Can an unprotected sexual encounter increase the risk of a sexually transmitted disease?

Hi doctor,

I am circumcised and have no sexually transmitted disease. I had an unprotected penile to vaginal exposure. It took less than ten minutes; I had used a condom but it broke within the last two minutes. I did not ejaculate, but took a shower and urinated after the incident. She said she was fine when I asked about her health status and said not to worry. On the same day, after 16 hours, I started my post-exposure prophylaxis using Tenofovir, Lamivudine, and Dolutegravir (PEP TLD) and completed 28 days with perfect adherence and no further exposure. I did a fourth-generation HIV combo test, which came back negative three days post-exposure. My all other STDs are also negative. Today is 25 days post PEP and I do not have any symptoms, feeling fine except for severe anxiety.

What is your opinion about my risk and my test after 31 days post-exposure and three days post-PEP (fourth-generation combo test from the vein)? Also, I consulted some doctors who said there is no need to test again because the fourth generation is accurate and has not been affected by PEP. I know there is confusing information about testing after PEP, but what is your opinion from clinical practice? Are there any cases like mine, that tested negative (4th generation) after PEP completion and then turned positive later?

Thank you.

Hi doctor,

Is there clear evidence that PEP affects fourth-generation tests? Is there any patient from your experience who tested negative after PEP using the fourth generation, and then, turned positive in the next tests? I want the answer from clinical practice because guidelines have more caution! Many doctors whom I consulted said PEP does not affect the fourth generation, while others said it may, according to guidelines. Please guide.

Thank you.