Condoms

To reduce the risk of HIV infection for people who are sexually active, the important thing is to remember to keep a barrier, preferably latex, between you and the other person’s body fluids. Condoms and other latex barriers will help protect you from another person’s body fluids. Used correctly and consistently, condoms have been proven effective in helping prevent the transmission of the HIV virus. Below are the results of three famous studies with couples (one person HIV positive, one negative) and the rate of transmission while using condoms:

As you can see, condoms are not 100% effective, but they do reduce the incidence of transmission dramatically--if used consistently.

There are lots of condoms on the market. Which ones work best?

The condoms that have been proved best to help prevent the transmission of HIV are made of latex. Another kind new to the market is the polyurethane condom, sold under the name of Avanti. Read the packages. They will give you information on whether the condom:

• Is latex, polyurethane or lambskin (lambskin could prevent pregnancy, but does not protect you from HIV or other sexually transmitted diseases)
• Comes lubricated (matter of personal preference between couples)
• Contains spermicide (some people feel they are getting extra protection but the chemical could cause a reaction in some people)
• Size (most condoms measure approximately 190 millimeters long. Some are longer and some are shorter).
• Expiration date (must be used before date on package)

Some helpful hints for condom use:

• Use a new condom for each sex act (vaginal, anal and oral).
• Handle condoms carefully. Ripping package open with teeth, jagged fingernails, and even the wrapper can tear or put tiny holes in the condom.
• Put the condom on when penis is erect and before any vaginal, anal or oral contact with your partner.
• Prevent an air bubble while leaving room in the tip of the condom for semen. Squeeze the tip as you began to unroll it all the way down the erect penis. (To increase sensitivity to the man, a drop of lubricant could be placed on the head of the penis before you put on the condom).
• If additional lubrication is needed, be sure to use a water soluble type (K-Y Jelly, Wet, ID, Astro-Glide, Duragel, etc.). Oil based lubricants may increase the chance the condom will break.
• To prevent the condom from slipping off, hold it firmly at the base of the penis and withdraw from your partner while the penis is still hard. Wrap the condom in a tissue and throw in the garbage. Do not flush it down the toilet.
• For those people who are allergic to latex, there are two options:

1. Use the Avanti (made of polyurethane)
2. Use two condoms, one latex and the other lambskin. Keep the lambskin next to the person who is sensitive to latex.

• When performing oral sex on a woman, use a dental dam, latex sheath or plastic wrap to prevent contact with vaginal fluids.

What about this new "female condom"?

This is something new on the market in the last two years. The brand name is Reality, and it is the only woman controlled contraceptive for protection against HIV and other sexually transmitted diseases (STD). It’s made of polyurethane, which is less irritating. It can be inserted up to 8 hours ahead of sexual intercourse without interfering with normal body functions. Another benefit of polyurethane is that it conducts heat, and sensations are not dulled. This product comes with a water based lubricant, but oil based products can be used.

The female condom does take some getting used to, but it is catching on with women. Most like the fact that they don’t have to depend on someone else for protection, and by inserting it ahead of time, lovemaking is not interrupted.

A sample of this product is available at the Orange County Health Department.

More Information from Orange County Health's HIV/AIDS Section, the source of the above info.!

SOME NOTES on the Orange County Health Department's Discussion: Latex, like all materials, has holes in it. After all, all materials are made of molecules, which in turn are made of atoms, which in turn are made of electrons, protons, and neutrons. There's always some space for the particles to move around. However, latex is less porous than sheepskin--that is, its holes are smaller, and less passes through. This is because sheepskin, just like your own skin, breathes. (Your own skin has IgA antibodies in it that protect you from microbes; the sheepskin is non-living, of course, so does not!) According to Laurie Garrett (1994), who wrote The Coming Plague, it was discovered that the HIV virus could pass through the holes in the latex gloves of surgeons! The HIV collects on one side and then passes through the holes. To reduce this, the surgeons started wearing two gloves. The double layer of latex acted as a better barrier--the HIV that passed through the holes in the first layer of latex usually got trapped by the second layer and rarely passed through. Physicians also change their gloves frequently during surgery, both because latex gloves may tear, and because the virus that collects on the glove does not get the opportunity to go through! However, it's not possible to use two condoms--unless one is made of sheepskin--because of the friction created (S. Douglass, 2000, CENTAUR). But manufacturers started double-dipping condoms in latex, creating two layers of latex to keep you safer! Nothing is 100% safe, of course, and condoms may tear.

HOW LONG CAN YOU LEAVE A CONDOM IN? Well, as long as you're having intercourse. Although some manufacturers suggest that people can wear the female condom safely all night, you should change it if you have intercourse again, even with the same partner, as condoms do tear! In addition, remember TOXIC SHOCK? It was linked in part to synthetic particles from tampons which irritated the mucosal lining of women's vaginas, causing lesions in the lining, and trapping microbes behind the not very porous synthetic particles! So change your condom and wash as soon as possible after intercourse!

CONDOMS, IF USED PROPERLY, are fairly (though, as noted above, never 100%) effective in preventing the transmission of diseases like HIV, gonorrhea, and chlamydia, which are spread by the mucosal lining, along with body fluids such as blood and semen, according to an article by Anjetta McQueen (2001; Study: Condoms Fight HIV, Gonorrhea; Washington, D.C.: Associated Press; posted in Dr. Douglass' class discussion). Condoms, however, should not be relied on to prevent the transmission of ulcerous skin infections which the condom does not cover properly! Avoid contact with ulcerous skin sores and blisters! If you come into contact with these, wash at once!

Jeffrey Laurence, MD (2002; AIDS Reader 12(3):85-86; reported in Reuters Health/Medscape
discusses condom use's failures to block HIV in all cases in an article on obstacles to microbicide utility. Laurence writes:

For example, if the relative risk for acquisition of HIV by receptive fellatio is set at 2, then receptive vaginal sex offers a 10-fold greater risk, and receptive anal sex a 50-fold higher risk of infection.[10] But the risk of acquiring HIV in the female partners of infected men who use a condom "regularly" is decreased only 20-fold over no condom use.[10] And a microbicide will certainly be less effective than a condom, unless the concept of "regular use" translates into something very different for both methods.

I'm not sure whether the risks increase exactly 50-fold, or 10-fold in these cases, but--you have an approximation!!! In summary: what many people consider "regular condom use" is insufficient to block the transmission of HIV. Other STD's are even more contagious!!!

[Back to HIV Page 1]

[Back to Table 2]

[Back to TOP]