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Human immunodeficiency virus (HIV) is a virus that infects cells in the immune system. If it’s not treated with antiretroviral drugs, the immune system can become severely weakened.

An important way that HIV is transmitted is through sex, particularly during vaginal or anal sex. Anal sex has a higher risk of transmitting the virus due to the rectum’s thin lining, which can tear easily during sex.

One of the ways to help prevent HIV transmission during sex is to use a condom. When used consistently and effectively, condoms can provide an effective defense against the virus.

Keep reading to learn more about the different types of condoms and how to use them to prevent contracting HIV and other sexually transmitted infections (STIs).

Condoms can help prevent transmission of HIV and other STIs. They do this because they form a barrier that viruses and bacteria cannot effectively pass through.

According to the Centers for Disease Control and Prevention (CDC), lab studies have found that the barrier created by condoms is effective against even the tiniest pathogens, including HIV.

However, results from lab tests can be different from what’s found in daily life.

This is because it’s possible that people may not use condoms consistently or correctly during sex.

Data collected by the National Institutes of Health (NIH) from both lab and epidemiological studies estimates that, when used consistently and correctly, condoms lower the risk of HIV transmission by about 85 percent.

Let’s examine what some of the research says.

Men who have sex with men

A 2018 paper analyzed the findings of four studies that looked at self-reported condom use in men who have sex with men (MSM). Researchers reported the effectiveness of condoms per number of HIV-positive sexual partners.

It was found that people who reported that they always used condoms with each sexual partner reduced their odds of contracting HIV by 91 percent.

Meanwhile, people who reported never or only sometimes using condoms with each sexual partner increased their odds of contracting HIV by 83 percent.

Heterosexual couples

A 2016 review of 25 studies examined condom effectiveness in heterosexual couples. In the studies that were evaluated, one of the partners was living with HIV while the other partner was HIV-negative.

The researchers found that condoms could reduce the transmission of HIV to an HIV-negative partner by more than 70 percent when used consistently.

They also found that the protective effect provided by the condom was higher when the male partner was living with HIV.

Condoms and antiretroviral therapy

HIV is treated with antiretroviral drugs. These are medications that are taken daily to help prevent the virus from replicating and further weakening the immune system.

A large 2016 study looked at HIV transmission risk in 888 heterosexual and 340 MSM couples who were not using condoms. In the study, one partner was HIV-negative, and the other partner had HIV with an undetectable viral load and was taking antiretroviral drugs.

During 2 years of follow-up with 58,000 reported condomless sex acts, no HIV transmission from HIV-positive partners to HIV-negative partners was seen.

This ties into the concept of undetectable = untransmissible (U=U). Taking antiretroviral drugs daily as prescribed can reduce viral load to undetectable levels in 6 months or less. When this happens, there’s no risk of transmitting HIV to a partner during sex.

A big part of a condom’s effectiveness at preventing HIV has to do with using it correctly. Now let’s examine how to put on and remove a condom if you have a penis.

To put on a condom

Follow the steps below to put on a condom:

  1. Place the condom onto the tip of the erect penis so that the reservoir tip faces up. If the penis is uncircumcised, be sure to pull back the foreskin first.
  2. Gently pinch the reservoir tip at the end of the condom to help remove any air bubbles.
  3. Proceed to roll the condom all the way down to the base of the penis.

To remove a condom

After sex, a condom must be removed. Follow the steps below to properly remove a condom:

  1. While holding the condom at its base, gently withdraw the penis before it becomes soft.
  2. Carefully remove the condom from the penis.
  3. Throw the condom away. It may be helpful to tie it closed or wrap it up in a tissue so that semen won’t spill out of it.

Condoms can come in a variety of sizes, shapes, and textures. They can also be made from different materials. Below, we’ll explore a few of the important things to know about condoms.

Condoms come in different sizes

There are a variety of different condom sizes available. Condom sizes are typically measured in terms of length and width.

Selecting a condom that fits is very important. A poorly fitting condom can lead to breakage or slippage. It can also affect the amount of pleasure experienced during sex.

Condoms are made from different materials

It’s possible to purchase condoms made from a variety of different materials, including latex and synthetic materials, like polyurethane and polyisoprene.

Lambskin condoms are more porous than other types of condoms. This allows germs, particularly viruses, to pass through the condom. Because of this, they’re not effective at preventing HIV and many other STIs.

It’s estimated that about 4.3 percent of the worldwide population is allergic to latex. People with a latex allergy can use condoms made of synthetic material to prevent having an allergic reaction while protecting against HIV transmission.

Condoms can break

It’s possible for a condom to break. This has been reported to occur about 2 percent of the time and can have potentially serious consequences.

When a condom breaks, its ability to prevent HIV, other STIs, or pregnancy is compromised.

If a condom breaks or slips off, do the following:

There are also many things that can help prevent a condom from breaking:

  • Buy condoms that fit. Make sure a condom fits before using it. Condom sizing can vary by manufacturer, so be sure to read the package labeling before purchasing.
  • Store condoms properly. Try to store condoms in a location that’s cool and dry. Avoid putting them in a wallet or purse, because exposure to heat or friction may damage them.
  • Note expiration dates. An older condom may be more likely to break. Additionally, all condoms come with an expiration date. Regularly replace any condoms that have passed their expiration date.
  • Gently open the condom. Use your fingers to carefully remove a condom from its packaging. Using your teeth or scissors can damage it.
  • Check for damage. It’s possible that some condoms may be damaged. Before using a condom, check it for any holes, tears, or other defects.
  • Put the condom on correctly. Always be sure to put the condom on correctly. Not doing so can decrease its effectiveness. Some common mistakes that can happen are:
    • removing a condom too early or putting on a condom too late
    • unrolling the condom before putting it on
    • not removing air from the reservoir tip
    • putting on a condom inside out
  • Don’t double up. Never use two condoms together at the same time. This can cause friction that can lead to breakage.
  • Always use lube. Use a water- or silicone-based lubricant during sex. Avoid using oil-based lubricants with latex condoms as they can cause the latex to break down.
  • Never reuse a condom. Always dispose of condoms promptly after sex.

To use condoms to effectively prevent HIV, it’s important to note the material of the condom. Always use condoms made from latex or a synthetic material like polyurethane.

Since lambskin condoms are more porous than other types of condoms, viruses can pass through. For this reason, they do not prevent HIV.

Additionally, some condoms may come coated with a spermicide, which is a chemical that works to kill sperm. One of the most common spermicides is called nonoxynol-9.

The CDC doesn’t recommend using condoms with nonoxyl-9 for the prevention of HIV. This is because nonoxyl-9 can disrupt the lining of the genital tissues and may actually increase the risk of HIV transmission.

Overall, condoms are a highly effective way to help prevent the transmission of HIV through sex. However, there are some risks associated with using condoms that it’s important to be aware of:

  • Breakage. As we discussed earlier, it’s possible for condoms to break during sex, which can lead to exposure to bodily fluids containing HIV. When using condoms, always take steps to prevent breakage.
  • Latex allergy. Latex condoms can cause an allergic reaction in people with a latex allergy. To help with this, condoms made from synthetic materials like polyurethane or polyisoprene are also available.
  • Certain STIs. While condoms can prevent HIV and many other STIs when used consistently and correctly, they may not prevent some STIs that are transmitted by skin-to-skin contact. Examples include HPV and genital herpes.

Condoms are also available for people with a vagina. These products are often called internal condoms or “female” condoms.

Studies have suggested that internal condoms have a similar effectiveness to external (“male”) condoms. However, so far, no studies directly compare the effectiveness of external and internal condoms.

Let’s examine how to use internal condoms.

To insert a condom

Follow these steps to insert an internal condom:

  1. Squat, sit, or lie down in a comfortable position.
  2. Squeeze the ring at the closed end of the condom.
  3. Using your index finger, gently insert the condom as far into the vagina as it will go. Avoid making any twisting motions.
  4. Use the large ring at the open end of the condom to cover the area outside of the vagina.
  5. Make sure that the penis inserts into the condom during sex. If possible, help guide your partner so that this happens.

To remove a condom

After sex, the condom must be removed. Follow the steps below to do this:

  1. Grip the large ring at the open end of the condom.
  2. Gently twist the ring while pulling the condom out of the vagina.
  3. Throw the condom away. It may be helpful to tie it closed or wrap it up in a tissue so that semen won’t spill out of it.

While HIV can spread during oral sex, the risk of this happening is very low. However, various factors may increase a person’s risk, including:

  • bleeding gums or mouth sores
  • sores on the genitals
  • having another type of STI

Using a dental dam can help prevent the transmission of HIV and other STIs during oral sex. To use a dental dam:

  1. Carefully remove the dental dam from its packaging.
  2. Place the dental dam so that it’s flat and covers the opening of the vagina or anus.
  3. After sex, throw the dental dam away.

Making a dental dam

It’s also possible to make a dental dam from an external (“male”) condom. To do this:

  1. Make sure the condom is made from latex or polyurethane before using it.
  2. Remove the condom from its packaging and unroll it completely.
  3. Use scissors to cut off both the tip and the bottom of the condom.
  4. Cut down the side of the condom. This should produce a flat piece of material.
  5. Use the flat material to cover the opening of the vagina or anus.

Condoms can prevent the transmission of HIV. To do so effectively, they must be used both consistently and effectively.

Because of this, it’s very important to be sure to put on and remove a condom correctly. Ensuring that condoms fit, storing them properly, and using lube during sex can all help prevent condom breakage or slippage during sex.

Condoms include external (“male”) condoms and internal (“female”) condoms. Dental dams can also help prevent HIV transmission.

A healthcare professional can help address any questions or concerns regarding HIV prevention. They can also supply valuable information on other preventive methods for HIV, such as PrEP or PEP.