Dr. Bob. One day you will win a global prize for the man you are! Finally got my wake up call. Hard way to learn. Vaginal sex with women of unknown status. Condom fell off when I was inside her (2-3 min). Ran to the Health Dept and got 30 days Truvada and Kaletra 16 hours later. Do you feel I am a high risk??

Health Department was hesitant to give me PEP but I insisted. They said my risk was low because I was the inserter, hetero male and my penis skin was intact. Are they on target?

How well is the urethra intact/protected?

How effective is PEP? Really scared. Thanks Dr. Bob. I owe you.

Hi,

Condom failure (or improper use) has the same risk as unprotected sex. Consequently you do have some degree of risk for STDs, including HIV. PEP may be considered in situations such as these, particularly if the unknown-status partner was considered to be at high risk for infection (sex worker, intravenous drug user). As I don't know any details about your gal-pal, I can't really advise whether PEP should have been recommended or just offered. Considering the Health Department was "hesitant" to prescribe PEP, I would assume your risk was not "high."

Whether HIV transmission will occur after an exposure depends on many factors involving both the virus (viral strain, viral load, etc.) and the host (immune integrity, concurrent infections, local trauma, etc.)

PEP will significantly decrease the risk for transmission; however, PEP is not 100% effective.

You can read much more about the issues mentioned above in the archives. As you can probably imagine, I've addressed many similar questions in the past. Have a look.

Good luck.

Dr. Bob