Last week, a Colorado boy picked up a used condom on his school’s playground and put it into his mouth, apparently thinking it was a balloon. Though this might not seem like news, media outlets across the country, and even internationally, have reported on it extensively. The stories have all focused on his supposed risk of HIV and other sexually transmitted infections (STIs), the years of testing and treatment he might have to face, and the school’s failure to protect him. However, few have checked in with health professionals to see what the danger really was so that other parents could be put at ease about this gross—but relatively common—situation.
The incident was first discussed as the lead story on Denver’s ABC affiliate, KMGH. The anchors introduced the piece by describing it as “any parent’s worst nightmare. An 8-year-old boy finds a used condom on a playground. That little boy is now being tested for [sexually transmitted diseases] after putting it in his mouth thinking it was a balloon.” The rest of the story, which featured a field reporter walking slowly through the playground and speaking to the boy’s mother (who hid behind a tree and only used her first name), was big on melodrama and blame for the school district, but short on statistics about STIs or the student’s actual risk.
The articles that followed didn’t do a much better job balancing fear and fact. The Huffington Post, for example, ran a piece about the situation with a teaser calling this “a potential life-threatening mishap.” It then compared the situation to one in which a child got herpes from a day-care provider and used an irrelevant quote from a pediatrician who said, in reference to that case, that the herpes virus is easily spread. Most articles seemed to rely on the boy’s mother’s quotes from the original television story, in which she said that her son is at risk for HIV, hepatitis C, herpes, chlamydia, and gonorrhea; that it will take a year to be sure that he hasn’t been infected; and that he might be in for “a lifelong [process], millions of dollars in medical bills.” And many outlets pointed out that the school’s spokesperson would not admit fault.
Overall, it seemed like the goal was to alarm rather than educate.
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In reality, however, STIs are rarely transmitted through casual contact of any kind—like toilet seats, handshakes, or shared utensils. And even picking up a used condom is not particularly hazardous.
As always, it’s hard to calculate exact risk of STI transmission. Given that we don’t know the exact circumstances of the boy’s exposure, it would be foolish to say there was absolutely no danger. There are many factors that would contribute to his chances of getting a disease: how long the condom had been on the playground; how much semen was in it; whether it had dried; the position he held it in when he put it to his mouth; and whether he had any open sores on his lips or mouth.
Mostly, though, the determining factor would be whether the semen contained any bacteria or viruses, the concentration of such germs, and how well they hold up outside the body.
HIV, for example, is relatively fragile outside the body. Some studies have found that under laboratory-controlled conditions it can live outside the body for a few days or even weeks in blood, but it is killed by heat, sunlight, and humidity. No studies have ever been done on how well it survives outside the body in semen. However, according to AIDS Map, an international clearinghouse of HIV and AIDS information, “studies which have sought to culture HIV from semen in the laboratory have often found it difficult to do so, indicating the low quantities often present in semen.” More importantly, “HIV transmission has not been reported as a consequence of contact with spillages of blood, semen, or other body fluids.” In other words, according to this organization’s research, no one has ever reported getting HIV from the contents of a used condom.
The Centers for Disease Control and Prevention (CDC), furthermore, does not discuss used condoms, but it does say that exposure to thrown bodily fluids (including blood and semen) has a negligible risk for HIV transmission. The truth is that even direct oral contact with HIV is not much of a threat for transmission: The CDC estimates that the infection rate for unprotected oral sex with an infected partner, whether giving or receiving, is too low to calculate.
There is less precise information available for other STDs, but most do not do well outside of a human host. Gonorrhea, for example, thrives in warm, moist places and therefore cannot live for more than a few seconds outside the body. Similarly, herpes is thought to live for only ten seconds outside the body and transmission typically requires direct contact between infected and non-infected skin. Hepatitis C, on the other hand, can survive outside the body at room temperature for up to three weeks. Again, though, the CDC says that it is not spread by casual contact such as sharing eating utensils, breastfeeding, hugging, kissing, holding hands, coughing, or sneezing. It is also not spread through food or water. In fact, the CDC reports that even sexual activity poses a very low risk of transmission, as the virus is primarily spread by direct blood-to-blood contact such as sharing needles.
The child’s mother is, of course, right to have him tested for all STIs just in case, as some of these diseases can be cured and all can be treated if there is an infection. I am a little confused by her suggestion that the testing process would take a whole year—testing for most STIs can be done right after exposure. When it comes to HIV, the time between infection and possible blood detection is three months at the longest, though newer tests can find it much sooner. Peace of mind is important, and follow-up tests can put lingering anxiety to rest, but it seems inaccurate to suggest it will take a year to know if he’s been infected with an STI.
As I said earlier, used condoms on the playground are certainly gross. They are also, unfortunately, fairly common (I’ve disposed of more than a few myself), and not cause for panic. The young boy involved is likely embarrassed—especially if he knows his story has gone international—but he should not be afraid. And any parent who sees or learns of their own child picking up a used condom should also not be. We should, however, probably remind our children not to put things they find on the ground in their mouths: Other germs, like those that cause the common cold and the dreaded stomach flu, can survive outside the body for awhile and live on objects. So, even if it’s not a condom, it’s best to leave it where it is.