Condom Use

[oops27]

I had anal sex for the first time (receptive)  I thought I was being safe, but now I am nervous.  It was protected, condom used.  My question is that when he came, he thrust a few more times.  Now when I took the condom off him, I noticed that the semen was not just at the tip of the condom, but spread throughout.  Is that common?  I am worried that after he came, he thrust, which could mean the semen moved up the condom, but what if some came out of the opening near the base of his penis and slid down the outside as he continued to thrust?  Is that a risk?  Do I need to test?  I did fill the condom with water later and there were no holes.  I don't want to get fixated on this and dwell if I don't need to.  Can you give me some advice.  Is it possible that I could be infected?

[H. Hunter Handsfield, M.D.]

Sigh.  All I can do is assess the odds.  I guess I don't know how I could have been more clear than "condom-protected sex is safe", "I do not recommend HIV testing after particular exposure events unless it was a particuarly high risk, such as a known positive partner without a condom", and "The chance you caught HIV during the event you describe is too low to warrant testing".

But in response to your plaintive cry "I just feel I could use a really straight answer. Do I need to worry about HIV in this incident?":  NO!

HHH, MD

[monkeyflower]

While you wait for Dr. Handsfield's answer: no.

As for the semen squishing around in the condom, I can't say I've ever really noticed, but I'm sure that's extremely common. Next time, just make sure you leave some space at the tip as a little semen repository ;-)

[oops27]

I just feel I could use a really straight answer.  Do I need to worry about HIV in this incident?

[sparkeler]

I don't think he is saying you should be tested bc of a condom was used.  He is saying that gay men should know the status of their partner(s) to be entirely safe.  If you feel you should be tested for peice of mind, then do it.  However, it will be  negative.

[H. Hunter Handsfield, M.D.]

In general I do not recommend HIV testing after particular exposure events unless it was a particuarly high risk, such as a known positive partner without a condom.  A wiser approach is simply regular testing for sexually active people at potential risk, such as once a year.  The chance you caught HIV during the event you describe is too low to warrant testing from a strick risk assessment perspective.  But as I have said innumerable times, if you don't find my advice 100% reassuring and are going to lose sleep about it--that is, if knowing your HIV test is negative will help you sleep better--feel free to do it.  If you do, a single antibody test 6-8 weeks after the event is suffcient.

HHH, MD

[oops27]

You didn't say if I need to be tested because of this incident?

[H. Hunter Handsfield, M.D.]

I'm not an expert on the mechanics of sex or condoms and cannot say how often semen gets smeared around the shaft as opposed to staying in the condom tip.  But surely it happens a lot.  But the bottom line (no pun intended) is that condom-protected sex is safe.  You definitely don't need to dwell on it.

That said, in response to "I thought I was being safe":  You were only half safe.  Since you don't say your partner's HIV status, I assume you do not know.  The single most important safe sex strategy for gay men, aside from condom use for anal sex, is knowing and sharing HIV status.  Condoms sometimes break, and often intentions for non-insertive sex go out the window in the heat of the moment.  No gay men should ever have sex with a new partner without asking his HIV status and sharing one's own.  Ever.  Follow that guideline, as well as condoms for anal sex, and you probably will never get HIV.  Do not follow it, and there is a very good chance you will.

Good luck--  HHH, MD