Condoms and STDs -- Especially AIDS


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A Condom Could Save your Life?



Provided by Department of Health & Human Services



The booklet is to help you understand why it's important to use condoms (rubbers, prophylactics) to help reduce the spread of sexually transmitted diseases. These diseases include AIDS, chlamydia, genital herpes, genital warts, gonorrhea, hepatitis B and syphilis. You can get them through having sex--vaginal, anal or oral.

The surest way to avoid these diseases is to not have sex altogether (abstinence). Another way is to limit sex to one partner who also limits his or her sex in the same way (monogamy). Condoms are not 100% safe, but if used properly, will reduce the risk of sexually transmitted diseases, including AIDS. PROTECTING YOURSELF AGAINST THE AIDS VIRUS IS OF SPECIAL CONCERN BECAUSE THIS DISEASE IS FATAL AND HAS NO CURE.

About two-thirds of the people with AIDS in the United States got the disease during sexual intercourse with an infected partner. EXPERTS BELIEVE THAT MANY OF THESE PEOPLE COULD HAVE AVOIDED THE DISEASE BY USING CONDOMS.

Condoms are used for both birth control and reducing the risk of disease. That's why some people think that other forms of birth control--such as the IUD, diaphragm, cervical cap or pill--will protect them against diseases too. But that's not true. SO IF YOU USE ANY OTHER FORM OF BIRTH CONTROL, YOU STILL NEED A CONDOM IN ADDITION TO REDUCE THE RISK OF GETTING SEXUALLY TRANSMITTED DISEASES.

A condom is especially important when an uninfected pregnant woman has sex, because it can also help protect her and her unborn child from a sexually transmitted disease.

THIS BOOKLET WILL ANSWER MANY OF YOUR QUESTIONS ABOUT CONDOMS. YOU WILL LEARN:

  • Who should use a condom;
  • What the Federal Government and condom manufacturers are doing to help ensure that the condoms you buy are of high quality;
  • What you need to know to choose, store, and use condoms the right way.


Keep this booklet handy and refer to it when you have questions about condoms. Note well: Condoms are not 100% safe, but if used properly, will reduce the risk of sexually transmitted diseases, including AIDS.

FACTS ABOUT SEXUALLY TRANSMITTED DISEASES

  • Sexually transmitted diseases (STDs) affect 12 million men and women in the United States each year.
  • Anyone can become infected through sexual intercourse with an infected person.
  • Many of those infected are teenagers or young adults.
  • Changing sexual partners adds to the risk of becoming infected.
  • Sometimes, early in the infection, there may be no symptoms, or symptoms may be easily confused with other illnesses.


Sexually transmitted diseases can cause:
  • Tubal pregnancies, sometimes fatal to the mother and always total to the unborn child.
  • Death or severe damage to a baby born to an infected woman.
  • Sterility (loss of ability to get pregnant).
  • Cancer of the cervix in women.
  • Damage to other parts of the body, including the heart, kidneys and brain.
  • Death to infected individuals.


See a doctor if you have any of these symptoms of STDs:
  • Discharge from the vagina, penis and/or rectum.
  • Pain or burning during urination and/or intercourse.
  • Pain in the abdomen (women), testicles (men), and buttocks and legs (both).
  • Blisters, open sores, warts, rash, and/or swelling in the genital area, sex organs, and/or mouth.
  • Flu-like symptoms, including fever, headache, aching muscles, and/or swollen glands.


You can get more information about preventing sexually transmitted diseases by calling the National AIDS Hotline, the National Sexually Transmitted Diseases Hotline, or your state or local hotlines.

ANSWERS TO YOUR QUESTIONS

  1. Who should use a condom?

    A PERSON WHO TAKES PART IN RISKY SEXUAL BEHAVIOR SHOULD ALWAYS USE A CONDOM.

    The highest risk comes from having intercourse--vaginal, anal or oral--with a person who has a sexually transmitted disease. If you have sex with an infected person, you're taking a big chance. IF YOU KNOW YOUR PARTNER IS INFECTED, THE BEST RULE IS TO AVOID INTERCOURSE (INCLUDING ORAL SEX). If you decide to have sex with an infected partner, you should ALWAYS be sure a condom is used from start to finish, every time.

    And it's risky to have sex with someone who has shared needles with an infected person.

    It's also risky to have sex with someone who had sex with an infected person in the past. If your partner had intercourse with a person infected with HIV (the AIDS virus), he or she could pass it on to you. That can happen even if the intercourse was a long time ago and even if your partner seems perfectly healthy.

    With sexually transmitted diseases, you often can't tell whether your partner has been infected. If you're not sure about yourself or your partner, you should choose to NOT have sex at all. BUT IF YOU DO HAVE SEX, BE SURE TO USE A CONDOM THAT COVERS THE ENTIRE PENIS TO REDUCE YOUR RISK OF BEING INFECTED. This includes oral sex where the penis is in contact with the mouth.

    If you think you and your partner should be using condoms but your partner refuses, then you should say NO to sex with that person.

  2. Will a condom guarantee I won't get a sexually transmitted disease?

    NO. THERE'S NO ABSOLUTE GUARANTEE EVEN WHEN YOU USE A CONDOM.

    But most experts believe that the risk of getting AIDS and other sexually transmitted diseases can be greatly reduced if a condom is used properly.

    In other words, sex with condoms ISN'T totally "safe sex," but it IS "less risky" sex.

  3. How can I get the most protection from condoms?
    • Choose the right kind of condoms to prevent disease. Be sure to choose:
      • Latex
      • Disease prevention claim on package label

      Also consider:

      • With spermicide
      • Separate spermicide
        • Gel
        • Cream
        • Foam

      • With lubricant
      • Separate lubricant (Select only water-based lubricants made for this purpose.)

    • Store them properly.
    • Remember to use a NEW condom EVERY TIME you have sex.
    • Use the condom the right way, from start to finish.

  4. How does a condom protect against sexually transmitted diseases?

    A CONDOM ACTS AS A BARRIER OR WALL TO KEEP BLOOD, OR SEMEN, OR VAGINAL FLUIDS FROM PASSING FROM ONE PERSON TO THE OTHER DURING INTERCOURSE.

    These fluids can harbor germs such as HIV (the AIDS virus). If no condom is used, the germs can pass from the infected partner to the uninfected partner.

  5. How do I choose the right kind of condoms to prevent disease?

    ALWAYS READ THE LABEL. Look for two things:

    • THE CONDOMS SHOULD BE MADE OF LATEX (RUBBER).

      Tests have shown that latex condoms can prevent the passage of the AIDS, hepatitis and herpes viruses. But natural (lambskin) condoms may not do this.

      In the future, manufacturers may offer condoms of other materials and designs for disease prevention. As with all new products that make medical claims, such as "prevention of sexually transmitted diseases," these new condoms would have to be reviewed by the U.S. Food and Drug Administration (FDA) before they are allowed to be sold.

    • THE PACKAGE SHOULD SAY THAT THE CONDOMS ARE TO PREVENT DISEASE.

      If the package doesn't say anything about preventing disease, the condoms may not provide the protection you want, even though they may be the most expensive ones you can buy.

      Novelty condoms will not say anything about either disease prevention or pregnancy prevention on the package. They are intended only for sexual stimulation, not protection.

      Condoms which do not cover the entire penis are not labeled for disease prevention and should not be used for this purpose. For proper protection, a condom must unroll to cover the entire penis. This is another good reason to read the label carefully.

  6. What is the government doing about condom quality?

    THE FDA IS WORKING WITH CONDOM MANUFACTURERS TO HELP ENSURE THAT THE LATEX CONDOMS YOU BUY ARE NOT DAMAGED.

    Manufacturers "spot check" their condoms using a "water-leak" test. FDA inspectors do a similar test on sample condoms they take from warehouses. The condoms are filled with water and checked for leaks. An average of 996 of 1000 condoms must pass this test.

    (Don't try the water-leak test on condoms you plan to use, because this kind of testing weakens condoms.)

    Government testing can NOT guarantee that condoms will always prevent the spread of sexually transmitted diseases. HOW WELL YOU ARE PROTECTED WILL ALSO DEPEND A GREAT DEAL ON WHICH CONDOM YOU CHOOSE AND HOW YOU STORE, HANDLE AND USE THEM.

  7. Are condoms strong enough for anal intercourse?

    THE SURGEON GENERAL HAS SAID, "CONDOMS PROVIDE SOME PROTECTION, BUT ANAL INTERCOURSE IS SIMPLY TOO DANGEROUS A PRACTICE."

    Condoms may be more likely to break during anal intercourse than during other types of sex because of the greater amount of friction and other stresses involved.

    Even if the condom doesn't break, anal intercourse is very risky because it can cause tissue in the rectum to tear and bleed. These tears allow disease germs to pass more easily from one partner to the other.

  8. Should spermicides be used with condoms?

    In test tubes, a spermicide called nonoxynol-9 (a chemical used to kill the man's sperm for birth control) has been shown to kill the germs that cause sexually transmitted disease. Some experts believe nonoxynol-9 may kill the AIDS virus during intercourse, too. SO YOU MIGHT WANT TO USE A SPERMICIDE ALONG WITH A LATEX CONDOM AS AN ADDED PRECAUTION IN CASE THE CONDOM BREAKS DURING INTERCOURSE.

    Condoms with spermicides have an expiration date. Pay attention to that date.

  9. How do I buy spermicides and how should they be used?

    Spermicides generally come in the form of jellies, creams or foams. You can buy them in pharmacies and some grocery stores.

    You can also buy condoms with a small amount of spermicide already applied. But some experts believe it's a good idea to add more spermicide to the amount that comes on the condom.

    If you do add a spermicide, place a small amount inside the condom at its tip. After the condom is on the penis, put more on the outside. Spermicides can also be put inside the woman's vagina. Follow the directions for use.

    If you have oral sex, use a condom without a spermicide. Although swallowing small amounts of spermicide has not proven harmful in animal tests, we don't know if this is always true for people.

    Spermicide products and condoms with spermicides have expiration dates. Don't buy or use a package that is outdated.

  10. Should I use a lubricant with a condom?

    Some condoms are already lubricated with dry silicone, jellies or creams. IF YOU BUY CONDOMS NOT ALREADY LUBRICATED, IT'S A GOOD IDEA TO APPLY SOME YOURSELF. Lubricants may help prevent condoms from breaking during use and may prevent irritation, which might increase the chance of infection.

    If you use a separate lubricant, be sure to use one that's water-based and made for this purpose. If you're not sure which to choose, ask your pharmacist.

    Never use a lubricant that contains oils, fats, or greases such as petroleum-based jelly (like Vaseline brand), baby oil or lotion, hand or body lotions, cooking shortenings or oily cosmetics like cold cream. They can seriously weaken latex, causing a condom to tear easily.

    Your pharmacist can answer your questions concerning condoms and spermicides.

  11. Does it matter which styles of condoms I use?

    IT'S MOST IMPORTANT TO CHOOSE LATEX CONDOMS THAT SAY "DISEASE PREVENTION" ON THE PACKAGE.

    Other features are a matter of personal choice.

  12. What do the dates mean on the package?

    Some packages show "DATE MFG." This tells you when the condoms were made. It is NOT an expiration date.

    Other packages may show an expiration date. The condoms should not be purchased or used after that date.

  13. Are condoms from vending machines any good?

    It depends. Vending machine condoms MAY be OK:
    • If you know you are getting a latex condom,

    • If they are labeled for disease prevention,

    • If you know the spermicide (if any) is not outdated, and

    • If the machine is not exposed to extreme temperatures and direct sunlight.

  14. How should condoms be stored?

    You should store condoms in a cool, dry place out of direct sunlight, perhaps in a drawer or closet. If you want to keep one with you, put it in a loose pocket, wallet or purse for no more than a few hours at a time.

    Extreme temperatures--especially heat--can make latex brittle or gummy (like an old balloon). So, don't keep these latex products in a hot place like a glove compartment.

  15. How should condoms be handled?

    GENTLY! When opening the packet, don't use your teeth, scissors or sharp nails. Make sure you can see what you're doing.

  16. What defects should I look for?

    IF THE CONDOM MATERIAL STICKS TO ITSELF OR IS GUMMY, THE CONDOM IS NO GOOD.

    Also, check the condom tip for other damage that is obvious (brittleness, tears, and holes). Don't unroll the condom to check it because this could cause damage.

    NEVER USE A DAMAGED CONDOM.

  17. How should I use a condom?

    Follow these guidelines:
    • Use a new condom for every act of intercourse.

    • If the penis is uncircumcised, pull the foreskin back before putting the condom on.

    • Put the condom on after the penis is erect (hard) and before ANY contact is made between the penis and any part of the partner's body.

    • If using a spermicide, put some inside the condom tip.

    • If the condom does not have a reservoir tip, pinch the tip enough to leave a half-inch space for semen to collect.

    • While pinching the half-inch tip, place the condom against the penis and unroll it all the way to the base. Put more spermicide or lubricant on the outside.

    • If you feel a condom break while you are having sex, stop immediately and pull out. Do not continue until you have put on a new condom and used more spermicide.

    • After ejaculation and before the penis gets soft, grip the rim of the condom and carefully withdraw from your partner.

    • To remove the condom from the penis, pull it off gently, being careful semen doesn't spill out.

    • Wrap the used condom in a tissue and throw it in the trash where others won't handle it. Because condoms may cause problems in sewers, don't flush them down the toilet. Afterwards, wash your hands with soap and water.

    • Finally, beware of drugs and alcohol! They can affect your judgment, so you may forget to use a condom. They may even affect your ability to use a condom properly.


SEXUALLY TRANSMITTED DISEASES, INCLUDING AIDS, CAN BE PREVENTED!

Learn the facts so that you can protect yourself and others from getting infected. Condoms are NOT 100% safe, but if used properly, will reduce the risk of sexually transmitted diseases, including AIDS. If you have unprotected sex now, you can contract sexually transmitted diseases. Later, if you decide to have children, you might pass the diseases on to them.

If you would like more information about condoms and how to prevent sexually transmitted diseases, talk with your doctor or call the National AIDS Hotline. It's open 24 hours a day. Trained operators will answer your questions and can send you more information.

For AIDS information in English, 1-800-342-AIDS.
For AIDS information in Spanish, 1-800-344-SIDA.
Deaf Access, 1-800-AIDS-TTY
The National STD Hotline, 1-800-227-8922

Dept. of Health & Human Services
Public Health Service
Food and Drug Administration
Center For Devices and Radiological Health
HHS Publication FDA 90-4239

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