[Question #7399] Vaginal fluids inside condom

3 months ago
Hi Doctor Hook,

Me and my friend both male went to red light area in india. We chose one female CSW. My friend went first. After 15-20 minutes he came out and I went in. She was throwing condom used with him in dustbin. Then I removed my pants and she opened a new condom from wrapper and put it on my penis. We had sex for about 2 minutes but due to guilt I asked her to stop. I masturbated with condom on and after few seconds she removed condom and I again masturbated with same hands. But again I couldn't conclude and we left the place. 
1. After that I realised She did not wash her hands after having sex with my friend. I'm sure her vaginal fluids from previous exposure condom was on her hand and it went inside my condoms tip when she put the condom on my penis. The secretions got trapped inside the condom tip. I'm uncircumcised. What is my risk here? Is this same as unprotected sex? Did I get infected with HIV because the trapped secretions might have went inside urethra and uncircumcised skin during sex 2. Also I used same hands for masturbation which had vaginal fluids after removal of my condom. What is my risk here? I'm getting married in 3 months. Do I need testing. I'm very much scared. Thanks in advance!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
3 months ago
Welcome. Thanks for your confidence in our services. As explained in the forum's introduction and FAQs, users do not select the moderator who responds to their questions. Dr. Hook and I have worked closely together for nearly 4 decades; we have identical expertise and our evaluations, opinions and advice never differ significantly from one another.

Both your questions can be combined and discussed together. First, HIV is never transmitted by hand-genital contact, even when potentially infected genital fluids are used for lubrication. Such exposure does not allow sufficient virus exposure to the specialized cells that the virus must contact (and enter) for infection to take hold. Even with entirely unprotected vaginal sex with an infected female partner -- imagine 10-15 minutes in the vagina with no condom -- the average HIV tranmission risk (again, this is only if the woman is infected) is once for every, 2,500 exposures. That's equivalent to sex with infected women once daily for nearly 7 years before infection might occur (2500/365 = 6.8 yr). Given that statistic, what could the risk possibly be for the events you describe?

Being uncirucmcised roughly doubles the risk of HIV if exposed. "Double" sounds like a lot -- but if you think about it, doubling the risk discussed above changes the odds to 1 in 1,250 per epsiode of unproted vaginal sex -- still low for any one exposure. And remember, you don't know your CSW partner has HIV. Given the circumstances, it seems she may be at high risk. But even among the highest risk sex workers, the large majority do not have HIV.

Should you be tested? From a strictly medical standpoint, there is no need. However, people who come to this or similar forums typically are nervous and anxious, and often are more reassured by negative test results than by professional opinion, no matter how expert that adivce might be. If this advice settles thing for you, you can move on without worry and without testing, and can marry without putting your wife at risk for HIV. But if you're going to remain worried, feel free to be tested if the negative result will make your life easier. In that event, an AgAb (4th generation, duo) HIV test 4 weeks after the event will be 99% reliable, and one at 6+ weeks 100%. (This advice does NOT mean I believe you might have HIV. I do not. I suggest it stricttly for the reassurance you may feel from the negative result.)

I hope this response is helpful. Let me know if anything isn't clear. Best wishes for your upcoming marriage!

HHH, MD
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3 months ago
Thank you doctor for your reply. Do you think my exposure is similar to unprotected sex as you consider my risk as 1 in 1250? Or it is a zero risk as you also mentioned I do not need to test medical standpoint. Is it because the virus becomes inactive after it leaves the body which then transferred inside of the condom? I'm just trying to understand why it's not a risk? Or the amount of fluids which went inside the condom or on my hands while masturbating are not enough to cause infection? Shouldn't they become inactive coming in contact with air as mentioned in many forums? Have you ever seen anyone infected similar to my exposure. Will I be the first one if I get infection this way. 

Thanks 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
3 months ago
These are repeating questions already answered. Please carefully re-read my reply above. One chance in 1,250 was not an estimate of your risk. It was intended to indicate that even an exposure considered high risk (unpproted vaginal sex) is lower risk than you might have believed. Your risk was zero for practial purposes and i explained why. Since there have been NO known cases of HIV transmission by hand-genital contact, it should be obvious that I have never seen such a case myself.

Will you be the first such case in the world? After billions of events just like it? Of course that is extremely unlikely. But as also said above, you are free to be tested for HIV for reassurance.
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3 months ago
Thank you doctor!

I am sorry you may have already covered this but just some points I wanted to confirm with you if my understanding is correct

1) For an adult only HIV risks are unprotected anal or vaginal sex, sharing drug needles, unprotected oral sex. 
If it's protected sex then condoms should not break and stay intact untill end.

2) My concerns regarding the fluid come in contact with the inside of the condom i.e. "hand to inside of the condom to genital" is just not the way HIV is spread? Circumcised or uncircumcised ? Any What Ifs are pointless. In 40 years of HIV, there has been no case reported for these kind of scenarios.

3) Masturbation with vaginal fluids is not a risk for HIV ? Circumcised or uncircumcised.

Thank you Doctor for your time and for educating about the transmission risks. 
I hope I get settled with your reply to above points and don't come back to this forum again.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
3 months ago
1,3) Your understanding is correct, except that unprotected oral sex is extremely low risk, and receiving oral sex maybe truly zero:  there has never been a proved case of HIV transmission mouth to penis. And of course nobody can prove that such exposures, or masturbation with vaginal fluids, is truly zero risk. But since there are no known cases, you can assume it is zero for all practical purposes. I don't recommend HIV testing after such exposures.

2) Again, nobody can say it's zero risk if infected fluids get inside a condom. But entirely unprotected vaginal sex carries only 1 chance in 2,500 or getting infected, obviously contact with the small amount of fluids inside a condom must be extremely low risk. I really wouldn't worry about it.

That concludes this thread and I hope the discussion has been helpful. Even if you do not "get settled" with these repiles, please note that there is no point in starting a new thread with the same questions. The answers won't change, regardless of additional details or "what if?" questions about unlikely scenarios come to mind. Thanks for your understanding.

Best wishes and stay safe.


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