[Question #9909] Condom Slip

27 months ago

Dear Doctors,

I am currently dating a new girlfriend and we have already decided to conduct tests together in the next couple of weeks but have yet to do so.

Since the beginning, we have decided to always use condoms for any type of activity (oral and other) since we have not tested together.

On one occasion, my condom slipped and was left behind hanging/ dangling as i widthdrew. She was laying on her back and i was on top. I assume that this is because i had not widthrawn directly after ejaculating (waited for about a minute). The ring of the condom was clearly outside and we were able to retrieve the condom easily.

My question is: 1) Am I at risk of HIV following this encounter 2) Assuming i was laying on top of my girlfriend and my penis was touching her genital areas (assuming my penis got out of the condom) before i completely lifted myself up, would this be a risk for hiv.

Thanks in advance for your assessment

H. Hunter Handsfield, MD

27 months ago

Welcome back to the forum. Thanks for your continuing confidence in our services.

First, congratulations on your and your partner's plan to be tested soon for common STDs. Assuming you've both had more or less average sex lives, i.e. dating and having had other partners, this is a wise strategy. So was your plan to use condoms until those test results are available. These approaches mark both you and your partner as being at inherently very low risk for HIV and most other STDs as well.

There are parallels between this question and your last two -- i.e. what seems to be an inflated view of HIV risks sexually. One of the statement in your previous threads was your own understanding that contact of HIV with intact skin is risk free. That's the usual scenario when the penis withdraws from a condom that remains partly in place in a partner's vagina or rectum. As long as the head of the penis and meatus (urethral opening) are covered up to that point, condom protection is believed to be complete. Your sexual positioning makes no difference: brief contact of your penis (including your meatus) with a partner's genitals is also risk free. (Even with entirely unprotected sex, when an HIV infected male deposits HIV-loaded semen in a woman's vagina, the average risk she will become infected is around one chance in a thousand. Given those odds, what could it possibly be from the trivial sort of contact you are asking about?)

So the direct answers to your questions are 1) No, there was no meaningful HIV risk from the events described and 2) no this also makes no difference.

Go ahead with your plans for mutual standard STD/HIV testing. But don't overdo it: you both should limit your testing to gonorrhea and chlamydia (a urine test for you and urine or vaginal swab for your partner) and blood tests for HIV and syphilis. All other tests commonly offered by labs as "comprehensive" STD panels are either too low risk or the tests are insufficiently reliable to be worthwhile.

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

HHH, MD

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27 months ago

Dear Dr. HH

Thank you for your reply, I really appreciate it.

From my understanding of your reply, i should not be worried of that particular encounter when it comes to HIV? Apologies for asking in a direct manner but i am trying to reduce my overthinking of this particular "incident".

Also she has told me that last summer she had done a rapid HIV test through fingerprick (an NGO was offering those at an event - she just tested not because she had a reason to but because she happened to spot them at the fair) and the result was negative. All of last year, she only had one Partner before me and never had unprotected penetrative sex with him. She did mention that she might have done frottage with him but never unprotected penetration... I'd rather avoid searching the internet for this test but how reliable are those tests and should i be more comfortable knowing here recent history (i.e. that she had tested negative last summer and only had one partner for months before and after that test)

Thank you!

H. Hunter Handsfield, MD

27 months ago

"i should not be worried of that particular encounter when it comes to HIV?" See above: Even if she has HIV, there was no possibility you caught it. And anyway, the possibility a woman like your partner has HIV is nearly zero anyway. HIV is really, really rare in sexually active women in the US, not counting sex workers and injection drug users. And you say she has had a recent negative HIV test. Why does the possibility of her having HIV even enter your mind?? It should not. (These issues also seem to reflect back to my opening comments -- that you seem to think HIV is more common and various sexual events a lot more risky than they actually are.)---
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27 months ago

Dear Dr. HH

Thank you very much for the reply, this was helpful.

H. Hunter Handsfield, MD

27 months ago

You're welcome. I'm glad to have helped. Best wishes and stay safe.---