How to reasonably evaluate risk after a broken condom
October 17, 2013 7:31 AM Subscribe
I am a woman on hormonal birth control and in a mostly monogamous relationship with a guy. My boyfriend recently had sex with a woman who's been having unprotected sex with multiple partners, and the condom broke (pregnancy is not a concern). What's a reasonable course of action from here?
I'm okay with the protected sex risk but I don't want to spend months using condoms with my boyfriend. How many days should he wait to get tested? Getting test results from the other woman may not be possible, but we can try. If it matters, the demographic of everyone involved is 20-30s undergrad or grad student.
I'm okay with the protected sex risk but I don't want to spend months using condoms with my boyfriend. How many days should he wait to get tested? Getting test results from the other woman may not be possible, but we can try. If it matters, the demographic of everyone involved is 20-30s undergrad or grad student.
I would evaluate this risk as trivial. Most STIs travel more easily from men to women than vice versa, and a broken condom is lower risk than unprotected sex for STI transmission.
Also, it sounds like this woman has no known STIs. I really would not worry about it at all.
Your risk tolerance may vary.
posted by 256 at 8:19 AM on October 17, 2013 [2 favorites]
Also, it sounds like this woman has no known STIs. I really would not worry about it at all.
Your risk tolerance may vary.
posted by 256 at 8:19 AM on October 17, 2013 [2 favorites]
this woman has no known STIs
Um, she's having unprotected sex with multiple partners (STI status presumably unknown), and a lot of STIs are both common and asymptomatic. The chances of her having something without knowing it are not trivial.
It does depend on your risk tolerance but I'd absolutely take a condom over the risk of getting a serious STI, unless you know this woman's partners are STI-free. The risk of HIV in this case is pretty low (depending on the demographics of the woman's other partners) but still higher than my comfort level. The risk of other STIs is pretty high, again depending on her partners.
3 months is the standard wait time for highest accuracy (shorter for some STIs). If you don't care so much about accuracy and would be fine with "eh probably don't have it" or only care about a particular STI, you could wait a shorter time. I'd still use protection for at least a month though.
posted by randomnity at 8:43 AM on October 17, 2013 [10 favorites]
Um, she's having unprotected sex with multiple partners (STI status presumably unknown), and a lot of STIs are both common and asymptomatic. The chances of her having something without knowing it are not trivial.
It does depend on your risk tolerance but I'd absolutely take a condom over the risk of getting a serious STI, unless you know this woman's partners are STI-free. The risk of HIV in this case is pretty low (depending on the demographics of the woman's other partners) but still higher than my comfort level. The risk of other STIs is pretty high, again depending on her partners.
3 months is the standard wait time for highest accuracy (shorter for some STIs). If you don't care so much about accuracy and would be fine with "eh probably don't have it" or only care about a particular STI, you could wait a shorter time. I'd still use protection for at least a month though.
posted by randomnity at 8:43 AM on October 17, 2013 [10 favorites]
Mod note: Comment removed - quit arguing
posted by jessamyn (staff) at 8:54 AM on October 17, 2013 [4 favorites]
posted by jessamyn (staff) at 8:54 AM on October 17, 2013 [4 favorites]
I think this might be a question best posed to Planned Parenthood or the student health center, especially since what is reasonable to me might not be reasonable to you.
posted by sm1tten at 8:55 AM on October 17, 2013 [2 favorites]
posted by sm1tten at 8:55 AM on October 17, 2013 [2 favorites]
In the evaluation of risk (which is part of my job), I often suggest to people that even a small risk of a life-threatening illness is not worth taking if the reason for taking the risk is simply for comfort's sake.
In most cases, I'm counseling people to stay in the hospital for a single night to get checked out for possible heart disease, which they refuse to do because "I have things to do" or "I have to feed my cat" or some such thing. In my mind, even if the risk of dying of a heart attack is extremely low, I see no reason to take that risk because I can't be bothered to find someone else to feed my cat. I don't believe that my cat not missing a meal is more important than a potential threat to my life, although I meet people every day who feel differently.
I elaborate on that because in your case, you're weighing whether to use a condom for a few months (discomfort/convenience) versus the very small risk of a life threatening illness (HIV). I assume based on the wording of your question that you would rather have condomless sex and need to potentially take antibiotics or antivirals for such non-life-threatening STDs as herpes, chlamydia or gonorrhea, so we'll ignore those risks. Here is a chart from the CDC on the transmission risk for HIV. Although it's probably somewhat lower, we'll count a broken condom as being equal to a single act of unprotected penile-vaginal intercourse: probability 10 in 10,000 of contracting HIV (i.e. 1 in 1000). A small risk, but I believe that most reasonable persons would not take those odds of contracting HIV if it could be easily avoided.
If the exposure was amongst those listed as "negligible" (i.e. spitting), I believe the reasonable course of action would be to just move on and forget about it and go on your condomless way. However, in your case, I believe that using a condom for 3 months with your boyfriend is the most reasonable course of action.
posted by treehorn+bunny at 9:34 AM on October 17, 2013 [21 favorites]
In most cases, I'm counseling people to stay in the hospital for a single night to get checked out for possible heart disease, which they refuse to do because "I have things to do" or "I have to feed my cat" or some such thing. In my mind, even if the risk of dying of a heart attack is extremely low, I see no reason to take that risk because I can't be bothered to find someone else to feed my cat. I don't believe that my cat not missing a meal is more important than a potential threat to my life, although I meet people every day who feel differently.
I elaborate on that because in your case, you're weighing whether to use a condom for a few months (discomfort/convenience) versus the very small risk of a life threatening illness (HIV). I assume based on the wording of your question that you would rather have condomless sex and need to potentially take antibiotics or antivirals for such non-life-threatening STDs as herpes, chlamydia or gonorrhea, so we'll ignore those risks. Here is a chart from the CDC on the transmission risk for HIV. Although it's probably somewhat lower, we'll count a broken condom as being equal to a single act of unprotected penile-vaginal intercourse: probability 10 in 10,000 of contracting HIV (i.e. 1 in 1000). A small risk, but I believe that most reasonable persons would not take those odds of contracting HIV if it could be easily avoided.
If the exposure was amongst those listed as "negligible" (i.e. spitting), I believe the reasonable course of action would be to just move on and forget about it and go on your condomless way. However, in your case, I believe that using a condom for 3 months with your boyfriend is the most reasonable course of action.
posted by treehorn+bunny at 9:34 AM on October 17, 2013 [21 favorites]
The previous answer (by Treehorn+Bunny) misreads the table (which I assume means this table) in two ways. Firstly, the risk from "Insertive penile-vaginal intercourse" is 5/10,000 not 10/10,000 (it is this act that is being considered as the source of risk). Secondly, and more importantly, this is the risk where it is known that the source is infected, which is not the case in this example.
posted by Jabberwocky at 10:41 AM on October 17, 2013 [8 favorites]
posted by Jabberwocky at 10:41 AM on October 17, 2013 [8 favorites]
I wouldn't have non-monogamous (and yes, "mostly monogamous" is the same as non-monogamous when it comes to risk of STIs) sex without a condom, ever. Because there are lots of STIs (herpes, HPV, etc.) against which even perfect condom use does not provide full protection, I'd insist that my non-monogamous partner use barrier methods both with other partners and with me, every time.
It sounds, however, as though you are less risk-averse than I am, since you've been having condomless sex with your non-monogamous partner until now. So I think you have to ask yourself some hard questions about whether you're more afraid the diseases you may be at higher risk of exposure to now, compared to the risk you've been comfortable taking with the diseases you were always at risk of exposure to. There's statistical data on prevalence of disease, transmission rates, seroconversion, etc., available for all of these diseases, and you've been given some excellent links above. But at base, this is a personal emotional decision, and you need to make it for yourself, just as you've made the decision to accept some risk in having non-monogamous sex without a condom up until now.
posted by decathecting at 11:23 AM on October 17, 2013 [1 favorite]
It sounds, however, as though you are less risk-averse than I am, since you've been having condomless sex with your non-monogamous partner until now. So I think you have to ask yourself some hard questions about whether you're more afraid the diseases you may be at higher risk of exposure to now, compared to the risk you've been comfortable taking with the diseases you were always at risk of exposure to. There's statistical data on prevalence of disease, transmission rates, seroconversion, etc., available for all of these diseases, and you've been given some excellent links above. But at base, this is a personal emotional decision, and you need to make it for yourself, just as you've made the decision to accept some risk in having non-monogamous sex without a condom up until now.
posted by decathecting at 11:23 AM on October 17, 2013 [1 favorite]
Rereading my last comment, I'm worried that I may have come across as judgmental, and I didn't mean to at all. Your personal risk tolerance is a very personal, private decision, especially in sexual matters. So I don't necessarily think there is a "reasonable" way to make this decision, so much as there is a way that is reasonable for you given your own feelings and preferences. For me, a condom is a really minor inconvenience, and I really hate the idea of contracting an STI, even a minor, treatable one (probably in part because I loathe going to the gynecologist). But that's me. It sounds as though you dislike condoms a lot more than I do and are more risk-tolerant than I am about barrier protection. And that's totally your call.
I'd almost put this question in the same category as the "Can I Eat This?" questions that people post to AskMe pretty frequently. We can tell you the annual rates of salmonella and listeria poisoning, but we can't tell you how to weigh those risks against the deliciousness of the stew you accidentally left unrefrigerated overnight. That's a choice you have to make for yourself. And so long as you're open and honest with current and future partners about activities you've engaged in that might put them at risk, there's no objective right or wrong about it.
posted by decathecting at 1:36 PM on October 17, 2013
I'd almost put this question in the same category as the "Can I Eat This?" questions that people post to AskMe pretty frequently. We can tell you the annual rates of salmonella and listeria poisoning, but we can't tell you how to weigh those risks against the deliciousness of the stew you accidentally left unrefrigerated overnight. That's a choice you have to make for yourself. And so long as you're open and honest with current and future partners about activities you've engaged in that might put them at risk, there's no objective right or wrong about it.
posted by decathecting at 1:36 PM on October 17, 2013
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It looks like most results usually show up within 10 weeks, but waiting 12 weeks before testing would give more accurate results. You'll have to decide on your own risk-tolerance.
(On preview, this is the same link).
posted by insectosaurus at 7:39 AM on October 17, 2013