Protect Yourself! It Begins With YOU

Condoms

Condoms are the only form of protection which can both help to stop the transmission of sexually transmitted infections (STIs) such as HIV and prevent pregnancy. It is important that a new condom be used correctly each and every time you have sex. A number of different types of condoms are now available. Also, only latex and polyurethane condoms effectively prevent the spread of HIV, not those made of natural animal membranes.

Male Condom

What is generally called a condom is the male condom, a sheath or covering which fits over a man's penis, and which is closed at one end. Condoms are made of latex rubber, polyurethane, or animal skin but remember latex and polyurethane are the way to go - latex or polyurethane condoms are the only ones that effectively protect against HIV infection. For the best protection, the condom must be put on before the erect penis comes into contact with or enters the vagina (because pre-ejaculation fluids carry both sperm and disease). The condom must be carefully removed immediately after ejaculation so that no semen leaks out.

Some tips for using the male condom are:

• Make sure condoms are available and conveniently located. If no condoms are handy at the time of a sexual encounter, you may be tempted to have sex without one.
• Carefully withdraw the penis immediately after ejaculation so that semen cannot leak out of the condom as the erection is lost.
• Read the instructions - make sure the condom is on correctly before getting started. Use a new one every time. The man wearing the condom doesn't always have to be the one putting it on - it can be quite a nice thing for his partner to do.
• Fresh condoms are good condoms - check the expiration date on the condom wrapper; if it has passed, throw out the condom.
• Also look at the condom itself - does it seem dry, brittle, stiff or unusually sticky? If so, don't take chances. It's better to use a different one.
• Do not carry condoms in your wallet for long periods of time. Replace them every once in a while. Friction from opening and closing your wallet, and from walking can lead to tiny holes in the condom. Nevertheless, it is better to use a condom that has been in your wallet for a long time than to not use one at all.
• Don't use a condom that is brittle, sticky, or discolored. These are signs of age, and old condoms are more likely to break.
• If a condom package is damaged, don't use the condom because it also may be damaged.
• Use lubrication - to help ensure that the condom doesn't tear or come off, use some water-based lubricant inside and outside the condom. Be sure not to use an oil-based lubricant like Vaseline or other petroleum jellies, body lotions, mineral or vegetable oils - they can cause the latex to break down. Also, studies have shown that lubricants or condoms with nonoxynol-9 (a product often used in spermicides) may actually increase the risk of HIV transmission during sex and are not recommended as an effective means of HIV prevention.
• If you feel a condom break during intercourse, stop immediately and put on a new one. Remember, ejaculation does not have to occur for a pregnancy to result (pre-ejaculatory fluids can contain active sperm), or for a disease to be transmitted.
• Condom condition - store your condoms in a cool, dry place so they don't get damaged. Heat and excessive wear can cause a condom to tear during sex - glove boxes, back pockets, wallets and window shelves are all bad places to keep your condoms.
  

Female Condom

There is also a female condom which is used by a woman and which fits inside her vagina. It has two rings to keep the condom in place -- one ring is placed over the woman's cervix and another one is placed over her vulva. This positioning prevents the condom from being pushed up into the vagina, and creates a protective covering over the outside of the vagina, which prevents sperm from contacting the area. The female condom, like the male condom, is a barrier device used for birth control. It is also protective against HIV and most other STIs. Some tips for using the female condom are:

• Be careful not to tear condoms with sharp fingernails or jewelry.
  
• Use each condom only once.
  
• Make sure condoms are available and conveniently located. If there are no condoms handy at the time of a sexual encounter, you may be tempted to have intercourse without one.
  
• If a condom tears or breaks, if the outer ring is pushed up inside the vagina, or if the condom bunches up inside the vagina during intercourse, remove it and insert another condom immediately.
  
• When you remove the condom after intercourse, and you notice that it is torn or broken, some sperm may have spilled inside the vagina, increasing your risk of becoming pregnant. Contact your health care provider or pharmacy for information about emergency contraception.
  
• Do not use a female condom and a male condom at the same time. Friction between them can cause them to bunch up or tear.
  
• Remove tampons before inserting the condom.

Abstinence

Abstinence is defined as not having any kind of sex (oral, anal or vaginal) and not engaging in any activity that puts you or your partner in contact with either of your bodily fluids (semen, vaginal fluids, and blood). Abstinence is a way to postpone taking the physical and emotional risks that may come with sexual relationships until you feel you are ready to handle them. With perfect use, abstinence is effective in preventing pregnancy and sexually transmitted diseases. But it only works if you don't have sex of any kind. If you decide to have sex, you will need to choose another method to continue to protect yourself from pregnancy and disease. If you are in a relationship, talk with your partner about your decision to be abstinent and why it is important to you. Even if you have been sexually active before, you can still decide to become abstinent again for any amount of time that is right for you.

Talking about being abstinent can be difficult or awkward. It is very important, however, that you do discuss the issue with your partner. Remember that your definition of being "abstinent" may be different from your partner's definition. The following communication tips may help you when you talk to your partner about abstinence.

• It is virtually impossible for someone to read your mind. Don't expect your partner to magically know what you want.
  
• Acknowledge that this may be difficult to talk about. Reveal your own level of comfort. For example say, "This isn't easy for me to talk about, but it's something that I've been thinking about a lot."
  
• Request permission to bring up the topic. Be sensitive to when it may or may not be appropriate to discuss (e.g. not right before a big test at school or just as your partner is falling asleep!).
  
• Give your partner permission to say something that might be upsetting to you by allowing him or her to finish talking before you talk. Listen to what your partner is saying before responding.
  
• Respect your partner's attitudes, values and feelings about sex even though they may be very different from yours.
  
• Trust your instincts. If you feel unsafe or coerced into doing or saying something, stop and remove yourself from the situation.

Know your status, know your partner’s status

Get tested together. By knowing each other's status, you will eliminate any uncertainty and worry. If either one of you does have an STI or HIV, you'll want to discuss how to prevent the other person from getting it. Your health care provider can help you answer these questions.

Circumcision

Recent research has shown that males who are circumcised are less likely to get HIV than those who are not. But circumcision does not provide complete (100%) protection. For more complete protection circumcised men should still use a condom every time they have sex. Circumcision provides no protection to your sex partner.

If you choose to get circumcised it is very important that you abstain from sex until the penis is completely healed (usually about six weeks).

Multiple Concurrent Partners (MCP)

This has been identified as a key driver of the HIV/AIDS epidemic. MCP is a situation where men or women have more than one sexual partner at the same time and the partners can overlap for weeks, months or years. When men and women have more than one sexual partner in the same time period, they become part of a sexual network. If someone in the sexual network becomes infected with HIV, it increases the chances of HIV spreading to everyone in that network.

Research has shown that the key reasons many people have multiple concurrent partners include:

• Traditional attitudes to the submissive role of females in sexual relationships and the sexual dominance of males
  
• Gender inequality including lack of communication, choice and shared responsibility in relationships
  
• Poverty and the need for money and/material benefits
  
• Alcohol and other substance abuse
  
• Sexual dissatisfaction
  
• Peer Pressure
  
• Fatalism about HIV/AIDS
  
• Lack of personal prospects and/or hope for the future

The core message of MCP, is that having multiple concurrent partners puts you and your loved ones at risk. A safe relationship means:

• there are no secrets and lies
  
• communicating effectively with each other
  
• challenging cultural practices that support MCP
  
• there is respect and equal rights for and between men and women