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Old 05-03-2011, 06:47 PM   #1
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Should I get PEP?

I had a risky encounter a few hours ago and need advice.

I was the receptive anal bottom (I'm negative) for an HIV-positive top. He was wearing a condom.

A few minutes into sex (for the second time today), we heard a snap and realizing the condom broke, he pulled it out of me within 2-3 seconds. He had not ejaculated (nor was yet close to it).

I inspected the condom. The tear was a little smaller than the size of an uncooked pea. It was also 2-2.5 inches down the shaft, away from the head of the penis.

My partner is not yet on meds, so his viral load is not suppressed. Also, he's had a cold so that might've raised it more.

But, unless the condom shifted greatly inside my rectum, the hole 2.5" from the tip was likely not covering his urethra, or nearby. Also, he barely has any pre-ejaculate. Considering the size and location of the hole and the rapidity of which it was pulled out, should I go on PEP?

If the risk is so slight that it's not worth it, I'm not sure I'd want to subject myself to the tough month-long PEP regimen to prevent (what I hope is) a tiny chance. And I called my doctor and he said it was an "on-the-fence" situation (he's a sexual health doctor). I feel like had it really been a concern, he'd have said, "come down to my office now to start treatment now."

I thought I'd ask for a second opinion before the window is closed.

Thanks

Last edited by NoSleepTill; 05-03-2011 at 06:48 PM.

 
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Old 05-03-2011, 08:16 PM   #2
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Re: Should I get PEP?

First of all, your doctor's opinion should trump any opinion that you receive on this forum (there are no doctors here). The decision on whether or not to take PEP should always be between a patient and their physician. Having said that, I can give you my personal opinion on what I would do in this situation. Given the size and location of the tear on the condom AND the fact that your partner had not ejaculated AND the fact that he pulled out so quickly, I would not take PEP. It sounds like based on the condition of the condom that you still would have been protected from any preejaculate that was present. I don't see why a test would even be necessary other than for peace of mind- by your account you could not have had an exposure. But that is just my take based on what you posted- ultimately of course this is your call.

What I'm more concerned about is that you are bottoming an HIV positive person in the first place. Your situation shows why this is dangerous, even with a condom. I think you dodged a bullet this time but if you continue this practice you are putting yourself at risk for HIV in the long term because condoms will break on occasion as you now know first hand.

 
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Old 05-03-2011, 10:22 PM   #3
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Re: Should I get PEP?

going from what you say,
i would say no to pep but that is
only my opinion and means nothing .
good luck

 
Old 05-04-2011, 01:08 AM   #4
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Re: Should I get PEP?

Hey guy. I can truly say I know hands on what you are going through. The same thing happened to me on the 4th of April. Met a promiscuous guy (status unknown but likely pos), the condom broke and he lied (saying it was still intact). He pulled out in 3 seconds and I was leaning towards ignoring it all.

The same night, I spoke to a gay friend of mine who happens to be a surgeon and he told me since I was exposed, no matter how slight, why eliminate 30-day PEP when it could prevent a lifetime of meds? This got to me. 17 hours later, I got on PEP and I just finished the course yesterday.

Of course, I still have 6 week and 13 week tests before this is all over. Ultimately, this is your decision buddy. I know hands-on that it ain't easy, but I want you to know that I understand where you are and we could uplift each other if needed..

Goodluck!

 
Old 05-04-2011, 02:23 AM   #5
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Re: Should I get PEP?

Hi there,

this is defiantly an "on the fence " situation and agree with what other members have said. Unprotected anal sex with somebody who is positive is high risk but this was very brief. I'm sorry buddy ultimately this is your call and you should take the doctor's advice.

Kevin.

 
Old 05-04-2011, 03:13 AM   #6
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Re: Should I get PEP?

Hiya,

Buddy as per what you describe, it is highly unlikely that you must have been exposed to the virus being the time period of exposure was so short that i doubt it but as Kev said, it your call. PEP is not an easy ride buddy but again its your health and you are the best judge.

Best of Luck!!
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Old 05-04-2011, 07:29 AM   #7
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Re: Should I get PEP?

Hiya. I have a sticky on the top of the page talking about PEP. Im with joggen as regards its somthing ONLY you and a doctor should decide on. If you choose to do so, then you must act quickly for the medication to have any effect.

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Old 05-04-2011, 11:20 AM   #8
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Re: Should I get PEP?

Thanks for the replies, everyone.

I just got off the phone with my doctor and my partner.

The doctor did not like that my partner's viral load was 48,000. However, given that the tear was 2-2.5 inches from the tip of the condom (down the shaft of the condom - about 1/3rd the way down), and given that my partner was not in "all the way," and given that the condom was tight on him when it snapped (and was then pulled out 2 seconds later)... my doctor said that the condom snap might have happened "outside" of me (as he was partially, but not fully inside me), and if it did happen inside of me, since it was tight, it was likely against his shaft and it was unlikely to have shifted that much to place the hole over his urethra. Also, as a side note, my partner had ejaculated a few hours earlier, and we had only been having sex for a few minutes when it broke, hence the likelihood of much pre-ejaculate was small. Right before the tear, my partner had pulled his penis out, and was inserting it again when the tear happened, again making it unlikely it had occurred deep inside me (if inside me at all, considering it was a few inches from the tip of the condom) and/or over his urethra.

My doctor thus recommended that I *not* go on PEP. He said if anything I most likely came into contact with his shaft, not with his urethra. The risk wasn't zero, he said, but nor was it particularly likely, given the strange circumstance (and especially given the non-centrality of the tear). And he said that PEP would not be overly recommended here. I've spoken to a few other health and former-health professionals, and most agreed with his assessment. I will try to put this out of my mind until testing (I suppose I'll go at 4, 8, and 12 weeks unless anyone thinks otherwise). Wish me luck, and thanks for everyone's help again!

Last edited by NoSleepTill; 05-04-2011 at 11:30 AM.

 
Old 05-04-2011, 11:35 AM   #9
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Re: Should I get PEP?

Hiya, you have a very wise doctor. Indeed if the tip of his penis was covered then indeed the risk is near enough zero, certainly due to the small time taken place. Your anal passage is vunerable and his penis head due to friction created by sex, and if his head was covered then yes you have little to worry about. I wont offer any advice other than for one once you have a good doctor here, and agreed fully with him.

As for testing, 4 weeks with a HIV DUO will be 99%, 8 weeks 99.89%. If you use a plan antibody test, then go for 6 weeks and 12 weeks.

Overall i thing all should be fine, but will keep our fingers crossed
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