[Question #6970] Possibility of transmission for any STI

9 months ago
Dear Dr.,

On 25 May , I went with a new girl friend, I did the following activities:

1- we kissed.
2- Oral sex as I am a receiver only.
3- I had protected sex in her vagina.

I did not ejaculate but when I was pulling out my penis, the condom slipped inside her because I lost erection (for my bad luck). Against all odds, what would be the possibility for HIV or any other STI to be transmitted if she is HIV+ or carrier for any STI, I am not saying she is, but my mind is deceiving me since this incident and I am totally sleepless.

Appreciate your detailed reply.

Regards,
Edward W. Hook M.D.
Edward W. Hook M.D.
9 months ago

Welcome to the Forum.  Thanks for your question. I'll be glad to comment.

The exposure you describe was virtually no risk and would not raise concern for me it I were you.  STIs including HIV are not transmitted by kissing.  Similarly, HIV is not transmitted even following unprotected oral sex from an infected partner and the risk for other STIs is miniscule.  Finally, condom protected sex is safe sex and would have prevented acquisition of any STI, including HIV if your partner were infected.  When condoms slip off as a male removes his penis from a partner, the condom has typically done its job and there is no exposure or STI/HIV risk.  I see no need for concern and no need for testing related to the exposure you describe.

If this is going to be an ongoing relationship, you may want to suggest that you and your partner both go for STI testing,  STIs can be asymptomatic and at the beginning of a relationship having been tested together is a great trust builder and removes any concerns which may be present.  It should not be considered a lack of trust but a confidence builder for both partners since STIs can be present and asymptomatic and no one wants to accidentally infected a partner because of past bad luck.

I hope that this information and perspective is helpful. EWH


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8 months ago
Dear Dr. Hook,

Thank you for your reply, but to have the peace of mind, I need to understand few points:

1- The condom slipped inside her vagina, so my bare penis (even for one-two  second or friction of second) has touched her vagina from inside without barrier.

Does this can put me on risk?

2- two days after the incident, I feel fatigue and dark yellow urine, can this be a symptom of any infection 


Best Regards,


Edward W. Hook M.D.
Edward W. Hook M.D.
8 months ago

Straight to your follow-up questions:

1.  I understand that the condom stayed inside of her vagina as you withdrew.  That is a virtually no risk event.  On the other hand, if the condom come off DURING sex, it would have been left behind, deep within her vagina and would take some effort to remove from her vagina.  With this partner, both are low risk events, but the risk associated with the latter situation is somewhat higher.  Neither situation changes my evaluation and advice regarding the potential benefits of you both being tested.

2.  Fatigue and dark urine are NOT signs of HIV or other STIs.  Further two days is really too early for any signs of HIV to occur.

I suspect you are worrying more than is necessary.  EWH

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8 months ago

Dear Dr. Hook,

Thank you for your update, but I am still worried since yesterday I have swollen lymph nodes under the armpit, I tried to get some info to ensure assessing my situation

1-      Her last interaction with any other man was on July 2019 and was protected sex, then she did her HIV tests on 10 October 2019, which showed negative results, can those tests be definite, or not?

2-      The condom probably slipped during the withdraw, not during sex

Based on the above and having the Swollen lymph nodes under the armpit after 13 days from the incident (I read it is symptom of HIV), should this be a point of concern.

I will go for sure for testing, but the waiting time is killing me, appreciate your reply


Edward W. Hook M.D.
Edward W. Hook M.D.
8 months ago

In reviewing your most recent and final follow-up I noticed that I have not yet suggested to you that the internet is absolutely the wrong place to go for advice and information of signs and symptoms of STIs, including HIV.  In fact, this is the single most common recommendation I provide to clients on this forum.  The internet is full of misinformation which is out of date, presented out of context, or simply wrong and it is quite difficult to differentiate fact from fiction in seeking information there.   The issue of lymph node swelling is one such area.  A trained clinician can detect and differentiate normal from abnormal lymph nodes but most untrained persons cannot.  Lymph nodes can be detected/felt in virtually everyone -most are entirely normal findings.  Swollen lymph nodes are NON-SPECIFIC and only sometimes provide a useful clue to moving forward towards a diagnosis.  While swollen lymph nodes can be present in persons with recently acquired HIV, if they are present, tests are ALWAYS positive.  In your case, the fact that you are feeling what may be lymph nodes in no way changes my assessment or recommendations.   As I said in my original reply - "The exposure you describe was virtually no risk and would not raise concern for me it I were you."  there is still my sense and nothing you have said sense in any way changes that assessment.  Thus, as final responses to your questions:

1.  Her results in October were conclusive and indicate that she does not have HIV.

2.  Understood.  I commented on this above.  Your condom did its job.

finally, having swollen lymph nodes under the armpit is very, very common and rarely due to HIV. 

I see you reason for you to worry.  I urge you to stay of the internet.  As this is my 3rd response, as per Forum guidelines, this thread will be closed shortly without further replies.  EWH

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