*** in the condom

Dear doctor,

I am a 30yo gay and had sex with a male partner (unknown HIV status) as follows: i gave him a hand job and he came on my hand. Just after that, I tried to put a condom on my penis but had a lot of trouble to do it; firstly, i put it the wrong way (ie on inside out) and had to touch it inside and outside with my contaminated hands. The issue is that, by doing that, i left some cum from my partner IN the condom. After that, we had anal sex with no condom breakage.
Do you think there is an HIV contamination risk since some cum has been in close contact with the head of my penis in the condom, while we were having anal sex ?

Thanks

[H. Hunter Handsfield, M.D.]

Welcome to the HIV forum.

The highest risk exposures for men having sex with men, i.e. unprotected anal sex with ejaculation, carry numerically low chances of transmission:  if the penile partner (top) has HIV, there is somewhere around 1 chance in 100 the anal partner (bottom) will catch it; and if bottom is infected, the transmission risk to the top partner is around 1 in 500.

Given those figures, what could it possibly be for the indirect contact you describe, with very small amounts of genital secretions?  There might be some theoretical risk, but it's a good bet nobody has ever been infected by such minor exposure.  So I wouldn't worry about it.

That said, I am still worried that HIV is in your future someday.  Why?  Because you had anal sex with a male partner of unknown HIV status.  That marks you as being at quite high risk, even if you always try to adhere to safe sex practices.  Condoms do break, and intentions for sexual safety often are forgotten in the heat of passion.  No man should ever have sex with another man without discussing their HIV status before sex, and either avoid sex entirely or be double cautious about safety with partners who are positive, don't know, or seem evasive in their replies.  Follow this rule and you can expect to go a lifetime without HIV.  Consistently ignore it and there's a very good chance you'll get it.

But you should have no worries for the exposure described here.

I hope this helps.

Regards--  HHH, MD