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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can HIV be contracted through protected sex?

Answered by
Dr. S. Murugan

HIV AIDS Specialist

Practicing since :1974

Answered : 2801 Questions

Posted on Fri, 23 Oct 2015 in General Health
Question: Hi Doctor,

I posted a query few weeks back regarding a possible exposure due to the fact that condom was lying in my underwear.
At that time you advised no further test is needed as the test were conclusive. However I still went ahead and had
a test done - again negative.

I was at the top of the world , happy with my life. I decided to go for a vacation and met up with friends in XXXXXXX
Everything was fine until last weekend when we got drunk and people started discussing their sexual escapades. unfortunately
for me I could never muster enough faith to tell them about the mental trauma I had been through. One thing led to
another and I found myself in a brothel of the infamous XXXX along with them. Though I refused at first but I was
jeered upon for being a spineless ass.

It may be the alcohol affect but suddenly there was a 'stupid adrenaline rush' that I need to man up and face this
fear of mine. I was however very cautious this time. I requested the CSW to put on the condom on me. I didnot had any
oral or anal sex. Just penetrative protected sex which lasted for may be 1- 2 minutes. During the act , I started
realising my foolishness and started loosing the erection due to that. I immediately withdrew, the csw pointed out
that I had already cum as there was a white line on the tip of condom. Thus I requested her to remove the condom and
she did it immediately.

Sir I know my foolishness can't be pardoned. But I needed to discuss this with someone so I decided to write down to
you. My panic attacks are back thinking about the situation. I am now again worrying about the miniscule holes theory
of condom defect. Also I did ask the csw if she was clean and she smiled and asked me to not worry but I can't trust
her. Hell I cannot even trust myself. So do you think I need to start the process of testing again for confirmation or
can I again forget about the episode as it was protected sex. Though this time I didn't get a chance to check the
condom with water but I am pretty sure that I did not see any rupture at the tip. Though It has been only 3 days but I have
already started to check for each and every symptom.

Have you ever seen/known about transmission after such an act ? Is it possible ?
What the hell i am doing ?
Answered by Dr. S. Murugan 40 minutes later
Brief Answer:
You are safe with protected sex.

Detailed Answer:
Welcome to HCM.
Thanks for posting your query once again to me.

You are just 28 years old. It is very difficult to overcome the sexual urge at this age especially under the influence of alcohol. There is nothing to repent upon the same. You did a wonderful job. That is you had a protected sex even under the influence of alcohol.
All the condoms available in the market, including 'NIRODH', the one propagated by Government of XXXXXXX are well standardized, withstands world class quality and subjected to lot of quality assurance programs by the manufacturers periodically.
So there is nothing to worry. As long as the condom remain intact throughout the act of sex without any tear you are safe. Avoid alcohol consummation at anytime as it would take away your judgmental capacity and inhibition and would lead to unsafe sex in future.
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. S. Murugan 32 minutes later
Dear Sir,

Thank you for such a prompt reply. It did relief me a bit. I wanted to clarify below queries

1)I wanted to know that in your illustrious career spanning over 40 years , Have you ever seen a case where a person got infected even without a rupture in condom ? (Assuming that they did not had unprotected oral or anal sex)
2)I still have few hours (today is the 2nd Day not 3rd sorry for the wrong information) to start the PEP , would you advice that given my situation ?
3)Also I did not wash off my penis immediately because it felt dry at that time , So would you still recommend that testing is not required ( personally I would love to hear that as the testing idea freaks me out ) ?
4) I read once that few doctors have an idea that condoms are not 100 % effective. Is it because they fear about rupture or the way it has been handled?
5) If the condom tore would that be obvious with naked eye.( I did not personally pull off the the condom, the CSW did. Though I am sure the penis head and tip were covered and had no tear).
6) You are associated with AIDS Society of XXXXXXX Executive member of Council of Sex Education and Parental International, XXXXXXX Association for the study of Sexually Transmitted Diseases and AIDS. What is the epidemic scenario in XXXXXXX specially sonagachi ? Is it Bad ?
Answered by Dr. S. Murugan 11 hours later
Brief Answer:
STDs can occur with protected sex over uncovered area, not HIV

Detailed Answer:
Welcome back.

1. We had seen cases of STDs with protected sex over the uncovered area of genitals like peno-scrotal junction and scrotum and no case of HIV so far.
2. If you had an absolute protected sex PEP is not necessary.
3. Not washing immediately after the protected exposure, has in no way increase the risk.
4.Rupture or tear condom is possible when not used properly. If used correctly it offers a high degree of protection.
5. She said that condom had semen, it means it had not torn
6. The incidence of HIV in west Bengal is far less than the other eastern provinces and XXXXXXX Andhra Pradesh, XXXXXXX and Tamil Nadu. So the prevalence of HIV among the commercial sex workers must be lesser than with counter parts of XXXXXXX or south XXXXXXX
Dr S.Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. S. Murugan 9 hours later
Dear Sir,

Thank you for all those wonderful replies. I have been a keen follower of your work since the first incident. your responses installs confidence in people. So thanks for the wonderful service you are

Now I read once that you advised a patient that ' HIV is a well manageable
disease.' Thus I would like to understand how ?

What is the average amount of drugs consumed by patients while treatment ?

what type of cost do they bear on a monthly basis?

What is the average life expentency for a infected person ?

Can I volunteer in one of those 'aids help' campaigns?

Does the government of XXXXXXX allow an infected person to travel abroad?
Answered by Dr. S. Murugan 30 minutes later
Brief Answer:
HIV has to be treated life long as per the present situation

Detailed Answer:
Welcome back.
HIV is to be treated life long. A combination of three drugs have to be given. Many drugs are available. Preferable and suitable combination has to be followed with strict adherence to avoid resistance to the drugs. Drugs cost a minimum of INR 1200 and above per month . People can live comfortable with drugs 20 years and above. Combination has to be switched over as per toxic effects or according to the response to the treatment. Periodic monitoring is essential. You can involve yourself with some voluntary organization which cares for the HIV positive people. I greatly appreciate your interest in the HIV care.
Dr S Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. S. Murugan 3 hours later
Dear Doctor,

Thank you once again for the valuable informations. Everything you told me is slowly but effectively sinking in.

1) I have seen many experts give risk assessment online. It seems that the rate of transmission in hetrosexual cases is 1 in every 1000 exposures. Given the fact a person is wearing a condom during a sexual act. what is the associated risk along with it ?

2) Have you ever seen a case where a person got infected during a condom breakage ?

3) In the last follow up , I asked whether people who are infected are allowed to travel abroad. If possible kindly clarify on that.

4) Kindly let me know how confident you are about my situation ? I have not slept/eat for past three days your assurance means everything to me.

5) How can I gain control on these irrational sexual urges ?

6) Is there any need to get tested ?
Answered by Dr. S. Murugan 2 hours later
Brief Answer:
HIV risk for you is almost negligible

Detailed Answer:
Welcome back.
1.With protected sex HIV risk is almost nil
2.I am yet to see a case of HIV in an individual with broken Condom.
3. Travel abroad with HIV is not forbidden except for Gulf countries for job.
4. In my view your risk for HIV is remote.
5. By doing masturbation, you can reduce the sexual urge.
6. Have a Consultation with a psychiatrist and get calm yourself.
7. By having a test and ruling out HIV, will bring you mental calmness
Dr S Murugan
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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