Hi Doctor

I am a guy,

and had a few visits in sex workers in the last monthes.

For each visit we used only one condom,

and the sex workers were using the same condom

for the first protected blowjob and then second/later protected vaginal sex 

with the same condom which was used for first blowjob.

In some of the visits, 

I could feel a relatively strong contact of the partner's teeth 

with the condom during the first protected blowjob,

and afterwards we continued to protected vaginal sex with the same condom 

which was used for the first protected blowjob.

In all sexual encounters the condom looked intact after the vaginal sex,

but I did not check the condom carefully for tiny holes or made water test.

Now I know that if the condom gets a visible hole/tear 

during the first protected blowjob by teeth rubbing on condom,

the condom will always  shred  immediately during the second/later vaginal sex with the same condom.

Condm shredding/failure will happen from

the stress on the damaged condom during vaginal sex.

By the condom shredding I will know that the condom failed during the vaginal sex,

and I was in HIV risk from this vaginal sex.

So from this I conclude that there were no visible holes or tears 

in the condoms during vaginal sex with the sex workers, 

and I was not at HIV risk from this aspect becuase all condoms looked intact 

in the end of second vaginal sex.

My concern relates to microscopic/tiny holes on condom whcih could put me in HIV risk 

during the vaginal sex sessions.

My question is : 

Microscopic/tiny holes on condom which can be created 

by the first blowjob with teeth rubbing by sharp and thin incisors for example,  

will always lead to condom sherdding during 

the second/later vaginal sex with the same condom?

I know that microscopic/tiny holes on condom by blowjob from teeth is a rare case, 

but I think it still may happen.

My final question is if in the rare case there were some 

microscopic/tiny holes in condom which were caused by the first protected blowjob 

by contact of sharp and thin incisors teeth with the condom, 

will such microscopic holes in condom will always lead to condom  shredding/failure 

during the second/later vaginal sex with the same condom?

Or the condom can remain intact with such microscopic/tiny holes on the condom 

during the vaginal sex, 

and in this case I can be in HIV risk withouth knowing,

becuase during vaginal sex HIV infected fluids from partner's vagina 

can enter through these microscopic/tiny holes on the condom and cause HIV infection.

Thank you

First, as you seem to already know, microscopic holes in condomes is pretty much an urban myth. I guess in theory a nick from a tooth or other sharp object could lead to condom breakage, but otherwise little or no risk. To the extent microscopic condom defects sometimes occur, there is believed to be little or no infetion risk. In other words, for condom protected sex, if the condom does not break wide open, it is safe to assume protection is complete.

That said, anyone with multiple partners or sex with sex workers is at some risk of HIV and other STIs, even with no observed condom failures. Persons in your situation are wise to be tested from time to time -- e.g. every few months or perhaps once a year -- for HIV, syphilis, gonorrhea and chlamydia. If you haven't been tested recently, I suggest you do so.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

Hi Doctor,

So what you say is even that I used the same condom for first protected blowjob 

with relatively strong contact of the partner's teeth with the condom,

and then vaginal sex with the same condom,

I had no HIV risk from the last sexual encounters,

this is because the condom didn't break wide open in all the sexual encounters.

About theoretical microscopic holes on condom, 

is it correct to say that even it the 

rare  case of having vaginal sex with a condom with microscopic holes it

(microscopic holes on codndom which were caused by manufacturer defecets 

or by teeth friction with condom  by protected blowjob  

which happens before the protected vaginal sex with the same condom using for the both sexual acts). 

In that case of microscopic holes on condom during vaginal sex, 

the condom will most likely shred and thus let me know of the condom microscopic defects.

But even in the unlikely event that the condom will not shred/break 

with these microscopic holes on it during vaginal sex,

this will not put me in HIV risk because HIV fluid can not enter through 

such microscopic holes on the condom during vaginal sex.

Thank you for the answers.

Second and third:  No microscopic hole of any kind is known to increase HIV or other STD transmission risk, and you're on the right track with your statement about fluid transfer through small openings. I'm not an expert in the science of condom materials, but I believe hydrostatic pressure considerations essentially prevent the fluid transfer that would be required to allow exposure to high enough quantities of virus or bacteria for infection to take hold. It is reasonable to be concerned that teeth could cause a weak spot that would result in overt condom rupture, which is one reason to use a new condom for vaginal sex following oral. Beyond that possibility, suggest you drop this entire line of reasoning.

That said, never assume condom are 100% protective. There are plenty of instances in which people acquired HIV despite apparently consistent condom use without breakage.  I would guess that in most cases there were lapses in condom use that were unrecognized, or that were not admitted. Hence advice for periodic STD/HIV testing in people with your sort of sexual lifestyle.

Thank you for the explanations I have understood them.

What did you mean when you say:

"Beyond that possibility, suggest you drop this entire line of reasoning."

I should also clarify that I admire your responsibility, i.e. given you sexual lifestyle, the level of safety you are regularly following. And I don' tmean to imply you are at high risk for HIV despite condom use; it is extremely unlikely you'll ever have it. I'm just trying to promote a couple of common sense protections, and probably periodic reassurance.