Condom - hole midway

[John_024]

Hi there,

I am bit anxious over an episode last night. I was with a sex worker last night and had protective vaginal sex with her (all without ejaculation). One instance we used a condom provided by the CSW. Upon checking the condom after the act, there was actually a small hole mid way along (very small – when I filled the condom with water, it squirted out). The head of the condom was totally intact (no water escaped), so my penis head was covered. I understand that you guys always state that when a condom fails it does so in a very obvious way – this was not the case.

Assuming that this tiny hole was present during the act (mid way up the condom), am I at any risk of HIV. I always tend to check condoms after I have penetrative sex – to stress again when I tested the ‘head part’ of the condom, no water escaped. Please advise.

Thanks.

[John_024]

thanks for the quick response Doc!

The CSW was actually in Manila. But I am assuming your advise does not change given the location of the sex worker.

Regards,

[H. Hunter Handsfield, M.D.]

Welcome back to the forum.

Such a small defect in the condom is unlikely to result in transmission of any STD.  You are correct that condom defects of this sort are rare -- I don't think I've ever previously had either a patient or a forum user say they discovered a small leak by water testing.  So I guess it can happen.  But still, it's rare.  (And I still don't recommend water testing after sexual exposures.  It remains correct that almost all condom failures are obvious and involve complete condom rupture.

In any case,  I agree with your self analysis -- i.e. that the main importance of condoms is coverage of the head of the penis and urethral opening.  Given that, plus the very small leak, I would count this as complete protection -- for sure against HIV, and probably for all STDs.

FYI, because of the large number of questions we get from users with sexual exposures in Dubai, I have exchanged emails with the director of the main STD clinic there.  HIV is apparently rare in CSWs there, and the clinic is unaware of any ex-pats in Dubai who had ever acquired HIV.  If it happens, it is extremely rare.  Although it's been a few months or maybe a year since our last communication, I doubt things have changed since then.

So no worries.  In the absence of symptoms, I don't recommend testing for HIV or other STDs.

Best wishes and stay safe--   HHH, MD