Nov 22, 2002
According to the CDC, an exposure caused by a condom splitting rarely results in HIV transmission - why is this?
Response from Mr. Kull
While the CDC does not provide more explicit information than this (condom breakage rarely resulting in transmission), we can explain some of the possibilities by extrapolating from other pieces of information available.
First of all, condom breakage does not necessarily mean mucous membrane exposure to fluids. Condoms can break or tear in different areas on the condom that are not near mucous membranes, and can also occur without ejaculation. Condoms that break with ejaculation poses a more significant risk to the receptive partner, but the exposure to semen could be significantly less than exposure to fluids without condoms. The receptive partner is still likely to be exposed to a smaller volume of fluid (when compare to not using a condom at all).
We're also looking at odds. Condoms stay intact more than they don't, so you're already working with pretty low odds of transmission per sexual contact. A small proportion of condom breakage results in an uninfected person being exposed to HIV infected fluids. Additionally, if you add up all of the factors that contribute to transmission (viral load of the host, immune response of the uninfected partner, presence of STIs, volume of fluid-mucous membrane contact), a condom used, even if it breaks, reduces the relative risk to not using a condom at all.
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