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Ivory81000
  Posted: 1/29/2008 10:47 PM Subject: What‘s the chance of getting an STI/STD when using a condom
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Hi,

I‘m new here and have a problem. I wasn‘t sure wher eto turn to and that‘s how I came to this website.

I‘ve been seeing this guy for awhile and we‘ve had sex. Because we live in 2 different cities we‘re having an open relationship until the summer where I move back. He believes that whatever happens between him and any other girls stays between them and the same with us - whatever happens between him and me stays between us. I don‘t have a problem with this.

But since we are sleeping together I said that if he wants to have sex with me I think he should get tested and show me documentation that he‘s clean. I won‘t know his sexual history or any of the girls he might have slept with and this way I know I‘m safe. He can do everything in his power to protect me but condoms aren‘t 100% effective, some things can be transmitted in other ways and if I happen to get infected then I know I did everything in my power to protect myself.

Here‘s what he said:
-If I trusted him I wouldn‘t worry about it because he‘ll be safe. I know the type of guy that he is and he will do all he can to be safe but nothing is fool proof right?
-The chances of getting an STI/STD when wearing a condom is very small. Since we see each other about once a month he would be getting tested about once a month until mid-May.
-It‘s a hassle for him to go to the doctors that frequently.
-I‘m being obsessive and paranoid.

In the end I gave him an ultimatum:
1) Get tested before you see me if you want to have sex with me. Otherwise I won‘t have sex with you - intercourse or oral.
2) If you don‘t want to see me because of this then fine, I‘m willing to accept that.


My questions are:
-How small are the chances of getting an STI/STD when wearing a condom? When I‘m looking at stuff it just says the the risks are reduced but not by how much.
-Do you think I‘m right in this case? Or is he right and I‘m being too paranoid? Should I not really bother with him getting tested and sleep with him anyway?


hopeless_dreamer
  Posted: 1/31/2008 9:26 PM Subject: Whats the chance of getting an STI/STD when using a condom
WomanSaver MoFo
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The questions you are asking are difficult to answer, but theyre precisely the right questions to ask.

The actual percentages that condoms decrease chances of std transmission are not known by any decent certainty. Thats why the sources dont quote actual numbers. Additionally, the tranmission rate varies from one virus/bacteria to another, so there is no single number that you could go by. Gonorrhea has one type of infectivity rate and herpes has another. Using a condom does decrease your overall risk for infection across the board, but does not elimintate it.


I cant give you full numbers because I dont know them for all of the diseases. However, I do remember reading a recent journal paper on HPV. There was a recent study  published in June of 2006 in the New England Journal of Medicine on the transmission of HPV to young women (college students) who did not have HPV at the start of the study. The study looked at how condom usage affected infectivity rate with HPV. Of the women who were sexually active and used a condom less than five percent of the time, their incidence was 89.3 per 100 patient-years at risk (Ill explain this in a moment). Of the women who always used a condom, their incidence was 37.8 per 100 patient-years at risk. What this means is that in each category of women (say you had 100 of each group) after one year of sexual activity, you would expect 89 of the women in the first category to have HPV and 38 of the women in the second category to have HPV. Technically, these arent percentages, but you can think of them that way.

The study is somewhat frustrating because it doesnt give raw numbers, but it does goes on to say that after adjusting for the number of partners that the women had (more partners increases risk of infection), it turns out that good condom use reduces your chance of infection by about 70%. Sadly, the study doesnt say what it drops it from, but you can imagine something on the order of a 15-30% chance of infection with perfect condom use under this statement. If you take in all the data as a whole, its basically saying that condoms do help decrease HPV infectivity, but does not eliminate it. Even with perfect condom usage, your risk of getting HPV lies somewhere between 15-40% if you have intercourse with an infected partner.

Do I think your concerns are valid? Absolutely. You are not being paranoid. The study showed that the greatest risk was with those women who had multiple partners, or whose partner had multiple partners. This places you at quite a risk of infection, even with perfect condom use. Frankly, I wouldnt trust him to get tested regularly (or get tested and then not have sex until he sees you). Its really a false sense of security, and hes not going to stick to it anyhow. Even with testing, theres no easy way to ensure you are protected when he has multiple partners (there are issues of latency and false negatives, etc). Good luck with your decision.

In case youd like to read the article yourself, it is titled Condom Use and the Risk of Genital Human Papillomavirus Infection in Young Women. It was published in the New England Journal of Medicine in June of 2006. Its pubmed ID is 16790697. Links are below.

Abstract & links:
http://content.nejm.org/cgi/content/abstract/354/25/2645

Full Article Text:
http://content.nejm.org/cgi/content/full/354/25/2645

PDF of article:
http://content.nejm.org/cgi/reprint/354/25/2645.pdf


Ivory81000
  Posted: 1/31/2008 9:34 PM Subject: Whats the chance of getting an STI/STD when using a condom
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Hmmm. . .Thanks a lot for your reply. I don‘t really know what to think/do now.

If he said he‘d get tested and shows me documentation, how do I know it‘s real? By the way, I‘m Canadian. Is there a universal symbol on it or something so I can be sure he did get tested?

I want to be safe but at the same time I do want to have sex with him.  I don‘t know what to do.


Dr.WomanSaverM.D.
  Posted: 1/31/2008 9:39 PM Subject: What‘s the chance of getting an STI/STD when using a condom
WomanSaver MoFo
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Ivory81000 wrote:
Hi,

I‘m new here and have a problem. I wasn‘t sure wher eto turn to and that‘s how I came to this website.

I‘ve been seeing this guy for awhile and we‘ve had sex. Because we live in 2 different cities we‘re having an open relationship until the summer where I move back. He believes that whatever happens between him and any other girls stays between them and the same with us - whatever happens between him and me stays between us. I don‘t have a problem with this.

But since we are sleeping together I said that if he wants to have sex with me I think he should get tested and show me documentation that he‘s clean. I won‘t know his sexual history or any of the girls he might have slept with and this way I know I‘m safe. He can do everything in his power to protect me but condoms aren‘t 100% effective, some things can be transmitted in other ways and if I happen to get infected then I know I did everything in my power to protect myself.

Here‘s what he said:
-If I trusted him I wouldn‘t worry about it because he‘ll be safe. I know the type of guy that he is and he will do all he can to be safe but nothing is fool proof right?
-The chances of getting an STI/STD when wearing a condom is very small. Since we see each other about once a month he would be getting tested about once a month until mid-May.
-It‘s a hassle for him to go to the doctors that frequently.
-I‘m being obsessive and paranoid.

In the end I gave him an ultimatum:
1) Get tested before you see me if you want to have sex with me. Otherwise I won‘t have sex with you - intercourse or oral.
2) If you don‘t want to see me because of this then fine, I‘m willing to accept that.


My questions are:
-How small are the chances of getting an STI/STD when wearing a condom? When I‘m looking at stuff it just says the the risks are reduced but not by how much.
-Do you think I‘m right in this case? Or is he right and I‘m being too paranoid? Should I not really bother with him getting tested and sleep with him anyway?


Hi Ivory81000.

I have to tell you first of all, the arrangement between you and your boyfriend is considered very risky behavior.  Whether he is using condoms or not and whether you two are getting tested or not, there is still a risk of passing sexually transmitted infections to each other.  Here‘s why:
1. As you know condoms are not 100% effective against spreading STDs.  The statistics can be a bit misleading or confusing but in general condoms are supposed to be about 98% effective if used consistently (every time you have sex) and correctly (worn in the proper manner).  But we are human and sometimes slip up, or make mistakes and don‘t use condoms consistently or correctly, so if you take an average, considering human error, condoms are only around 85% effective.  The numbers I have stated are just rough estimates. The effectiveness will decrease even further if used less consistently or improperly.
2.  Getting tested monthly doesn‘t guarantee that he is STD-free.  For example HIV can take 3-4 weeks or even longer to show up on a routine screening test, and multiple tests are needed to confirm the HIV status.  So he could test negative, and still be carrying HIV, putting you and any other sexual partners at risk of getting infected.

My suggestions:
-Avoid being in any relationship where you feel your partner may be putting you at risk knowingly or repeatedly. 
-As far as possible try to maintain a monogamous relationship with one partner.
-Use latex condoms every time you engage in sexual activity with your partner and be sure you know how to use them correctly.
-If there is any doubt, you AND your partner should get tested and treated for any possible infections, and avoid having sex till you both are done with your treatment.
-See your ob/gyn for regular PAP smears.

It shouldn‘t really matter what the exact percentage risk is... Any percentage is a big risk when it comes to your health and possibly your life... Stay safe.

-DrWS


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