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Condom tear and possibilities of pregnancy.

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Hello. I am very worried that I could have contracted HIV. Last night I had sex with an ex who I know sleeps around with many other girls. I regret this and don't even know why I did it. Anyway, right before we had actual intercourse I told him to put on a condom. He said he had to go to the bathroom to "pee" but I never heard the toilet flush but did hear the condom wrapper open. I was so afraid that he could of did something to the condom but didn't really think he would want to do that. So when he came in I felt it was on and we had sex. After like 20 min I told him to stop because it was burning so we stopped. He took off the condom and put it in a black plastic bag. This morning when I woke up I took the bag to the bathroom acting like I was going to flush it. I examined it and I saw a hole on the tip part. I didn't put water in it or anything to see if there were other holes that I couldn't see, but there was some stuff in it and nothing was leaking except from the hole I saw. This was not just a tiny hole, it was like maybe half or a quarter size of a penny, not enough to stick like a finger through but definitely enough to clearly see it. I asked him about this a little while later and he said that he did not do anything to it and that he went to the bathroom to pee and put it on when he came back in the room. I never heard the toilet flush and I heard the condom wrapper in the bathroom. If he didn't do anything to the condom then why would he lie about where he put it on and why would there be a very viewable hole? Also, the sex burned which never happens to me. My biggest question and fear, and the whole reason I'm writing this is because I'm scared I could have HIV from this. If he does have HIV, what are my chances of getting it from this experience? I don't think he ejaculated because we didn't finish, but there were definitely liquids in the condom, that could have or did get in me. Also, I had just shaved and there could of been a cut or something on me. The sex was burning. And he gave me oral sex right before. I did not for him. I'm sorry for this long message, but please explain whatever you may know that could help. I am very scared this could have caused me to contract HIV if he has it. I don't know if I'm worrying for nothing or over paranoid but this just won't leave my mind. It's all I think about.

Category: HIV- AIDS Specialist

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Category: HIV- AIDS Specialist
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Hello,

Thank you for choosing DoctorSpring.

The chance of contracting HIV through this episode is very less. Obviously I won't be able to explain the hole in the condom, whether it is an accidental tear or whether he did it on purpose.

The hole in the could put you in risk for a pregnancy, not HIV. As you might be aware HIV transmits from contact of body fluids with mucosal surfaces, minor abrasion or wounds. That condom even with the hole should have offered good enough mechanical barrier for this transmission.

The burning sensation you had is non specific and does not indicate an HIV infection. I would advise you not to worry about it. However you can be 100% sure only by doing a HIV test. To rule out HIV infection and in general I would advise you to do the following tests.
1) You can do the Combo HIV antibody-antigen test which is a fourth generation test 3 weeks from the date of exposure to rule out HIV
2) If you persist having symptoms of burning sensation in the vagina or develop abnormal vaginal discharge, pain while passing urine, pain in the lower abdomen, spotting, any skin lesions I would advise you to do Serological tests for STDs.
3) If you are not on a contraceptive you should consider an emergency contraceptive pill (if this act was recent) or get a pregnancy test done if you miss your periods. Generally I would not recommend a pregnancy test in this scenario, but to be honest getting someone pregnant without mutual consent is the number one reason to deliberately damage a condom. So just to be safe.


Hope this helps
Feel free to ask followups
Thank you


Patient replied :

Hello. Thank you for your answer. I emailedy doctor and spoke with her and she says I could get PEP. She said she doesn't think I definitely need it but gave me a place to contact that works with PEP. I explained the situation to them and they said I am at risk but maybe a lower risk since I don't know if he ejaculated in me. We finished early but there was some stuff in the condom when I checked it. They said I can go to my nearest hopsital to get pep. Do you think I need this? It has to be within 72 hours and it's already been over 40, so I don't have much time to decide. My doctor doesn't think it's definitely necessary but the PEP nurse said I can do it to be safe. I dorm want to take these strong medications if I don't have to. What are my chances of having it vs not having it (if the guy had it)? I am going to paste the email I sent to my doctor since it has a lot more detail about the actual situation. Please tell me what you think. Thank you!!

Hi Dr. Miller,

How are you? I hope everything is well. I'm sorry to bother you but I just have something that is on my mind because of something I did last night and I don't know who else to ask. (Well it was technically today because it was at 3am). Because of this situation I am very worried that I could have contracted HIV and I'm really not sure if I'm just overly paranoid. This is so embarrassing but I will explain the situation. I'm so sorry for this long email. Last night I had sex with an ex who I know sleeps around with many other girls. I know when he does it he probably doesn't use protection (unless the girl requests it) because I used to see him for like two years and never used protection at all, this was like a year and a half ago. Anyway, I saw him yesterday and I regret this and don't even know why I did it. I am still with my boyfriend who is away until June and he does NOT know about this at all and hopefully never will. It was definitely a mistake and a big regret. Anyway, right before we had actual intercourse I told him to put on a condom. He said he had to go to the bathroom to "pee" but I never heard the toilet flush but did hear the condom wrapper open. I was so afraid that he could of did something to the condom because he lied and said he was using the bathroom but did not and I heard him open the condom, but I didn't really think he would want to do anything like that. The only reason he might is to try to get me somehow caught by my boyfriend because maybe he's jealous, I don't know, I can't think of any other reason. So when he came in I felt it was on and we had sex. After like 20 minutes I told him to stop because it was burning so we stopped. He took off the condom right away and put it in a black plastic bag. This morning when I woke up I took the bag to the bathroom acting like I was going to flush it. I took the condom out and I examined it and I saw a hole on the tip part. I didn't put water in it or anything to see if there were other holes that I couldn't see, but there was some stuff in it and I don't think anything was leaking except from the hole I saw. So there could have been other holes that I didn't see but I could not tell. This hole that I actually did see was at the tip and was not just a tiny hole, it was like maybe half or a quarter size of a penny, not enough to stick like a whole finger through but definitely enough to clearly see it and have stuff easily come out of it. I was so embarrassed and scared but a little while later I got the courage and I asked him about this and he said that he did not do anything to it and that he went to the bathroom to pee and that he put it on when he came back in the room. I never heard the toilet flush and I heard the condom wrapper in the bathroom. I did not see him put anything on in the room, I am almost positive he put it on in the bathroom and did not pee like he said because the toilet never flushed. Also, the hole was at the tip and that's probably exactly where someone would put it if they were to deliberately put a hole in it since that's where the "stuff" would come out of. If he didn't do anything to the condom then why would he lie about where he put it on and why would there be a very viewable hole at the tip? Also, the sex burned which never happens to me. My biggest question and fear, and the whole reason I'm writing this is because I'm scared I could have HIV from this. If he does have HIV, what are my chances of getting it from this experience? I read online that I would have equal chances to if we had unprotected sex because the condom is useless and not effective with a hole. I don't think he ejaculated because we didn't finish, but there were definitely liquids in the condom, that could have or probably did get into me. Also, I had just shaved in that area a few hours before and there could of been a cut or something on me. The sex was burning (I'm not sure if this was from the condom having the hole or maybe because I haven't had sex in a while). And he gave me oral sex right before. I did not do that for him (Thank God). Also, I just had the surgery to remove the cyst from my ovary about 3-4 weeks ago and still have the incisions that are healing on my lower stomach. Not sure if this surgery or the incisions could increase my risk. I'm sorry for this long message, but please explain whatever you may know that could help. I am very scared this could have caused me to contract HIV if he has it. I don't know if I'm worrying for nothing or over paranoid but this just won't leave my mind. It's all I think about. I had these fears before but this time is so much worse because the condom showed a hole in it the next morning when I checked it. Unless the hole wasn't there during sex, but then why did I see it in the morning? Would it at all be possible that the hole came after it was already off and the condom had no hole while we had sex? Don't see how that would be possible. I really feel like he did something to it because of the fact that he lied about using the bathroom and not putting it on in there. I am almost positive he put it on in the bathroom because like I said, I heard the wrapper and I did not hear him pee or hear the toilet flush at all and did not see him put it on when he got in the room at all. Why would he lie about where he put it on if he didn't damage the condom on purpose? I just had a HIV test last week and I was so relieved and now I am so worried and cannot stop thinking about this. I wish I never did this yesterday, mainly for this reason. I know I would only have a chance of getting it if he does have it but I have no clue if he does and the fact that he might of done something to the condom makes me worry so much more that he could have it and did this on purpose. The only way I can be sure is for him to take a test and then if it's negative I know he doesn't have it (unless he got it in the recent few months). I could never ask him to do that, we are not close at all. I'd be too scared to ask him and he would most likely think I'm crazy and not even agree to do it. I cannot take a test for myself until 3 months for absolute accurate results and I know I am going to go crazy until then. I will not stop thinking about it. Please tell me what you think. Once again, I'm so sorry for this long email, I just am really panicking.


Hello,
I have gone through the details.
Yes I would advise you to take the Post Exposure Prophylaxis as it is not possible to say whether you could get pregnant or not as it is not clear if he ejaculated or no.
Also in view of the probable hole in the condom, I would advise you to take post exposure prophylaxis. It has to be taken within 72 hours, but the earlier you take it the more effective it is.
Also it is relatively safe. You can have slight side effects with it like menstrual irregularities, spotting, nausea, vomiting, abdominal pain, fatigue, headache, dizziness and breast tenderness but they are nothing to worry. Hence I would advise you to go ahead and take it.
If you are on any medication at present do mention them to the doctor.

In addition like I mentioned in my earlier post you can do the following tests
1) You can do the Combo HIV antibody-antigen test which is a fourth generation test 3 weeks from the date of exposure to rule out HIV
2) If you persist having symptoms of burning sensation in the vagina or develop abnormal vaginal discharge, pain while passing urine, pain in the lower abdomen, spotting, any skin lesions I would advise you to do Serological tests for STDs.

I hope this has helped.
Thankyou


Patient replied :

Hello, sorry to bother you again. I just had a couple more questions. Today I went to get PEP. By the time I received it, it was around 62 hours after the incident. I know they say it can work up to 72 hours later but I have also read that the sooner you take it, the better the chance of its success. Am I at lower risk for this medication to work since I waited till almost the whole 72 hours? If so, how much less of a chance will it be that it may not work? I felt so
much better once I took this but now I am
worried that I waited too long and increased my chances of becoming infected. Also, if the man I was with did not have HIV and I was no exposed at all, can this medication do any harm? Because I know for example, if someone takes a medication that they don't need, it can make them worse, like a non-diabetic taking a medicine for diabetes or a non psychotic person taking a medication when they're not psychotic. So if I wasn't exposed to this disease at all, then will the medication do anything bad to me? Can it increase my chance of getting the disease in the future from someone or make me imune to the medication or something? Also, like I said I didn't take it till 62 hours after; do you know of anyone who waited that long, or Better, waited longer, and if so, what was their outcome ? I'm very nervous now because I took it only 10 hours before the deadline. Please let me know all that you can to help. Thank you so much!



Hello,
Yes PEP the sooner you take the more effective it is.
But in view of your case, where it is likely that your partner did not ejaculate, and also there was a condom on. Even if it had a hole the amount of semen that would have entered you would have been much less. Hence it will be effective even around 62 hours. You need not worry.
The medication will not do any harm, besides the side effects. It will definitely Not make you worse. If you did not get the infection the medicine will not do harm you. Like I said you can have side effects, but no harm like you have mentioned. No it will not increase your chances in the future nor will it make you immune.
But it is always advisable to take precautions and use protection (I understand in this case your situation was different as you were not sure about the hole).
Yes patients have taken at 72 hours too. But like I said in your case, likely hood of an infection was less, hence you need not worry.
You can safely put this incident behind you.

I hope this has helped.
Take care
Thankyou


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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