The Condom Broke. Now What?

oopsProtecting yourself with barriers like condoms is an important part of keeping yourself healthy when you and your partner don’t know one another’s STD status. Condoms are also great for pregnancy prevention. You can improve their effectiveness by learning how to put them on correctly, using a generous amount of lubricant, and checking their expiration dates.

But, sometimes, despite your best intentions, condoms break.

When that happens, you might wonder about your vulnerability to sexually transmitted diseases (STDs). And, if pregnancy is a possibility, you might also be concerned about sperm meeting egg. Luckily, there are still options. One, getting tested for STDs can help you receive treatment, if needed, in a timely manner. Two, if you act quickly, you can still take steps to minimize the risk of certain STDs or help avert an unwanted pregnancy.

Don’t let a broken condom immobilize you with fear! Take matters into your own hands, and learn what to do if a condom breaks.

How long does it take after a potential exposure until an STD test is likely to be accurate?

The answer to this question is: It varies. Each STD has a different “window period,” that is, the time it takes for an infection to be detectable. Some STDs can be tested for within days (if symptoms are present), while other STDs can take months to show up on a test. Also, while you might be inclined to wait and see if symptoms show up, remember that most STDs don’t have symptoms at all! When infections don’t have symptoms, they are said to be “asymptomatic.”

Check out this handy chart to see how long it takes for symptoms to appear, how common asymptomatic infections are, and how soon you should be tested.  (Similar information is available at a commercial website, but when compiling the below chart we sought reliable medical sources for which links could be provided.)

STD symptoms include when symptoms appear
how often asymptomatic when to get tested
chlamydia pain or burning while urinating; discharge; swelling; more as early as 1 to 3 weeks, but can take longer or appear earlier females: asymptomatic 75 percent of the time

males: asymptomatic 50 percent of the time

If symptoms are present, get tested right away. Otherwise, testing should be done 2 weeks after potential exposure.
gonorrhea discharge; pain or burning while urinating; increased urge to urinate; more as early as 1 to 14 days, but could take 30 days females: asymptomatic 80 percent of the time

males: asymptomatic 10 percent of the time

If symptoms are present, get tested right away. Otherwise, testing should be done 2 weeks after potential exposure.
syphilis early symptoms include painless sore or wet ulcer, rashes, flu-like symptoms; untreated syphilis can lead to severe health problems including damage to nervous system, heart, brain; death primary stage: 3 weeks to 3 months

secondary stage: 3 to 6 weeks after the primary stage

late stage: 1 to 20 years

Often, syphilis has no symptoms or has such mild symptoms that a person doesn’t notice them. In people with vaginas, sores could be internal and painless, and therefore easy not to notice. If symptoms are present, get tested right away. Otherwise, CDC recommends testing for syphilis at 6 weeks, 3 months, and 6 months after potential exposure.
genital warts flesh-colored, soft bumps on skin, which have a variety of different appearances 6 weeks to 6 months According to the CDC, “HPV infection usually has no signs or symptoms.” There is no test for the virus that causes genital warts when the infection is asymptomatic.
genital herpes cluster of blistery sores, usually on vagina, vulva, cervix, penis, buttocks, or anus 2 to 20 days, but can take longer 85 to 90 percent of people with genital herpes are asymptomatic If symptoms appear, get tested immediately to increase chances of accurate diagnosis. Otherwise, a type-specific IgG test can detect an infection within several weeks of exposure, but false negatives are more likely during early stages.
HIV early symptoms might include swollen glands; fever; headaches; fatigue; muscle aches. However, symptoms don’t usually show up until about 10 years, at which time the immune system is seriously compromised. 10 years, in most cases, although early symptoms might show up within 2 weeks to 3 months Early symptoms are usually not present. According to CDC, HIV can be detected in 2 to 8 weeks on average, though it can take 3 to 6 months. Repeat testing is recommended for anyone receiving a negative result less than 3 months after possible exposure.

This is only a partial list — there are around 30 STDs in all, and when you ask for an STD test you’re probably not going to be tested for all of them. A health care provider can help you determine which STDs you’re most at risk for.

STD tests vary depending on what you’re being tested for. Chlamydia and gonorrhea are usually detected with a urine sample. HIV can be tested with an oral swab or by taking blood. A blood test can also detect syphilis. If you have symptoms of genital herpes, genital warts, or syphilis, you might undergo a physical examination, and a sample might be sent to a lab to confirm a visual diagnosis.

If you are concerned about receiving an accurate diagnosis, be truthful about your sexual activity when consulting with a health care provider. You can also ask questions, like what kind of test is being performed, how accurate it is, what your chances are of receiving a false positive or false negative result, and whether or not you should be retested later.

What if my partner has HIV or hepatitis B?

If your partner is HIV positive or chronically infected with the hepatitis B virus (HBV), using latex condoms can dramatically reduce risk of virus transmission. If your HIV-positive partner is on antiretroviral medications, your risk is reduced even further. Additionally, if your partner is HBV positive, you can protect yourself by being vaccinated for HBV at the outset of your relationship.

However, if the condom breaks and you’re worried about your vulnerability to HIV or HBV, you have one option: post-exposure prophylaxis (PEP). When taken to protect against HIV, PEP entails a 28-day course of antiviral medications that are started within 72 hours (three days) of exposure — the sooner the better. If you believe you were exposed to HIV, you can obtain PEP in an emergency department, urgent care clinic, HIV clinic, or doctor’s office. Time is of the essence, so seek care as soon as possible. The medications associated with PEP have side effects and the regimen is not 100 percent effective in preventing HIV, but it reduces risk.

If your partner is a chronic carrier of HBV and you haven’t been vaccinated, PEP is available to protect against HBV infection as well. In this case, PEP usually consists of receiving the HBV vaccine; sometimes, HBV immune globulin is used as well. The CDC recommends receiving this treatment as soon as possible after exposure, preferably within 24 hours. If it has been longer than 24 hours but within two weeks, you can still receive PEP.

If you have already been vaccinated against HBV but have not had your immunity confirmed by post-vaccination testing, you can receive a booster shot after exposure for added protection. If you started but have not finished the HBV vaccination series, you can receive HBV immune globulin and complete the vaccination series.

Planned Parenthood Arizona carries the HBV vaccine, and you might be able to schedule an emergency appointment, but because time is of the essence you might prefer to seek treatment at an emergency department or urgent care center.

What should I do to decrease risk of pregnancy?

Have you heard of emergency contraception (EC), also known as the morning-after pill? If your condom broke and one of you is at risk for pregnancy, now is the time to take advantage of this option. Get your hands on emergency contraception as soon as possible — EC delays ovulation, so the sooner you take it, the more likely you will avert a pregnancy. You can obtain emergency contraception at any Planned Parenthood health center, many student health centers (depending on your university’s policy), as well as other pharmacies. Check out 24-hour pharmacies if your birth control failure happened after normal business hours. Princeton University has an emergency contraception locator — just enter your ZIP code!

Currently, Plan B One-Step is available over the counter, without a prescription — regardless of age (and you can find a $10-off coupon here). Everyone needs a prescription for ella, another type of EC, which can be obtained from a health care provider or online. Other EC pills require a prescription if you’re younger than 17 — and Planned Parenthood can provide one for you after a brief consultation. Here’s an infographic that breaks everything down:

EC 101Unfortunately, many states, including Arizona, have laws permitting pharmacists to refuse to dispense emergency contraception. While you can always count on Planned Parenthood to dispense emergency contraception, you might not know what fate awaits you if you walk into a corner drugstore. If a pharmacist refuses to dispense EC, you might want to ask if another pharmacist is available, or leave and try another pharmacy. But if you’re willing to advocate for yourself, you can remind the pharmacist that Plan B One-Step is legally available to anyone without a prescription. If this gentle reminder doesn’t work, you can tell the pharmacist that you will:

If you rely on condoms to prevent pregnancy, consider backing up your birth control with a package of emergency contraception that can be squirreled away for later use, if needed. Then you won’t have to worry about scrambling for EC after the condom breaks — you’ll have it at the ready.

You can obtain emergency contraception at any Planned Parenthood health center, whether you need it immediately or want to keep it around for later use. You can also pick up condoms, be tested for STDs, be vaccinated against hepatitis B and HPV, and receive education about safer sex.