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Condoms

The use of latex condoms with a water-based lubricant has proven effective in the prevention of STDs (sexually transmitted diseases) including HIV -- but proper use is imperative. Serious health complications may result from many sexually transmitted diseases and it is expected that those infected with HIV will go on to develop AIDS, a fatal illness. Thus the importance of proper condom use cannot be stressed enough. The promise that condoms will be effective 100% of the time in stopping the transmission of STDs cannot be given -- yet their effectiveness in substantially reducing your risk for getting or giving STDs has been proven.

Remember the key words in condom use -- the three "C"s --

Condoms -- use them Consistently and Correctly.

The most common form of STD transmission including HIV is through having unprotected oral, vaginal or anal sex. A very simple way to remember what kind of sex puts you at risk for infection is the word OVA -- oral/vaginal/anal. It's what you do that puts you at risk -- in other words the specific sexual behavior you engage in. Sexual orientation is usually not even an issue when it comes to STD transmission -- STDs do not discriminate, infecting gay and straight, black and white, young and old, female and male alike. So remember the word OVA -- oral/vaginal/anal.

Methods of prevention can be easily remembered by the letters A, B and C. A is for abstinence. B is for barrier -- using a latex condom that contains the spermicide nonoxynol-9 as a lubricant or a dental dam during cunnilingus. C is for a committed (sexually monogamous) relationship with someone who is HIV negative.

Of course the most effective way to prevent HIV transmission is to abstain from having sex altogether. But for many this is not a realistic option. Having a committed relationship with a person who is HIV negative is another option. This entails an agreement between you and your partner to be sexually monogamous and not to "shoot" drugs or share needles or syringes with others. Certainly trust is of primary importance here. But even with the best intentions at the moment when agreeing to sexual monogamy, it is not unusual for people to change their minds over time, or even to experience a totally unexpected "slip", especially if alcohol or drug use has impaired judgment. This is why -- to be on the safe side -- having protected sex even if you are in a committed relationship is prudent and well advised.

Before initiating sex with anyone you should make arrangements with your health care provider to discuss testing both you and your prospective partner for HIV infection as well as other STDs. If you decide to have sex with a person whose HIV status is unknown or you feel they may not have been honest about disclosing their true status or if you decide to have sexual intercourse or penetration with a person who is HIV positive, condoms must be used to reduce the risk of infection. Some people prefer not to use condoms because they feel it decreases their pleasure during sex. Others would be horrified to think of engaging in penetration without using one. Sex needs to be negotiated prior to its initiation with "safe rules" accepted and understood by both partners. A frank and honest discussion with your partner about past and current sexual behaviors will probably bring a higher comfort level than if you ask no questions; it could also lead to making more informed, careful choices that could literally save your life.

Condoms have proven effective not only in reducing risk of HIV infection or serving as a barrier type of contraceptive, but have also acted successfully as a physical barrier against sexually transmitted diseases such as herpes, syphilis, gonorrhea, hepatitis B and chlamydia -- all potential points of transmission of the HIV virus. In fact infection with gonorrhea or chlamydia increases the risk of HIV infection several times, while infection with herpes or syphilis increases the risk of HIV infection about fifteen times. If you are diagnosed with one of these STDs, a discussion about HIV testing and counseling is very important and indicated. When a person has at least one sexually transmitted disease, studies have shown that the risk for HIV transmission is much more likely. This is thought to be due to the body's altered defense mechanism when it is infected with an STD.

The proper use of latex condoms with a water based lubricant has proved effective in reducing exposure to HIV. It is in your best interest to use one during all acts of sexual penetration whether vaginal, anal or oral, every time, from start to finish. Condoms are inexpensive and easy to use once you learn the basics.

As we have mentioned, you should always use a latex condom as they are impermeable to the HIV virus, whereas, for example, lambskin condoms are not. And only water based lubricants should be used instead of oil base or lubricants such as Crisco and Vaseline which interact with the condom's chemical makeup causing it to dissolve and break down its physical barrier. Use a spermicide with the condom for added protection -- the spermicide nonoxynol-9 has been shown to kill HIV in laboratory tests. Spermicides are found in contraceptive foams, some lubricants, and some lubricated condoms. Never use spermicides alone instead of with a condom as their effectiveness has not been a proven factor in HIV prevention. Some people can develop a sensitive skin allergy of the penis, vagina, or anus from nonoxynol-9. Caution should be used if this happens and a discussion about use of latex condoms that are lubricated without nonoxynol-9 should be had with your health care provider. There are also small populations that can be severely allergic to latex. Please also discuss this with your health care provider if you think you may be allergic to latex. The use of polyurethane or female condoms may be evaluated but unfortunately they have not been proven to protect people against STDs in the same manner as latex condoms.

The condom should be put on before genital contact with the partner. The condom should be carefully rolled over the full length of the erect penis. Often there can be a loss of or inability to achieve an erection while putting on a "rubber". It can help if the act of putting on the condom is eroticized and made part of the sex play. The momentum is not broken. Once the condom is on the fully erect penis, any air pockets at the tip or on the inside of the condom should be smoothed out by a person's hand.

Condoms have a space at the end to collect the ejaculated semen but if for whatever reason the one you are using does not leave a space at the tip to create one yourself so that upon ejaculation rupture of the condom does not occur. During withdrawal, firmly hold onto the condom at the base of the penis to make sure there is no leakage of semen. To prevent slippage from occurring, withdraw while the penis is still erect. Roll the condom off then throw it away -- never use the same condom again. Some health care providers advise patients not to ejaculate in the condom but withdraw and finish ejaculation outside of the uterus/anus/oral cavity. This is in case the condom breaks; there is less chance of infection if there is no exposure to ejaculate. Do not ever penetrate without a condom even for a second or two as this does put you at some risk for STD transmission. Should a condom break during sex withdraw immediately, wash off and use a new condom. The passive partner should not douche. If orgasm has occurred and there is knowledge or a strong suspicion that your partner is HIV positive, contact your health care provider immediately for possible Prophylaxis treatment.

Always keep a condom away from heat in order to maintain the lubrication and be sure the condom you use is not old or dried out, because insufficient lubrication on the outside of the condom could cause it to break. Check the expiration date prior to use and if the package has been torn or damaged, do not use. Read the label instructions carefully.

Latex condoms are tested electronically for holes before they are packaged but some can be defective and break. Breakage is estimated at 2 condoms per 100. Condom failure is more often associated with incorrect use. Sometimes they are simply put on too late -- after semen or precum has already seeped out of the penis into the vagina or anus. And be sure you do not damage the condom yourself with your fingernails or teeth.

Try to remember the three words that go together and begin with C:

  • Condoms -- Use them consistently and correctly.

There is a female condom -- a lubricated sheath inserted into the vagina -- that laboratory studies have shown is an effective mechanical barrier to HIV transmission, though no clinical studies have confirmed this. Additionally vaginal spermicides are thought to offer little protection against infection, as are vaginal sponges or diaphragms.

Condoms should be used with any sex toys that are insertive and that you share with someone else.

It's always a good idea to have a supply of condoms on hand -- in case your partner doesn't have any. Be prepared for safer sex. And don't let alcohol or drugs impair your judgement. Under the influence you will be more likely not to use a condom properly -- or not to use one at all. Remember, condoms are an effective way to reduce the possibility of getting a sexually transmitted disease, including HIV infection. But they need to be used consistently and correctly, each and every time, from the beginning to the end of sexual penetration.

Should you even suspect that you have a STD (sexually transmitted disease) such as HIV please see your health care provider promptly. Or if you have questions about what kinds of condoms to use or how to use them contact your health care provider as well..

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