Babun sivaslı ve bilgili kardeşlerim

Hi doctor i just returned from china.About 40 hours ago i had protected sex twice while intoxicated the condom did not break but i just read about fake condoms being used there and they were provided by the call girls.Do you think i should start on pep and also what should i look out for in the coming days and weeks H. Hunter Handsfield, MD H. Hunter Handsfield, MD 29 months ago Welcome to the forum. Thank you for your confidence in our services. My first reaction is to congratulate you for having safe sex. You were not at risk as long as the condom did not break wide open. Poorly made condoms may break more easily, but if they remain intact, protection is complete. No viruses or bacteria (or sperm) can pass through intact latex; there is no such thing as microscopic leaks that allow this. That's an urban myth. (For example, there is no need for a "water test" to check for microscopic condom leaks.) Also, I don't know that all or most condoms in China are poorly made. That's probably another myth. In any case, the large majority of sex workers in China do not have HIV, so your partners probably were not infected. STDs are another story, but here too, you can rely on nearly 100% protection from the condoms. You should not take PEP on account of these events. You don't even need testing for HIV or other STDs. However, if having negative tests would reassure you more than my advice, feel free. Urine testing for gonorrhea and chlamyda is valid any time 5 days or more after exposure. A 4th generation (antigen-antibody) test for HIV and syphilis blood test are conclusive at 6 weeks or more afterward. In the meantime, try not to worry. Almost certainly you were not infected. If you have a regular partner, you can safely continue your usual sexual relationship. Let me know if anything isn't clear. HHH, MD --- 29 months ago Hi Dr thanks for the reply I did have 3 quick follow ups 1-As someone who does not engage in sex often i was suprised when i read many experts say that condoms although effective are not a sure thing even if they stay intact that surprised me i wanted to hear your opinion 2-There was brief open mouth kissing is that an hiv risk 3-in regard to herpes i guess i am at risk wgat should i look out for 29 months ago Hi dr i would appreciate if you can answer on my follow up H. Hunter Handsfield, MD H. Hunter Handsfield, MD 29 months ago Oops -- sorry I missed your follow-up question for a few days. 1) First, it is obvious condoms are not "a sure thing" since they sometimes break. Second, STDs transmitted skin to skin (herpes, HPV, syphilis) can be contracted because of skin contact above the condom. The risk is a lot lower than with condoms than without them, but higher than for those STDs transmitted mainly through sexual fluids (gonorrhea, chlamydia, HIV). But even for fluid transmitted infections, some risk remains. For example, the penis may slide inside the condom, carrying fluids underneath. All in all, condoms are highly protective, but all clinics treating HIV, STDs, etc see occasional infected patients who claim to have always had only careful condom use without apparent condom failure. As another example, couples who rely solely on condoms for contraception and use them properly have roughly 90% protection against pregnancy, not 100%. 2) Kissing does not transmit HIV. In fact, any kind of contact with infected persons' mouths or saliva is risk free -- for example, there has never been a known case of HIV transmitted oral to penis. 3) Even without a condom, the average risk for genital herpes is probably no higher than 1 in a thousand, and that's if the partner is known to have genital herpes due to HSV2. With a condom your risk is a lot lower still. Be on the lookout for penile blisters or sores within the next 10 days after exposure. If none, don't worry about it. Apologies again for the delayed reply. --- 29 months ago Hi thanks for the reply and as the saying goes better late than never Just one final follow up on number one You seem to paint a rather worrying scenerio on the reliability of condoms a bit different than the original answer of very small chance when using protection or maybe its just my anxiety seeing it that way would love to hear your final comment H. Hunter Handsfield, MD H. Hunter Handsfield, MD 29 months ago My initial reply and the additional informaiont yesterday are not in conflict. Don't confuse the nearly zero risk for any single condom protected exposure, which is what you first asked, from the accumulative risk after many exposures, which is what I addressed yesterday. Obviously if there is say 1 chance in 10,000 of an infection from one exposure there is 1 chance in 1,000 after 10 exposures. Ten times higher, but still low. Few if any safety devices are 100% effective. People die wearing seat belts and despite smoke detectors, and people who use condoms are highly but not absolutely protected. There's nothing mysterious in this -- it's common sense everybody knows. It is not possible to have an active sex life, especially with multiple partners, without some level of HIV/STD risk (assuming vaginal or anal penetration). Condoms are a critical element in keeping the risk low, but not zero. Best wishes and stay safe! ---

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