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Latex Allergy question - follow up on advice
Feb 8, 2009

Dr. Bob

I was the person who wrote to you about Latex Allergy and Safe Sex. First off, I would like to thank you for replying to my previous post. I know you get this a lot, but god bless your work on HIV prevention.

Before I go on and ask my question I wish to address my fellow stress and anxiety friends. You are not going through this alone. For those who visited sex worker, from personal experience and i agree with the doctor. You should go and level with your partner. If you come out with the truth and admit your mistake, they will most likely forgive you (trust me its a lot better den letting them finding out themselves later). This will help relieve some of your stress and guilt. Having support this time is really important for you. Also, please seek counseling. They really help. A lot of places in the US offer free counseling on HIV and AIDS related matter. Take yourself off of this side and, just spend roughly 10 minute on Google, I am sure you will find a lot of results. Secondly, if you think about. I tend to agree with the doctor on the medhelp forum and here. Generally, sex workers are high risk group, but most of them are probably HIV neg. They are not out there to get you! They worry about their own health more than yours. Things like reusing condom and sex worker purposely trying to infect you is kind of outrageous.(although I cant vouch that it wont happen). To be honest, I went back to the place where I visited the CSW ( this time I went and just had a talk with her, yes I know its weird but my anxiety got the worst of me ) they are just like any human. She was really nice and posed a good point to me. Ask yourself why would they want to be infected and become sick? Yes is true, its all about the money but, why would they risk their whole life and their future revenues on one transaction? Usually if they are sick, its an accident (condom broke) or had sex under the influence of alcohol or drugs.

Now on toward my question to the doctor =). I did savage through the archives, well maybe not hard enough. But here are a few questions that I would like further clarification on.

1. Usually when I see information on HIV transmission, It usually saids that HIV cannot permeate intact skin. HIV is only transmitted through mucus membranes, open sores or cuts, or any direct contact with the infectious bodily fluid (vaginal fluid, blood, breast milk etc.. I found Dr. Kull answer to be a little confusing http://www.thebody.com/Forums/AIDS/SafeSex/Archive/TransmissionNon/Q146136.html. So Is irritated skin or skin rash considered to be open wound or compromised skin where HIV can pass through?

2. When I use condoms in the states, I usually use condoms that have labels that says theyre effective in preventing HIV and STD. However, I am currently in another country, condoms here only label that theyre electronically tested and made of natural rubber latex. Are these condoms equally effective as those in the states? Brand doesnt matter? Latex is just latex correct? There is no other type of latex

3. I asked this before; I know youre going to say a 12 week test is the only definite and conclusive test. However, I am taking my test on the 11th week post exposure exactly 75 days after exposure). Im doing this because not that I cant wait for one more week, it is because I will have someone here with me during that time to go and take the test with me ( comfort and support) for whatever the result is. Does 1 week shy makes a lot of difference? Do you think from my exposure that a test result at that time is still considered conclusive?

Again to reiterate my exposure. I received protected insertive oral sex with a latex condom from a CSW. I dont know if the condom was intact after, I believe it was, or else I assume I would have felt it and she would have told me. Once again thank you doctor for reading my post regardless if you choose to answer it. I know its long, but I really wrote this out of my heart and seeking answers. Oh and by the way can you post information where I can find more information on tour foundation and make a donation? Thanks a lot! I will donate once I get my test result ! PROMISED!

Response from Dr. Frascino

Hello,

1. HIV can gain access into the body via contact of infectious fluids with mucous membranes or non-intact skin. Non-intact skin includes open wounds and skin that has been irritated or damaged enough (certain severe rashes, scrapes, scratches, broken blisters, lesions, etc.) to allow fluids to soak in (or ooze out).

2. I don't know where you are traveling, but most latex condoms are protective. However, I can't vouch for each and every brand made outside the U.S. When in doubt, carry your own supply of trusted condoms.

3. Sorry, I don't make the rules. The current guidelines recommend an HIV test at the three-month mark. Tests taken prior to three months are not considered to be definitive.

Next, I should point out "protected insertive oral sex" is not considered an HIV-transmission/acquisition risk, assuming the latex condom was used properly and did not break.

Finally, you can find out more information about the Robert James Frascino AIDS Foundation on the foundation's Web site, www.concertedeffort.org.

Be well. Stay well.

Dr. Bob

Allergic to Latex condoms and Protected Oral Sex (LATEX ALLERGY AND SAFE SEX) Feb 2, 2009

Doctor, i had protected insertive oral sex with a CSW two weeks ago for 10-15 minutes. I have a mild allergy to latex condoms. symptoms include( slight burning sensation or irritation on shaft of my penis and discomfort on area below my stomach). She finished me without the condom by masturbating me, because i could not finish with a condom.

My question is

1.in general does condom allergies increase risk of HIV transmission?

2. Even if i don't feel symptoms of my condom allergy right there and then could any part of my penis be irritated already and increase my risk of getting HIV?

3.Would a 9.5 week test for HIV be accurate for a protected insertive oral sex incident?

Thanks alot for spending time answering my questions!

Response from Dr. Frascino

Hi,

1. No, latex allergy per se would not increase your risk of HIV transmission.

2. No. HIV is only a risk if there is "non-intact" skin, such as an open wound.

3. If the sex was indeed protected, an HIV test wouldn't be warranted, assuming the latex condom was used properly and did not break. HIV cannot permeate intact latex. No way. No how. When HIV testing is warranted, a test at the three-month mark is considered definitive.

Finally, I should mention latex allergy can evolve over time and become severe. I suggest you use polyurethane rather than latex condoms. (See below.)

Be well.

Dr. Bob

LATEX ALLERGY AND SAFE SEX Dec 7, 2005

Dear Dr. Bob,this question is mostly for safe sex practices rather than HIV. Recently, had done a RAST test and further allergy screening. My 4 months Elisa is (thanks god ) negative.Hep B, C and syphilis screening also negative. Rast Test (blood and skin )showed an allergy to some food and also RUBBER . I am practicing safe sex, and experience mild but obvious allergy symptoms whenever i use condoms. I am not a fool to stop using condoms but it is really an aesthetic problem to have hive like skin rashes every time i have (safe) sex. I have tried to eliminate other contact with latex ( put an non allergic cover on my cars steering wheel, i am using special soaps and avoid some food). My dermatologist cannot recommend anything more than taking allergy pills for 2-3 days after sexual encounter, but this is no way a life-time strategy. Can you recommend something else? Anywhere else I could look for information for safe sex guidelines for people with latex allergy? Tried to read the archives but nothing found there. Thank you. Ex-worried well, John from Piraeus, Greece

P.S. i hope you had a great time in Myconos!

Response from Dr. Frascino

Hi John,

The best bet for folks with latex sensitivity is to use polyurethane condoms. In the US, the most popular brand is "Avanti." I'll post a few questions from the archives that address latex allergy.

Yes, I had an excellent time on Mykonos!

Stay well.

Dr. Bob

Non-Latex Condoms vs STD protection Aug 29, 2005

I'm pretty convinced that I have a condom (latex) allergy. It started slowly, becoming worse with each exposure. The last time genital area swelled almost instantly, turned very red and it was very painful to even sit down. I am aware of condoms made from polyurethane and other materials, however, none I have found protect against STD's or HIV. what are my options?

Response from Dr. Frascino

Hello,

For those with latex allergy, polyurethane condoms are unquestionably the best option. There have been at least six epidemiologic studies since the FDA approved polyurethane condoms in 1995 that address the question of their safety compared to latex condoms. Three of the six studies found equivalent extremely low rates of breakage and slippage between the two condom types; one study found polyurethane condoms to have a higher breakage but equivalent slippage rate compared to latex condoms; one study found higher breakage and slippage with polyurethane; and one study that addressed only breakage found higher rates with polyurethane condoms. Taken together, these studies show the breakage and slippage rates of polyurethane condoms are not unacceptably high and that using them is considered an effective safer-sex practice for those people unable or unwilling to use latex. I should also point out there are many anecdotal reports of increased tactile sensitivity with polyurethane compared to latex condoms. So that could be considered a bonus!

From an HIV-prevention standpoint, the only condoms considered unsafe are natural-skin (lambskin) condoms.

Dr. Bob

procrit and condoms

Feb 19, 2005

Hey Dr. Bob,

Looks like I may need Procrit to treat my anemia but my practitioner (not an MD) says maybe I should wait because it's coming out in an oral form soon and that way i wouldn't have to mess with the IV stuff. How long should I wait?

Next my new boyfriend says he's allergic to latex condoms --- causes itchy butt rash and he's not too happy with the polyurethane ones?

Any suggestions?

Response from Dr. Frascino

Hi,

You should wait for an oral form of Procrit??? That could be a very long wait. What oral form of Procrit??? That's an interesting comment that your "practitioner" made and more than anything clearly illustrates the dude (or dudette) definitely needs more practice before dispensing information. I know of no oral form of Procrit "soon" to be released or even on the very distant horizon. Next, Procrit does not require IV (intravenous) administration. It can be given subcutaneously (just under the skin) with a tiny needle. It is quite easily self-injected just once per week. I'd suggest you discuss this with your HIV specialist the real doctor and do mention the practitioner's advice was, shall we say, less than optimal.

Next, latex allergy is indeed a very real condition. Your new boyfriend can consult with an allergist to confirm whether he has the very significant kind of latex allergy. Some forms are so severe they can be like a bee sting reaction (anaphylaxis). If that is the case, polyurethane condoms are still your best bet at the moment. If, on the other hand, all he has is an "itchy butt rash" when exposed to latex, and he dislikes polyurethane, an option would be for you to wear a latex condom covered with water-based lubricant and then a lambskin condom over the top again covered with more water-based lubricant. In general, I do not recommend "double bagging" (using two condoms), as the friction between two latex layers can cause them to break; however, in this particular instance it's an option that you could carefully try.

Hope that helps.

Good luck!

Dr. Bob



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