[Question #11454] small hole in the condom

14 months ago

Hello I'm from Brazil.

I had vaginal intercourse with a girl using a condom. When I removed the penis there was a hole of about 1cm in the glans, at the time of removal the condom covered the urethra and foreskin, there was only this single hole that was in the glans. I believe the hole was only there for a short time, because if it continued it would have torn apart completely.

About the girl, she asked if I had a condom and after what happened I asked about diseases and hiv and she replied that she was taking tests.

My city has approximately 35 thousand inhabitants and according to official data, there have been 14 women with HIV since 2011.

1 - What is my realistic risk in this situation?

2- I have a girlfriend, can I have sex with her without a condom?

3- Because the urethra and foreskin are protected, can I say whose relationship was highly protected?

Edward W. Hook M.D.

14 months ago

Welcome to our Forum. Thanks for your questions. I'll be glad to comment. You do not mention anything about your age, your partner, or her risks and these are important factors in assessing risk for HIV as well as other STIs. That said, I suspect your risk for infection, as described below, is quite low. Most people do not have HIV and most single exposures do not lead to infection. In addition, your exposure was condom protected and while there may have been a recent tear in your condom, I suspect it did it's job much of the time. AS you point out, if the condom had been broken for long, it would have been broken wide open. The fact that your partner advocated use of a condom and reported testing suggests she is unlikely to be infected. In response to your specific questions:

1 - What is my realistic risk in this situation?

See my comments above- this was a relatively low risk encounter

2- I have a girlfriend, can I have sex with her without a condom?

As I said, above, the risk for infection (HIV or otherwise) is low but not zero. The best way to evaluate your risk is to get tested or, better yet, ask your partner to get tested. If her tests are negative, you could not have given you an STI, including HIV.

3- Because the urethra and foreskin are protected, can I say whose relationship was highly protected?

yes

I hope these responses are helpful to you. EWH

---

14 months ago

I am 30 years old, she is 23 years old and is not a sex worker or drug user and I did not have any other STDs. 

The entire relationship was with a condom and I often assessed the condition of the condom. When I pulled it out I saw that there was a small hole.

Should I really worry about this situation or should I continue as normal?

Can the glans be an entry point or only through the urethral opening?

What would be my risk with this whole situation?

Thanks

Edward W. Hook M.D.

14 months ago

Your message did not come across clearly. Please resend however let me repeat that this was a very low risk encounter. EWH---

14 months ago

Sorry for my English.

The girl is 23 years old and is not a sex worker or drug user. In my city of 35 thousand inhabitants, according to official data, 14 cases of HIV in women have been reported since 2011. I don't know if that is a little or a lot.

1- The urethral opening and foreskin were protected when the condom broke. Can I deduce that condom use was considered practically complete?

2- From your experience, is this an event that requires exams or can I continue as normal?

3- I read that the chance is 1 in 2,500 and I believe that in my city the HIV percentage is low. And the factors of the short exposure time and a very small hole, would my numbers be too low, would it be a more theoretical risk than a realistic one?

Thanks

Edward W. Hook M.D.

14 months ago

Thanks for resending your follow up questions. This is very helpful. Here are my replies.

1. Yes, as long as the tip of your penis, and the opening of the urethra were covered by the condom, the condom most likely did its job.

2. In your situation, I would have a few concerns and would not be worried. On the other hand testing is always a personal decision. Many of our clients prefer to test to make sure that they were not infected.

3. I agree with your assessment and your calculations. Using these figures, I would agree that there is a more than 99.99% chance that you were not infected through this encounter.

I hope this follow up information is helpful. Please don’t worry. EWH.

---

14 months ago

I always used a condom. When I saw a small hole and not a complete tear, I was worried. Even though the urethral opening was still protected.

I will use my last follow-up message to clarify some doubts

1- When you say that the tip of the urethral opening is still protected, the condom did its job. I believe that only the hole over the glans does not constitute a route of transmission. Am I correct?

2- You said that the chance of not being infected is greater than 99.99%. In a case like this in your clinic, would you recommend the test? Not for anxiety reasons, but as a clinical case.

3- I will follow your advice and not worry about this situation.

Thanks for the answers

Thank you, Doctor

Edward W. Hook M.D.

14 months ago

Final Responses

1- When you say that the tip of the urethral opening is still protected, the condom did its job. I believe that only the hole over the glans does not constitute a route of transmission. Am I correct?

While this has not specifically been studied, I would agree with your statment

2- You said that the chance of not being infected is greater than 99.99%. In a case like this in your clinic, would you recommend the test? Not for anxiety reasons, but as a clinical case.

Testing is always a personal choice. I would not be worried and probably would not test

3- I will follow your advice and not worry about this situation.

Great, glad to hear it. I'm pleased I could be of assistance. EWH

---