Using condoms is a fantastic way to minimize the risk of STIs. They don’t eliminate risk 100% – certain STIs like herpes and HPV can still be transmitted through skin-to-skin contact even if you’re using a condom. But overall, condoms are highly effective if you use them correctly!

Let’s talk about the different types of condoms out there. You’ve got external condoms, which are for penises, and internal condoms, which are for vaginas or anuses. External condoms can be made of different materials like latex, polyurethane, polyisoprene, and even lambskin. Just a side note, though, lambskin condoms do NOT protect against HIV, so keep that in mind.

Now, here’s how you put an external condom on the right way:

• Carefully open the foil packaging without tearing the condom.
  Hold the tip of the condom between your finger and thumb to make sure it’s the right way and there’s no trapped air inside (that can cause it to break).
• Put the condom over the tip of your penis. Squeeze the tip of the condom and roll it all the way down your erect penis.
• If the condom won’t unroll, it’s probably inside out. Start fresh with a new one, because there might be some semen or sperm on it.
• Keep an eye on the condom during sex to make sure it stays in place. If it slips off, stop and put a new one on.
• After you’ve finished and your penis is still hard, hold the condom in place and carefully remove your penis from your partner’s body. That’s it!

Click here for visual instructions:

https://www.cdc.gov/condomeffectiveness/external-condom-use.html

Internal condoms are another great option! These condoms are made of a soft plastic called nitrile, which is hypoallergenic. They are pretty cool because you can insert them ahead of time, before you start getting busy, which makes things more spontaneous. Plus, the inner ring of the condom can stimulate the tip of the penis during vaginal sex, and the outer ring can rub against your vulva and clitoris for added pleasure. Finally, one of the great things about using an internal condom is that you have control over your protection – you don’t have to rely on your partner to use one.

Here’s how to use an internal condom correctly:

• Carefully open the condom package, being careful not to tear it.
  Squeeze the soft inner ring between your forefinger or middle finger and thumb.
• Use your other hand to separate the folds of skin (labia) around your vagina, if you’re using the condom during vaginal sex. Then, push the squeezed ring into your vagina (or anus). Take your time, there’s no rush!
• Now, put your index or middle finger, or even both, in the open end of the condom until you can feel the inner ring. Push the condom as far up your vagina or anus as you can, making sure the outer ring is lying against the outside of whatever you’re working with!.
• During sex, make sure the outer ring of the condom stays on the outside of your vagina or anus at all times. If it accidentally gets pushed inside, no worries – just pause and put it back in the right place.
• Make sure the penis goes into the condom (that’s the whole point, right?), making sure that it doesn’t go between the condom and the wall of your vagina or anus.
•  Immediately after sex, slightly twist and pull the end of the condom to remove it, taking care not to spill any semen (sperm) that’s inside it. That’s it!

Click this link for visual instructions:

https://www.cdc.gov/condomeffectiveness/internal-condom-use.html

Now, onto a few important tips:

DON’T flush condoms – throw them in the garbage! Condoms can clog things up, so to speak, and aren’t good for the environment.

DON’T use two condoms simultaneously, be it an internal and external condom, two internal condoms, or two external condoms. This can actually increase the chance of them tearing or breaking, which defeats their purpose. Remember, one condom at a time is the way to go!

Lambskin condoms do NOT offer effective protection against STIs like HIV. These condoms have microscopic pores that allow the HIV virus to easily pass through. Stick to latex or polyurethane condoms for safer sex.
Switching from anal penetration to vaginal penetration without changing the condom can actually cause an infection. So always remember, put on a fresh condom with each switch!

A dental dam is a square-shaped piece of latex that goes over a partner’s genitals or anus during oral sex, preventing skin-to-skin contact. Since some STIs (herpes, for example) can spread this way, dams are a good way to lower your chances of infection!

When using one, be sure the dental dam or plastic wrap covers the entire vulva (labia, clitoris, and vaginal opening) or anus and that you hold both edges so the barrier stays in place. In addition, some dental dams are latex, so be careful not to use oil-based products with them, because oil degrades latex and can cause the dam to tear.  Finally, it’s important to remember to only use one side of the dental dam (if you flip it over, you and your partner will be exposed to whatever viruses or bacteria might be on the other side) and don’t reuse it.

Dental dams are sometimes not as widely available as condoms – so if you don’t have them on hand in the heat of the moment, here are some alternatives:

Cut up a condom!  Cutting up a condom and covering your partner’s genitalia is another method that can protect against STIs. Make sure the scissor is clean before doing this.
In a pinch, use plastic wrap!  Plastic wrap may be an effective barrier for various types of sex, can cover a broader area than dental dams, and is thinner (which transmits sensations and body heat more effectively).  They are also non-latex, so oil-based lubes and edible products (in the case of oral sex) are ok to use.  However, be aware that there’s no peer-reviewed research on how well plastic wrap protects against STIs. If you use plastic wrap, make sure it is not the microwavable kind, as that usually has small holes. As in the case of dental dams, stick to one side of the plastic wrap and don’t reuse it.

There’s also Lorals for Protection, a latex underwear brand that has been FDA-approved for STI prevention!  It doesn’t have to be held in place like dental dams or saran wrap and are super thin, which transmits heat and sensation. Lorals are also vanilla-flavored, which is a bonus! Unfortunately, there are not yet any alternatives for those who are allergic to latex, and so far, they can only be purchased online. Also, they’re pretty pricy – a 4-pack costs $25, and they’re meant to be used once and thrown away.  But they may be a good option for you – check them out here:  https://mylorals.com/

(If you decide to try these out, make sure you get the ones that are labeled “For Protection” – the others aren’t FDA-approved for STI prevention.)

Using lube with condoms can make sex safer because lube decreases friction during sex which can contribute to condoms breaking. There are four main types of lube:

• Water-based. These are good if your skin is sensitive, they’re gentle on sheets, and they wash off easily. However, some find these overly sticky or watery.
• Oil-based. This kind of lube lasts longer than water-based lube, and if you use pure oil it can double as a massage oil. However, oil-based products degrade latex barriers like condoms, which can cause them to break. Use water-based or silicone lubes with latex condoms instead.
• Silicone. This kind of lube is also good for sensitive skin and lasts longer than water-based lube. However, silicone lube can degrade silicone sex toys, so check the material of your toy before trying it out.
• Hybrid. A combination of water-based and silicone lubes.

Try switching them up and see what works best for you! 

Have you heard of PrEP? It’s a daily medication for those who are HIV-negative and it’s super effective in preventing HIV infection! If taken correctly, PrEP can provide up to 99% protection against HIV. You can choose between two kinds of daily pills (Truvada and Descovy) or a shot called Apretude that’s given by a provider every two months. You can check out Lauderdale Health Center, Livingston County Department of Health, Planned Parenthood, or Trillium Health if you’re in the Rochester area. You can also find other providers through this link: https://preplocator.org/. PrEP doesn’t protect against other STIs, though, so a condom is still a good idea!

In case of potential exposure to HIV, there’s something called PEP. PEP stands for post-exposure prophylaxis and it’s a short-term emergency medication. It’s taken when you’re at risk of HIV virus “taking hold” in your body after a potential exposure (forr example, if a condom rips or in cases of sexual assault). PEP needs to be started within 72 hours of exposure to be effective. You can get PEP from emergency rooms, sexual health clinics, or some doctor’s offices. Just make sure to call ahead and check if they offer PEP. You’ll usually have to take it 1-2 times a day for 28 days.

The HPV vaccine, which is safe to take, protects against 9 strains of HPV and has the potential to prevent more than 90% of HPV-attributable cancers. The vaccine is usually given to teenagers around the ages of 11 or 12, and sometimes even as young as 9, so there’s a chance you’ve already gotten the vaccine. If you’re not sure, just have a chat with a healthcare provider or check your medical records. If you haven’t, it’s not too late – the CDC recommends vaccinations for people up to the age of 26!

For more information on the vaccine and how to get it, click here:

https://www.cdc.gov/vaccines/vpd/hpv/public/index.html

Treatment for HIV, called antiretroviral therapy (ART), can greatly decrease an HIV-positive individual’s viral load (a measure of how much of the virus is in their system) eventually making the virus undetectable in that person’s body. This does NOT cure HIV – if that person stops taking ART, their viral load will increase and become detectable over time. 

However, those with an undetectable viral load cannot spread HIV to sexual partners.  This is called the “U=U” strategy – because Undetectable means Untransmittable!   However, even if you or your partner are on antiretroviral therapy and have an undetectable viral load, it’s still important to use condoms to protect against other STIs.

Keep in mind that even if you’re on medication for a curable STI, it’s possible to still spread the infection. It’s crucial to finish the entire course of treatment and ensure all symptoms are completely gone before resuming sexual activity. Consult your healthcare provider for their guidance on when it’s safe to have sex again.

For non-curable STIs like HIV and herpes, there are medications available that can help manage symptoms and greatly reduce the chance of transmission. Discuss with your healthcare provider to determine the best medications for your situation.

Lastly, it’s crucial that your partner gets tested if you’ve been diagnosed with (or even suspect) that you have an STI. Their health and well-being matter too!  

It’s important to get tested for STIs, including HIV, even if you don’t have any symptoms. Some STIs may not show symptoms or take time to manifest. It’s also super important to talk openly with your sexual partner(s) about your sexual health and STI testing – make sure you’re both on the same page and taking necessary precautions.  

The CDC recommends that everyone get tested for HIV at least once between the ages of 13-64, and more frequently for certain high-risk groups. Furthermore, all sexually active individuals younger than 25 years should be tested for gonorrhea and chlamydia every year. (gay, bisexual, and other men who have sex with men should also be tested for syphilis on a yearly basis). Those who have multiple or anonymous partners should be tested more frequently (e.g., every 3 to 6 months). Of course, if you have any abnormal genital pain or symptoms, visit a doctor immediately!

STI are diagnosed through a blood test, urine test, vaginal swab, oral swab, or fluid swab, if the infection is causing any fluid, pus, or discharge. A healthcare provider will determine which test is best for each patient after a physical examination and discussion of symptoms. If one has no symptoms, the test is typically done with a urine sample or a vaginal swab. STI testing is not part of a normal physical, so one will have to ask their healthcare provider to get tested. 

In most cases, you also have to directly request herpes screening. Healthcare providers can diagnose herpes by looking at or taking a sample or swab from any blisters or sores; however, the CDC does not recommend herpes testing for people without symptoms in most situations because herpes blood tests are limited, leading to the possibility of a wrong test result. The chances of wrong test results are higher for people who are at low risk of infection. However, if you have symptoms, have had sex with someone who has herpes, or your doctor sees physical signs of herpes infection, a blood test might be useful.
Unfortunately, there is no test to find out if a person has HPV – although there are HPV tests that can screen for cervical cancer, those are only recommended for women aged 30 years and older. The best way to prevent HPV is to get vaccinated (link to vaccine info)!

Lauderdale offers free/low-cost STI testing, as do Livingston County Department of Health, Planned Parenthood, Trillium Health, urgent care centers, and many doctor’s offices (see our clinical resource links under “More Resources”). Choosing a location that is both convenient and affordable is important. When getting tested off-campus, make sure the clinic accepts your insurance and ask about the cost ahead of time if there are any concerns.

Finally, although testing may help to prevent transmitting STIs to others, testing only tells you if you’re infected after the fact! It’s not a prevention method in and of itself, which is why other safer sex strategies are crucial to staying healthy.

When it comes to safer sex, there are plenty of options that don’t involve vaginal, anal, or oral sex. Get creative and explore activities like mutual masturbation, sexting, and virtual experiences through video calls (why not put Zoom to good use?). Remember, imagination can be sexy!