Sexual Health
Safer Sex
Condoms
What is a condom and how does it work?
A condom, also called a prophylactic or rubber, is a thin sheath that fits snugly over an erect penis to act as a barrier. The closed end of the condom catches the semen, so that it cannot pass into your partner at the time of ejaculation. There are many types of condoms available: latex rubber, polyurethane, lambskin, lubricated, and spermicidal. Most condoms sold in the U.S. are latex condoms which come in a variety of textures and colors. Latex and polyurethane condoms are the only condoms which prevent transmission of HIV.
Condoms should be used for all acts of vaginal, anal or oral sex (on a man) to help prevent pregnancy and/or the transmission of STDs (sexually transmitted diseases). Condoms are available in many varieties: colors, flavors, shapes, textures, lubricated, non-lubricated, with or without spermicide--almost any type to meet different needs. You may want to experiment with the type of condom that is most satisfactory to you and your partner.
How effective is a condom with in preventing pregnancy?
| Theoretical Effectiveness* | Actual Effectiveness** | |
| Condom | 97% | 86% |
*Theoretical effectiveness rates are based on studies that have been done to determine how effective a method itself can be, apart from user behaviors.
**Actual effectiveness rates reflect what happens to the pregnancy rate in a group of people who do not use this method correctly some of the time and who do not use this method every time they have intercourse.
How do you use the condom?
Condoms must be used correctly in order to be effective. Condoms are packaged individually. In order to maintain their effectiveness, they must be protected from heat.
- Putting It On
Before any sexual contact, when the penis is erect:- Pinch the condom at the tip and squeeze out any air.
- Place the rolled-up condom against the end of the erect penis.
- Unroll the condom to cover the entire penis. If you put it on backwards and it does not unroll easily, don't flip it over; there may be semen on it. Use another condom.
- Taking It Off
Right after ejaculation (coming):- Hold on tight to the condom at the rim (at the base of the penis) and pull out slowly while the penis is still erect. This will keep the condom from slipping off inside your partner or any semen from being spilled.
- Increasing Comfort
Insufficient lubrication can cause discomfort and chafing or condom breakage. Place a small amount of the water-based lubricant on the inside of the condom tip before unrolling it. This can increase sensation for the condom wearer. After unrolling the condom over the erect penis, place some of the water-based lubricant on the outside of the condom. - Extra Protection (for pregnancy prevention)
For vaginal sex, also use an applicator filled with spermicide inside the vagina for extra protection in the event of breakage. If the condom breaks, spermicidal jelly or foam should be inserted immediately into your partner.
What are the advantages of condoms?
- readily available over the counter, no exam is necessary
- allow the man to take an active role and shared responsibility in preventing pregnancy
- causes no serious health risk
- may increase ability to maintain erection longer
- provide lubrication (if using a lubricated condom)
- inexpensive (free at Student Health Center)
What are the disadvantages of condoms?
- may interrupt lovemaking because the condom must be placed on erect penis
- ineffective if used incorrectly or if the condom breaks
- may reduce sensitivity and pleasure
- may cause allergic reactions to latex, spermicide, or lubricant used with the condom
- may be messy or inconvenient
- necessitates prompt withdrawal to keep the condom from slipping off
- may result in less energetic lovemaking from fear that condom may slip off or break
- may taste bad (scented condoms such as mint are not spermicidally lubricated)
- may not protect against transmission of STD's transmitted through direct skin-to-skin contact (e.g. HPV, herpes)
Who can use condoms?
Condoms can be an effective birth control method for many people. However, you should not rely solely on condoms for pregnancy prevention if:
- you might not use the method consistently
- your partner is not supportive of the method (see "Communication" and "The Condom Comeback" for suggestions on how to talk to a partner about condoms)
- you or your partner are allergic to latex or specific spermicides or lubricants
Do condoms prevent STDs?
Although not 100% effective, for sexually active people condoms provide the best means of protection available today for STDs. Condoms cannot prevent STD transmission, but they can help reduce the risk.
Special Notes: Animal membrane condoms (lambskin) do not give protection against HIV infection and other sexually transmitted diseases. Therefore, the use of latex or polyurethane condoms is highly recommended.
Lisa Barber-Murphy, M.Ed., CHES;
rev 11/99, Becky Griesse, CHES:
rev 6/01,Ray Rodriguez, C.H.E.S.;
rev 5/03 Becky Griesse, CHES and Dev Sangvai, MD
Source:
Robert A. Hatcher, et al. Contraceptive Technology, 17th ed. (New York: Irvington Publishers, Inc., 1998)
Abstinence
What is it?
Clinical abstinence is defined by not having sexual intercourse. This includes vaginal, anal and/or oral sex on a man or woman.
Many people choose to define abstinence in different ways, but these other definitions may not be clinically sound. To some, abstinence may mean no sexual contact at all, to others it may mean no vaginal intercourse but may include oral sex. Because of this, it is important to discuss with your partner clear definitions of what abstinence means to each other. Decide in advance what sexual activities you will say 'yes' to and discuss these with your partner. Do this before getting in 'the heat of the moment'. Communication is key in practicing abstinence. And keep in mind, if you are 'abstinent' in one behavior (such as vaginal intercourse) but not others (such as oral sex), you are still at increased risk for STDs.
Clinical abstinence is the most effective way to prevent pregnancy and STDs. Abstinence can last as long or as short as you want. Many couples choose to practice periodic abstinence to prevent pregnancy and therefore, abstain from vaginal intercourse during the times when they believe the woman is most likely to get pregnant. However, periodic abstinence can be unreliable and has a high failure rate.
Choosing to abstain doesn't mean that intimacy or close contact with your partner is jeopardized. There are many ways to show your partner how much you care for them without having sexual intercourse. 'Outercourse' is one way to do this. This refers to any activity that can be shared between two people that does not involve the exchange of 3 main bodily fluids ' semen, vaginal secretions, and/or blood. This can include kissing, touching, massage, dancing, etc. Outercourse can keep intimacy alive in your relationship without putting yourself or your partner at risk for contracting STDs or getting pregnant.
How effective is abstinence?
Close to 100% effective
Benefits
- No doctor's visit is required
- Free
- Less likely to get an STD
- Anyone can use this method
Disadvantages
- May be difficult for some to stay abstinent for long periods of time
- If semen spills on or near the vagina, pregnancy is still a possibility, even without penetration
- STDs such as Herpes and HPV are contracted through skin-to-skin contact and therefore may be passed on even through there is no vaginal, oral or anal sex.
5/03, Becky Griesse, CHES
Talking About Sex
Communication
Deciding whether or not to have sex is an important part of a relationship. But even after you've made a decision, raising the subject can be difficult. It's natural to feel uncomfortable. Sexuality is not a topic many people have practice discussing. However, it is important to take responsibility for clearly communicating your sexual concerns. Expecting our partners to somehow know what we want without telling them places a heavy burden on them. Don't expect your partners to read your mind. Here are suggestions for dealing with what can be a very awkward situation.
How does one begin communicating about sex?
Getting started is the hardest part. After that, the conversation should get easier. Your partner will probably feel relieved that you brought up the issue. You might begin by discussing why it is hard to talk about sex. Individuals have different reasons for their uneasiness. Understanding those reasons can help set a solid foundation and often provides a good beginning for communication. Without such an understanding you risk experiencing or inflicting emotional and even physical harm. Inflicting harm in this way is unacceptable, unlawful, and in violation of the University Judicial Code. Read articles or books on sex that can provide a stimulus for discussion. Start with less personal topics such as discussing contraception technology and gradually move to more personal feelings and concerns as your comfort increases.
When is communication most effective?
Effective communication requires clear and accurate messages, honesty, openness, and sincerity. First, be prepared to talk when the time seems right. Be flexible about when to bring up the subject but don't wait until sexual intimacy is moments away.
It is most effective when there is an active listener and an effective communicator. The listener may facilitate communication by maintaining eye contact with his/her partner, asking questions, making brief comments, expressing appreciation for communication efforts, and using paraphrasing effectively. By summarizing in your own words your partner's message, you confirm that you understand. Showing attention encourages your partner to continue sharing important concerns. It is also useful to make sure you know each other's expectations. Ask your partner to provide some response to a message you think is important. "What are your thoughts about what I have just said?" encourages feedback.
Sexual communication is not confined to words alone. Facial expressions, touching, and sounds also convey a great deal of information. The value of nonverbal communication lies primarily in its ability to supplement verbal exchanges.
Pay attention to your partner's response. Slow down if your partner seems to be having trouble with what you're saying. Give your partner time to think about what you've said.. A lot of myths and fears exist about HIV and other STDs. If you are telling your partner that you have an STD, your partner may need time to adjust.
How do I ask those difficult questions?
Use open-ended questions to allow your partner freedom to express his/her thoughts. For example, "What do you think about...?", "How do you feel about...?". Avoid asking yes or no questions when you want to discuss an issue because you may get no more than the specific information requested. However, sometimes a brief yes or no is all that is necessary.
If you want to be more specific, structure your approach by asking either/or questions. This is helpful if your partner does not know where to begin with a response. For example, "Would you like to talk now, or would you prefer we wait for another time?" This also encourages more participation than simple yes or no questions.
Express your needs and desires from a personal perspective rather than tell the other person what to do. For example, "I would like us to practice safer sex...and I have a condom with me" rather than "You need to use protection before you can have sex with me." By beginning sentences with "I" language when stating your needs or requests to your partner you open up communication in a positive non-judgmental manner and help put your partner at ease. Your partner is more likely to be honest in return. Avoid "Why" questions as they often are taken as an attack or criticism. Rather than representing simple requests for information, they are typically used to convey hidden messages of anger that people are unwilling to communicate honestly.
How can I discover what my partner wants?
Finding out what someone desires sexually can be a risky and awkward experience, even for the most skilled partner. If you get to know your partners and develop lasting, trusting relationships, communication usually becomes easier. Slowly over time, you learn what she or he desires. But how do you discover what your partner desires if it's a limited relationship or merely a one-night stand?
"Just ask" is an easy answer that handbooks like this one love to give. But finding out what someone desires sexually is a complicated process of verbal consent, body language, and trust. No single method works every time. So it's up to you every time you get the urge to act, to figure out how to ask. Be creative. Make it part of the "turn on." Asking consent can show you are more sophisticated than the typical person who uses bumbling, awkward "trial-and-error" methods most of us learned in high school.
Many people may rely on body language alone to communicate their intentions and desires. For instance, if you're interested in kissing someone, you might move toward their lips slowly, allowing them time to turn away or back off. For some people, this is the most comfortable and least awkward way to initiate or receive sexual intimacy. But for others it might be confusing and intrusive. Unfortunately there is no universal dictionary that tells you what body language means. Therefore asking the person "Can I kiss you?" or even "Will you kiss me?" may be the best way to clarify exactly what you want and allow your partner the opportunity to voice his or her needs as well.
Although it helps, your conversations do not always have to be so direct. Asking someone, "What do you feel like doing?" or "What's on your mind" can help both of you begin to talk about what feels comfortable and exciting. Or, focusing on a specific issue or aspect of sexual activity can be useful. If you are interested in oral sex or intercourse, asking "Should I get a condom?" or "What flavor dental dam would you like?" could be a way to ease tension and still broach the subject.
Choose whatever method of communication is most comfortable and effective for you, but be aware that using words to describe how you feel and what you want may leave fewer questions or doubts in the minds of your partners.
How do I say no?
First, have a definite plan or strategy in mind for saying no to intimate invitations. This can help prevent being caught off guard and not knowing how to handle a potentially unpleasant situation. One approach that may be helpful involves the following.
Step 1: Say no in a clear, unequivocal fashion.
Step 2: Offer an alternative. This step will not always be an option if you wish to have no further contact with that person.
Avoid sending mixed messages. Occasionally check for inconsistencies between verbal messages and subsequent actions. Recipients of mixed messages might find it helpful to express their confusion and to ask which of the two messages they are expected to act on. Saying no in clear, unmistakable language is essential.
What if I say no and my partner remains persistent?
The "broken-record" technique of repeating your statement may help you stick to your values and needs without being manipulated by your partner to do something you don't want.
- Walk away from the situation.
- Avoid arguing and explaining yourself.
- The bottom line is that your body belongs to you. It is unloving and unethical for a partner to push, coerce, or force you to be sexual or intimate in ways that you are uncomfortable.
How do I convince my partner to practice safer sex?
The examples below illustrate how a conversation about condom use may proceed if you continue to state your commitment to safer sex.
Example:
Chris: "I don't like condoms, they ruin my sensitivity."
Pat: "Yes, I'm sure they can but I want to use one if we have intercourse."
Chris: "I can't keep an erection if I use a condom."
Pat: "Maybe it would help if I put it on...but we don't have to have intercourse if you don't want to wear one."
Chris: "I want to have sex right now...just this time without a condom won't matter."
Pat: "I want to have intercourse too, but I want us to use a condom if we do."
What if I already know I have an STD?
Talking openly and honestly about STDs and practicing safer sex helps educate partners and breaks the chain of transmission. If an STD is not talked about, your partner's health is being risked without that person having any choice in the matter. Receiving treatment is crucial and talking about treatment with a partner is appropriate and important. Your partner may be uncomfortable and need time to think things through before making a decision. This does not necessarily mean rejection. Although exercising patience may be difficult, it pays off in the end.
Remember to be clear in your own mind about what you will and will not do sexually. Knowing what you want will make it easier to talk about.
Adapted from Promoting Behavior Changes: Interactive Skill Building. ACHA HIV/AIDS Prevention Workshops. Jeffrey M. Gould and Anne R. Lomax 1991; Crooks, Robert and Karla Baur. Our Sexuality. 3rd edition. Benjamin/Cummings Publishing Co., Inc., Menlo Park, CA: 1987. Chapter 8 "Communication in Sexual Behavior" pp. 234-265; Lisa Barber-Murphy, M.Ed., CHES; Jason Schultz, `93.
The Condom Comeback
Condom excuse: "It doesn't feel good."
Condom comebacks: "If you're uncomfortable using condoms then let's try something other than intercourse."
-or- "Neither does sleeping alone."
Condom excuse: "It spoils the mood."
Condom comebacks: "The mood will come back."
-or- "So does your attitude."
Condom excuse: "It takes too long."
Condom comebacks: "Then you need practice and there's no time like the present."
-or- "Let me help you put it on."
-or- "A condom can make sex last longer."
-or- "We have all night. What's the rush?"
-or- "It's worth the wait."
Condom excuse: "You won't catch anything from me."
Condom comebacks: -or- "Yes, but you might catch something from me."
-or- "I know I won't, because either we use a condom or we are not having intercourse."
-or- "Then you won't get anything from me."
Condom excuse: "Just this once won't matter."
Condom comebacks: "It only takes once."
-or- "Then just this once I'll have to say no."
Lisa Barber-Murphy, M.Ed., CHES, rev 11/99
Last Modified Date: 08/21/00
Latex Dams
(STD protection only)
What is a latex dam?
A silky, thin piece of lightly scented natural latex designed to act as a barrier during oral sex on a woman or oral/anal sex (rimming). When used properly, a latex dam can help reduce the risk of transmitting STDs (sexually transmitted diseases).
How do you use a latex dam?
For oral sex on a woman, remove and lay it flat covering the entire vulva, vaginal opening and clitoris. For anal/oral sex, cover anus using a latex dam. For additional lubrication, moisten the vulva or anal area with a water-based personal lubricant (such as WET, ForPlay, or Astroglide), before putting the dam in place, taking care not to leave lubricant on your fingers. Lubricant on the fingers may make it difficult to hold the dam in place. Be sure not to flip over the dam or switch sides ' if necessary, use another dam.
Always use a new dam if you switch from oral/anal to oral/vaginal sex to reduce the risk of infection from harmful anal germs. Do not share latex dams. Dispose of the latex dam after one use by placing it back in the original package and throwing it away ' do not try to flush down the toilet.
Do not stretch the dam.
Do not expose to direct sunlight - heat and light accelerate the degradation of latex film.
Store in a cool, dry place, at room temperature (59-86 degrees F).
Do not use during penetrating penile/vaginal or penile/anal intercourse.
This product contains natural rubber latex which may cause allergic reactions in some individuals. If you experience a reaction, stop using this product and contact your physician.
Availability
If you can not find latex dams, you can use a condom, latex glove or non-microwaveable plastic wrap.
To make a dam out of a condom:
- be sure to use one without spermicide on it
- unwrap and unroll the condom
- cut off the tip and base
- cut up one side.
5/20/03 Becky Griesse, CHES
Source:
Sheer Glyde Dams: http://www.sheerglydedams.com/
Glossary of Sexual Health Related Terms
AIDS
Acquired Immune Deficiency Syndrome; an infectious disease which destroys the immune system's ability to fight infections; caused by a virus (HIV) which is transmitted through contact with infected blood, semen, breast milk, vaginal and cervical secretions. HIV may also be transmitted from an infected woman to her baby during pregnancy or in the birth process.
Anal intercourse
sexual behavior in which one person's penis is inserted into another's anus
Bisexual
a person who feels sexually attracted to or has had sexual contact with both males an females
Candidiasis
a vaginal infection that is caused by the excessive growth of a yeastlike fungus that occurs normally in the body
Chlamydia
an often asymptomatic, but treatable, sexually transmitted disease; can cause permanent damage to reproductive organs
CIN
Cervical Intraepithelial Neoplasia; a pre-cancerous condition initiated by the human papillomavirus (HPV)
Coitus interruptus
a birth control method in which the male removes his penis form a woman's vagina before ejaculation; also called withdrawal
Condyloma
genital warts, caused by a virus called the Human Papillomavirus (HPV)
Contraception
techniques, devices or drugs used to prevent pregnancy; also called birth control
Cowper's glands
two small structures, attached to the urethra in the male, that secrete a few drops of clear, sticky fluid during sexual arousal
Cunnilingus
the oral stimulation of the female genitals
Cyrotherapy
a procedure in which liquid nitrogen is used to destroy genital warts by freezing the area
Cystitis
an inflammation of the urinary bladder causing painful and frequent urination
Diaphragm
a dome-shaped rubber contraceptive device that is inserted into the vagina to block the cervical opening
Dysmenorrhea
pain experienced before or during menstruation; typically backaches, abdominal cramps, and aches in the thighs
Dysplasia
abnormal cell growth
Ectopic pregnancy
a pregnancy in which the fertilized egg implants itself in a site other than the uterus, most often a fallopian tube
Ejaculation
the expulsion of semen from the penis, usually during orgasm
ELISA
Enzyme-Linked Immunosorbent Assay; one of several blood tests used to diagnose the HIV infection
Emergency
post-coital contraceptive taken within 72 hours of unprotected sex
Contraception
Estrogen
hormones produced primarily by the ovaries; responsible for sexual maturation, regulation of the menstrual cycle, and maintenance of the uterine lining fallopian tubes - the two narrow tubes that were as a pathway for the eggs to move form the ovaries to the uterus
Fellatio
the oral stimulation of the male genitals
Genitals
the sex organs of males and females, typically the penis, testes and scrotum in males and the vulva in females
Genital warts
lesions or growths which occur on or around the genitals, anus or throat; spread through sexual contact
Glans
the tip of the penis or clitoris, rich with nerve endings
Gonads
the testes or ovaries (reproductive glands)
Gonorrhea
a sexually transmitted disease usually spread through vaginal intercourse; difficult to detect because often asymptomatic
Herpes
a common viral infection which causes cod sore-like blisters or rashes around the mouth or genitals; spread by skin-to-skin contact with the infected area
Heterosexuality
a sexual orientation in which a person is sexually, emotionally, and socially attracted towards members of the opposite sex
HIV
Human Immunodeficiency Virus: A virus which causes AIDS or other life threatening opportunistic infections
Homophobia
an irrational fear of or hostility towards homosexuals
Homosexuality
a sexual orientation in which a person is sexually, emotionally, and socially attracted toward members of the same sex
Hormones
chemical substances, secreted by the endocrine glands in the bloodstream, that have an effect on physiological functioning and psychological behavior
HPV
Human Papillomavirus; the family of over 100 viruses, some of which cause genital warts
IFA
Immunofluorescent Assay; one of the several blood tests used to diagnose HIV
Impotence
the inability to have or maintain a firm erection despite stimulation; also called erectile dysfunction
Infertility
the inability of a man, woman, or couple to conceive child, usually after one year of trying
Intrauterine device
a small plastic device inserted into the uterus for birth control
(IUD)
Latex condoms
an impermeable rubber sheath which fits over the erect penis and functions as a contraceptive device; helps protect against some sexually transmitted disease, including HIV/AIDS
Nonoxynol-9
a spermicide, which is effective in preventing pregnancy and some STDs when used with a condom
Oral contraceptive
birth control pills
Ovulation
the process by which a mature egg is released from the ovary
Ovum
a mature egg cell
Pap smear
a procedure in which a small sampling of vaginal cells are taken from the cervix to test for cervical cancer
Pelvic inflammatory
an inflammation of the fallopian tubes, the lining of the uterus,
disease (PID)
and/or the lower abdominal cavity; result of various bacterial infections, such as chlamydia or gonorrhea
Premature ejaculation
a common male sexual dysfunction in which ejaculation uncontrollably occurs before or shortly after intercourse begins
Premenstrual
a combination of physical and psychological symptoms that some
syndrome (PMS)
women experience prior to menstruation
Prodrome
first stage of herpes infection, often characterized by tingling
Progesterone
a hormone that maintains the uterine lining during pregnancy
Recurrences
herpes outbreaks which occur again at irregular intervals
Rimming
the oral stimulation of the anus; also referred to as analingus
Semen
a mildly white fluid, containing sperms, that is ejaculated from the penis during orgasm
Seminal vesicles
two sac-like organs that contribute secretions to seminal fluid
Sexually transmitted
an infection caused by a bacteria, virus, or protozoa; transmitted
disease (STD)
primarily through genital contact; also sometimes referred to as a sexually transmitted infection (STI)
Skin condoms
a sheath made from animal membranes which fits over the erect penis and functions as a contraceptive device; it does not protect against STDs
Sperm
the male reproductive cell which contains half of the chromosomes necessary for fertilizing an egg
Spermatogenesis
sperm production
Spermicides
contraceptive chemicals that kill sperm
Syphilis
STD caused by a microorganism which enters the bloodstream
Testes
the pair of male reproductive glands, located in the scrotum, which produce sperm and sex hormones
Testosterone
a hormone secreted by the testes in the male and adrenal cortex in both sexes
Toxic shock
an illness occurring when highly absorbent tampons provide an
syndrome
environment of growth of bacteria in the vagina
Trichomoniasis
a common vaginal infection, characterized by an odorous, yellowish discharge and vaginal itching; caused by a parasite (trichomonas); also sometimes shortened to 'trich'
Vaginal film
a spermicide inserted next to the cervix
Vas deferens
ducts that carry sperm form the testes to the base of the urethra
Vasocongestion
in response to sexual arousal, the accumulation of blood in the vessels and tissues of various body parts, especially the genitals
Western Blot
one of several blood tests used to diagnose HIV