Protected sex

[StupidGuy186]

Dear Doctors. Thanks for a terrific page. I am a Swedish male who recently visited a swingers club in a large city in my country. Here, I learnt to know a sympathetic married couple who invited me to have sex with the wife. I had about 30 seconds of protected vaginal sex before I stopped because I did not feel comfortable with my choice. During the brief encounter, my penis was not entirely hard, but I checked that my condom stayed on, and it looked intact when I threw it away. Could you please enlighten me on the HIV risks from this encounter? Are there any other diseases which you - from your impressive clinical practice - have seen transferred under such circumstances?

[StupidGuy186]

Thank you very much. This is reassuring, but I will indeed anyway avoid putting myself in such an uncomfortable situation again. You say that condoms work, but I think the messages of e.g. FDA and other knowledgeable institutions on this topic (about 85% effective?) are somewhat confusing. I have problems with understanding how HIV and some other diseases can be transferred at all when a condom is correctly used, it doesn´t break or slip and there are no other riskful acts involved. But controlling for all these factors may perhaps present a huge challenge for epidemiological studies?

[Edward W Hook, MD]

We try to stay out of politics on this site but let me make two points.  First, you are correct that studying condom use is VERY difficult. There is, obviously, no way observe condom use in order to make sure that people are using them correctly (and we know that many peole use them incorrectly) so all data is based on self report.  We thus think that the estimates that condoms, when used properly, are less than 100% effective tend to be conservative.  We just don't know how conservative.

The second point is the political one.  The current US administration has an agenda which promtes abstinence to the exclusion of all other methods for HIV/STD prevention.  Because of this, they have a vested interest  in promoting "rules" for the FDA and other official statements which inidicate that condoms are less effective than they probably are. EWH

[Edward W Hook, MD]

I feel comfortable in telling you the your risk for HIV is zero.  I say this for several reasons.  First and by far foremost, you used a condom and condoms work.  Secondly, the fact is that one of the governing principles of many swingers clubs is that its members do not have STDs which could be transmitted to other members (obviously, the "guest" policy which you were invited to take part in reduces the effect of such guideline), and finally, even if your partner was infected (this is unlikely) and had you not used a condom (you did) your risk of infection would only be 1 in 1000 exposures.  Putting these factors together, you really have nothing to worry about in terms of HIV and do not have any medical reason for HIV testing.

Other STDs, also most unlikely in the situation you describe.  Take care.  EWH