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QUESTION: if i used a very low quality condom when having sex with a prostitute but the condom did not burst, should i be worried about HIV????

i did hear popping 3 times but when i cummed , it was there inside the condom. also while having sex, i saw the condom .it was intact{i could not see any tear in it....}

ANSWER: Dear Worried:

Peace and Namaste.  An intact latex condom prevents HIV in fluids from passing through the membrane.  As such, it protects one or both partners from infection.  If the condom is of such low quality that blood, semen, or vaginal secretions can pass through it, it certainly lowers the degree of protection.   On the other hand, it appears that it does reduce (by your description) the amount of ejaculate (cum) to which your partner was exposed.
It is unclear whether it protected you from blood, vaginal secretions, or the semen of your partner.

It would seem, however, that it would reduce the amount of the fluids to which you were exposed.  I would say that you reduced - though perhaps not as much as you might have - the risk.

Be on the safe side, abstain AND get some condoms from a local testing center and learn your current HIV status, then return in 6 weeks and be tested again.  Most programmes offer condoms to those at risk of transmission.

Best to you and yours,

Terry

---------- FOLLOW-UP ----------

QUESTION: namaste. i have told you that it {condom} contained my stuff & i could not see any breaks in the condom. it was latex condom for sure. if it is impervious on the inside{because it reduces the woman's exposure to my fluid} how can it allow her vaginal secretions to get in????? and also in this case would a 6 week testing be conclusive????

Answer
Namaste again.  

I cannot evaluate what is a very low quality condom from your first email so was unclear as to whether latex or not.  Secondly, seeing your ejaculate in the condom doesn't guarantee that some didn't seep out - again, not clear what 'low quality' means in real life.  Bottom line is that if you were in contact with any of her vaginal secretions or blood - and oft the shaft of the penis is exposed even when a condom covers the tip - it places you at some risk.  

6 weeks for an antibody test wouldn't be conclusive, but at 6 weeks if you were infected it would probably be reactive and show positive.  Not "conclusive" but good indicator.  There are other tests - PCR and bDNA that can look for the virus or parts of it instead of the antibody - or p24 antigen testing.  Problem with p24 - cheapest of the alternative - is that it has as high as a 12% rate of false positives - alarming you needlessly.

I hope that helps.

Best to you and yours.

Terry  

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Terry B

Expertise

Help in assessing personal and professional risk of HIV transmission; tips in teaching about HIV/AIDS; cultural competency for teaching about HIV/AIDS in Catholic settings; considerations in US and overseas HIV/AIDS programs and education for health and other professionals. Specific questions about treatment should be referred to your health provider; opinions and information offered are not meant to replace medical advice

Experience

Seven years with academic medical center and national AIDS education and training center, seven subsequent years with focus on international HIV/AIDS in East and South Africa. Former clinician, bioethics preceptor at an academic medical center and presenter in wide range of fora including international AIDS conference.

Organizations
Disabled American Veterans American Public Health Association MENSA AA

Publications
Human Variety, EC Sociological Society Proceedings of the International AIDS Conference, Durban, South Africa "HIV and Primary Care"

Education/Credentials
BS Psychology MPH Master of Public Health PhD studies underway

Awards and Honors
Naval School of Health Sciences, Hospital Corps with Highest Honors, Neuropsychiatry with Honors and High Distinction

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