Condom Issue

[moto77755]

During a break in vaginal sex, I removed a condom while my (I would estimate high risk) female partner used the bathroom. I realized that I did not have a backup and (3-5 minutes later) I put the same condom back on. While doing so, I put it on inside out. I realized the mistake and fixed it, and then we continued having sex, but of course by that time it didn't matter. The condom did NOT break, but I'm concerned about the exposure to the used condom. Do I have an HIV risk? Any other risk?

BTW: I do not normally reuse condoms.

Unrelated to the above, but I have read that anal sex with a condom is higher risk than, say, vaginal sex with a condom. Is this purely related to the higher possibility of condom breakage? Or is there some other reason?

[Edward W Hook, MD]

Sorry to have not commented earlier.  As I said in my original answer, based on my original reading of your post, there was a risk and pointed out that that risk was no greater and PROBABLY SMALLER than the risk from unprotected sex, and that that small risk was present ONLY IF your partner was not infected.  I missed the part about removing the inside out condom then taking it off and putting it on a third time.  That however oes not change my assessment.  As you know, condoms are not rigid.  Thus there is a risk that there were genital secretions trapped between folds where the condom surfaces touched, preventing exposure to air or drying an thereby preserving the potential viabiltiy of HIV, had it been present.  My answer to you stands for that reason.  The risk however, as I also pointed out was small and certainly did not warrant PEP  .  

Finally, the fact that you have both now tested negative makes any of these iscussions only theoretical.  With both of you having negative tests, there is no risk.  

Finally, I would add to your "bottom line" that in addition to talking with your partner, I would suggest you be prepared and have more than a single condom available- reuse of conoms is not a good idea.  EWH

[moto77755]

FOLLOWUP:  I decided to stop by her office and talk to her about her status, and it turns out she had worried about the same thing! I guess I made a bad assumption about her STD risk--I definitely assumed things that were not true.

We both got tested again. Double negative on the instant HIV test. Blood version for all STDs including HIV will be back next week, but I'm assuming this is a non-issue at this point.

Bottom line for anyone reading this post: TALK TO YOUR PARTNER before you jump to conclusions. It turned out to be a LOT easier than I expected and we both felt much better!!

[moto77755]

It's pretty late back in the States... I'm sure he'll see this in the morning.

Just wondering if I should get PEP now... I took it once before. Made me nauseous sometimes, so I'm not really keen on getting it again. But I guess I should head over to the clinic... one month is better than a lifetime.

[Teddygink]

Seems like a no risk deal to me given the litany of posts on here that would support that. Of course I've never understood how vaginal fluid used in masturbation could be no risk so who knows?  C'mon doc. I know it's late but your devout followers need your sage wisdom

[moto77755]

Actually I got the condom corrected BEFORE resuming sex. It was on incorrectly for only about 30 seconds.

[Teddygink]

Mostly they say the  reason for no risk outside the body is that the virus loses infectiousness once it's exposed to air and that the amount of fluid involved is too low amount. The two combined make it a no risk situation. Perhaps putting the condom on inside out and then reinserting makes it a risk because the virus could still be active and once it's back inside the vagina the temperature could assist in infection. Seems like a stretch considering that at least some of the virus should have died once it was exposed and no fresh fluid would have come in contact with the penis during sex by virtue of the condom being on. Again I really hope the doc can clarify. They're both incredible so I'm sure they'll have an answer.

[moto77755]

I've always wondered about this, as there are people that are infected through needle pricks. Though I guess that's not the same as vaginal fluid, but there is certainly air exposure.

This question was also answered (though not by the doctor) in the negative here:

http://www.medhelp.org/posts/HIV-Prevention/is-there-any-risk-wile-condom-being-turned-over-an-reused/show/1490136

[Teddygink]

I understand. I'm a little shocked the doc said this had any potential risk. Everytime the question of vaginal fluid infectivity outside the body comes up he says no risk. If this is in fact a risk then pretty much every other scenario where vaginal fluid is involved should be a risk as well regardless of whether or not the transmission route occurred inside the body. Infected vaginal fluids either are or are not infectious outside the body I wouldn't think there would be any special circumstances on the issue. Hopefully he'll get back to you soon on it.

[moto77755]

It was exposed to air on a bed table for 3-5 minutes, so it did have time to dry a bit. It was on that table the entire time she was in the bathroom.

It was not very wet, if at all, and didn't slip on as easily as expected, which is how I noticed that it was backwards.

[Teddygink]

Sorry to jump into someone else's thread but your last response confuses me. You say above that taking a condom off and leaving it out for a while, obviously exposing it to air and then putting it back on inside out and proceeding to resume sex could potentially be an exposure risk equal to unprotected sex. I am assuming this is because of contaminated vaginal fluids. If what you say here is true than it would seem logical that those same vaginal fluids could potentially infect someone if they were used as lube for masturbation after taking a condom off and getting said lube on the hand used to masturbate. In fact, it would seem even more risky given that the fluids in the masturbation scenario would be transferred immediately where the above scenario they sit around a while exposed to the air before putting the condom back on.

Can you please shed some light on this issue for me. How is putting on a used condom inside out as risky as unprotected sex and masturbating with vaginal fluids no risk when both situations are using the same infected fluids in the same quantities?

[moto77755]

Wow... based on the post below I had previously expected you to say no risk. I thought the virus may have already broken down once exposed to the air for that long... how long does it take for the virus to break down outside the body?

So is the answer to this post incorrect then?

http://www.medhelp.org/posts/HIV-Prevention/Can-re-using-a-condom-outside-in-give-me-HIV/show/652926

I am in Thailand, where the rate of hetero transmission is quite a bit higher based on recent studies. (Perhaps due to subtype differences?) Should I get PEP then?

[Edward W Hook, MD]

Putting on a condom which has alreay been use inside out transfers material (genital secretions) from the outside of the condom to your penis and thus carries some risk of STD and HIV transmission.  As you know from elsewhere on the Forum and your earlier questions, IF your partner had HIV your risk of infection from a single unprotected exposure is about 1 in 1000.  How putting the recently used condom on inside out changes this is hard to say.  I would suspect the risk if also about 1 in 1000 or perhaps lower, not higher.

Any increase risk related to conom protected anal sex is ue to the increased risk of breakage, nothing more.  EWH