Expert: Terry B - 10/18/2006

Question
While I was having sex the condom broke. only noticed after I have finished. after six weeks of exposure my doctor recommended that I take a HIV pcr qualitative test. it came back negative and my doc told me not to worry and I don't need to take another test as I was at low risk. I know the woman for about 2 yrs, I also told her that I took a test and she told me I should have done it coz she knows she is clean.

2 week later after my negative pcr I had sex again with the same woman and the same thing happened the condom broke again.
I also know that she has not been with anyone else from our last encounter.  

My question : is it possible to have sex with someone who is infected (not that she is infected well I don't know for sure ) and not get infected ?
should I take another test to make sure again ?
am I at low risk is this situation?  that I tested negative therefore I might mean that she is also not infected

Thanks  

Answer
Dear Jerry:

Peace. Thank you for your questions; I will answer in order.

1)  Is it possible to have sex with someone who is infected and not get infected?  
Yes.  With HIV, as with other infectious diseases, an exposure (being in contact with a pathogen) does not always lead to an infection.  Some of the factors that mediate (impact chances of an HIV exposure becoming an infection) the ROUTE by which you are exposed (i.e. through open wound, injection, blood-to-blood versus exposure to intact skin), the AMOUNT of the fluid to which you are exposed, the size of the AREA exposed, the CONCENTRATION of the pathogen in the fluids (how much virus is in the fluids), the FREQUENCY (how often you are exposed), the DURATION (how long you were exposed to the fluids), etc.

2) Should I take another test to make sure again?
This is up to you, weigh how much it helps in your peace of mind.  As you probably know by now, your being tested after potential exposure is a poor way to manage your health or that of your partner.  Would it not be easier, given that you have known this woman for some time, to talk her into going to testing WITH you so as to inform both of you?

3) Based on what you have described, i.e. the condom breaking somewhere into the sexual act, we can assume you were exposed to her vaginal secretions along a smaller area of your penis than if you had not used a condom at all.  While release of your ejaculate occasioned by the broken condom may have exposed her to a quantity of your fluids, I would think your relative risk is smaller than hers in this situation.

Regarding condom use:

If you continue to engage in fluid exchange activities, ensure that the condom is latex, within expiration date (yes, read the label in the light prior to use), and use water-based lubricant - avoid vaseline or any oil-based lubricant as these cause the latex to weaken and break down.  Place the condom on an erect penis prior to entry and remove it after ejaculation.   More detailed instructions on proper condom use can be found at www.thebody.com and other sites.

I wish you well - and recommend highly that you and your partner be tested together at a counseling and testing site.

Sincerely,

Terry