Protected Sex - Menstrual Blood on outer condom

[idiot_dave]

Dear Doc

One of my friends had protected sex with a CSW in India. The person first fingered the outer labia (it did not seem to be wet). Then he put on 1 condom. Since it was put on in reverse, he took it off and put it on the correct way. In the process, he might have touched the tip of the condom. However, the finger (which had touched the labia earlier) had brushed against many surfaces in the interim, so there should not even be a direct transmission of the vaginal fluid (if any, since the labia was not wet). Then the person put on the 2nd condom on top of the first one.

After 1-2 minutes of intercourse, he ejaculated in the condom, and later examined the condoms in the bathroom. The semen was in the condom; however, the outer condom had a slight coating of blood on it; which may have been menstrual. The person checked both condoms by filling with water and made sure that none of them were broken. They had not slipped off either, and the person is reasonably sure that the blood was on the outer one (he had no blood discharge or cuts on the penis). Hence the presumption that it was menstrual blood.

Is there any significant statistical probability of contracting HIV from this kind of exposure? I had read the other posts about condom infection by touch, but came across none of having an instance of menstrual blood getting on the outer condom.

My friend is incredibly worried and hence anxiously waiting for your revert

Thanks

[Edward W Hook, MD]

I'm sorry, there are volumes written addressing the questions you hare asking.  The mechanics and mechanisms of HIV transmission are really beyond the scope of this, or any, space limited forum.

Sexual transmission occurs when the virus gets through or below the surface layers of skin and mucosal surfaces.  The friction of sex helps this to happen.  This is the reason that only a tiny proporion of exposures to infected partners lead to transmission.

Direct blood expsoure refers to HIV introduced deep into tissues as occurs with needles, not surface contamination or even possible contamination sof surface scarapes and wounds.  EWH

[Pharoah247]

A related discussion, hiv by fingering a woman in periods was started.

[idiot_dave]

Dr Hook

Apologies, but just out of curiosity, and maybe for interest of other people browsing, could you elaborate how exactly HIV is passed on to a man while having unprotected sex (mechanics, biology, odds), specially with CSWs?

If you can share statistical odds associated with various events, it will surely be useful info.

Also, I presume the meaning of "direct blood exposure" (as discussed in other threads) is shared needles / blood transfusion and not blood coming in contact with genitalia.

I hate to burden you with so many questions, but am finding it useful to ask questions at a site which gives reliable & authoritative info and not having to rely on cut-paste data available generically.

Thanks

[Edward W Hook, MD]

Again, the blood does not increase risk to the events you describe which are no risk.  EWH

[idiot_dave]

Dr Hook

Thanks for the response. The condom was reversed immediately i.e. prior to the penetration and the 2nd condom was put on top of the 1st one. Only after that penetration occured. The tip of the condom was touched with the tip of the finger which had touched the labia earlier. However, the worry here is less since the same finger was brushed against multiple surfaces between the 2 events.

However, the worry is on account of the blood. Could it have got on the inside somehow, leading to any risk?

Thanks

[Edward W Hook, MD]

Welcome to our Forum. I presume you are "your friend", not that it matters.  There is no risk from the exposure that you describe with one possible exception.  If you put the condom on, then took it off and put it on again after reversing it, there is no risk of infection as long as no penetration has occurred. On the other hand, if you out a condom on, initiated sex and then stop and reverse the condom you are exposing yourself to your partner's genital secretions and therefore have some small associated risk.

Otherwise condom associated sex is safe sex and virtually no risk.  There is also no need to test condoms in the way you describe. Condoms do not leak "a little".  Rather, when condoms fail, they break wide open.

Touching a partner and getting their genital secretions, even with blood present does not put you at risk for HIV.

Hope these comments help. No meaningful risk.  EWH