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Appendix IV: Condoms and safer sex


Even before AIDS, condoms were used to prevent sexually transmitted diseases (STD) and unplanned pregnancies. With the growing awareness that AIDS is a potential threat to all of us, condoms have been in the spotlight as one of the strategies to avoid infection with HIV, the virus that causes AIDS. For people who are already HIV-positive, condoms are one way to reduce the likelihood of passing the virus on to others.

This information sheet aims to give you clear information about the male and the female condoms and about their role in safer sex. Needless to say, this information is equally important for both men and women.

How safe are condoms?

Condoms make sex safer. They do not make sex absolutely safe. Condoms do sometimes fail – sometimes because of manufacturing defects, sometimes because the people using the condoms are not as careful as they should be. There are still risks involved in sex even if you use a condom. However, condoms greatly reduce your risk of contracting STD, including HIV infection, and avoid unplanned pregnancy. Condoms are not 100 per cent foolproof, but they are much better than using no protection at all.

Remember that it is impossible to tell by looking at a person whether he or she has HIV or another STD. Unless you are absolutely sure of your partner or partners, use a condom or another means to ensure safer sex, such as sex without penetration.

The male condom

What is a good male condom?

Condoms should be of good-quality latex, and each batch should have been routinely tested by a national consumer organization to see that the condoms meet quality standards and are not defective. In many places, tested condoms carry a quality control mark. If you are living in a place where you are not sure of the quality of condoms, your local family planning association may be able to advise you.

Using a lubricant increases the effectiveness of the condom, both in protecting against infection and in providing lubrication so that the condom does not tear. Most condoms are already lubricated when manufactured. If the condom is not lubricated, use a water-based lubricant – never use oil or greases, such as Vaseline, as they will damage the condom. If you engage in anal sex, you should use an extra-strong condom with a water-based lubricant to reduce the risk of the condom breaking.

Condoms should be packed in a non-transparent package, and not exposed to sunlight, fluorescent light, excess heat or dampness during storage. Good-quality condoms stored properly will probably last a year from the date of manufacture in tropical countries, and longer in temperate climates. If you have not used a condom before, find a new, good-quality condom and unwrap it, so that, in the future, you will be able to tell the difference between a good-quality condom and one that has deteriorated due to heat, humidity or poor storage.

How to use a male condom

1. Always check the expiration date (or date of manufacture) on the condom wrapper or package. Take the condom out of the package; make sure you don’t damage the rubber with your fingernails, jewellery or the foil of the wrapper.

2. Put the condom on after the penis has become erect, but before the penis has come into contact with the partner’s genitals. Hold the top of the condom and press out the air from the tip, so that you leave a centimetre of empty space for the semen at the top of the condom.
3. Roll the condom all the way to the base of the erect penis. Use both hands.

4. After ejaculation, withdraw the penis immediately before erection is lost, holding the rim of the condom to prevent spilling.

5. Tie a knot in the condom; wrap it in tissue and dispose of it carefully. Wash your hands.

Never re-use a condom.

How to use a male condom

1. Check expiry date on packet

2. Pinch teat

3. Roll down fully

4. After intercourse remove carefully from base

5. Tie knot and put in bin

The female condom

What is a female condom?

The female condom is a strong, soft transparent sheath made of polyurethane and intended for contraception and STD prevention, including HIV. The sheath has a flexible ring at each end. (See illustration 1, next page)

The inner ring at the closed end is used for insertion and helps keep the device at the upper end of the vagina. The ring is removable. The larger, thinner, outer ring remains outside the vagina when the condom is inserted, and anchors the condom so that the sheath covers the external genitalia as well as the base of the penis during intercourse. The condom is pre-lubricated with a non-spermicidal silicone fluid, to make insertion and movement during intercourse easier. Using the fluid has no side effects.

The condom is inserted manually into the vagina before intercourse. (See illustrations 2 and 3, next page.)

The female condom can be placed in the vagina at any time before intercourse and removed afterwards. Neither removal nor insertion requires an erect penis, as is the case with the male condom. Each condom is currently labelled for single use.

Why is the female condom important?

As women often have to rely on their partners’ willingness to use condoms during every act of sexual intercourse, there was an urgent need for other preventive methods, especially those that women can control to protect themselves against STD/HIV. Other than the male condom, the female condom is the only method that provides protection against both STD/HIV and unplanned pregnancy. Furthermore it is the only method giving this dual protection over which women themselves exercise some control.

How much does it cost?

In developed countries, the female condom is sold in pharmacies for between US$ 2 and US$ 3 per condom. A special price of less than US$ 1 has been negociated for the public sector in developing countries. As the demand increases, the price should decrease.

How can it be made available?

The female condom does not require medical supervision and, in addition to family planning and STD/HIV centres, can be distributed through a variety of other channels, such as private health practitioners, community-based services, pharmacies/chemists, and school-based clinics. These channels could also provide the necessary information about the effectiveness, safety, correct use and disposal of the female condom. Donors to family planning and STD/HIV programmes may be willing to purchase the female condom or help subsidize the price to consumers.

To avoid pregnancy, women can also use birth-control methods such as the pill or the diaphragm (cap). However, remember that only condoms – male and female – protect against STD.

How to use a female condom

1. Check expiry date on packet



4. Final position of inserted female condom