Expert: Terry B - 12/4/2007

Question
Dear Terry B,
first of all I want to thank you for doing taking time to help other people.
Well as the title says I had a problem. I slept with a woman and when we would change positions sometimes the condom would slip out from my penis and hang out from her, I don't know if you know what I'm saying, I hope you do. Towards the end I started pushing harder until I had an orgasm right after that I came out from her and she noticed she had sperm inside her. I started freaking out inside my head and I remember that she said that it didn't break but I'm not quite sure if it broke or the condom slipped out and stayed inside of her (which actually happened to me before) and then I ejaculated. I have replayed the scene so many times in my head that know I don't know what really happened. Anyway I freaked out and told her I'm really scared of STDs so she told me she made a test like a month and a half ago and that she is disease-free but that is not enough for me. The worst part is that I have a girlfriend and since we are together for a long time we don't use condoms and I cant bear the thought of giving something to her because I was weak, especially HIV. I've been having nightmares, I cant concentrate on work and since I read that when you get infected you start having symptoms of the flu, psychologically it has affected me because I started feeling shivers and a bit hot. I read that when the condom breaks the woman is in higher risk because of the men's sperm in contact with a large area but I still cant stay calmed. I'm going to go take a test after 6 weeks and its actually weird because they told me that I will have the results in one hour (I'm in another ountry) are these tests reliable?? What is the probability of a false negative after 6 weeks? I will definitely wont have sex with my girlfriend until I'm sure that I'm clean.

Answer
Dear Richard:

Peace.  What you describe, if I understand you correctly, is the condom slipping off your penis as you withdrew from your partner.  I realize the information can't help you for this instance, but this is why when using a condom to ensure it extends to the base of your penis and protects you against exposure to fluids of your partner, and why it is recommended that you grasp the base of the condom on your penis while still erect and withdraw a bit more carefully.  You'll know next time, I guess, and "careful" is a word sometimes ignored in the midst of passion.

The bottom line with your exposure is that your penis was exposed for a relatively short time to her fluids, though it does seem that she was exposed to your fluids when the condom slipped off.  Your risk is significant but low.  Relying on her report is nice, but as a politician once said: "Trust but verify" - and you do not have access to her medical records or test results.  

For you, your health, and that of your loved ones, please see a reputable counseling and testing site or your physician and be tested for HIV and other sexual infections.  Some testing can find possible HIV earlier than six weeks, but it is often expensive and may give you false positive results.  At six weeks, a standard ELISA and Western Blot antibody test is probably reliable, though six months is recommended for absolute certainty.  The "results in one hour" probably referred to how soon your test results would be finished, not whether they would be accurate an hour after your exposure.

Now the tough stuff - the question appears to be, "Should I risk being honest with someone with whom I have a more meaningful relationship, or potentially expose her to a life-threatening disease so as not to embarrass myself?"  
I would recommend you speak with a counselor at an HIV testing center who can help you with your approach, and you might also consider telling your girlfriend that you've been reading statistics on birth control failure rates and want to add a condom for added protection while you develop a more honest strategy.

The best to you and yours, and hopes for healthy and adult relationships.  

Terry