question to Dr. Hook.

[ALEX555]

Hi Dr. Hook, all specialists say that properly used condom constitutes a safe sex practice. But how about reusing the same condom?  I visited massage parlor on April 22 and think I was at risk. Before the intercourse, my partner (young girl) put condom on me, and I went inside for 3-4 minutes.  When I briefly stopped without ejaculation, she took condom off, and gave me handjob for 1-2 minutes. She then picked up that same condom and put on me. We, then continued for second time, but I never ejaculated. To my best memory, the condom never broke, but I’m asking myself repeatedly if I put myself at risk. So, what would constitute risk in this activity: the fact that condom could break, or while it was rolled back mine and her fluids could exchange. What would use say about used condoms risk. In your posts, you always state that if condoms were used properly, there is no risk. Was mine situation risky? I would perhaps forget about the incident, but two weeks after I had weird symptoms: red/sore throat, slight pain under chin and cheek bone (where lymph nodes located), itchy ears, decreased appetite and temperature from 36,8 to 37 C for about 3-4 days. I also took the test before my encounter, and never had unprotected sex. Do I need  testing in regards to this incident?

[Edward W Hook, MD]

I do not do this to argue.  If you choose to not believe my asessment, that is your right but do not expect me to argue.  As I said above  (this is a direct copy - "Is the improper use of a condom this way just as risky as no condom- no.  The improper use you describe probably still reduces your risk of infection somewhat but how much it does or doesn't cannot be quantified.  having said that, i would still argue that your risk is rather low.  Here's why. If your sex was totally unprotected and if your partner was HIV infected , your risk of infection would still be less than in 1,000.  Your odds are still better because of your partial protection."  EWH

[Edward W Hook, MD]

The issue has to do with what if there is a small amount of secretions caught in one of the condom folds.  Then it would not be exposed to drying or air and thus the lifespan of anything in the material (vaginal fluid or pre-ejaculatory fluid for instance) could be prolonged.  If these secretions had HIV or other STD agents, then you would be exposed to them.  Bottom line, condoms are designed for single use.  Using them more than once increases one's risk, by possibly allowing some exposure to whatever one's partner has in their secretions.  EWH  

[Edward W Hook, MD]

You are right.  I have categorically stated repeatedly that properly used condoms work and negate the risk of exposure. In your case however the condom was not used properly. the re-use of the condom is likely to expose both you and your partner to each other's secretions and therefore the risk of infection.  Is the improper use of a condom this way just as risky as no condom- no.  The improper use you describe probably still reduces your risk of infection somewhat but how much it does or doesn't cannot be quantified.  having said that, i would still argue that your risk is rather low.  Here's why. If your sex was totally unprotected and if your partner was HIV infected , your risk of infection would still be less than in 1,000.  Your odds are still better because of your partial protection.

As for your symtoms, I would suggest you ignore them.  You may missed our repeated statements that the symptoms of the ARS are TOTALLY non-specific and when people experience "ARS symptoms" they are much more likely to have something else, usually some other, more typical virus infection.  When this has been studied in the US, less than 1% of persons seeking medical care for "ARS symptoms" are found to have HIV, the remainder having symptoms due to other processes.  In addition, it is also important to realize that many person who acquire HIV do not experience the ARS.  For a person to try to judge their HIV risk based on "ARS symptoms" is a waste of time.

Do you need testing- perhaps.  You risk is very low however.  Thus, if you get tested now, nearly 4 weeks after exposure, about 85% of all tests that are going to be positive.  When you combine that figure with your partial protection and your relatively low risk of infection to start with, when that test comes back negative you can be confident that you do not have HIV.  I hope this helps.  EWH

[Edward W Hook, MD]

You are correct that this is your last comment. Further questions and comments will be deleted.  As for your test result- believe them.  The tests are good.  At 4 weeks 85-90% of test results that are going to be positive will be.  given the low risk nature of your exposure, I do not think you need further testing.

End of discussion.  EWH

[ALEX555]

    I'm soory Dr. Hook, I forgot to mention, that a person who performed the test had squized 3 or 4 drops of my blood to solution. I know that the test is normally performed with only one drop. At the end, there was a red clear line in Control, but it looked like there was slightly visible solution spot vertically, to what counceling person said that it was remainings of unobsorbed solution. Was the test valid? I received the test confirmation form.

[ALEX555]

  Hi Dr. Hook, this is a last question from me. Following your advise, I did get tested today by Rapid HIV 1/2, which came back negative. It was very stressful and nearly cost me heart attack. Anyway, referring to your very first comment, where you said that if I get four weeks test back negative with relatively low risk exposure that I had, I can be confident that I don't have HIV? Is further testing warranted? Can you please comment on this. Best Wishes.

[Edward W Hook, MD]

You are looking for precision that does not exist.  There are no studies of improperly used condoms to provide data of the sort you seem to so desperately want.  As for whether on not to get tested, I would probably not but that is a personal choice,  Make up your own mind.  EWH

[ALEX555]

     Thanks for you reply. So, from what I understand from your risk assessment the risk is to low to measure? The infection this way does not happen with measurable frequency. Am I correct? Have you ever seen any documented/undocumented case someone getting infected the way I descibed? Do you strongly recommend testing? Do you think the odds astronomically in my favor?

[ALEX555]

        Also, just to mention, that nobody even recommended testing for such a low exposure.

[ALEX555]

    Hi, Dr. Hook, but do you agree that amount of secretion would be insignificant for exposure in the method you describe. Also, overall do you agree that the chance of single exposure would be too low to measure? As with for example unprotected sex, one exposed at high risk by vaginal or anal fluids inside the body. In my case with proper protection the risk would be much more lower. My protection on the other hand remained in tact while inside, thus again risk would be similar to hand to genital to hand no risk exposure. The bottom line is, should I go tested Tuesday, I can be assured that the test would be undoubtly negative, assuming it was the only exposure?

[ALEX555]

   Hi Dr. Hook, Thank you for response. Your answer is somewhat confusing me. From what I know about HIV virus, is that it is very fragile and can only live inside the body, otherwise it quickly damages and unable to pass on. Now assuming that I used condom for penetration, and it did not break the risk should be close to zero. Also, while condom was taken off, it was not put back until 2 minutes after, that means that virus would not have survived by that time. This risk of exposure is rather consider to be hand to genital to hand. It so happen that I'm very anxious a person, I went on number of medical sites, including medical community here and ask them the same question. All replies were no risk situation at all, but not low risk as you stated. Can you please explain, what is the confusion here?