1. Are Sexually Transmitted Infections (STIs) on the rise?
Recent evidence from Public Health England shows that in recent years there have been steep rises in some STIs in some groups, particularly men who have sex with men (MSM) and young (16-25 year old) heterosexuals:
2. What is the best way to protect myself from STIs, including HIV?
You can protect yourself and your partner from HIV and other STIs by making sure that exposure does not occur – and by reducing the chance of HIV or STI transmission to yourself or your partner if exposure does occur.
Condoms are still the cheapest, easiest and least complicated way to protect against HIV and STIs.
- to get tested regularly (at least once a year, or more frequently if you are classed as ‘high risk’)
- only having sex with others who you are sure are HIV-negative. Although do remember that every risk exposure means that you need to wait to ensure the latest HIV test is conclusive (allowing for the “window period” of infection showing up in the test).
You can also vary the sexual activities you do – such as avoiding penetrative sex.
Medical interventions can also greatly reduce the chance of HIV infection. These include drug interventions, such as PEP or, if your partner is HIV positive, relying on him or her being much less infectious as a result of taking HIV medication which can result in an “undetectable viral load”.
3. Why should I use a condom?
Condoms, when used effectively, prevent exposure to HIV as they create a barrier against HIV-infected body fluids (vaginal fluid, semen or anal mucus). They also protect against many infectious STIs such as gonorrhoea, chlamydia and syphilis – although it’s important to note that even condoms do not provide 100% protection, and regular screening (especially if you have symptoms) is vital.
4. What condoms should I use?
You should only use condoms which carry a British Standard kitemark or CE mark and which are within their expiry date.
Because the human body varies so widely, condom manufacturers have created a huge range of different types of condom to suit individual size, shape and sensitivity. So shop around until you find the kind that fits you best.
Some people have a latex (rubber) allergy. For those people, non-latex condoms, like Durex Avanti, Mates Skyn and Pasante Unique should be used.
For men who have problems with condoms, such as loss of sensitivity, or premature ejaculation, there are products on the market to help with this. Extra thin condoms are available from most shops and online. Some outlets also sell ‘delaying’ condoms which can help with premature ejaculation.
5. How do I put on a condom correctly?
This video, and the step by step instructions below, explain how to use a condom correctly:
- Remove the condom from the wrapper carefully using your fingers – do not use your teeth to open the packet as you could damage the condom before you use it.
- Squeeze the air out of the teat on the tip of the condom and place it over the erect penis.
- Roll the condom down the length of the erect penis to the base of the shaft (near your pubic hair).
- If necessary, apply some water-or-silicone-based lubricant over your condom-covered penis. This is especially important for anal sex as the anus is not self-lubricating, whereas vaginal fluid does provide lubrication during sex.
- Be sure to check the condom occasionally during intercourse, to ensure it is still intact and hasn’t split.
- After ejaculation, pull out whilst holding on to the base of the condom, so that you don’t leave it behind. Be sure to pull out before your penis becomes soft.
- Remove the condom carefully and wrap it inside tissue. Dispose of it in the bin – don’t flush it down the toilet to protect the environment.
- Wash your hands (and your penis) to be sure you do not have any body fluids on your hands and further reduce the risk of STI transmission.
6. What lubricant should I use?
Lubricating a condom is especially important for anal sex (the anus is not self-lubricating) and in vaginal sex (if the female partner has vaginal dryness).
If you don’t use enough lubricant, or use the wrong kind, it can increase the risk of “condom failure”. This makes transmission of HIV and other STIs possible.
You should only use water-based lubes (for example K-Y Jelly, Liquid Silk and ID Glide) and silicone-based lubes (Eros Bodyglide and Skyn Max) with latex condoms.
Using oil-based lubricants such as Vaseline, cooking oil, moisturiser, sun cream, baby oil or butter is very risky as these products damage condoms and can cause them to break. However, oil-based lubricants can be used ONLY with non-latex condoms such as Durex Avanti, Mates Skyn or Pasante Unique.
One last thing: don’t rely on saliva to lubricate your condom as it dries quickly, and your condom could tear easily.
7. What is condom failure?
Sexual health clinics often report patients who have experienced “condom failure”. This is when the condom has torn, split or come off during sex, increasing the risk of HIV and STI transmission. Reasons for this include:
- Failure to put a condom on properly (see Question 5 above)
- Condom has split because it dried out – perhaps from not using lubricant, or using spit
- Condom has split because oil-based lubricant was used, damaging the rubber during sex
- Having sex for a long time without checking the condom, without re-lubricating or without changing to a new condom if it has torn
- Using a condom that has passed its expiration date (always check the packet).
8. Where can I get condoms from?
The London HIV Prevention Programme (Do It London) currently provides over 80 gay bars, clubs and saunas in London with free condoms that can be picked up by popping in. You do not have to buy a drink to collect your free condoms, as they are funded and provided by local authorities in the city.
Our condom partner is the well-known NHS Freedoms Shop. Do It London condoms are intended to be a “starter pack” for use in an emergency. But the free scheme is a stretched public resource so we encourage you to buy your own condoms and lube to ensure you always have a supply.
Freedoms also offers an extremely cheap/subsidised online service that anyone can use to purchase a range of condoms and lube. They have a “try before you buy” service which can help you choose the best condom for you. For a wider selection of condoms and other safe sex products, visit the Freedoms website, or call their dedicated team on 020 7685 5977.
Of course, you can also buy condoms at the supermarket, at your high street chemist, as well as at many newsagents and 24 hour petrol stations.
8. Do I need to use a condom even if my partner is on the pill?
When you have sex, both of you are responsible for your sexual health – protecting yourselves against pregnancy and sexually transmitted infections (STIs). Having sex without a condom puts you and your partner(s) at risk of infection.
You or your partner may not realise that you have an STI because many people have no noticeable symptoms – around 70% of women with chlamydia and 50% of men with chlamydia don’t have symptoms. Just because you can’t see any obvious symptoms, such as sores or warts, it doesn’t mean you’re free from STIs.
Some people think it’s acceptable to pressure their partner into having sex without a condom. It’s not. People might have several reasons for not wanting to use one.
Find out more about why condoms are so important.
9. Do I need to use a condom even if I intend to pull out?
The “pull out” method is NOT effective to protect against HIV or STIs. Although HIV is found in large quantities in semen, it is also present in pre-ejaculate (or “pre-cum”) and vaginal fluid and anal mucus. This means that, even without ejaculation, there is a risk to both partners if HIV is present in bodily fluids.
Similarly, most bacterial STIs are present in the mucous membranes, rather than in semen, so there is a high risk of transmitting STIs through penetration even without ejaculation, if they are present.
10. Do condoms come in different sizes?
Yes – and different shapes too. See Freedoms shop for the range.
11. I don’t cheat on my partner therefore I don’t need to wear a condom, do I?
The decision on whether to stop using condoms is one that you must make together. It’s important to get tested for HIV and STIs before you stop using condoms, to make sure that either of you can be treated for any infections that are present to enable you to have condomless sex without risk of passing anything on.
If one of you were to have a sexual encounter outside the relationship, you would need to let the other person know (especially if that encounter is unprotected) to ensure that you can review your decision not to use condoms and, if necessary, start the process of using condoms, getting tested and deciding together about the shared responsibility of ceasing to use condoms.