[Question #4217] Fluid inside condom and hiv

32 months ago
Hi Drs. 

I recently had sex with a woman and didn’t ask her about her hiv status but she is a risk. 

We used a condom and lube. While having sex I got flaccid a few times and the condom got loose while I was inside her. I then got flaccid again and slowed down and saw the condom was halfway down my shaft and loose. My penis head was always covered by the condom when I was inside her but here’s the problem:

I did not ejaculate but there was a whitish, gooey fluid along the entire inner side of the condom. When I removed the condom it collected at my penis head and I wiped it off with a tissue. I then put on another condom and continued having sex until I got flaccid again and just pulled out and removed the condom with no problem. Assuming this whitish gooey fluid is vaginal secretion, can I get HIV this way?

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

If indeed vaginal secretions worked their way inside the condom, this could risk HIV. However, it is statistically unlikely your partner had HIV; and even if she did, remember that even without a condom, the risk of HIV from a single episode of unprotected vaginal sex is around once for every 2,500 exposures. That's equivalent to having sex once daily with infected women for 7 years before infection might be likely. In other words, the odds are very strongly in your favor, even if your partner had HIV. The risk of other STDs (gonorrhea, chlamydia, syphilis, etc) is higher. It would make sense for you to be tested for HIV and these other STDs, but you can expect negative test results.

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

HHH, MD
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32 months ago
Dr Handsfield,

Thanks for your response. 

I’ve read on your prevoius posts that vaginal secretions get inside condoms the majority of times yet condoms are virtually 100% effective against hiv. Has anyone ever gotten hiv from secretions going inside a condom?

Also, when should I get tested?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
From your description, it sounds like a larger amount of vaginal secretions may have found their way inside than usually occurs. In any case, this is far from a precise science. And of course it is impossible to know whether someone has "ever gotten HIV" in this situation. 

I would recommend a standard HIV antigen-antibody test ("duo", "4th generation" test) and a syphilis blood test 6 weeks after the exposure. A urine gonorrhea/chlamydia test can be done 4-5 days after exposure.
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32 months ago
Ok Dr. 

I just texted her, and she told me she does not have HIV as far as she knows. 

Last question: why did you tell this person (#2229) they do not need to be tested from possibly getting secretions inside condom and recommend I do need to be tested?

Is my chance of acquiring hiv the same as this persons—1 in a couple million?

[Question #2229] HIV Risk from Baggy / Loose Condom

15 months ago
Hello,

I had protected sex with a girl who had had unprotected sex with others in the month prior, and I am concerned about HIV risk.

The problem is that the condom I chose to use was a baggy one, the Trojan Ecstasy Ultra ribbed (feel free to look it up to see what I'm talking about). It was baggy all the way down my shaft, allowing for extra movement of my penis. It is a very wide condom. It had no reservoir tip. I'm concerned because at some points when I took my penis out of her in between having sex, the condom had bunched up and slightly hung over my penis. I pulled it back so that the tip of the condom was at my penis tip. There was ALWAYS condom covering my head and tip and part of shaft during penetration, and ring was always on a part of the shaft, but I am concerned about vaginal fluids from the penetration going from her to my uncovered part of shaft, and then when I pulled the condom back down as it hung over my penis I may have introduced vaginal fluids from shaft to the tip of the condom and then to my urethra? Or would that be no risk since it is analogous to mutual masturbation / secretions in the outside environment? I'm concerned that her vaginal fluids got into the loose fitting condom (my penis tip directly touched her vagina but am concerned fluids got inside baggy condom and to my tip). I'm also concerned that if she had had unprotected sex with others in the month before me she could be in the acute part of HIV and more likely to transmit (If she has HIV, which I know to begin with may be a low chance).

Thanks for taking the time to respond.
15 months ago
*** Sorry doctor, that second last line should say "(my penis tip  DID NOT directly touch her vagina but am concerned fluids got inside baggy condom and to my tip"
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
15 months ago
Welcome to the forum. Thanks for your question.

You are focused almost entirely on the condom and whether it protected you completely. It probably did -- I'll get into that in a minute. But you should also think about two other factors:  How likely is it your partner had HIV? And if she did, what were the transmission risks, without a condom? The answers are 1) very unlikely (probably under 1 chance in a thousand) and 2) also very unlikely -- the average transmission risk from unprotected vaginal sex, if the female partner has HIV, is around once for every 2,500 exposures. That's one reason many spouses of HIV infected people never catch it themselves (which perhaps you didn't know). In other words, in the US and other industrialized countries, HIV rmains rare in even the most sexually active heterosexual singles.

For these reasons, even if you hadn't used a condom, I would estimate the chance you caught HIV at less than 1 chance in a couple million, and wouldn't even recommend HIV testing after only a single exposure like this. Don't get me wrong:  I'm not recommending casual sexual encounters without condoms. Even though the risk of HIV is miniscule, it isn't zero and why press your luck? And of course there are other STDs to be concerned about.

Now to your specific questions:  You are correct that as long as the head of your penis and the urethral opening were covered, this would be considered safe sex in regard to HIV, as well as for other STDs transmitted primarily through genital fluids, i.e. gonorrhea, chlamydia, and hepatitis B. There is somewhat higher risk of those transmitted skin to skin, like herpes, HPV, and syphilis. However, syphilis is even rarer than HIV in partners like yours; HPV is pretty normal and universal anyway (you probably already are infected and there is little increased risk from any one exposure); and herpes also is uncommon in this situation.

So I don't advise testing for any STDs unless or until you develop symptoms. However, if you would like the reassurance of negative test results -- even though the risk is extremely low -- you could have a urine test for gonorrhea and chlamydia any time more than 3-4 days after the event, and blood tests for syphilis and HIV at 6 weeks.

And of course I don't need to tell you to purchase your own, properly fitting condoms!

I hope this information is helpful. Best wishes and stay safe--   HHH, MD

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
32 months ago
I cannot respond any better than I did above:  "it sounds like a larger amount of vaginal secretions may have found their way inside than usually occurs. In any case, this is far from a precise science. And of course it is impossible to know whether someone has "ever gotten HIV" in this situation."

The important issues that your risk from this event was extremely low, especially since you provide additional evidence your partner probably did not have HIV. It's entirely up to you whether to be tested or not; I said "it would make sense" but that's not the same as advising you to do it. Your choice entirely. But in general, whenever someone is anxious enough to ask these sorts of questions, and especially if so anxious as to pore over other threads looking for trivial discrepancies in advice, they almost always should be tested. Such persons generally are more reassured by negative test results than by expert opinion based on probability, statistics, etc.

That completes the two follow-up comments and replies included with each thread and so ends this discussion. I hope it has been helpful to you.
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