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Condom Slipped Off

I had sex with an escort girl from Phillipine in Singapore, which cost me $800 for 6hrs, however while having sex I looked at my penis and realized that condom slipped off. I immediately withdrew my penis and told her about the situation. She appeared really calm and used her fingers to get the condom out of her vagina. I then washed my penis with soap and peed, Since I was freaked out I asked her if it was ok, she said no its not ok since we have to use protection, and I enquired further if she has some disease or get tested regularly upon which she stated no. After that she wanted to have it one more time, however I kept on insisting her to tell me if I am gonna have to do something about what happened. She said the following,
1. she trusted me and I should trust her
2. she was educated and has been doing it for a couple of years and aware of sexually transmitted diseases
However, her assurance no effect on me since I didnt have any proof of her being negative. Hence, I kept bringing it up and she got upset to the extent that she stormed out of the room calling me crazy. According to my estimate, my penis must have stayed exposed for 1-2 minutes in her before I realized the slippage. I am completely paranoid, I feel like I am dying already, the virus is in my blood stream killing me on the inside. I have absolutely no idea whatsoever. What should I do now, please doctor help me!
17 Responses
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300980 tn?1194929400
MEDICAL PROFESSIONAL
I agree.

This thread nees to end at this time.  EWH
Helpful - 0
Avatar universal
HIV rapid test came out negative after one month of exposure with nPEP. Doctor says he has not witnessed a single seroconversion after one moth negative test, he says its highly unlikely.
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
Please take this exchange to the HIV communtiy site.  EWH
Helpful - 0
Avatar universal
The escort agency just called informing me that they got that escort tested again on the 10th of Jan 2011, and it was negative, however since I have started PEP I cant discontinue. Please advise.
Helpful - 0
Avatar universal
Sorry for junping on the tread Dr but I think I can add some info as my situation was the same and i have found valuble info that probably can help this fellos anxiety!

I had a similar situation as you! Filipino CSW in Singapore! I too took PEP and now in a way wish I hadnt knowing the facts that I do know!
Once you take PEP you have a long wait for a conclusive test 4 months! as there is no data to support the affects of PEP and early testing... If you look at my posts you will see! I had a HIV DUO 1 day post PEP and a Highly sensitive RNA test 10 days post PEP (39 post exposure) they were  negative!!!!  however the DR's can still not say im in the clear untill 3 months post PEP, even though everything looks good with my negetive results!   The reason I might not have bothered with PEP are follows.

Official stats.... 45 million women in the Phillipines, 3000 estimated positive feamles (1/15000) with a prevelence of 0.2% in Sex workers!
The Aidsmap official risk estimate is 0.07% (1/500) Per penetrive vaginal sex with a KNOWN hiv positive feamle... Ours is less as we dont know the CSW had HIV.

http://www.aidsmap.com/Estimated-risk-per-exposure/page/1324038/

Our Risk

So Chance she had HIV 0.2 (1/500) x Exposire 0.07 (1/1500) = 1/750000 chance we contracted HIV

However on the plus side PEP makes the odds even better, the estimated success of PEP is 80%!

This brings our rate up to

1/750000  x 1/5 (rate of estimated failure of PEP) = 1/37500000!!!!!!!!!!!!!!!! Yes 1 in 3.75 Milllion!

Personally now Id have settled for the 1/750000 and had a conclusive test at 1 month... instead i have to wait for 4 months for a conclusive test that has a 1 in 3.75 million chance of being positive!
Feel free to drop me a personnal message if you fancy chatting about it all!
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
From here on out, your interactions should be with your doctor.  I'm sure you will be fine.  EWH
Helpful - 0
Avatar universal
Doctor, I just had my first dose of Combivir 300mg (1 tab twice) + Kaletra (2 tab twice). I got tested negative using rapid test before taking these, and the doctor took my blood samples for Liver and kidney function test. He offered me a 6 months package in 2700USD inclusive of std test, consultation, and LFT. I don't know how my body is going to take these, and what will happen to me in the future. The doctor said you are a borderline case as far as risk assessment is concerned, and if you are a risk taker then don't do anything. However, he says if something goes wrong you might regret it all your life. He stayed short of recommending or otherwise, but implied I should take it as the worst case scenario.
Helpful - 0
Avatar universal
Hello just a small bit of info that may help.... If you look up UNAIDS, WHO and HIV Insite you'll find the the Phillipines has an extreamly low prevelence of HIV.... something like an estimate of 3-4000 women in a nation of 45million women.  Also the Prevelence in CSW is thought to be less than 0.2%.

Regards
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
The side effects of PEP include gastrointestinal side effects, nausea, vomiting and liver dysfunction.  Further, conclusive assessment of the presence or absence of infection will only be available 8-12 weeks following completion of PEP.  If you choose to take PEP, as mentioned above, these are all things you should discuss with the doctor who prescirbes it (i.e. toxcitiy,follow-up plans, costs, etc), not me.  EWH
Helpful - 0
Avatar universal
Many thanks, really appreciate it, however if I go ahead with PEP what will be the consequences that I would have to face and for how long since I stay alone and no one really to take care of me. Furthermore, after the PEP how long would I need to wait before get tested conclusively. I really appreciate your time and profound insights.
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
I have nothing more to say.  The fact that your partner had a negative HIV test less than 3 weeks makes it very, very unlikely that she caught HIV in the interval.  I would not recommend PEP in this situation.  It is easy for the doctor to write a prescription for PEP - it has no consequence for him.  EWH
Helpful - 0
Avatar universal
I apologize profusely for not writing everything down in one post, I went to see a doctor and he says since you had an exposure with a CSW who you cant get tested without going into ifs and buts which qualifies you for PEP. It has side effects like diarrhea nausea, and lethargy which many of his patients endured except few who suffered from Jaundice. He says he cant say more, either you get her tested or think about PEP.
Helpful - 0
Avatar universal
Doctor, I am still ambivalent about PEP. I know its a personal decision, however I am not a doctor to know about my risk of infection, side effects, hindrance to my activities, my job etc. Please advise me before I cross the 72hrs time window. Its my only lifeline if I am God forbid infected, and you have to show me a direction knowing my risk.
Helpful - 0
Avatar universal
Thanks for your advice. Since I called the escort agency and they provided me the details of the last medical examination done i.e Negative on 24 Dec 2010 in Singapore. I went down really hard on them and they advised me not to be this discreet with their escorts. However, the escort called me and said I was thinking way too much into it, she was clean, has a child in Philippines and I was a moron. Having said that nobody knows what happened between 24Dec and 8Jan 2011, but since you say the need is low for PEP, I wont take it on account of the side effects. Its a gamble, and I am betting my life. I will take the 1 in 1000 risk figure, and spend the next 4 weeks trying to calm myself down. Your reassurance would be highly appreciated.
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
I am sure that if you want PEP you can get it althought I feel that the nee is low.  Decisions about PEP are a personal decision in which one should consider the likelihood that infection will occur, the likelihood of drug side effects, one's personal anxiety and the cost of the drugs (expensive, typically in the neighborhood of $1000).  

If you choose to try to find someone to provide you with PEP, please hold them accountable for all that goes with it (i.e. follow-up, answering your questions, etc).  Sadly, there are all too many health care providers willing to provide it, thinking that their jobs are done when the prescriptions are written.  This is not the case.  In my opinion, it is essential that anyone who provides PEP also provide follow-up and a commitment to answer their patient's questions about risk, side effects, etc.  Often this is not done.

EWH
Helpful - 0
Avatar universal
Many thanks. Just to make things clear, the encounter took place 6hrs ago and she always uses condom and she said its a standard. When I asked her thoughts about HIV risk, she said she doesnt worry since its always protected, and if slippage ocurs both parties should be trusting. She really didnt seem to be concerned about it, took a new condom out and wanted to continue after washing herself. However, I am not a trusting soul, and completely wierded out. Should I get PEP or anything that might lower the risks? I have heard PEP has side effects though, anyway the bottom line is she didnt seem to care much about it and quickly forgot what happened. However, its just not the case with me and I just feel like I have an axe hanging over my neck for the next few weeks. Now all I can think about is preparing myself for demise
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
Welcome back to the Forum.  I know from our past interchanges just how fearful you become after an exposure of this sort and hope that I can be helpful by providing you with some facts.  

It is not clear to me how long ago this exposure occurred and whether your partner requested you to use a condom or whether it was something you requested.

if your partner was the one who suggested condom use you can be quite comfortable that she did not have HIV or other problems since commercial sex workers who used condoms do so to protect themselves from their clients, not to protect their clients.  Further, your partner told you that she got checked regularly for STDs and that she did not have infection.  People do tell the truth.  Furthermore, at an expensive place like the one you went to, part of the expense is related to their efforts to make sure that their workers are not a danger to their clients (to do otherwise would be bad for business).  It is a fact that it is usual for commercial sex workers in the Philippines to get checked regularly for STDs and HIV in order to be permitted to continue working.  

Also, remember that even if the VERY unlikely situation that your partner had HIV, your risk of infection form a single exposure is only 1 in 1000 (1 1/10th of 1).  

Bottom line, your risk of HIV is very, very low and not something to worry about (there's not much you can do about it at this time anyway).  For your own peace of mind you may wish to get checked for common STDs (gonorrhea, chlamydia) at any time more than 2-3 days after your exposure and for HIV using a DUO (combined HIV p24 antigen/HIV antibody) test 4 weeks following this event.  When you do, I am confident your tests will be negative. and urge you to believe the results when you get them.

I hope my comments are reassuring.  EWH
Helpful - 0

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