Expert: Terry B - 1/7/2007

Question
while having sex my condom erupted and lady told me at once,what i saw was,the top portion of the condom was totally lost and it had come to the end of pannis.so the tip was exposed to her vagina although for short time but still long enough to get hiv. i m very much in fear as she was a prostitute. please tell me after how many days i could get my hiv test done.and what r the chances of infection getting transmitted. please reply soon. thanx,amit

Answer
Dear Amit:

Peace.  The good news is that wearing a condom protected you by reducing the duration of your exposure and the amount her fluids to which you were exposed.  This reduces your risk considerably as compared to not wearing a condom; even among sex workers in most settings, most are not HIV infected, so this reduces your risk further.  In short, your chances of an HIV transmission having occurred are small.

At the same time, there is some slight chance of an exposure, and I wish I could tell you there is an immediate test that could tell you accurately whether you were infected; there are a couple or more tests that may tell you earlier than the standard, reliable, ELISA and Western Blot combination (the usual HIV-1 and HIV-2 antibody test) but they are expensive, less accurate, and not everybody can get them.   Most of what I have read suggests waiting unless you are within 72 hours of exposure.

IF you are in a setting where such testing is available and affordable by you, you might ask to see a counselor and/or health care provider and request a p24 antigen test - this reacts more quickly to possible HIV than the ELISA but has reportedly about a 10 % false positive rate - meaning 10 % of the time it might suggest you are infected when you are not.  This, of course, can cause needless anxiety.  There are other tests with similar problems in reliability.  

In some places, health care workers (and in other places, people who report an exposure immediately) can begin taking antiretroviral medications within 24-72 hours of the exposure; it is thought that in some cases, taking the medications reduced the chances of an exposure becoming a transmission.  There are several problems with this practice, however, not the least of which is the need to take the medications as prescribed despite significant side-effects, and lack of a convincing body of evidence that this makes significant difference.

While it may seem difficult to someone who wants to know immediately, protecting others from your semen and blood throughout at least six weeks while you wait for a counseling and testing appointment and take the antibody test is probably your best route.  

As I noted, your chances of being infected, based on what you describe, are small but not non-existent; there is little that can really be done at this point if you are infected except protect others.  Having a reliable HIV antibody test at least six weeks (or six months as some would recommend) after exposure should confirm my bet that you were not infected.

I hope this helps; chances are you are not infected.

Sincerely,

Terry