Despite this being an age where HIV drugs are known to reduce the risk of transmission, both for uninfected people and those living with the disease, one fact remains irrefutable: short of abstinence, condoms remain the single-most effective means of preventing HIV today.
While study models vary, most research indicates that condoms can reduce the risk of HIV anywhere from 80% to 93%. By comparison, pre-exposure prophylaxis (PrEP) can reduce transmission risk by between 62% and 75%, while treatment as prevention (TasP)—using antiretroviral therapy to reduce the infectivity of an HIV-positive person—has been shown to be an effective means to reduce infection risk within the constraints of a mixed-status (serodiscordant) relationship.
To ensure that you remain at minimal risk of infection, it’s important not only to use condoms correctly and consistently, but to avoid common mistakes that occur more often than you might think.
In ascending order:
8. Not sizing the condom correctly
According to research from Emory University, 13% of men surveyed said that condom slippage occurred during sex. Another study showed that 21% of African American men don’t use condoms because they are too tight. Both of these issues relate directly to incorrect condom sizing, wherein people still often believe that, insofar as condoms are concerned, “one size fits all.” Ultimately size does matter, and finding the right one can make the difference between having trouble-free or troublesome sex.
Learn how to properly size a condom by using this easy, step-by-step guide.
7. Not putting the condom on correctly
Rolling the condom on inside out. Not rolling the condom all the way down the shaft of the penis. Failing to leave a reservoir tip at the end. These are just some of the mistakes that up to 30% of men make when using putting on condoms. Learning how to use a condom properly is not something one automatically picks up. It's something that takes preparation and practice.
The best rule of thumb—for both men and women—is to always have an adequate supply of condoms on-hand. When you’re ready to put the condom on, remember that it should look like a ski cap with the bottom edge rolled up and not in. And if you make a mistake during sex, don’t try to put the condom on again. Simply toss it out, grab another, and give it another go. Practice makes perfect.
4. Removing a Condom Too Early
It would be a lie to say that using condoms inherently enhance sex. Most people would probably agree that it’s just the opposite. As a result, nearly 20% of men report removing a condom early out of sheer frustration, stating that they either dislike the lack of sensation or have lost an erection due to condom use. Instead of just giving up and going bare, try to engage in masturbation or other non-insertive sexual act until the erection returns. '
The use of "cock rings"—rubber, plastic or metal rings placed tightly around the base of the penis and testicles—can help better sustain erections by restricting the flow of blood away from the erection. (You can make an impromptu one by simply taking an unused, unrolled condom; poking a hole through the tip; and stretching the ring around the penis and testicles). If lack of sensation is the issue, thinner latex or polyurethane condoms may help enhance the experience if used properly.
1. Not Using Condoms at All
The figures speak for themselves: among serodiscordant heterosexual couples, the incidence of HIV in couples who never used condoms was seen to be five times greater than in couples who used condoms correctly and consistently (2.3% versus 11%). While PrEP and modern antiretroviral therapy may greatly narrow that gap, providing added layers of protection, we’re nowhere yet near the point where anyone can say abandon condoms. Don’t.
Sources:
10. Not checking the label
Always check the label when buying condoms. It’s always best to choose latex, the condoms of which are shown to have nearly 50% less failure rate than non-latex condoms (1.92% vs. 3.47%, respectively). If you have a latex allergy, the U.S. Food and Drug Administration (FDA) has approved polyurethane condoms that are as effective in preventing HIV as latex ones (although they do tend to slip offer easier). And always be sure to check that if the condom has a reservoir tip. Not all do.
For condoms you may already in storage, regularly check the expiration date. And always err on the side of caution when deciding whether to keep a condom or not. If exposed to heat (say, in a locker or in the glove compartment of your car), a condom can give up the ghost well before the use-by date.
This is particularly true for latex condoms lubricated with a spermicide, which have a two-year life span, at best. Avoid novelty condoms (e.g., glow-in-the-dark, warming, flavored condoms) which, even if FDA approved, generally have nowhere near the shelf life of the good-and-tried basic condom (and may have additives and sugar that can potentially affect rectal or vaginal tissues).
9. Not using the correct lubricant
Using oil-based lubricants can more than double the failure rate of latex condoms when compared to recommended water-based lubricants (7.7% vs. 3%, respectively). Some research also suggests that condom lubricants high in glycols(propylene glycol or glycerol) may cause damage to delicate epithelial tissues, particularly when used during anal sex. Bottom line, spend as much time shopping for appropriate water-based lubricants as you do the condoms themselves.
Always check the label when buying condoms. It’s always best to choose latex, the condoms of which are shown to have nearly 50% less failure rate than non-latex condoms (1.92% vs. 3.47%, respectively). If you have a latex allergy, the U.S. Food and Drug Administration (FDA) has approved polyurethane condoms that are as effective in preventing HIV as latex ones (although they do tend to slip offer easier). And always be sure to check that if the condom has a reservoir tip. Not all do.
For condoms you may already in storage, regularly check the expiration date. And always err on the side of caution when deciding whether to keep a condom or not. If exposed to heat (say, in a locker or in the glove compartment of your car), a condom can give up the ghost well before the use-by date.
This is particularly true for latex condoms lubricated with a spermicide, which have a two-year life span, at best. Avoid novelty condoms (e.g., glow-in-the-dark, warming, flavored condoms) which, even if FDA approved, generally have nowhere near the shelf life of the good-and-tried basic condom (and may have additives and sugar that can potentially affect rectal or vaginal tissues).
9. Not using the correct lubricant
Using oil-based lubricants can more than double the failure rate of latex condoms when compared to recommended water-based lubricants (7.7% vs. 3%, respectively). Some research also suggests that condom lubricants high in glycols(propylene glycol or glycerol) may cause damage to delicate epithelial tissues, particularly when used during anal sex. Bottom line, spend as much time shopping for appropriate water-based lubricants as you do the condoms themselves.
8. Not sizing the condom correctly
According to research from Emory University, 13% of men surveyed said that condom slippage occurred during sex. Another study showed that 21% of African American men don’t use condoms because they are too tight. Both of these issues relate directly to incorrect condom sizing, wherein people still often believe that, insofar as condoms are concerned, “one size fits all.” Ultimately size does matter, and finding the right one can make the difference between having trouble-free or troublesome sex.
Learn how to properly size a condom by using this easy, step-by-step guide.
7. Not putting the condom on correctly
Rolling the condom on inside out. Not rolling the condom all the way down the shaft of the penis. Failing to leave a reservoir tip at the end. These are just some of the mistakes that up to 30% of men make when using putting on condoms. Learning how to use a condom properly is not something one automatically picks up. It's something that takes preparation and practice.
The best rule of thumb—for both men and women—is to always have an adequate supply of condoms on-hand. When you’re ready to put the condom on, remember that it should look like a ski cap with the bottom edge rolled up and not in. And if you make a mistake during sex, don’t try to put the condom on again. Simply toss it out, grab another, and give it another go. Practice makes perfect.
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| 10 Condom Mistakes You Should Never Make |
6. Lack of preparation
Research from the National Institute of Allergies and Infectious Diseases (NIAID) has shown that the breakage rate for condoms is between 0.4% and 2.3%. While this can be caused by any of the above-listed reasons, lack of preparation is often cited as a chief culprit. Simply put, in the rush to put on a condom, a person will inadvertently tear the condom when opening and removing it from the package.
How to avoid this? Firstly, try to avoid tearing the condom package open with your teeth. Instead, open the package carefully along the edge or, better yet, pre-tear one or several of the condom packages before sex even begins. Ultimately there is no reason why a condom can’t be altogether removed it packaging and simply left on your bedside table before starting (provided they are kept well away from any direct, prolonged heat exposure).
Research from the National Institute of Allergies and Infectious Diseases (NIAID) has shown that the breakage rate for condoms is between 0.4% and 2.3%. While this can be caused by any of the above-listed reasons, lack of preparation is often cited as a chief culprit. Simply put, in the rush to put on a condom, a person will inadvertently tear the condom when opening and removing it from the package.
How to avoid this? Firstly, try to avoid tearing the condom package open with your teeth. Instead, open the package carefully along the edge or, better yet, pre-tear one or several of the condom packages before sex even begins. Ultimately there is no reason why a condom can’t be altogether removed it packaging and simply left on your bedside table before starting (provided they are kept well away from any direct, prolonged heat exposure).
5. Leaving the condom on too long after ejaculation
Post-coital cuddling is great but avoid leaving on a condom for too long after ejaculation, particularly if the penis is still inserted in the vagina or rectum. Even if this is not the case, try always to remove a condom immediately after ejaculation before the condom has the chance to slip off and cause spillage. All it takes is a few moments to remove, tie up the open end, toss in a waste receptacle, do a quick wipe, and you’ll be back to cuddling before you know it.
Post-coital cuddling is great but avoid leaving on a condom for too long after ejaculation, particularly if the penis is still inserted in the vagina or rectum. Even if this is not the case, try always to remove a condom immediately after ejaculation before the condom has the chance to slip off and cause spillage. All it takes is a few moments to remove, tie up the open end, toss in a waste receptacle, do a quick wipe, and you’ll be back to cuddling before you know it.
4. Removing a Condom Too Early
It would be a lie to say that using condoms inherently enhance sex. Most people would probably agree that it’s just the opposite. As a result, nearly 20% of men report removing a condom early out of sheer frustration, stating that they either dislike the lack of sensation or have lost an erection due to condom use. Instead of just giving up and going bare, try to engage in masturbation or other non-insertive sexual act until the erection returns. '
The use of "cock rings"—rubber, plastic or metal rings placed tightly around the base of the penis and testicles—can help better sustain erections by restricting the flow of blood away from the erection. (You can make an impromptu one by simply taking an unused, unrolled condom; poking a hole through the tip; and stretching the ring around the penis and testicles). If lack of sensation is the issue, thinner latex or polyurethane condoms may help enhance the experience if used properly.
3. Leaving the Issue of Condoms and STDs Unspoken
According to research from Emory University's Center for AIDS Research, 60% of college men reported that they have never discussed condom use before sex, often "winging it" once the actually engaged in intercourse. Rates are seen to be higher when it comes to discussing HIV and other sexually transmitted diseases, with 75% of young people failing to discuss HIV with a sexual partner, according to the Kaiser Family Foundation. There’s no denying that it can be a difficult conversation, particularly if you are HIV-positive and need to find a way to disclose your status. But here’s the bottom line: a 2013 study published in the American Journal of Men's Health concluded that gay men who did not disclose their HIV status were three times more likely to engage in condom-less anal sex than men who did.
According to research from Emory University's Center for AIDS Research, 60% of college men reported that they have never discussed condom use before sex, often "winging it" once the actually engaged in intercourse. Rates are seen to be higher when it comes to discussing HIV and other sexually transmitted diseases, with 75% of young people failing to discuss HIV with a sexual partner, according to the Kaiser Family Foundation. There’s no denying that it can be a difficult conversation, particularly if you are HIV-positive and need to find a way to disclose your status. But here’s the bottom line: a 2013 study published in the American Journal of Men's Health concluded that gay men who did not disclose their HIV status were three times more likely to engage in condom-less anal sex than men who did.
2. Inconsistent Condom Use
Beyond the very real issue of increase HIV transmission risk, inconsistent condom use often reflects a person’s attitude about the risk associated with having sex with certain individual or having a certain type of sex act (e.g., insertive/receptive, anal/vaginal). It is our perceived risk of infection—versus the actual risk—which often places us at highest risk. Today, only 65% of men engage in consistent condom use, according to the U.S. Centers for Disease Control and Prevention (CDC), while 20% of HIV-negative gay men and 11% of women report having unprotected anal sex. Ultimately it’s important to educate yourself on the actual risk associated with sexual activities and to understand that, despite the odds, HIV infection can sometimes occur after a single, condom-less sex act.
Beyond the very real issue of increase HIV transmission risk, inconsistent condom use often reflects a person’s attitude about the risk associated with having sex with certain individual or having a certain type of sex act (e.g., insertive/receptive, anal/vaginal). It is our perceived risk of infection—versus the actual risk—which often places us at highest risk. Today, only 65% of men engage in consistent condom use, according to the U.S. Centers for Disease Control and Prevention (CDC), while 20% of HIV-negative gay men and 11% of women report having unprotected anal sex. Ultimately it’s important to educate yourself on the actual risk associated with sexual activities and to understand that, despite the odds, HIV infection can sometimes occur after a single, condom-less sex act.
1. Not Using Condoms at All
The figures speak for themselves: among serodiscordant heterosexual couples, the incidence of HIV in couples who never used condoms was seen to be five times greater than in couples who used condoms correctly and consistently (2.3% versus 11%). While PrEP and modern antiretroviral therapy may greatly narrow that gap, providing added layers of protection, we’re nowhere yet near the point where anyone can say abandon condoms. Don’t.
Sources:
- Weller, S. and Davis-Beaty, K. "Condom effectiveness in reducing heterosexual HIV transmission." Cochrane Database of Systematic Reviews. 2007, Issue 4: DOI: 10.1002/14651858.CD003255.
- Grant, R.; Lama, J.; Anderson, P.; et al. "Preexposure Chemoprophylaxis for HIV Prevention in Men Who Have Sex with Men." New England Journal of Medicine. December 30, 2010; 363(27):2587-2599.
- Thigpen, M.; Kebaabetswe, P.; Smith, D.; et al. "Daily oral antiretroviral use for the prevention of HIV infection in heterosexually active young adults in Botswana: results from the TDF2 study." Sixth International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention. Rome, Italy; July 2011; abstract WELBC01.
- Baeten, J.; Donnell, D.; Ndase, P.; et al. "Antiretroviral Prophylaxis for HIV Prevention in Heterosexual Men and Women." New England Journal of Medicine. August 2, 2012; 367(5):399-410.
- Choopanya, K.; Martin, M.; Suntharasamai, P.; et al. "Antiretroviral prophylaxis for HIV infection in injecting drug users in Bangkok, Thailand (the Bangkok Tenofovir Study): a randomised, double-blind, placebo-controlled phase 3 trial." The Lancet. June 15, 2013; 381(9883):2083-2090.
- Baeten, J.; Donnell, D.; Ndase, P.; et al. "Antiretroviral Prophylaxis for HIV Prevention in Heterosexual Men and Women"" New England Journal of Medicine. August 2, 2012; 367(5):399-410.
- Gallo, M.; Grime, D.; and Schulz, K. "Nonlatex vs. latex male condoms for contraception: a systematic review of randomized controlled trials." Contraception. November 2003; 68(5):319-326.
- Golombok, R.; Harding, R.; and Sheldon, J. "An evaluation of a thicker versus standard condom with gay men." AIDS. January 26, 2001,15(2):245-250.
- Begay, O.; Jean-Pierre, N.; Abraham C.; et al. "Identification of personal lubricants that can cause rectal epithelial cell damage and enhance HIV Type 1 replication in vitro." AIDS Research and Human Retroviruses. September 2011, 27(9):1019-1024.
- Crosby, R.; Sanders, S.; Stephanie, A.; et al. "Condom Use Errors and Problems Among College Men." Sexually Transmitted Diseases. September 2002; 29(9):552-557.
- Reece, M.; Dodge, R.; Satinsky, S.; et al. "Experiences of condom fit and feel among African‐American men who have sex with men." Sexually Transmitted Infections. Oct 2007; 83(6): 454–457.
- Kaiser Family Foundation. "National Survey of Adolescents and Young Adults: Sexual Health, Knowledge, Attitudes and Experiences." May 19, 2003. Publication 3218.
- Jacobs, R.; Kane. M.; and Ownby, R. "Condom Use, Disclosure, and Risk for Unprotected Sex in HIV-Negative Midlife and Older Men Who Have Sex With Men." American Journal of Men's Health. May 2013; 7(3):186-197.
- Anderson, J. "Condom Use and HIV Risk Among US Adults." American Journal of Public Health.June 2003; 93(6):912-914.
- New York Department of Health and Mental Hygiene. "Women, Unprotected Anal Sex and HIV Risk" New York Vital Signs. February 2010; 9(2):1-4.
- Saracco, A.; Musicco, M.; Nicolosi, A.; et al. "Man-to-Woman Sexual Transmission of HIV: Longitudinal Study of 343 Steady Partners of Infected Men." Journal of Acquired Immune Deficiency Syndromes. May 1993; 6(5): 497-502.
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