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New Question About Lambskin Condoms Not In Archives
Nov 27, 2003

Dear Doctor:

PLEASE HELP!!!

First off, thank you for your warm, caring but straight-forward advice and counseling that you provide in this forum. You are helping to save lives, and improve the quality of life for many.

My question: Are there any clinical studies about lambskin condoms? I understand that there have been lab studies which demonstrate that the HIV virus is smaller than the holes in lambskin condoms, therefore the virus can pass through. However, is this a theorhetical conclusion only? Is there any practical evidence of transmission? I have read (or perhaps misread) that the virus does not exist by itself, and must attach itself to something (like a cell.....is my medical non-expertise showing?); following this thought, although the virus is small enough to pass through a lambskin condom hole, the cells in which they inhabit are not small enough, and therefore the practical risk of transmission is neglible. This theory aside, I have also read (in this forum in the archives) that using a lambskin condom is better protection than not using anything. I have also read in this forum that using a lambskin condom is exactly like using no protection at all.

I know that as a prescriptive measure, the answer is clear -use a latex condom. However, like many questions in your forum, my question in part relates to past activity, not future conduct. There is a part that does relate to future conduct however. You see, the activity in question was engaged in by my wife, who had an affair over several months with one man, and a one night stand with another man. Now that most of my anger has subsided, and we both are endeavoring to heal our relationship, the question arises as to whether I continue to sleep with my wife without using a condom. If my wife has placed hereself at risk, then I would be placing myself at risk if I continue to sleep with her without the aid of a condom.

As you can imagine, I am going through a difficult situation as a result of discovery of the affair. Anger, guilt (did I cause her to have an affair?) and other emotions aside, I have two children with my wife, and I need to make responsible, informed decisions, while trying to heal my marriage. Using a condom with my wife could "insult" or "scare" her, since the only reason I would be using the condom is as a result of her past conduct. On the other hand, if I do not use a condom, I am increading my own risk of infection, and worst case scenario, my kids would end up with no parents a lot earlier than necessary.

A few additional facts: There is no indication or knowledge that either of the men my wife was with were HIV positive. The man that my wife was with the most was the one who used lambskin condoms and claims that he has been tested several times as a part of his routine blood work, that he is negative, that he is straight, and that he has been in monogamous relationships most of his life (hard for me to believe though since he was married at the time; besides, I grew up believing no one is sex, and only practiced safe sex). The other man with whom my wife was with only twice is of unknown status completely, the condom that was used was of unknown material, that he claimed he was straight, but I do know he used cocaine and claimed never to used IV drugs.

Final facts: all this happened while I was in China for several months on business, and when I got back, I had slept with my wife twice unprotected before I found out, and then had all these issues to deal with. So, I am already at potential risk.....

Final words: Please post this or in your answer please point out to women that they need to take condoms into their own control and responsibility. For some reason, I always knew to use latex with non-oxidol9 before marriage - my wife on the other hand never knew that there were condoms out there that provided no disease protection. Women need to know to inspect the condom to make sure it is latex, and not to be fooled into thinking that "f he is wearing a condom, it is safe". As an aside, my wife was very disturbed that the warning label on lambskin condons about no disease protection is in VERY SMALL PRINT - not something a women buying condoms is going to read most likely.....

PLEASE HELP.

Response from Dr. Frascino

Hello,

The kinds of studies you are asking about "practical evidence of transmission" from using lambskin condoms of course can never be done for ethical reasons. However, I can tell you that your theory of "negligible risk" is not correct. The risk is real and far from negligible.

The solution to your problem seems rather obvious to me. Your wife had the potential risk, so ask her to be HIV tested, or be tested together.

I agree the warning label on lambskin condoms is way too small. That's why practical HIV prevention information should be taught to everyone in sex education classes before they become sexually active. But that's another problem altogether.

Your overall risk appears to be relatively low, but not completely nonexistent. It also seems like you still have some issues to work out with your wife. Resolving any remaining doubts or concerns pertaining to HIV may help heal the rift. Finally, I should note that condoms and lubricants containing Nonoxinol 9 are no longer recommended, and should, in fact, be avoided. They can cause irritation to the vaginal lining, which can increase the risk of HIV transmission.

Dr. Bob



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