HIV - Prevention Expert Forum
Lambskin Condoms
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This forum is limited to prevention of HIV and to safe sex in general. All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Lambskin Condoms

I dated a woman of unknown status recently briefly. We had intercourse maybe a total of 6-8 times. She had a latex allergy so we used lambskin condoms. I didnt notice the warning on the box about there being no HIV protection. I've never used them before and was ignorant. I don't even think SHE knows about the lack of HIV protection.  She has used them with an unknown number of partners. However, she is from a very rural low risk area (northern NH). A couple of questions.

1) Should I bother being tested? I'm a mathematical person by nature and understand the odds are probably minimal. Its been 6 weeks at this point since last contact.

2) Whats the deal with lambskin? Did I get any protection? I know now that the pores are theoretically large enough to pass the virus but there has to be at least some reduced risk?

Thanks
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You ask an interesting and important question, but one that hasn't come up very often on the forum.  I'm happy to address latex (or polyurethane) versus natural membrane (e.g., "lambskin") condoms.  The quick answers to your specific questons are 1) I see no need for HIV testing in this circumstance and 2) I agree with your common-sense conclusion that "there has to be at least some reduced risk" -- probably a lot of reduced risk.

For 20+ years, it has been almsot universally stated by health authorities and health education websittes that latex condoms (or, more recently, polyurethane) protect against HIV transmission and that natural membrane condoms may not, because of natural pores in the membranes through which secretions and virus might pass.  Some sources go so far as to say there is no HIV protection.

However, that advice has been based almost entirely on assumption, not data.  To my knowledge, there are no reports of HIV transmission occuring through a natural condom that did not overtly rupture.  HIV transmission risk is depends on the amount of virus exposure, and in general large amounts of virus have to gain access to susceptible cells in places like the urethral lining, the thin skin under the foreskin, or the lining of the cervix or rectum.  On common-sense grounds, it seems very likely that an intact natural membrane condom markedly reduces, and probably entirely prevents, exposure to sufficient virus to result in HIV infection.  Even the relatively large pore size probably makes little difference.  Even with pores quite a bit larger than the diameter of the virus, fluid dynamics (surface tension and related issues) generally prevent significant amounts of fluid pasage.

For sure, I agree with your own conclusion that using such condoms is much safer than not using a condom at all, and I believe they have gotten an undeserved bad rap.  Someone who finds latex or polyurethane condoms unacceptable, but who is happy with natural membranes, definitely should use them rather than having unprotected sex.

Bottom line:  1) As I said, I see no need for HIV testing, at least not from a risk assesment perspective.  But of course feel free to do it if you'll feel better with a negative test. 2)  Latex or polyurethane condoms remain preferred, but natural membrane condoms almost certainly are an acceptable substitute if the former are unacceptable to the user.

I hope this helps.  Best wishes--  HHH, MD
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H. Hunter Handsfield, M.D.Blank
University of Washington
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