who instructed me to take one of my partner's pills (Atripla), until my visit with him for a script of PEP.

In his words this brief exposure did not seem significant enough that I would become infected considering (how brief the exposure, my partner's undetectable levels, and me starting the meds/PEP).

Obviously, I am very nervous and feeling quite sad about it and I just wanted to ask for your opinion too. Thank you.

Response from Dr. Frascino

Hi,

I absolutely agree with the assessment and advice you received from your partner's HIV specialist. See below.

Dr. Bob

Neg top - Poz bottom Oct 13, 2010

Im HIV negative. My partner is HIV positive. He is currently taking Atripla as prescribed religiously. His viral loads are at undetectable levels and it has been this way for almost 2 years.

We have always been very careful, except for a couple weeks ago when I topped him bare (after a long night of drinking of course)....... im now obviously worried that we fucked up big time.

Ive heard things about the risk of transmission being much lower when the poz person is undetectable and on meds daily....... obviously I know there is a chance I could have gotten already.

But how worried should I be?

I know the only real way to know is to get tested but its only been about two weeks so from what i understand they couldn't even test for it yet in me successfully at this point. its really starting to bother me now...... Id feel better even knowing if i should just assume i have it..........

Thanks

Response from Dr. Frascino

Hi,

Should you just assume you have it??? No, of course not. What you heard about the risk of HIV transmission being significantly lower if the positively charged partner has been taking effective antiretroviral therapy that has driven his HIV plasma viral load to undetectable levels for six months or longer is absolutely true. That said, I do agree that despite this decrease in risk, the transmission risk is not completely eliminated. Testing is warranted. I'd suggest you and your Mr. Happily-Ever-After read through the chapter in the archives related to magnetic couples. There you will find information regarding harm-reduction measures, including PEP (post-exposure prophylaxis) and PrEP (pre-exposure prophylaxis).

Try not to worry. The statistical odds are all in your favor that this boozy Brokeback Mountain sex-capade did not result in viral transmission.

Good luck.

Dr. Bob



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