Yes. Condoms are valuable because they make for safer sex, but not safe sex. An important factor in safety is, of course, the time when the condom is first worn. Though they are not usually worn during foreplay, it is during this stage of lovemaking that close bodily contact obviously occurs, as indeed it does after the man has lost his erection and the condom has been removed. Warts, herpes, and syphilis may all be handed down through close bodily contact. If there is contact with the penis and the vulva even if there is no erection, or ejaculation, chlamydia or gonorrhoea might be transmitted.

In a large survey done when I was working in a sexually transmitted diseases clinic we found that chlamydial infections were more usually transmitted despite a condom being worn during actual penetrative sex, than was gonorrhoea.

Recent research has shown that, contrary to popular belief, HIV can be transmitted through oral sex. Obviously gonorrhoea can also be spread in this way.

When the doctor says you can catch HIV from fluids, eg, blood, does that include vaginal fluid? Can you catch it only if you have a big cut? I’ve heard that normally your body has greater pressure than the environment and therefore the germ cannot get into your body even with a cut. Is this true? Name and address withheld

HIV can certainly be caught from cervical and vaginal fluids. There was a myth that it was impossible to catch HIV from women - nothing could be greater nonsense, even though the Government for a time in the 1980s encouraged this view. HIV is very readily caught from vaginal fluids, and in many parts of the world is now the principal way in which HIV is spread. Men don’t have to have a big cut, or even an abrasion. The skin beneath the foreskin on the penis is sufficiently porous to allow the HIV to pass through it. Don’t believe all you hear. HIV, although not as readily spread as some other infections, doesn’t need cuts, scratches, abrasions or bruises to penetrate the circulation.

Is hepatitis C sexually transmitted? If so, how? Can it be caused by poor health or sanitary conditions, such as in underdeveloped countries? Louis Armand, Thousand Oaks, USA

Hepatitis C is sexually transmitted. It is a blood-borne complaint, but there may not have to be obvious bleeding. Hepatitis C is more readily transmitted than HIV. It is probably also present in other bodily fluids, but this is not absolutely certain. Obviously when people are living closely together there are a great many ways in which there may be transmission of blood other than through sexual intercourse, but it isn’t spread by contaminated food, poor hygiene, etc. As is widely known, dirty needles, shared needles, etc, used in drug abuse is a possible cause and in the past, blood transfusions were. However, blood used for transfusion is now very carefully checked for Hepatitis C but many long standing cases of this disease stemmed from this cause.

My sister-in-law was recently diagnosed with trichomoniasis, which caused a great deal of disruption to the whole family of seven children and husband. They are now separated and the husband has had a test for the disease and been given the all clear. How could this disease have been contracted by the wife when the husband still shows no sign of infection? Name and address withheld

Obviously we cannot talk about your sister-in-law’s particular case as we don’t know the circumstances and haven’t carried out an examination, etc. In general, three important facts have to be recognised about trichomonas vaginalis infection (“TV”):

(1) TV can’t usually be detected in the male. It usually presents very minimal, if any, symptoms in the man; he may notice a slight tingling at the end of his penis, very minimal discomfort when passing urine. He may have thought the skin around the opening of his penis was very slightly pinker than usual, and could even have had a minimal discharge. The symptoms are absolutely unnoteworthy with TV, and many don’t have any at all. Likewise it is very hard to culture TV from swabs taken from a man.

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