Condom Breakage

                                                                                                                                                         
This page will look at what to do when a condom either slips off or breaks. This is one of the most feared situations a sex worker or client can go through. It is important to know what to do in this situation to limit the potential damage to your health and to limit the amount of freaking out a client will do if it happens. The last thing you need as a sex worker when you have a condom break, is some strange man yelling and screaming at you.

I have always considered this more of an issue for girls than guys. Maybe its because I am a sex worker and I have seen and heard clients freak out and watched ladies have to deal with this as well as their own health concerns. To minimise the amount of freaking out that goes on, here are a few steps to take if you have a breakage or a slippage:

Don't panic..  

it's done and there is nothing to be acheived thru panic. If you panic you will always make mistakes or do the wrong thing so just breathe and relax

Find the condom...  

  find it and make sure you find it all and get it all out 

locate the remainder of the condom. If it's inside you, scoop it out or drag it out. If it has burst make sure you have no latex left inside you as it will cause infection if there is any left in you. It sounds gross and is gross, but you really do need to sit there and put the condom back together like a jigsaw puzzle if it has broken into pieces to make sure you get all the pieces out of you. If you don't get all of it out an infection manifests like thrush and you will get itching, discharge and pain like you have cystitis or a UTI.

Peeing out Cum.... 

to flush out any cum you may have inside you, urinate as soon as you can. Start drinking water immediately and pee as much as you can. You have to flush it out by urinating not by douching as one pushes it out and the other pushes it further in. You urinate thru a seperate tube in your body, but urinating still aids in clearing the cum from your body. It's like after you do a booking and you pee and lot's of the lube you have used comes out or if you've ever had sex without a condom and a guy has cum in you, you will have noticed lots of the cum comes gushing out if you pee afterwards.

Pushing out cum......

Squat down and use your muscles to relax and then push out the cum. It is the same action and muscle control you will use when having sex and if you have ever used a sea/Beppy sponge when it comes time to get it out.  When you use a sponge you squat down, push hard with the muscles in your vagina to push it further out of you, and then you relax your muscles so you can insert your fingers to pull it out. Do this action over and over again to try and push the cum out and then release your muscles so it can dribble out. DO NOT INSERT YOUR FINGERS TO TRY AND SCOOP IT OUT LIKE YOU DO WITH A SPONGE.

Morning After Pill...  

the morning after pill has changed alot in the last few years. It no longer makes woman sick or makes them get their periods like it use to. You need to take it ASAP because the longer you leave it, the less effective it is. You do not need a prescription for this pill, you can just buy it over the counter at your local chemist. For more information please see this site:

http://www.fpahealth.org.au/sex-matters/factsheets/76.html

Post Exposure Prophylaxis or PEP

PEP is a course of medication they give to people who are HIV+. It is basically either a course of AZT or a combination of drugs or 'therapies' depending on your exposure risk. If you have a low risk exposure such as a condom breakage from a person you dont know but you dont think is not an injecting drug user, is not someone who is doing loads of bareback sex as a sex worker and is not a gay man, then you have low risk factors and will only be given one drug.

If you have a high risk exposure like were having sex with a street based sex worker (male, female or tranny), was probably an injector, and/or was gay, then you will be given a combination therapy as they need more drugs to try and knock out the HIV.

They do not know if doing this stops you from contracting HIV. It is in test stage only.  You need to go to a specialist centre to get it prescribed for you such as Albion St Clinic, St Vincents Hospital and RPA Hospital. A normal GP can not get it for you. They can prescribe it but will know nothing about it and it will cost you over $1k as opposed to $12 if your on the trial. You need to take it ASAP and after 72 hours they wont prescribe it for you at all.

Basically what happens is you go into a Centre that is part of the trial and is able to prescribe it, they ask you what happened to assess your risk factors and then they blood test you to get a baseline of bloodcell (T Cell count). They also make you sit in a room with a psych who asks you awfully helpful questions like what will you do if your results come back as HIV+ (dumbshit question). Its basically pre-test counselling. They then prescribe you the medication, you get it filled at their pharmacists on premesis and take the meds. In 2 weeks time you go back for another test and they give you more counselling. You then go away for a few days and then come in and pick up your results.

They will not give you HIV Test results over the phone - its against the law to do so. By two weeks they can basically see if there is a drop in T Cells. If there is a drop off they monitor you more closely and can change the therapy of drugs your on. If your tests are ok you go back at the one month stage for another test. By this stage they can get a really good idea of T CELL count. If they have definately dropped and a false positive result has been ruled out, then you become their best friend.

They monitor TCells as these are the bits in the blood that die off if you contract HIV. T Cells are your white blood cells which make up your immune system and are responsible for fighting infections. Your immune system or T Cells is what HIV attacks, so they measure the amount of T Cells your have and if the amount of T Cells drop off, they know that HIV could be present and reproducing in your body and attacking your immune system. They measure HIV and the stages of HIV thru counting TCells.

This is better explained by contacting the PEP Hotline who's number you will find here along with more information:

http://www.health.nsw.gov.au/sexualhealth/pep.html

STI Transmission

          Microbes - these are toys that actually look like STIs do under the microscope! (All the coolest health promotion workers should have a set if you ask me lol)

The thing to keep in the front of your mind is that Sex Workers in Australia have one of the lowest incidents of STIs out of anywhere in the World. This can no longer be relied upone however as there is a growing trend to workers doing bareback full service as the economy gets worse and competition gets fiercer. If you are concerned about STI transmission and wish to be tested for it, Sexual Health Clinics will tell you to wait a minimum of 2 weeks before they will test you, or you need to develop symptoms of an STI and they will test you sooner.

They say they make you wait because it takes 2 weeks for an STI to grow to the point where it can be seen and measured. These days lot's of testing is done by DNA testing for STIs rather than having to grow them in laboratories o yourself, so hopefully this 2 week wait may change in the future.

If you have ANY concerns, go and see your local Sexual Health Centre or sex worker friendly Doctor if you have one.

What to do if you have a client freaking out in your face

Let's do it in point form...

1. tell him not to yell at you or panic because it's not fair on you because you have to deal with threat of pregnancy and you're the receptive partner so HIV is a larger concern to you
2. if he calls you to panic some more, tell him to call his local sexual health centre and they will be able to give him more accurate professional information that your not able too
3. inform him that statisticaly sex workers in Australia have the best sexual health our of anyone in the world including non sex workers in Australia
4. tell him you use condoms with everyone you see (which you should be doing)
5. tell him you get tested for STIs every 3 months (which you should be doing)
6. tell him if he is really concerned he should go to his local sexual health centre the next day, not his GP for testing and for a chat

As a sex worker what you should do

1. take some very deep breaths
2. seperate yourself from your client by going to the bathroom, take some more deep breaths, try and pee and squat down and try and push it out
3. calm your client down if he isn't ok
4. call a friend who is a sex worker and freak out at her
5. meet up with a friend and have strawberry pancakes and/or chocolate cake
6. go and get the morning after pill the same day or next day

As a sex worker what you shouldn't do

Scooping....  

SWOP which is the sex worker organisation in NSW, pushes the "scooping" line in NSW to sex workers. This is where you go to the bathroom, insert your fingers slowly inside yourself and scoop out any cum that may be inside you. They tell you to be really careful not to scratch yourself with your finger nails because that will allow HIV or other STIs to more easily infect you. Here's the thing.... there is NO point in trying to scoop the cum out because it is already inside you, in other words.. the risk is there and /or the harm has already been done. There is absolutely NO point in trying to minimise the harm at this stage. Once the cum is inside you, if it has chlamydia in it, you have already been exposed so there is no point in trying to scoop it out. If you fear pregnancy, the cum is already inside you and swimming, so there is NO point in trying to scoop it out because it has swum past where your fingers will reach.

All scooping will do is risk you scratching the inside of your vagina with your nails which could result in micro tears and scratches. This will make it alot easier for HIV transmission to happen, will scratch off the thin protective membrane you have in your vagina, increase chances of a Urinary Tract Infection... it will do more harm than good. The other thing it will do is push the cum further up you which could increase the chances of pregnancy happening.

If a health promotion worker tells you to do something, please question EVERYTHING and ask yourself if it makes sense. Sometimes they aren't given training when they start a job, are given bad information or simply don't keep up to date with their knowledge.

Flushing....

DO NOT get in the shower and flush water up your bagina or try and wash it out. This will just push the cum further up inside you which is not ok.

Helpful Links:

http://www.health.nsw.gov.au/sexualhealth/common_stis.html   list of common STIs

http://www.health.nsw.gov.au/sexualhealth/symptoms.html    list of symptoms for common STIs

http://www.health.nsw.gov.au/sexualhealth/getting_tested.html#clinics   clinics to get tested in if you have a broken condom

http://www.health.nsw.gov.au/sexualhealth/languages.html  place to get resources if you have a favourite working lady who does not speak English. Check the bottom of the link and it has links to other pages written in a variety of Asian languages.