A Condom Broke — Your 72-Hour Action Plan
If a condom broke during sex and you've found this page, you have a clear and time-sensitive set of decisions to make in the next 24-72 hours. The good news: most of those decisions have clean, evidence-based answers. None of them is panic-level urgent — but a few are clock-dependent.
Below is the exact playbook. Read the relevant sections for your situation.
Right now (first hour)
- Don't douche. Vaginal douching after exposure does not reduce STI or pregnancy risk and may actually increase risk by disrupting normal flora.
- Don't try to "wash out" semen. Same reason. Plain water/soap rinse externally is fine; don't do anything aggressive internally.
- Save the broken condom if possible. A piece of evidence about timing for any clinical evaluation in the next few days. Tie it off, refrigerate it (sounds weird; you can also just describe what happened to clinicians).
- Take a breath. The interventions you need are not "right this minute" emergencies. You have hours, in most cases days.
Within 5 days — Emergency Contraception (if pregnancy is a concern)
The window for emergency contraception (EC) is 120 hours (5 days) from unprotected sex. Effectiveness drops with delay; earlier is much better.
Options:
Plan B / Generic levonorgestrel
- Window: Most effective within 72 hours; up to 120 hours
- Cost: Over-the-counter, $20-50 at pharmacies; available at most CVS, Walgreens, Walmart, and online (Amazon, Wisp)
- No prescription needed
- Less effective at higher body weights (above ~165 lb / 75 kg). Ella may be better in this case.
ella (ulipristal acetate)
- Window: Up to 120 hours, with maintained effectiveness throughout
- Cost: Prescription, $50-100; available via telehealth (Wisp, Nurx, Hers)
- More effective than Plan B at higher body weights
- Better choice if more than 3 days have passed since exposure
Copper IUD insertion (most effective EC)
- Window: Up to 5 days after exposure
- Cost: Insurance-covered usually; without insurance ~$1000
- Effectiveness: >99%
- Side benefit: Ongoing contraception for 10+ years if you want it
- Where: Same-day appointment at Planned Parenthood or sexual-health clinic
If you're considering pregnancy prevention, levonorgestrel is the fastest path (just walk into a pharmacy and buy it). Copper IUD is the most effective if you can get same-day access.
Within 72 hours — Post-Exposure Prophylaxis (PEP) for HIV
PEP is a 28-day course of HIV antiretroviral medication that significantly reduces HIV acquisition risk after possible exposure. It must be started within 72 hours of exposure. Earlier is much better. Within 24 hours is ideal.
When PEP is recommended
CDC guidance: PEP is reasonable when:
- Partner is HIV-positive with detectable viral load (or unknown status), and you had condomless vaginal/anal sex
- Partner is from a high-prevalence community (MSM, IDU, from a country with high HIV prevalence), HIV status unknown
- Sexual assault — automatic recommendation regardless of partner risk
When PEP is NOT typically recommended
- Partner is undetectable HIV-positive (U=U applies — no PEP needed)
- Partner is verified HIV-negative within the past 3 months
- Receptive oral sex (very low transmission risk)
Where to get PEP
- Emergency room — fastest if it's late at night or weekend
- Urgent care — many can prescribe PEP
- Sexual-health clinics — same-day visits often
- Telehealth — services like Nurx and Wisp now offer PEP prescriptions in many states
- Your primary care doctor — if you can be seen quickly
Tell them it's a PEP request and emphasize the timing. Some EDs are slow with non-emergency-feeling presentations; clinical staff need to know this is time-sensitive.
What PEP involves
- 28-day course of antiretrovirals (typically tenofovir + emtricitabine + dolutegravir)
- Daily dose, generally well-tolerated
- HIV test at start (must be negative to start PEP)
- HIV test at 6 weeks
- HIV test at 12 weeks
- Sometimes HIV test at 6 months for high-risk exposures
Cost: Usually covered by insurance under ACA preventive care. Manufacturer assistance available for uninsured.
Within 1-2 weeks — Other STI testing
For STIs other than HIV, immediate post-exposure testing is usually not useful (the infection hasn't established enough to detect). Recommended timing:
- Chlamydia + gonorrhea: Test at 2 weeks (urine + swab as relevant)
- Syphilis: Test at 4-6 weeks (blood)
- HIV: Test at 4-6 weeks (fourth-generation antigen/antibody)
- Hepatitis B: Test at 6-12 weeks if exposure was high-risk and you're not vaccinated
- HSV: Symptomatic testing if symptoms develop; routine blood testing not recommended
You can wait until you can schedule a single visit, or use an at-home kit at the right time. AT-home: LetsGetChecked, Everlywell, etc.
What about expedited partner treatment?
If your partner has a known active STI infection, your clinic can sometimes prescribe expedited partner therapy (EPT) — antibiotics for you without waiting for your test results. This is most useful for chlamydia exposure. Available in most US states.
If you suspect (but don't know) your partner has an STI, talk to a clinician about pre-emptive treatment vs. testing-then-treating.
What about hepatitis B?
If you have NOT been vaccinated against hepatitis B and the exposure carried risk:
- Hepatitis B immune globulin (HBIG) + vaccine series within 24 hours of exposure
- Available at ER, urgent care, sexual-health clinic
If you have completed the Hep B vaccine series, you are protected and need no acute intervention.
A quick decision tree
If exposure was within the past 72 hours:
| Concern | Action | Window |
|---|---|---|
| Pregnancy | Plan B (OTC) or ella (Rx) or Copper IUD | 5 days |
| HIV from possible-positive partner | PEP at ER or sexual health clinic | 72 hours |
| Bacterial STI (chlamydia, gonorrhea) | Test in 2 weeks | Not urgent |
| Syphilis | Test in 4-6 weeks | Not urgent |
| Hepatitis B (if unvaccinated) | HBIG + vaccine at ER | 24 hours |
If exposure was more than 72 hours ago: PEP is no longer effective. The post-exposure interventions become: STI testing on the appropriate schedules. Move forward, not backward.
What to do about future exposures
If broken condoms are a recurring concern, talk to your provider about:
- PrEP — daily pill or twice-yearly injection prevents HIV regardless of condom outcomes
- Different condom types — sometimes a size/fit/material issue causes recurrent breakage
- Internal condoms — alternative to external; nitrile, latex-allergy-friendly
- Long-acting contraception — for pregnancy prevention without timing pressure
When NOT to use PEP
Some scenarios where PEP is not warranted:
- More than 72 hours since exposure
- Partner is HIV-negative or undetectable (U=U)
- Receptive oral sex only (very low HIV risk)
- Frequent ongoing risk — PrEP is the right tool, not repeated PEP courses
If you need PEP more than once or twice, your provider will recommend transitioning to PrEP.
A final word
A broken condom is not the end of the world. It is a specific situation with specific interventions on specific timelines. Most of the time, the right action is: get emergency contraception if relevant, evaluate for PEP if HIV exposure is plausible, schedule STI testing for 2-6 weeks out, and move forward.
The interventions exist because the situation is common. You're not the first; you won't be the last. Now you have the playbook.
For more on prevention going forward, see PrEP vs PEP, Free STI Testing, and our HIV pillar guide.
