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My condom broke during sex; small cuts

Hello Doctors. I'm a 22 yr old serving in Africa right now. My ignorant self decided to go to a massage parlor and took advantage of the offer for sex. Prior to arriving I had shaved my genital area and had a few knicks at the base of my penis. Anway, I put on a condom and agreed to have sex with the mesus (forgive my spelling). While having sex my condom broke midway. I pulled out and half of my shaft was exposed. The base was still covered with the remains of the condom. I removed the remains and placed on a new condom. I asked the mesus to perform fellatio to get myself lubed up. I again engaged in sexual intercoarse and finished (condom intact). I was worried because the condom broke. I asked her several times if she had hiv. She told me she did not and seemed very convincing. She also said that she gets tested regularly.

My concerns are threefold: a) possible transmission from brief time my penis was inserted in her vagina while condom broke, b) possibility that if there was a trace of hiv that it may have entered the very small knicks at the base of my penis, c) was it a poor choice (frankly, after the fact, the whole encounter was a poor choice) to have placed a new condom on my penis without first washing it off? I hope you can help. Thank you.
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300980 tn?1194929400
MEDICAL PROFESSIONAL
Welcome to the Forum.  I will try to help.  Once a condom breaks during intercourse, the act is considered "unprotected" and therefore the person is at risk for STDs, including HIV.  You should get tested. The prevalence of both STDs an HIV in many African nations is higher than in other parts of the world.  Because of your exposure, if it is less than 72 hours since your exposure, you are a good candidate to receive what is called "post-exposure prophylaxis" (PEP) for HIV.  There is a risk which while not higher than 1 in 1000 is high enough to warrant evaluation and possibly receipt of PEP.  If you are in this time window, I would seek evaluation sooner than later.  At that time you should also be tested for other STDs.

As far as your risk related to condom breakage is concerned while variables such as duration of exposure, etc are of theoretical concern, there are no studies to help us know how things change over time or in different situations.  Best to just say unprotected and act accordingly.

As for your specific questions

1.  See above. There is some risk.  Risk for other STDs (gonorrhea, chlamydia, etc) is higher than for HIV but HIV is the tough one to treat.    
2.  There is no reason to think that the nicks at the base of your penis make you any more (or less) susceptible to infection than others.
3.  No, there are no data to suggest that putting on another condom without washing your penis, etc was a poor choice.

Hope these comments help. Please feel free to ask a follow-up question or two if anything I have said is unclear.  EWH

  

Helpful - 1
Avatar universal
A related discussion, Anal sex condom tore. was started.
Helpful - 0
Avatar universal
A related discussion, condom broke,  very short exposure was started.
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
The latter. If you were to get HIV, it would require taking medications continuously as opposed to other STDs which can typically be handled with a single course of treatment.  If the folks you talk to decide it is appropriate, they would not be able to diagnose HIV but would be giving you therapy designed to prevent you from getting it while the infection is still incubating and is otherwise undetectable.  EWH
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Avatar universal
Thank you doctor Hook. When you say "HIV is the tough one to treat" do you mean that it is harder to diagnose within the 72 hour time frame or that if one was infected it is harder to treat or both?
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