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Somehow I need to clear my mind as I'm scared.
Jan 18, 2011

Dear Doctors

I've been an avid reader of your site for quite a time now. I love in Mexico City and am an active bisexual guy bottom in men2men and have ALWAYS used condoms since I was 18. Now I'm 35 and so far haven't been infected, even though I've had two scares in my life. On Jan 1st 2011 I had sex with a guy and the condom failed. I think he might have been inside me for some seconds but didn't ejaculated since I made him pull out to check if the condom was fine. It wasn't, but there was no ejaculation. On that I'm certain. It was weird that I broke since it was no rude sex and he wasn't hung up. He was the one to request the condom right at the beginning so I felt he was somewhat responsible it's a rule for me not to have sex when they don't bring one and never request it. No pain at all during intercourse. I've had LOTS of sexual partners. Gay casual partners, but always been careful to the extreme of being paranoid. Anyway, so far it's worked out pretty well.

I got really worried about this breakage episode and the day after that went to the local HIV specialists. The Doc told me he didn't consider my case to be worth of PEP. That the risk is minimum. Anyway, last friday almost 2 weeks after exposure I've been getting a weird headache on my left-back side, some sort of dizziness and left neck pain. Nothing else. But I'm scared of it being ARS. You know how this works for a worried person. Now, I've got questions.

Mainly, did the Doctor at the HIV Center acted right by not recommending the PEP I requested?

Thanks a lot for your kind help.

Response from Dr. Frascino

Hi,

I would agree your HIV-acquisition risk would be very low. Whether or not to offer a course of PEP would depend on the likelihood of your partner being HIV infected. HIV specialists are usually good judges of HIV-transmission risk and the need for PEP.

Your symptoms are not worrisome for or suggestive of HIV acute retroviral syndrome (ARS).

I would recommend an HIV-antibody test at the three-month mark. The odds are very much in your favor that you did not contract HIV from this broken-condom incident.

Good luck!

Dr. Bob



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