[Question #3176] Lambskin condom

91 months ago

Hi Dr Handsfield,

I am 32 years old middle eastern male(circumcised) without any STD, It was a week ago that I had a sex with a white sex worker in SC, Columbia, she asked me about protection and of course I had one. However I did not notice that it was a lambskin condom. I had 5 mins of protected vaginal sex and I ejaculated inside, condom were intact all the time.

I do not know her HIV status and I believe she was not a drug user, at least she looked healthy. I am monogamous and it was my first time after few years of being in the relationship with my wife. My concern is what is the chance that I am infected by HIV, I am asking this since I've read on the internet that lambskin condoms have pores that viruses can pass from them. I developed health anxiety and could not sleep since last week. I have burning sensation on my skin and I dont know whether it has something to do with the HIV or it is my anxiety.

Thank you so much.

Edward W. Hook M.D.

91 months ago

Welcome to our Forum. Dr. Handsfield and I share responsibility for answering questions. I will be answering your question today.

You are correct that years ago studies showed that lamb skin condoms had small pores in them which would theoretically allow the HIV virus to pass through them. Despite this however I would classify your single exposture to a CSW as being relatively low risk for acquisition of HIV or other STI. I say this based on the following facts:

1. Most CSWs in Columbia S.C. Do not have HIV. Certainly less than 5% and probably closer to 1%. That your partner asked about condom use suggests that her risk might be lower than that.

2. Even if she were infected, most HIV is transmitted, on average, less than once in every 1000-2000 acts of vaginal intercourse.

3. The condom is likely to have offered at least partial protection.

The symptoms you report however is not a sign of recently acquired HIV and is far more suggestive of anxiety and being hyper aware of normal sensations which you normally would not notice.

As I said, you risk for acquisition of a HIV is quite low. Nonetheless at about four weeks I would suggest you consider obtaining a test using a combination HIV antigen- antibody test at least 4 weeks after your exposure. These tests are 99% accurate at 4 weeks and entirely conclusive any time more than 6 weeks after exposure.

I hope this information is helpful. EWH

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91 months ago

Thanks a lot Dr Hook for your quick and informative response.

Today I booked an appointment for the test which will be in three weeks from now.
Just one question, today I felt extreme weakness in my legs and a little bit of skin rash on my back, not sure if these are related to my last week exposure or my anxiety is mimicking these symptoms.

Thanks a lot

Edward W. Hook M.D.

91 months ago

The symptoms you describe are not suggestive of recently. Acquired HIV. Some persons with recently acquired HIV experience a syndrome called the Acute Retroviral Syndrome (ARS) typically between two and four weeks after acquiring HIV which consists of high fever, sore throat, muscle and joint aches and, sometimes a skin rash or diarrhea, all occurring at the same time. Leg weakness is not part of the ARS and a localized rash on the back does not sound like the ARS.

I want to restate that your exposure was low risk and while theoretically less effective than latex condons, your lamb skin condom further reduced your risk for infection beyond its baseline risk. Please don't worry. EWH

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91 months ago

Hi Dr Hook,

Thanks a lot for your response, I gave a NAAT test here in Vancouver, BC; 11 days after the exposure that I explained. Today I received the result and it was negative, I was told that it is over 90% accurate (from 10 to 14 days after exposure). Shall I re-do the test after 4 weeks or I should consider this as a conclusive result? I am not too sure whether this NAAT test is as advanced as the tests that are offered in the US.

In the past 3 weeks, reading professional advices from you and Dr Handsfield calmed me down, unfortunately there are too many websites and forums that cause more anxiety to those people who are worried about their health. I truly appreciate what you and Dr HHH do for all of us all around the world.

Edward W. Hook M.D.

90 months ago

Given the circumstances of your exposure, I really see no need for further testing.

Sorry for the delay in getting this final reply to you. EWH

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