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Using condoms
   Last updated: 25.06.04
 
It may be that, after weighing up the various risks involved in vaginal or anal sex, that you decide to give it up in favour of other safer sexual practices. There are many other kinds of sexual activities which you can enjoy other than penetration, or other kinds of penetration you can explore other than with a penis. If you want to explore some of these options, you might want to think about some of the other activities detailed in the A–Z of safer sex.

But if like many people you want to keep on having penetrative sex, either anally or vaginally, then learning to use condoms properly, and using them consistently, is the major step in adopting safer sex.

Reliability of condoms
Condoms are not totally safe sex: they reduce the risks of penetrative sex. Experience with birth control shows that over a period of a year about 6% of women who use condoms as their sole form of contraception will get pregnant. Although this is not all down to condom failure – a proportion of the pregnancies are no doubt due to failure to use condoms every time – this is still quite a high failure rate. Moreover, it is important to bear in mind that whilst condoms are required to provide protection during one week of each month in order to prevent pregnancy (the week during which a woman is ovulating), a condom must provide protection on each and every occasion of sexual intercourse if it is to be a reliable form of protection against HIV infection and other STIs.

However, the main reason that condoms fail is because they are used incorrectly – they are torn during opening, oil–based lubricants are used, or they are put on incorrectly, for example.
In general, condoms provide an effective barrier against HIV and other STIs, and given that so many people practice penetrative sex as part of their sex lives, it is important that they are used properly. They are still the most effective barrier to HIV transmission during sexual intercourse.

In this section, we outline how to use condoms and lubricants most effectively, which cuts down on the already small risk of something going wrong.

Condom reluctance
You may also have negative feelings about condoms. They can be uncomfortable, they can reduce the sensation during sex, and can often interrupt your fun when you have to find a condom, open the packet, find the lubricant and put it on. Nobody is saying that condoms are perfect, or that sex will be just as good if you use them. But, frankly, they are the best thing we have now to cut down on HIV transmission during sex.

Strategies for women whose partners will not use condoms
Some men will refuse to use condoms with women, despite the potential risk of HIV. Remember that women cannot control condom use. Men wear condoms, not women. Women who perceive themselves at special risk of acquiring HIV should consider the following strategies:
  • Ask their partner to wear a condom and use water-based lubricant which does not contain nonoxynol-9

  • Use a female condom (vaginal pouch) and lubricant. Although women may insert the female condom, this is not like a female-controlled prevention technology (such as the diaphragm). It is not discreet - your partner will always know you are using it - and he can fuck between the wall of the vagina and the female condom, in which case it will offer no protection

  • The effectiveness of the female condom with regard to preventing HIV infection has not been established

  • Withdrawal: the European Study Group on Heterosexual Transmission of HIV has recently reported that HIV-positive men who always withdrew before ejaculating had not infected their partners, even after 18 months. This suggests that if loss of sensation is the problem, fucking without condoms may not present a significant risk unless ejaculation takes place, and may in some cases be an agreeable solution for both partners. However, Australian AIDS organisations have mounted specific campaigns to warn gay men against this strategy, after research suggested that a significant proportion of (an admittedly small number) of new infections were occurring among men who were using this technique instead of condoms.