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Last month, I had sex with a woman. After about 10 minutes of intercourse, she took the condom off, performed oral sex for about a minute, and put the used condom on inside out. I think her vaginal fluids must have been on the condom and now I am scared that if her vaginal fluids contained HIV, I could have been infected.

How likely is that?
Answered by: Anke Ehrhardt

Since HIV/AIDS is a serious illness, it can be natural to be concerned about the possibility of infection. However HIV is not an easily transmitted virus. HIV is not passed along by routine or household contact, and only rarely by only limited or fleeting sexual contact.

Condoms are a highly effective means of preventing HIV transmission, but only if they are used consistently and correctly. Certainly, the scenario you describe does not constitute correct use on several levels. Although HIV cannot remain intact for very long in the open air, it is possible that a very small amount of infectious bodily fluids could theoretically have been transmitted in the brief time you described. For transmission to occur, at least five conditions would have to have been met:

1) she would have to be HIV-positive;

2) her current viral load would have to be sufficient for her to be infectious;

3) some significant quantity of vaginal fluids would have to be adhering to the condom, and not wiped away during the removal and replacement process;

4) you would have to have had a cut, abrasion, or other site on the penis where HIV could enter your bloodstream; and

5) HIV would have had to successfully entered and infected you.

The cumulative possibility that all five of these conditions were met in your situation is quite low, although not theoretically impossible. However, other sexually transmitted infections can be transmitted more easily, and thus you might consider making an appointment at an STI/HIV testing and counseling facility.

You could begin by visiting the website of your local health department. You may also wish to include STI/HIV testing as a routine part of your health care check-ups.

To better acquaint yourself with misconceptions and realities concerning HIV transmission, you may wish to visit the HIV transmission section of the website of the Center for Disease Control and Prevention (CDC) (http://www.cdc.gov/hiv/resources/qa/transmission.htm), which offers answers to commonly asked questions. You could also check the HIV transmission Q&A board at the comprehensive website The Body (http://www.thebody.com/Forums/AIDS/SafeSex/index.html).

If you find that you are experiencing excessive, persistent, or unwarranted fears of HIV infection, please consult a qualified mental health care provider who can help you understand and address the underlying causes of your concerns.

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Anke Ehrhardt, Ph.D.
Center Director and Principal Investigator 

Dr. Anke A. Ehrhardt is the Vice Chair for Academic Affairs and a Professor of Medical Psychology in the Department of Psychiatry at Columbia University and has been the Director of the HIV Center since its beginning in 1987. She came to Columbia University from the State University of New York at Buffalo where she co-directed the Program of Psychoendocrinology at Children’s Hospital.
Dr. Ehrhardt is an internationally known researcher in the field of sexual and gender development of children, adolescents, and adults. For the past 35 years, her research has included a wide range of studie...
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