[Question #1579] Lambskin condom and HIV risk

46 months ago
Hi, Doctors -

I'm sure you're familiar with the Tinder dating app. 

I met a girl last night at a hotel who I matched with on Tinder. She didn't look like her picture but I decided to have sex with her anyway.

I had brought several durex condoms with me but she told me she was allergic to those and that we needed to use lambskin condoms. I had sex with her for about a minute or two before I pulled out. The condom didn't break but afterwards I googled more information about lambskin condoms and a-lot of sources online say that they don't protect against HIV.

I asked her twice before sex if she had any STDs and she said no. 

This took place in Northern Indiana (South Bend, Indiana) where her and I are both from. I don't think the HIV rates are too high in this area but I don't know for certain. She was black and I think potentially from a poorer family. 

Do I need to get tested over this?

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Welcome back to the forum.

I also reviewed your earlier discussion with Dr. Hook. One basic fact you should understand is that heterosexual transmission of HIV averages only once for every 1000-2000 episodes of vaginal sex with infected partners. Statistically it is unlikely your recent partner has HIV -- probably under one chance in a thousand. So we can roughly estimate your risk of HIV from this event, if it had been unprotected, at 1 in a million (1/1000 x 1/1000 = 1 in a million). Further, as Dr. Hook mentioned in your earlier thread, people rarely lie about HIV/STD status when asked directly. So the chance your partner had HIV and your risk probably even lower than this estimate. 

As for natural membrane condoms, there indeed have been many statements over the years -- sometimes from public health agencies that should know better -- that they do not protect against HIV or other STDs. That is simply untrue. Any barrier is better than none. Although there are pores in natural membranes, the amount of fluids that can seep through them is very small. There has in fact never been any research study that examined how well latex vs natural membrane condoms work for HIV/STD prevention, there also have een no reliable scientific reports of anybody catching HIV because they used the wrong kind of condom. Latex (or polyurethane) condoms have been better studied and are preferred, but the actual elevated risk from natural concoms undoubtedly is very small and they may in fact be equally safe. (If you are in touch with your partner, you could tell her about polyurethane condoms, which have no pores and are beleived to be truly equivalent in protection to latex -- and can be used by latex allergic persons.)

I almost never recommend testing for HIV or other STDs after any single exposure unless much higher risk than this -- e.g. unprotected sex wtih a known infected partner (unless of course symptoms appear). A smarter approach for dating singles or men who occasionally have commercial sex partners is to plan on testing at regular intervals, such as once a year. However, you certainly could test in a few weeks if you wish. Some people will be more reassured by negative testing than by expert analysis based on science, probabilities, and statistics. So it's up to you -- although if somehow I were in your circumstances, I wouldn't do it myself.

I hope this has been helpful. Let me know if anything isnt' clear.

HHH, MD

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46 months ago
Thanks that is helpful. I worry a-lot about my health and should probably stop putting myself in these situations. I recently got out of a long term relationship so it has been hard adjusting to the lack of regular sex I was engaging in before. But thanks again for your help. Take care. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Thanks for the thanks. I'm glad to have helped.

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