[Question #2196] Risk of STI via protected sex

96 months ago

I am a male that had sexual intercourse 3 days ago with a female. I do not know the sexual history of this individual and therfore do not know if they have any STIs. I cannot really ask this individual either as it was a one night stand. A condom was used during sexual intercourse. However, while removing my Penis from her vagina after I had ejaculated, the condom slipped off. I'm not sure if there's any risk of infection from this. A few minutes later we had sexual intercourse again. We used a condom this time as well. After I ejaculated I removed myself without the condom slipping off. I'm not sure if any of this is cause for concern. I'm wondering if any prophylactic measures should be considered?

H. Hunter Handsfield, MD

96 months ago

Welcome back to the forum. Thanks for your quesiton.

Most STIs are not efficiently transmitted -- that is, even unprotected sex with a known infected partner usually doesn't result in transmission. More important, condoms work: they are highly effective against infections transmitted through fluids (gonorrhea, chlamydia, HIV, hepatitis B) and pretty good, although not perfect, against those transmitted primarily by skin contact (HSV, HPV, syphilis). Slippage of the penis from the condom during withdrawal is considered fully protected, so that aspect doesn't make much difference.

Given the low overall risk, for sure I would not recommend any prophylactic treatment. I don't even recommend testing unless you develop symptoms, i.e. urethral discharge or painful urination, or penile sores. However, if you would like to be tested for additional reassurance, you can have a valid urine DNA test for chlamydia and gonorrhea any time (valid 3+ days after exposure) and blood tests for syphilis and HIV after 6 weeks. The chance of any other is too low, or tests to unreliable, to be tested for anything else.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

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