[Question #7632] Hiv Exposure Pep (No idea about condom type used)

2 months ago
Hi doc. had an exposure 2 days ago (in Anaheim, CA) in the evening where I had protected vaginal sex with a woman and I ejaculated in the the condom. It was a random hookup and she is quite into the hookup scene. She also works as a stripper. I asked her if she had any STIs and she she denied having any and she said that she gets tested regularly. I used a condom she had. Anyway, I was worried and got a PEP assessment and my doctor said that I did not need it. So I left. However I worry a lot and found out about lambskin condoms. I never knew about them. My worry is what type of condom she used. It was dark and I couldn't tell. It was white in color (some websites says that lambskin is very white). I am probably being paranoid. She was very careful. After putting on the condom, she put on lube. She also gave me oral after putting on a condom. After I ejaculated, she took the initiative to make sure to hold the condom properly until she got off me so that there will be no slippage or discharge at the end. All in all, I don't think I need PEP. However I am still a bit concerned on the off chance that the condom was lambskin. What do you think?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
2 months ago
Welcome to the forum. Thanks for your question and your confidence in our services.

You really needn't be worried at all about HIV in this situation and I agree with your self assessment that "I don't think I need PEP". I'll start first with noting it's a sign of sexual responsibility, and a low risk of infection, that a condom was used; and that your partner obviously is careful about using them properly. Second, in the US in general and in Southern California, the chance any particular sexually active woman -- including strippers, sex workers, etc -- has HIV is under one chance in a thousand. Third, even without a condom, the average transmission risk, if she did have it, is once for ever 2,500 unprotected vaginal sex exposures.

Finally, and perhaps most important given your concerns, condoms work -- and the type of condom makes no difference. If a condom remains intact, i.e. doesn't break wide open, protection is complete. That natural membrane condoms in theory are less safe has never been proved to be a problem in real life:  any barrier is better than none, and there are no reports of anyone getting HIV despite use of a natural membrane condoms. Any increased risk is trivial. In any case, it seems unlikely your partner uses such condoms routinely:  given the evidence of sexual safety and responsibility she shows, it would be very surprising if she doesn't use latex or polyurethane condoms.

So all is well. I don't recommend HIV or STD testing, let alone PEP in this situation.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD
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2 months ago
Thank you doctor. That helps a lot. I will not get PEP. I have never done random hookups before and this made me nervous. That along with all online websites saying that animal membrane condoms were not effective also scared me. I know most websites are very conservative about risks(so that they are never wrong and maybe for legal reasons), but they could at least say that the risk of using a lambskin condom only increases the risk by a trivial amount. Thank you again.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
2 months ago
It is untrue that natural membrane condoms are "not effective". As suggested above, there are theoretical concerns that might reduce effectiveness, but this has never been shown to actually be a problem. It's never actually been researched in any detail at al, i.e. there are no studies of regular users of natural membrane vs latex condom users to learn whether one groups has higher STD/HIV rates than the other. But based on all we know -- including the science of fluid dynamics and passage of fluids through small pores -- suggest little increased viral or bacterial transmission risk. As I said above, logic alone dictates that any barrier is better than none. Of course, you're exactly right that advice from many websites and agencies, including scientific and respected ones, sometimes is colored by a CYA legal philosophy. Still, you can reduce that sort of misinformation by relying on professional (or professionally moderated) sites -- they aren't immune to the legal issues, but in general the errors will be fewer and less egregious.---
2 months ago
Thank you again. I won't worry about this anymore.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
2 months ago
I'm glad to have helped. Thanks for the thanks. Take care and stay safe.---