[Question #2078] *Possible* Condom Failure - PEP required ?

46 months ago
Dear Dr,

      Hi ! I have a question with regards to possible condom failure. I am a bisexual male in Melbourne, Australia who just a few hours ago had anal sex with another male (26, Caucasian), who claims to be 'free of any diseases' (However, he was ready to have sex without a condom until I insisted on using one). I am the insertive (top) partner and he is the receptive (bottom) partner.

 I have been always very fastidious when it comes to safe sex. In this episode, after ejaculation and pulling out, I noticed that there was no semen in the reservoir tip on the condom! Instead, there seemed to be semen outside the condom instead ! This has never happened to me before and I struggle to explain how it happened. The condom was too big for me and I lost my erection whilst wearing the condom so there is a possibility that the semen leaked backwards, out from the condom's orifice. Another possibility that I could think of is that I somehow inverted the condom while pulling it off, but I could not be sure. What I am afraid of the most of is that there could be a small tear or puncture that I someone missed. To check this I filled the said condom with water but I detected no leak, though I might miss a pin point hole that would have caused a small slow leak. 

Basically, I can't explain why or how semen ended up outside the condom and nothing in the reservoir tip. Whilst he claims to be negative, he seemed to be ready to have unprotected sex with me until I insisted on wearing a condom. Therefore, based on this possibility of a condom failure, should I get PEP ?

Cheers
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Welcome to the forum. Thanks for your question.

However, I'm not sure I can help very much. You were there and I wasn't. I have difficulty imagining how semen could be present on the outside of the condom in the circumstances you describe. There is no way a "pinhole" could occur that would allow semen to leak out but still hold water. My best guess is that it wasn't semen at all, but secretions from your partner's rectum. In addition, it seems unlikely your partner has untreated HIV, regardless of his apparently inconsistent condom use.

So my best judgment is that this was entirely safe sex and that PEP is not warranted. However, for a professional opinion about it, consider contacting your nearest sexual health centre. Australia's government supported SHCs collectively are probably the world's best network of STD/HIV prevention services. (If you happen to be in Sydney or Melbourne, you have access to the best of the best -- but all are very good, to my knowledge.)

I hope this has helped a little bit. Let me know if anything isn't clear.

HHH, MD

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46 months ago
Thanks for your reply. As per your advice I called the Victorian Aids Council for advice and they also share the same opinion, that I do not need PEP, as the most likely explanation is that some semen leaked backwards and I checked the condoms for holes after.

I guess I am somewhat reassured and my earlier anxiety is probably due to being in a situation I have never experienced before .

Thanks


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Thanks for the follow-up. After replying, I began to wonder if maybe the condom was turned inside out as you removed it. In any case, glad you're feeling better about it. Best wishes and stay safe.

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46 months ago
Yeah, that is another possible scenario but the more I think about it, the more I realise that how the semen ended up outside the condom is probably quite irrelevant. I cannot think of a scenario which involves an intact condom (which I have verified), semen being found outside the condom AND me being exposed. Basically, I used a condom AND it didn't break, so that should be enough. Even if there was total rupture of the condom (which there isn't), or some how the condom slipped and exposed my urethra (a scenario which I think is impossible as I did check during sex) , semen would be remain in the rectum after ejaculation, not all over my hand and outside the condom. Thats my logic anyway lol

I think I should stop obsessing about this.

Thanks for your reassurance again.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
You're welcome. Best wishes and stay safe!

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