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.

Condoms come in lots of colors, textures, lengths, widths, and thicknesses. The most important thing when choosing a brand is that the condoms be made of latex or polyurethane (plastic). Both of these are effective in preventing STDs, HIV and pregnancy.

Avoid using animal skin (or “natural”) condoms, which prevent pregnancy but aren’t as effective in preventing all STDs, including HIV. Also, while male condoms are more popular, female condoms, which are inserted into the vagina, are also an option.

Oil-based lubricants (for example petroleum jellies, body lotions, mineral or vegetable oils) should not be used with latex condoms because they can cause the latex to break down, reduce or eliminate the condom’s effectiveness.

Using a pre-lubricated condom, or applying a small amount of water-based lubricant inside and outside the condom can help prevent rips.

Oil-based lubricants (for example petroleum jellies, body lotions, mineral or vegetable oils) should not be used with latex condoms because they can cause the latex to break down, reduce or eliminate the condom’s effectiveness.

The condom should be put on before any genital (skin-to-skin) contact. Some STDs can be transmitted without intercourse, through genital contact. Also, pre-cum can contain semen and STDs (including HIV), so you need to wear a condom the whole time from beginning to end, each and every time.

• To open the package, tear gently on the side (not with teeth or scissors, which could rip the condom itself). Pull the condom out slowly (with care) to prevent ripping.

• The rolled condom should be placed over the head of the penis when it is hard.

• 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 penis.

• The condom should fit snugly – but not too tight – so that it won’t slide off or break during intercourse.

• If you start to put on a condom inside-out, don’t use it. Throw it away and use a new one. You’ll know it’s inside out because it won’t roll down the length of the penis easily.

• If the condom rips at any time, throw that one out and use a new one.

The most common mistake is not using condoms from start (of sexual contact) to finish (after ejaculation). Immediately after ejaculation, hold the base of the condom (so it stays in place and semen cannot spill out), and slowly withdraw the penis – while it is still hard.

The condom should be wrapped in tissue and thrown away in the garbage (not in the toilet as it may clog).

There are several ways to reduce risk of getting or passing HIV. These include:

Condoms: Use condoms. When used consistently and correctly, condoms are highly effective in protecting against HIV, as well as many other sexually transmitted diseases (STDs). Female condoms are another highly-effective tool specially designed for women to prevent HIV and many other STDs. Like male condoms, female condoms are a barrier method of protection. Female condoms are inserted into the vagina. Some women like female condoms because it puts them more in control over condom use.

PrEP: For added protection, talk with your health care provider about whether pre-exposure prophylaxis (or PrEP) is an option for you. PrEP is a once-daily pill, available by prescription, for people who do not have HIV that can reduce the risk of getting HIV by more than 90 percent.

Treatment as prevention: If you have HIV, establish a treatment plan. Not only can you improve your health with antiretroviral (ARV) treatment but you can also significantly reduce – by as much as 96 percent – the chances of passing the virus on to others.

Clean injection equipment: Never share needles, syringes or other drug preparation equipment. You can get clean needles from pharmacies or needle-exchange programs. Only use syringes that come from a reliable source. If you need help with addiction, find drug treatment programs near you using the HIV.gov locator.