Condoms

Laboratory studies have shown that latex condoms provide an effective barrier against even the smallest STD pathogens.

Epidemiologic studies that compare rates of HIV infection between condom users and nonusers who have HIV-infected sex partners demonstrate that consistent condom use is highly effective in preventing transmission of HIV. Similarly, epidemiologic studies have shown that condom use reduces the risk of many other STDs. However, the exact magnitude of protection has been difficult to quantify because of numerous methodological challenges inherent in studying private behaviors that cannot be directly observed or measured.

Theoretical and empirical basis for protection: Condoms can be expected to provide different levels of protection for various STDs, depending on differences in how the diseases or infections are transmitted. Male condoms may not cover all infected areas or areas that could become infected. Thus, they are likely to provide greater protection against STDs that are transmitted only by genital fluids (STDs such as gonorrhea, chlamydia, trichomoniasis, and HIV infection) than against infections that are transmitted primarily by skin-to-skin contact, which may or may not infect areas covered by a condom (STDs such as genital herpes, human papillomavirus [HPV] infection, syphilis, and chancroid).

To achieve maximum protection by using condoms, they must be used consistently and correctly. The failure of condoms to protect against STD/HIV transmission usually results from inconsistent or incorrect use,
rather than product failure.

• Inconsistent or nonuse can lead to STD acquisition
  because transmission can occur with a single sex act with
  an infected partner.
• Incorrect use diminishes the protective effect of condoms
  by leading to condom breakage, slippage, or leakage.
  Incorrect use more commonly entails a failure to use
  condoms throughout the entire sex act, from start (of
  sexual contact) to finish (after ejaculation).

Use a new condom for every act of vaginal, anal and oral sex—throughout the entire sex act (from start to finish). Before any genital contact, put the condom on the tip of
the erect penis with the rolled side out.

If the condom does not have a reservoir tip, pinch the tip enough to leave a half-inch space for semen to collect. Holding the tip, unroll the condom all the way to the base
of the erect penis.

After ejaculation and before the penis gets soft, grip the rim of the condom and carefully withdraw. Then gently pull the condom off the penis, making sure that semen doesn’t spill out.

Wrap the condom in a tissue and throw it in the trash where others won’t handle it.

If you feel the condom break at any point during sexual activity, stop immediately, withdraw, remove the broken
condom, and put on a new condom.

Ensure that adequate lubrication is used during vaginal and anal sex, which might require water-based lubricants. Oil-based lubricants (e.g., petroleum jelly, shortening, mineral oil, massage oils, body lotions, and cooking oil) should not be used because they can weaken latex, causing breakage.