Hi! I'm a male in my late 40s that recently engaged in anal sex with another male of unknown status  in Spain. I was the bottom. It was the first time I had anal sex in many years ! He spoke very little English and my Spanish was non-existent. Before engaging in anal sex, we had a couple of minutes of oral sex, where he was the insertive partner and I was the guy giving the blow job. He wanted to use a condom for the BJ, something which I haven't done in a long time as I hate the taste of latex and I was concerned about my teeth damaging on the condom. After a brief period of oral sex, we went of to have a brief period of anal sex, which was to me, uncomfortable, but he made sounds that sounded like an orgasm. Pulling out, the condom appeared empty. There was no obvious tears. My fingers was checking the condom constantly during penetration so I've confident it didn't slip. My first reaction was that semen might have leaked out from a tear somewhere. I pulled out the condom carefully (he was quite confused by all this! ) and filled the condom with water. Everything happened pretty quickly but grossly, I didn't not identify any obvious leak. In retrospect, whilst I probably can be confident that the reservoir tip and the head area of the condom  is intact, I probably did not examine the upper part of the body and the ring area to look for more subtle tears, especially one that could be caused by my teeth earlier.

I've read that condom failures are usually obvious as there is an obvious rupture but the empty condom is causing a bit oof anxiety. I did ask him if he ejaculated but I dont think he understood me. I usually have a HIV test every 6 months ( even though my sexual contact is oral only, until this encounter), with my last test being a month ago. Do I need to bring my test forward? Do I even qualify for PEP ?

We're experts in HIV and other STIs, and not the details of sex and how it works. However, it seems to me that by far the most likely explanation for the empty condom is that your partner did not ejaculate. Maybe he faked his orgasm; or had an orgasm without ejaculation (which probably can happen sometimes, especially if that person had ejaculated recently). Whatever the explanation, it I clear you were not exposed to his semen. I don't see how it could have "leaked out" and still left no trace inside the condom.

Testing condom for leaks after sex is pointless and has no value in preventing HIV or other STIs. You are exactly right that condom failures usually involve obvious rupture:  f a condom doesn't break wide open, protection is complete. The idea of microscopic pores or small holes that can all STI/HIV transmission is an urban myth. And if any such hole were small enough to only be revealed with a water test, it would not be nearly enough to allow HIV transmission. (Even with unprotected sex with ejaculation in the rectum. if the penile partner has HIV, the average risk to the bottom partner is no more than 1%, i.e. one chance in a hundred. As for unprotected oral sex, the risk of HIV is no higher than one chance in 10,000 (according to CDC), and that's only if the penile partner has untreated HIV. (That's equivalent to giving BJs to infected males once daily for 27 years before infection might be probable.)

So my answers to your brief closing questions are:  1) No, you don't need HIV testing on account of this event; it's fine to wait until your next scheduled 6 monthly teat. Of course you are free to test sooner if you wish:  simple reassurance is a valid reason for testing even if the risk is nil. 2) In any case, I definitely would not advise PEP.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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