Hello dr. I am studying in China, and on 21st of June i met a woman in her 40s through a dating app, she came from another city to visit here. In the night we met and she brought me to her room in the hotel, where we had sex. While doing sex at one point i notices that my condom was not on, it has slipped, when i tried to find is it as stuck somewhere between her thigh i thin, during the time the condom was off, i don't know i was inside her or not, or if i was inside, how long was i. I have no idea that during that time there was some penetration without condom, or it slipped when i was coming out. I didn't know her status. The next day i started taking PEP, i asked her on that app, if she is infected or not, she got angry with my question and blocked me. Since then i am so much scared that she might have infected me.  Since the day i started taking PEP i have pain in muscles,  joints, fatigue, lack of appetite, and today on day 9th, i have a bit sore throat only at one side of the throat, i can touch the throat and feel the pain. I am so much worried. Please help me .

Hi there,

Thank you for your inquiry. From what we gather from the question, you were asking about the possibility of HIV transmission through a condom slipping off while having protected vaginal sex. 

From the information given, this scenario is determined to be of Low Risk (evidence of transmission occurs through these activities when certain conditions are met). In order for HIV transmission to occur in this circumstance, a number of requirements must be fulfilled.

HIV transmission occurs when the following conditions are met: There must be the presence of HIV positive fluid (semen, pre-cum, vaginal fluid, rectal fluid, blood, or breastmilk), coupled with direct access to the bloodstream. 

This scenario is considered to be Low Risk because you aren't sure if direct access to the bloodstream occurred without a condom (vaginal penetration) , it is also unknown whether there was any presence of HIV positive fluid.

Protected vaginal sex is considered Low Risk due to improper 
use and potential breakage of the condom which is what happened in the scenario above. Condoms are highly effective strategies to help prevent the sexual transmission of HIV. When this highly effective strategy is used consistently and correctly the risk for HIV transmission is very low (1). 

In regards to the symptoms you described, HIV often mirrors other viral infections such as the flu; therefore, it is best to refer to a healthcare provider. Taking medications such as PrEP and PEP is recommended to lower the risk of acquiring HIV, so good job for starting PEP. 

For the situation above, it is recommended that you refer to a healthcare provider for HIV screening. 

Helpline Transmission Equation .jpg

Thank you,

AIDS Vancouver Online/Helpline, Sonali

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1. Condom Effectiveness 



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