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Ask the Doc :: The condom ripped!
Dear Doctor Jason,
I recently had sex with another guy, and discovered that the condom ripped inside of me. He hadn’t come, but I’m afraid I might have contracted HIV. What is my risk factor here? Please help, I can’t even sleep because of this. Also, how long do I have to wait to get tested in order to be sure?
Doctor Jason’s Response:
This is not uncommon, especially since condoms can break for a variety of reasons; yet, it is very nerve-wracking when it happens to you. The risk for getting HIV depends on a few things: (1) he has to have HIV in order to give it to you, (2) ejaculation or pre-cum with HIV in it, (3) length of time of exposure, and (4) ability to get into your blood from the rectum.
The longer the time of exposure, the greater the risk of getting HIV, meaning that if the condom broke early on during sex, then there is a greater risk than if the condom broke right before sex ended. The rectum has a lot of blood vessels (ask anyone who has hemorrhoids), and irritation from not enough lube, too much friction, or if another sexually transmitted infection is present (like herpes or gonorrhea) will increase the risk of getting HIV.
When something like this happens, where you are not sure if you might have gotten HIV from sex, you can call the local emergency room or your doctor to find out if you are eligible for non-occupational post-exposure prophylaxis (nPEP) which may prevent you getting HIV. This has to be started within 72 hours of the exposure in order to have the best chance of preventing HIV infection.
With regards to testing for HIV, there are different types of tests that can be used. The "rapid" test is based on a small sample of saliva or blood from your finger, and it gives you results in 15-20 minutes. It is really good if it has been at least 3 months since you were at risk of getting HIV. There is another blood test that is more accurate, becoming positive after 6 weeks, that may take up to 3 days for the results. Finally, there is a very specific, but more expensive, test that looks for the virus itself, and this can be positive as early as 3 days after a risky exposure.
Dr. Faulhaber is a graduate of Tulane University in Psychology and Cellular and Molecular Biology and received his medical degree from the University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School. He performed his residency training in Internal Medicine and Pediatrics at Saint Vincent’s Hospital in Manhattan, where he then served as a Chief Resident in Internal Medicine. He completed his fellowship in Infectious Diseases at New York University, where he specialized in HIV/AIDS, Hepatitis, and fungal infections. Since fellowship, he has been working as an Internal Medicine/Infectious Diseases physician at Fenway Community Health in Boston. He is a Clinical Instructor in Medicine at Harvard Medical School, and he is affiliated with Beth Israel Deaconess Medical Center. He has been the lead author or co-author of several journal articles and textbook chapters on infections with HIV, other viruses, bacteria, and fungi. He is also accredited by the American Academy of HIV Medicine.
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