Hi Dr. Bob...thanks for such a wonderful service.

Last Thursday, I hooked up with a guy online, and was the bottom in protected anal sex. I always practice safe anal sex...always. Well, I found out (after several minutes at least), that the condom broke. He knew about it, but kept going without telling me. He didn't ejaculate inside me, but "barebacked me" for a while (without my knowing). Needless to say, I'm scared and I'm furious with him.

He insisted he was negative, but when I asked him about his last tests, he was contradictory and nervous. Due to financial limitations, I chose not to get PEP...and now I wished I would have (now it's too late).

On Saturday and Sunday, I started noticing pain in my rectum/anus (inside, no discharge), and prodromal symptoms (tingling legs) typical with HSV2 onset. (I'm HSV2+).

So now I'm panicked. Haven't slept in days. The top won't return my calls, as I've asked him for a rapid HIV test (which, if neg, would alleviate my anxiety).

So, can you please offer some words of wisdom and advice?

thanks so much.

Hi,

Not sure I have words of wisdom and/or advice that will significantly help your situation, other than to encourage you to keep things in perspective as you endure the window period waiting for your definitive HIV test results.

On the downside, broken-condom sex carries the same degree of risk as unprotected sex, and being the receptive partner for anal sex is the riskiest route for acquiring HIV sexually. In addition your top gun scumbag, who didn't let you know the condom broke, is also now not returning your calls or agreeing to get a rapid HIV test.

However, on the upside, the exposure was relatively brief and he didn't ejaculate inside your love canal. The CDC's estimated per-act risk for acquiring HIV from receptive anal sex with a partner confirmed to be positively charged is 5 per 1,000 exposures. Your estimated risk would be less, as we don't know scumbag's HIV status and ejaculation did not occur.

My advice is not to panic. It certainly won't help. Get help for your anxiety if needed during the window period. Anti-anxiety mediations and/or counseling can be very beneficial.

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

Dr. Bob