figure321
Asking for a friend . Friend used a condom with a new girl he met online. Condom broke at some point . May have broke outside at the very end or inside the girl at some point. Girl then reveals to guy that she had slept with someone recently 2 weeks ago and 4 weeks ago with no protection (no condom used) both times . It was the same partner she slept with at 2 weeks and 4 weeks prior to meeting my friend. Girl takes the oraquick test and it shows negative. Another thing to note ... girl said she had strep throat about a week or two ago before meeting my friend and the doctor gave her antibiotics and it went away in a couple days . She had chills one night and sore throat 2 days . No rash and no fever according to her. Is there a chance her oraquick result today showing her history from 2-4 weeks with previous partner is not accurate enough since oraquick requires 3 months to be completely accurate and that her strep throat was actually seroconversion  to HIV . Should my friend be worried and start post exposure prophylaxis or is he most likely fine and just do an rna hiv viral load test 10 days after he hooked up with her to see his status? Is her oraquick result at 2-4 week post exposure with previous unprotected partner reliable enough for my friend to be calm about not getting HIV from her ???
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helpline-volunteer
Hi there,

Thank you for your inquiry. From what we gather from your question, you are asking about the possibility of HIV transmission after engaging in protected sex wherein the condom broke. From the information provided, this scenario is determined to be High Risk (There is evidence of transmission through these activities and are the majority of cases of transmission).

For HIV transmission to be possible, three components must be met (see below).

Helpline Transmission Equation .jpg
HIV transmission requires the presence of HIV positive fluid (such as semen, vaginal fluid, pre-cum, rectal fluid, breastmilk, etc), coupled with a High, Low, or Negligible Risk activity that provides the virus with direct access to the bloodstream.

It's important to remember that even with consistent condom usage, the risk of HIV transmission is not reduced to zero (1). This is due to a variety of factors, including improper use and potential breakage of the condom. Given that the condom did break in this case, this scenario is considered High Risk as any HIV positive fluid present would have direct access to the bloodstream.

In regards to your question about testing, home testing kits such as OraQuick are not recommended as they can yield false results. Therefore, both individuals should refer to a healthcare provider for HIV testing. Many HIV tests, such as fourth generation and rapid tests, are considered conclusive at 6 weeks (2). However, some guidelines still recommend retesting at 12 weeks for completely conclusive results, when accuracy is 99.9%.

PEP is recommended if it has been 72 hours or less since possible exposure. 

Recommendation: Refer to a health care provider for HIV testing and PEP.

Regards,

AIDS Vancouver Helpline/Online, Ashley

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Additional Resources:
HIV transmission and condom use (1)
HIV testing (2)
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