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Condom slip and prohylaxis
May 26, 2006

I recently had sex with an HIV positive woman and in the process the condom slipped out. I realised this quickly and pulled out of her, went to the bathroom and cleaned my penis. The following day, I went to see a doctor who prescribed prohylaxis for me. My questions are: 1. What are the chances of getting infected with HIV in this circumstance? 2. I was told that my chances are minimal (even without taken the prophylaxis. By the way, the side effect is killing me and I'll be happy to stop taking them) 3. How accurate is a PCR HIV test in a month of exposure to HIV?

Response from Dr. Frascino

Hello,

"The condom slipped out . . . ." Hmmm . . . shouldn't that be you slipped out of the condom little guy??? Oh well, no matter. I agree your overall HIV risk is minimal. To specifically answer your questions:

1. the estimated per-act risk for acquisition of HIV from unprotected (including condom "slip-outs") insertive penile-vaginal sex with a partner confirmed to be HIV positive is 5 per 10,000 exposures. Your estimated risk would be much less because we don't know the status of your partner and the exposure was very brief at best.

2. I agree the chances are minimal. I also agree that taking HIV meds is no picnic. I've been swallowing fistfuls on a daily basis for over a decade!

3. PCR should not be used for routine HIV screening. In particular you should not use PCR if you are on PEP (antiretroviral drugs).

Dr. Bob



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