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Condoms and other barriers, when used consistently and correctly, greatly reduce the risk of HIV and other STDs. Most condom failures result from incorrect use of the condom, not because the condom itself was faulty.
  • Condoms are made of latex, polyurethane, or natural animal membranes, and include both traditional (male) and Reality® (female) condoms.
  • Other effective barriers for STD protection include dental dams, condoms which have been cut into flat rectangles, plastic wrap, and latex squares.
  • "Consistent use" means using a condom or other barrier every time a person has anal or vaginal sex. Ideally, condoms or other barriers should be used for oral as well as genital or anal sex. However, the risk of transmission of HIV and most STDs during oral sex is much lower than for anal or vaginal sex.
  • "Correct use" involves following these steps:

Traditional (male) condoms

  • Latex (rubber) or polyurethane condoms are best to use. Some people, however, have allergies to latex; polyurethane condoms are good alternatives for such people. Natural membrane condoms may be slightly less effective, but they are better than nothing and probably prevent most STD/HIV transmission.
  • Condoms need to fit properly. They come in slightly different sizes, shapes, and styles, but most condoms will fit most men.
  • Condoms need to be opened and handled carefully. Condoms in damaged packages or past their expiration date should not be used. Condoms should not be stored for prolonged periods in a wallet or in hot or sunny places (for example, in a car or by a window).
  • Plenty of water-based lubricant should be used to reduce the friction that can cause breakage. Some condoms are packaged with lubricant, but often there is not enough; additional lubricants are recommended. Oil-based lubricants like Vaseline, some hand creams, Crisco, butter, mineral oil, or other oils can dissolve or weaken latex and lead to breakage. Water-based lubricants are available in drug stores next to the condoms.
  • The condom must be put on after erection and before any sexual touch. Some condoms have a reservoir tip; some don't. In either case, the tip of the condom should be squeezed while the condom is unrolled in order to leave an airless pocket to collect semen.
  • After intercourse, the penis should be withdrawn while still erect. The base of the condom should be held around the base of the penis to prevent it from slipping off or spilling semen.
  • Condoms should not be reused. They should be thrown in the trash, not in the toilet. (They can plug the toilet.)

Female condoms

Female condomThe female condom is an alternative to the male condom for vaginal sex. It can be used for anal sex as well, although its effectiveness for this use has not been well-studied.

  • Like male condoms, female condoms need to be opened and handled carefully. Condoms in damaged packages or past their expiration date should not be used. Condoms should not be stored for prolonged periods in a wallet or in hot or sunny places (for example, in a car or by a window).
  • Lubricant should be used to reduce the friction that can cause breakage. The female condom comes with some lubricant. Lubricants are also available in drug stores next to the condoms. (Unlike latex condoms, the Reality and other polyurethane condoms are not damaged by oil-based lubricants. Still, Public Health recommends only water-based lubricants for simplicity's sake, and because the body may not be able to cleanse itself of oils as easily as it can of water-based lubricants.)
  • The female condom must be inserted in the vagina or anus before any sexual touch. It may be inserted up to 8 hours in advance of intercourse.
  • The open end of the female condom (at the outer ring) is designed to cover the area around the opening of the vagina or anus. The condom clings to the vaginal or rectal wall, providing a barrier between the vaginal lining and the penis.
    For insertion in the vagina, the inner ring should be squeezed between thumb and middle finger. The inner ring is used to guide insertion and to help hold the condom in place. The inner ring should be placed as far as it will go inside the vagina. It is in the right place when it can't be felt. Proper insertion into the vagina may require practice and can be improved by the cooperation of both partners.
  • For insertion into the anus, the inner ring can be removed. The condom can be inserted in the rectum with fingers or placed on the erect penis. Proper insertion into the anus may require practice and can be improved by the cooperation of both partners.
  • The condom should not be twisted. The outer ring should remain outside the vagina or anus.
  • For removal, the outer ring should be grasped and twisted in the hand and then pulled gently to remove the entire condom.
  • Public Health recommends that female condoms not be reused. Although some studies have shown that they maintain effectiveness when cleaned and reused a few times, Public Health believes the evidence is not yet strong enough to recommend that practice. It is clear that even after careful washing, a used condom is unlikely to be as free of contamination as a new one. After use, female condoms should be thrown in the trash, not in the toilet . (They can plug the toilet.)

Other types of barriers

  • The barrier must be placed on the genitals or anus before oral contact to prevent any exchange of fluids or any contact between mouth and the genitals or anus. It must be in place before any sexual touch. The barrier should cover the vaginal opening and labia or the anus and perineum.
  • The barrier can be:
    • A condom that has been cut so that it can lay flat
    • A dental dam
    • A latex square
    • Plastic wrap
  • As with condoms, oral barriers need to be handled carefully. They shouldn't be stored for prolonged intervals in hot or sunny places (for example, in a wallet, in a car or by a window).
  • Lubricants can be placed between the oral barrier and the genitals. Only water-based lubricant should be used since oil-based lubricants break down latex. Lubricants are available in drug stores next to the condoms.
  • Barriers should not be reused. They should be thrown in the trash, not in the toilet. (They can plug the toilet.)