The term “STD” (sexually transmitted disease) is increasingly replaced by “STI” (sexually transmitted infections). Is this change (which started as early as the late 1990s) a matter of political correctness? An effort to reduce stigma affiliated with disease? Or are there real distinctions between infection and disease, hence adopting a more medically accurate term?
The correct answer: all of the above.
In the days before “STDs” there was only “venereal diseases”, and sex workers were the culprits. Image from the DailyMail.co.uk
Medical Jargon
Usage can be confusing because the medical distinctions between infection, illness, disorder and disease often overlap. In general, however, “infection” is only considered an illness or disease when symptoms occur. Many sexually transmitted bacteria and viruses are contagious without causing symptoms (or may have asymptomatic periods). Just a handful of these include chlamydia, gonorrhea, herpes simplex, HPV, hepatitis and HIV.
Most STIs are treatable. Some strands of HPV can be wiped out by the immune system alone (but not always). But some STIs are not curable, like herpes and HIV (as of today). Contrary to popular confusion, it is not correct to differentiate STIs as “curable” and STDs as “incurable”.
The major distinction is that all STDs are caused by infections. However, not all infections develop into illness or disease. Also, a disease is always associated with symptoms; an infection is not so consistent.
Does this mean it’s wrong to use “STD” in the twenty first century? I would argue no. In many instances, STI and STD are used interchangeably and refer to the same thing.
Why I Say “STI”
I think it boils down to semantics and meaning. Some people feel that dropping the word “disease” only reinforces stigma. Why not just face the fear head on? The more we speak of “disease” the more normalized it becomes, right? Well, not necessarily. “STD” eventually replaced the more euphemistic term “venereal disease” by the 1980s, yet stigma firmly remains.
Personally, I prefer the term STI for two reasons. Firstly, “STI” is a broader term thus more inclusive. Secondly, using the term STI helps raise awareness that physical symptoms are not a reliable way to determine your status. A person can be infected with no symptoms and pass on the infection to others without having a disease.
Serious point here: According to the CDC, 1 in 5 people who are living with HIV today in the United States do not know their status (CDC 2013). In fact, people who do not experience symptoms and/or are not tested are the ones most likely to pass on infection to others. There are serious consequences when STIs are left unknown and untreated. It increases the risk of infection for other STIs and disease. In short, ignorance (RE: stigma) of getting tested and assuming you won’t get an STI is the greatest cause of infection.
The fabulous sex educator, Andrea Renae (@theandrearenae), recommends the Judgement Free Health Care Providers directory, which is inclusive of LGBT and Queer people, Asexuals, Demisexuals, Polyamorous relationships, sex workers and people living with HIV. There is also the safer sex video Pleasure Rush initiative (NSFW) by GALAEI.
This post is written by Tashia Amenerio, founder of the non-profit HPV Awakening. She writes from her personal experience why she is pushing for HPV be reportable- meaning sexual partners must legally inform each other of their status- and why she urges you to sign the petition to get the FDA to approve HPV testing for men.
(Un)Knowing HPV
Graph from the CDC. Fourteen million will become newly infected with HPV this year. This means that almost every sexually active person in the US will acquire HPV at some point in their lives.
When diagnosed with HPV, life as you know it is over. You face disturbing contradictions within the medical community . On the one hand, there are those who describe it as “this generation’s AIDS”. On the other side, you are faced with medical “experts” who don’t know their head from a hole in the ground and tell you that HPV is nothing to worry about.
Here is the kicker: Most HPV strands, like most cold or flu strands, really don’t do much of anything but chill out in your body having a viral party of genome development. The issue(s) arise when you get people who are knowingly infecting others with cancer causing strands- a crime of which I’m personally all too well aware. And then you have others who are unknowingly transmitting the STI. A major reason for this is because it is not standard practice to get tested for HPV- and there are no official tests made publicly available for males- despite the fact that HPV is the most prevalent STI in North America right now.
So What Can We Do?
www.hpvawakening.org.
Well, I started a nonprofit HPV Awakening Inc. I lecture all over the Florida and have done a few media interviews. I sit here now writing you about my experiences and I’ve launched a petition that needs 100,000 signatures by May 28th, 2013, so that it can go to the White House to get HPV male testing approved by the FDA. Sign the petition.
I have contacted several local media stations and sites. And I have tried moving my civil court case Tashia Ameneiro vs. Zamil Xavier Lopez to a criminal one in order to have the state acknowledge the fact that HPV cancer strands should be taken as serious as AIDS/HIV strands.
The Miami Dade DA has kindly informed me that, well, HPV isn’t mentioned in the Florida statute at all. Thus they can’t help me. This is in spite of the fact that my case is backed with the full support from the local police department that filed my report (Miami Gardens), and they are willing to facilitate the investigative work!
So here is where you the reader come in. What can you do? Well, if you have ever been diagnosed or know someone that has been- I can relate. It sucks and it isn’t easy. And fun (insert EXTREME sarcasm) questions and situations follow diagnosis.
From Why Me? To What I Will Do About It!
In my case, I had been a virgin with no sexual experience prior to my ex, so I didn’t have to go through the questioning phase of Who? But I did have to go through the constant questioning phase of Why? After I received my diagnosis and contacted my ex he kindly informed me that he had known but since it hadn’t directly impacted me he hadn’t cared.
But that wasn’t the only “Why”. The “Why me?” phase kicked in and it kicked in for several of my friends too. Because once you get sick, it isn’t just you. It’s you and those that care about you, or who know you in a caring light- family, acquaintances, associates, co-workers and strangers you disclose to- that are impacted.
I remember one conversation in particular with a friend of mine that went through a bad life phase (attempted suicide and was a bug chaser at one point in time) sitting on the stairs while we shared a smoke (a short lived habit I picked-up during that “Why be and Why bother” phase). He was crying because he couldn’t understand how “Good people like [me], who never do anything risky end up getting sick and people like [him], who have tried every way possible to be ill and die didn’t.” Easy answer: “I don’t know what a ‘good’ person is, but sometimes Shit Just Happens.” It is a matter of what you do with the situation that counts.
I finished the cigarette and realized that some habits aren’t worth starting or maintaining just to stay wallowing in self-pity.
For those of you that are still reading, I say Yay! Thank you in sharing in my past misery. It really does love company.
Please sign the petition to get HPV male testing approved by the FDA. Go to We The People to sign.
The US faces an HPV epidemic, yet there is still little known about the virus. A Florida-based grassroots organization, HPV Awakening, is fighting to expand research about the virus to provide resources for treatment and prevention. Public awareness is in desperate need of an energy boost.
HPV is the most prevalent and rapidly spreading STI in the USA according to a February 2013 report (PDF) by the CDC (Center for Disease Control and Prevention). Based on the most recent data on STIs in 2008, the report finds approximately 80 million Americans are infected with some form of HPV- which makes up 71% of all STI infections in the country. And it is spreading fast, as most people with HPV do not know they are infected. Fourteen million will become newly infected this year. This means that almost every sexually active person in the US (regardless of sexual orientation, number of partners, age, income, etc.) will acquire HPV at some point in their lives. In other words, we are officially in an HPV crisis.
Sounds pretty serious, eh? In most cases, HPV will go away by itself before it causes any health problems- particularly in young people. The problem is that there are many variations and strains of HPV- 40 of which are related to cancer- and there remains much unknown medically about the virus and how to detect it.
For example, there is no certain way to tell who will develop health problems from HPV and who will not. For men, there is currently no FDA-approved HPV test, which means that men who have clear STI screenings with negative results should not consider themselves HPV-free or at zero-risk. The only form of testing a male can have is through an anal pap smear (used to check for anal cancer), and only if he has been the recipient of anal sex, not directly as a method to check for HPV. For women, there are test to directly detect the virus, but they are not mandatory- you still have to specifically ask for them, despite how prevalent HPV is in the USA. In 2009, the FDA approved DNA testing for HPV yet blood donations and samples are not screened.
What is HPV? Human Papillomavirus is an infection of the skin and mucous membranes. There are over 100 strains of HPV of which 40 are identified as sexually transmitted infections. It is often called “genital warts”, because when a strain causes warts (not all do) and symptoms are visible it appears as tiny cauliflower-like clusters on the genitals. These HPV types can also infect the mouth and throat. Other strains are cancerous and some are a direct cause of cervical, anal, and oral cancer. On average, about 15,000 women get diagnosed yearly with cervical cancer and about 80% of these cases are cause by HPV.
In most cases, HPV shows no symptoms yet remains highly contagious, and unfortunately, condoms do not offer 100% protection. However, they are by far safer than going without protection. It is generally stated by health organizations that condoms provide approximately 70% protection against HPV.
How does it spread? Penetrative sex or exposure to bodily fluids, like semen, is not needed to contract HPV. It is transmittable by skin-to-skin contact during oral, vaginal, anal, and manual sex. It is most commonly transmitted from direct genital-to-genital contact (touching two sets of genitals together without a protective barrier). Some strains can be transmitted from kissing.
The CDC recently reported that HPV is contactable from mother to child through vaginal birth. Yet there is still much unknown about the virus. For example, the only studies released for HPV cases in children are from oral cancer cases. As the non-profit organization, HPV Awakening points out, no information has been released about whether or not children are being examined for anal, cervical or other cancers caused by HPV.
How is it diagnosed? HPV is detected from examination of warts and from tissue samples taken during a gynecological or urological exam. For women, a PAP smear does not test for the virus itself, but may detect precancerous condition that are caused by HPV. There are DNA tests that can be done with or without a PAP smear. These tests can determine if the type of HPV is a high-risk stain. For men, there is currently no FDA-approved HPV test, which means that men who have clear STI screenings with negative results should not consider themselves HPV-free or at zero-risk.
Is it curable or treatable? No. Warts can be removed. However, the virus may still remain in the body and can be transmitted to partners, and/or cause long-term health problems like cervical cancer.
Unfortunately, neither public awareness nor medical understanding of HPV matches these severely high statistics. Few people, both teens and adults, think about how a condom is only 70% effective against the virus or that a clear STI screening does not indicate that they are HPV-free. Blood banks do not screen for HPV.
And HPV is considered a “none-reportable” STI. This means that the US government and the CDC do not feel that individuals have a legal obligation to be informed by a partner that they have had a history of or currently have an “active” case of HPV.
Yet rather than acknowledging our unfamiliarity and unawareness of HPV we, the general public, continue to reinforce great social stigma with being diagnosed with an STI. And thus, the ignorance continues. This is precisely why the non-profit group HPV Awakening exists: to educate the general public and push for more investment in medical research.
HPV Awakening Inc.: was founded by Tashia Ameneiro shortly after she was diagnosed with HPV at 25 years old. She contracted the virus from her first sexual partner who had known he was a carrier but did not tell her. It wasn’t long after that Tashia found herself trying to coop with a severe lack of public resources compounded with social stigma for being diagnosed with an STI. The impact of being diagnosed led her and her friends (Virginia Pena and Yvette Rodriguez) to launch HPV Awakening- A nonprofit to counteract social stigma through public education.
The Miami-based organization is the first established non-profit in North America to address general HPV that is not limited to one cancer form or another caused by HPV. They run workshops, lectures, and info booths at universities, schools and community events to raise public awareness about HPV and how to protect one self. They have partnered with major community-based organizations, such as the Village South/WestCare – Project IMPACT, hosting the First Cervical Cancer Day at FIU in January 2013 to provide a wide range of free health information to the public. HPV Awakening has also partnered with several student organizations such as VOX, WSSA (Women’s Studies Student Association), The Vagina Monologues, and One Billion Rising.
Along with improving public awareness, HPV Awakening is also putting pressure on the FDA and greater medical science community. They are pushing to make HPV caner strands “reportable” and get HPV male testing approved. They are also trying to expand medical and social research about the virus and the impact it has not only physically, but mentally and emotionally.
They need your support: As with all social causes, people’s support is essential to their survival. HPV Awakening functions through the hard work of just Tashia, her mother, and a few friends. They currently have no funding or sponsorship. All the things they have managed thus far have been done through their own pockets and free-time. They need support from everyone and have set up a donation bank on their website.
They desperately need funding for basic things like printing information pamphlets, free condoms to distribute, website management and sponsorship to attend relevant events like Gay Pride Fest- Miami Beach, AFO, and Exxxotica Expo.
They welcome any support. This includes actions as simple as sharing their facebook page or more involved help such as volunteering at their events and donating money to help them stay afloat.
We are celebrating Valentine’s Day 2013 by acknowledging some of the most lavish, smart, and intriguing safer sex resources out there and giving them our thank yous for their hard work.
For safer sex guidelines we applaud and recommend you check out the following…
Planned Parenthood: A non-profit health organization that offers reproductive health care and advice on contraception, safe sex, and family planning. They’ve been around since 1939 and in many cases are the only place where one can access birth control, STD/STI testing, sex education, couples counseling, etc.
The Body: A medically-based HIV/AIDS resource in the US which provides information on everything one needs to know about HIV/AIDS, including advice on prevention, HIV testing, treatment, safely navigating a mixed-status relationship, HIV/AIDS policy and activism, and the latest research on HIV/AIDS and other STDs. This humongous site offers everything from Blogs, podcasts, bulletin boards, “Ask the Experts” forum, first-person stories and interviews, conferences and news coverage, and library resources.
SEX ETC: Who better to understand high school sex politics than the peers who are living and experiencing it themselves. The blog, magazine, and stories on this site are written by and for teens and young adults across North America. It provides different media to engage with sexual health info, such as videos about safe sex, forums where teens can participate and moderate discussions with other teens, a 400 words sex glossary, a state-by-state reference to info on birth control, health care access and your rights to sex education in “Sex in the States” guide, and a range of surveys and guides to sex ed activism.
Scarleteen: A progressive sex-ed site written for teens who are female, male, genderqueer; gay, straight or somewhere in between. It provides over 200 articles about sex, health, and relationships, covering everything from STIs to sexual orientation, body image, self-esteem, to birth control, masturbation, misogyny, sexual abuse, and technical advice from French kissing to BDSM. The site also provides interactive question-answer-discuss services, including their new live help feature providing safe, anonymous live chats with Scarleteen’s staff and volunteers.
SEX-ED LOOP: Another great resource for teens, based in Chicago, that gives up to date information on sexual health, rights, and identity through a range of social media channels including a weekly text messaging service and clinic finder that will identify health care services throughout Chicago. Also provides helpful articles about gender identity and sexual orientation.
HIV InSite:A non-commercial, well-established source developed by the Center for HIV Information at the University of California San Francisco. The site offers an extensive collection of original material including a complete textbook about the clinical management of HIV/AIDS. It is also a great resource for global HIV/AIDS research, statistics, and policy analysis.
Our Bodies Ourselves: A global non-profit that promotes evidence-based information on girls’ and women’s health. The information provided on the site is vast and includes excerpts from their famous book on reproductive health, as well as first-person blog stories that range from topics like body image, nutrition, menstruation, pregnancy and much more.
Well, that’s a handful of some of our favorite safer sex resources from sound sexual health organizations. Do you have any resources to share? Please let us know in the comments below!
A site about condoms and condom stories is never complete, and neither is the lavish, outlandish history of the device. It’s history is full of insights into human character with all its flaws and foibles.
The invention of the latex condom is relatively new in modern history. However, the principle to protect against sexually transmitted diseases and infections (STIs) dates back to at least 1,000BC (Perera, 2004: 95). Ancient Egyptians were protecting themselves with linen sheaths from a parasitic disease known as Schistosomiasis. Anthropologists have also found evidence of female condoms to prevent pregnancy. The Petri Papyrus of 1850BC lists several female condoms, one of which was crocodile’s dung cut up on auyt-paste and inserted into the vagina. In fact, animal dung was used as a female contraceptive across many societies. The Aztec Badianus manuscript of 1552 explains, “and you shall put into the vulva the crushed herb of the calabash or cucurbita root and eagle’s excrement.” Dung stuffed linen aside, the one devise that could protect against both STDs and pregnancy wasn’t produced until 1855 during the industrial revolution and the advent of vulcanized rubber.
Of course, when safer sex first became a known practice in ancient societies, the scientific frameworks for understanding biology, medicine, sexuality, and public health were vastly different. Hippocrates, the father of western medicine once stated, “After coitus if the woman ought not to conceive, she makes it a custom for the semen to fall outside when she wishes this” (R.I.Chalmers, 1987)… pause … blink … isn’t this reminiscent of the 2012 Teaparty Candidate Todd Akin’s infamous statement that women’s bodies can prevent pregnancy in cases of “legitimate rape”?
Anyway, I’m not stating that the risks of unwanted pregnancies and transmitting or contracting STIs is significantly less in contemporary life because we may have greater public awareness and better medical technology. Rather it’s to recognize that health science and perceptions of “risks” and “healthy” sexuality are products of social contexts- its history and location, politics and economics- and therefore have a transformable quality. That’s what makes the story of the condom throughout human civilization so interesting; because, like a flirtatious cuttlefish, it morphs into so many different types, shapes, and sizes, not to mention the amount of knowledge, myth and stigma that have carried throughout its making.
Contraceptive Censorship
Just to mention a few effects of stigma: In 1873, the U.S. government illegalized the advertisement of any contraception. That same set of laws also allowed for the confiscation of condoms sent through the mail and banned the sale of any condoms in up to thirty states (Collier, 2007). Due to the belief that venereal disease was the price one paid for sinful choices, health experts from The American Social Hygiene Association objected to American soldiers being issued condoms- so during WWI they weren’t (Perera, 2004).
So what preceded the latex condom? As the most basic device for safe sex, different versions of the barrier method were utilized in most societies for millennium, and thus it is near impossible to account for all sexual practices, customs, beliefs, and attitudes. Here we take a glimpse into some western society habits in which the devise was made at the expense of sexual pleasure; almost all made with only hetero-male health and interests in mind; and certainly most practices kept in secrecy from public mind and records.
Medieval to Victorian, Dung to Intestine
The first western medical record of the condom is found in Gabriello Falloppio’s book on syphilis published in 1564 when the STD was a European epidemic. He details condoms that he made from linen sheaths dipped in salt and herbs and tied under the foreskin. Nothing in his records test comfort or sexual satisfaction, but we do know that animal intestines eventually became the superior condom material.
Users tended to hail from higher-income strata as condom were expensive and available only in boutique shops in the cities where seamstresses handmade each baudruches. Louis XVI could afford to have his animal-bowel condoms lined with velvet and silk. There were some available for those with less income if one was willing to buy second-hand. As Shyama Perera’s explains in her book Taking Precautions: An intimate history of birth control (2004), there was a “Miss Jenny” in 1820s London who hand-washed used condoms and resold them at a more affordable price.
The Rise of Rubber
By the 1850s, vulcanized rubber was invented and condoms started to roll out of factories. The process was labor intensive as each rubber condom was dipped in cement and then hand-shaped and smoothed by rubbing and trimming. It was also a major fire hazard because gasoline and benzene were used to suspend the rubber. Rubber condoms were reusable and had a shelf life of about 3 months making them more economical, but the “skin” condoms remained the preferred product for better comfort and sensitivity (keep in mind, lubricant wasn’t invented until 1957. Ouch!). Also, at this time, there were no standard quality control methods. According to condom historian, Aine Collier, some American factories sold their defective condoms at a cheaper price rather than discard them.
Another outcome of the Industrial Revolution was the beginning shifts of condoms away from a sign of wealth towards health. By WWI, the use of condoms was more prominent among European soldiers as the rate of STDs increased. Armed forces would distribute them for free to its members even in countries where condoms were illegal for the general population (the U.S. military did not catch on to condom sense until WWII).
Introducing Trojan Latex
In 1920, Young Rubber Company, the makers of Trojan, was the first to manufacture a latex condom, which was a great improvement from the rubber condom because they were easier and far less of a fire hazard to produce. Latex is also thinner, smoother, and stronger with longer lasting shelf life then rubber. By 1932, Europe’s first latex condom, Durex, was manufactured on conveyor system assembly lines, making them far less labor intensive nor subject to human error.
Marie Stopes’s first health clinic in London did make condoms readily available and was the only outlet from which women could buy them. However, the clinic encouraged women to use female contraceptive techniques, such as the cervical cap, rather than rely on protection made for men.
Quality Control
Stigma around the use of contraceptives continued and disinformation meant that not everyone trusted condoms. Of course, the lack of quality control specifications didn’t help. Perera (2004) documents rumors stating that Catholic factory staff would deliberately poke holes in condoms. The introduction of electronic testing machines helped eradicate rumors. By 1957, the manufacturing process advanced to dramatically reduce the amount of defective rubber and latex, and also allow the first lubricated condom on the market. It wasn’t until the 1960s that most countries in Europe and North America established a certification of national standard specifications for condoms manufacturers to follow.
What were once common problems of slippage and breakage are virtually obsolete with contemporary production. Today, different studies on latex condom breakage tend to reflect a breakage rate of around .4%, or only 4 breaks in every 1,000 uses. Which means that if a condom breaks than it is highly likely caused by user-error rather than manufacturer issues.
The Discovery of AIDS and Height of Condom Use
With industrialization, condoms increasingly became relied upon. Yet it wasn’t until the 1980s and 90s when HIV/AIDS was first declared a pandemic, that condoms became fervently promoted by governments and health organizations. Within the first year of the UK campaign, condom sales increase by 20%. 1988 was the first time in condom history in which condoms were the most popular birth control choice for British married couples. In the U.S., condoms ranked third in popularity among married couples, and a strong second among single women following the Pill.
The Femidom
It was during the time of the first HIV/AIDS crisis that the female condom was manufactured on a large scale despite many experts’ false and damaging advice that women were at “low risk” of contracting HIV. The Femidom, or FC2, is far more advanced than lemon halves used by ancients and cervical caps promoted in the 1920, which do not protect against STDs/STIs. The FC2 is a device made of polyurethane that is inserted into the vagina with a wide base that sits on the outer parts of the vulva. Besides allowing females to be in control of condom use, another advantage of the FC2, is that it can be inserted for up to 8 hours before sex- so no intermission needed for application.
Contemporary Condom Conundrum
The twenty-first century condom is produced by a greater range of manufacturers, non-profit organizations, and government programs around the world. Thanks to modern technological innovation, condoms are far more comfortable, safer, stronger, and smoother then Greek goat’s bladders or oiled silk paper. Who knows what the next advancement will be. There are reports of spray-on condoms in the midst.
The promotion and availability of condoms has also dramatically improved. Nowadays, condoms are typically displayed in public restrooms, supermarkets and pharmacies, or bought in bulk online without age restriction or parental consent required. And they are affordable enough to not need rinsing and re-using!
Condoms have reached a status of “common sense” for many. An American-based 2010 study by the Alan Guttmacher Institute found that the condom is the most common protection used at first intercourse (females 68% and males 80%).
However, the same study found that as individuals continue to have sex, their use of condoms decreases as they get older. The rate of STDs/STIs is extremely high among American youth: One in two sexually active individuals will get a STD usually before the age of 25. According to the American Academy of Pediatrics and the Henry J. Kaiser Family Foundation, two-thirds of all individuals who become infected with STIs in the United States are younger than 25 years old! The reason for this is because young people simply are not using condoms and other barriers consistently or correctly to protect themselves and their partners.
Want to see a visual account of condom history? Here is a mini-documentary (7:47min.) by Trojan to commemorate Condom Month (February, of course), and posted by Queerty Online Mag.
…So the condom campaign continues. History never ends. For a more on problems with condom use, read here about the case to include more condoms in everyday popular culture.
I’m sure you know, or at least have heard of someone who claims that condoms make sex feel less good. Condoms (and other safe sex tools) don’t have the best reputation. It doesn’t help that we rarely see safer sex happening in media representations of sex that is hot, fun, or romantic. But it doesn’t have to be this way. As we’ve discussed elsewhere, there is no solid empirical evidence to back up negative claims about condoms. Studies find that people who use condoms correctly and are used to using them tend to report greater pleasure with protected sex than those who go without protection.
This does not mean that people on an individual level do not experience problems when enjoying protected sex. There is a difference between knowing how to put on a condom and knowing how to use them well. That is why it tends to be people who use them often and consistently that report greater sexual satisfaction. It takes practice and know-how to feel confident and learn what feels good for you and partner(s). Condoms can add a playful and sexy dimension to sex but, as with anything sexy, you need a positive attitude and a dash of creativity. In this post, we offer some ways to help spice up condom use.
In sum, the main tricks to loving the glove are:
1) Communicate 2) Take turns putting it on 3) Practice 4) Be prepared 5) Be playful and have fun 6) Lubricant! 7) Be aware of condom sizes and experiment with different ones
For more on these points, continue reading. Warning: explicit, NSFW illustrations below.
Before we begin, the basics of condoms should be known. Check out our user manual. Once you understand these essential steps to condom care you can explore ways that may enhance sexual pleasure and make condoms a part of sex- rather than a disruption to it.
This post focuses on condom use for penis and sharing sex toys, but some tips here can also apply to safer anal and vaginal oral sex using barriers including condoms, dental dams, cling film saran wrap, or latex/nitrile gloves. For more info on protective lesbian sex check out this sex column. For specifically gay protective sex info, the Gay Men’s Health Charity is an excellent resource. (Some links are affiliate links that earn us a small commission).
Introducing condoms to partners
This isn’t something that should feel awkward no matter how casual or serious your relationship. It can be as simple as just stopping what you are doing and handing over a condom. Sometimes you won’t need to say anything at all. Or, as suggested by Robin Mandell at Scarleteen, when you feel the heat turning up and sex might happen, take a quick break and retrieve condoms from wherever you keep them (ideally with easy access- discussed below). You can say something as casual as, “No pressure. I just wanted to get these out just in case we need them.”
Condoms do not keep people from getting close- Silence does.
Asking someone to use a condom is to show care for the well-being of you both. Communication really is key and talking about sex might mean explaining what you like, what’s your favorite position, or how to use condoms and use them in ways that work for you both. Talking together about these things will cultivate intimacy and deepen your bond (not hinder it!), because you are sharing the responsibilities of sex and caring for each other.
Great sex is about sharing control
As Heather Corinna explains, this is something that safer sex can help support. Learning how to discuss condom usage and exploring sexy ways to put on a condom and what feels good together will make talking about other facets of sex a lot easier, such as how you’d like to try something new. This also means that both people are making decisions and choices which are fundamental to both amazing sex and healthy sexuality.
Take turns putting on barriers
Related to the above- condoms can be a lot more erotic when one partner puts it on the other. There are many ways to turn up to heat with a condom. When done in a deliberately slow manner with some stroking, teasing, eye contact, putting on a condom can be exciting.
You can put the condom on together. For example, one person takes the condom out of its package and places it over the head of the penis (make sure that you unravel it right-way down, not inside out). The other person pitches and holds onto the reservoir tip of the condom as the other unrolls it down the shaft of the penis with one (or two hands). This not only turns up the heat, but also ensures confidence in both actors that the condoms is put on correctly.
Practice Makes Perfect
Learn how to put it on. You can use the ol’ fashion banana, or the aid of a dildo or willing partner to practice how to unravel the condom. It should unroll downward to the base without too much pulling or stretching. If any exertion is needed to get the condom to the base then it is probably the wrong size. Practicing by yourself will relieve any worry about losing an erection or the uncomfortable pressure of being judged on your condom skills. Ladies and guys, you can always practice when you masturbate. This will also help you learn your pleasure spots and what feels best with protection. Or practice with your partner. When the time is right, either you or the other can put on the condom, so it’s good for everyone to knows how. For many couples, this also helps to naturalize the process. It’s not about “making” a guy do something; it’s about something people do together for each other.
Be Prepared
One of the great advantages to condoms is that they are readily available for anyone to buy without a prescription and they are relatively cheap- even free at some health clinics like Planned Parenthood. So equipping yourself with this contraceptive takes far less time, research, and planning.
Also, it will help things run a whole lot smoother and greatly reduce the buzz-kill if you can reduce condom-hunting time. So keep condoms (and lubricant) in a dedicated, handy place next to your bed where you are sure to find it.
Be playful
Keeping condoms in an easily accessible place is helpful, but that does not mean that it is always best to rush through the process of putting one on. Great sex is to have fun with it. When you introduce condoms have a sense of play. And if things get awkward as you’re learning how to do safe sex, let yourself laugh about it. This helps take the pressure off.
Buy some glow-in-the-dark condoms and leave your partner in suspense until the lights go out! Or incorporate condoms into erotic foreplay. Try slipping it on his penis with your mouth. If you are using gloves, get some props and play Doctor. Spice it up by carrying a condom with you in your handbag or pocket and discreetly show it to your partner to hint what’s on your mind.
Lubricant
This is really important. Especially, if you or your partners complain about reduced sensitivity, lubricant will improve sensation immensely. Put two drops of water-based lubricant inside the tip of the latex condom before putting it on. Even if dryness is not a problem for a person, lubricant that is made for condoms will lasts longer than the natural stuff.
Two points here. First, make sure your condom fits well. Condoms aren’t one-size-fits-all, and a condom that’s too small or too big is likely be difficult to put on, very uncomfortable, and much more likely to break. If you are not sure what will fit, check out our Condom Size Calculator. If you experience certain discomforts, such as condoms being too tight, or too long, we have suggestions at our condom guide. If you’re providing the condoms, it might be useful to have a variety of types and styles so you and your partner can choose what seems right. Variety sample packs can be found online, and at some drugstores.
Second point, if you are in a longer-term relationship, you have the advantage to experiment with different types of condoms and lubricants together to discover what suits you both best and have fun while doing it! There are many different styles of condoms out there from thin, to thick, to wider in certain spots, snugger in other spots, etc. There’s variety in texture: ribbed, studded, contoured, pouched; variety in non-latex condoms; and there is plenty of variety in lubricants that can enhance sensation dramatically. You could buy a variety pack of condoms to find the best ones. Or make a date out of it and visit a sex shop and choose together.
There are hundreds of sexy ways to put on a condom that do not interrupt the flow. Here are just two examples: Excellent hand-drawn illustrations that will no doubt spark ideas by custom condom size company TheyFit.com.
Condoms inclusion technique demo from TheyFit.comCondom inclusion technique demo from TheyFit.com
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If I haven’t convinced you yet about the sensual side of condoms, take this with you: Everyone needs to accept this reality. If you’re sexually active and not practicing safe sex then you are likely to transmit or contract a disease or infection. To prevent this from happening, to experience healthy fulfilling sexuality, you have to learn how to use protection.
A recent study by researchers at Stanford Medical School reveals that a large portion of young women are irresponsible in bed, meaning they ain’t protecting themselves. The year-long study collected data from 1,194 sexually active females aged 15 to 24 who visited Planned Parenthood clinics and were beginning contraceptive pills, patches, injections, or vaginal rings for the first time. At the beginning of the study, only 36 percent of participants consistently used the “dual method” (relying on both hormonal contraceptives and the condom), which meant that STI and STD protection was compromised. Getting pregnant seems to be the only risk to care about.
Surprised? To be honest, I wasn’t either as I know many friends whose first time using birth control was when they entered a relationship with someone they trust, and that trust included believing (hopefully, with medical proof) that neither person carried STIs.
However, it gets worse: The study found that over 50 percent of young women did not resume condom use after they discontinued hormonal contraceptives. That’s right, NO protection!
Less Youth are Using Condoms
Why is this happening? And how can prevention improve? According to Rachel Goldstein M.D., lead author of the study, the most influential factor of condom usage is the partner’s attitude toward condoms. When a woman did not know how her partner felt about condoms or knew that he felt they were “very important”, she was more likely to be a dual method user than when her partner thought condoms were “not at all important”. The researchers speculate that power imbalances within the relationship impact the woman’s ability to negotiate condom use. “It appears that her partner’s feelings may be more important than her perceived risk of a sexually transmitted infection or her own beliefs about dual method use,” said Goldstein. This is an important point of concern. There are many factors, including levels of mutual respect, emotional maturity, and self-esteem that need to be considered when counseling youth about healthy sex (Scarleteen offers great advice on negotiating condom use). Of course, the study concludes that more counseling is needed to accompany hormonal contraceptive treatment that emphasizes the risks of STIs and STDs.
However, I think this is only one piece in the very complicated puzzle of sexual relations. Plus, the research does not address why young women are not resuming condom use after discontinuing hormonal medication.
In fact, condoms are not very popular among young adults in general. According to the American Academy of Pediatrics and the Henry J. Kaiser Family Foundation, the rate of STIs in people 15-24 years old is exceptionally high. Two-thirds of all individuals who become infected with STIs in the United States are younger than 25 years old! The reason for this is because young people simply are not using condoms and other barriers consistently or correctly to protect themselves and their partners.
Condoms Miss the Limelight
Now, most teens in North America have been exposed to sex ed and know why condoms exist, but this is obviously not the only means to ensuring healthy sex lives. Indeed, sex pedagogy in North America is riddled with censorship (that’s a whole other post), and health counseling should accompany hormonal contraceptive use. Both these solutions, however, overlook a larger social problem. The social stigma which has developed around STIs and diseases has produced negative attitudes and ignorance towards safer sex. It’s fair to say that this negativity permeates in our popular culture.
Condoms and other safer sex practices have acquired an unsexy reputation from their very absence in romantic and steamy and sex positive representations. Pornography, films, romance novels, or how-to articles in popular magazines rarely represent the condom and how it can actually increase sensuality, not dull it. And this is something that needs to change because it limits our knowledge, attitude and imagination about what healthy sex can be.
This is not to say that viewers of media are passive recipients who are easily influenced by what is on TV. But media can be interpreted as a cultural artifact that reflects beliefs, attitudes, prejudices of the times. It is a matter of what sells, and unfortunately, the mainstream only works to reinforce the notion that safer sex is a chore.
One Solution: Safer Sex Porn!
There are some who have sought to exert control over the representation of safer sex through alternative media. One honorable example is the 1990 video short, Current Flow, by Jean Carlomusto starring Annie Sprinkle and Joy Brown. This explicit video was made in response to Cosmopolitan magazine publishing a piece which erroneously claimed that virtually no females could contract HIV. The short is basically about a woman (Annie Sprinkle) masturbating on the couch with her vibrator. Suddenly her vibrator stops and we see a woman enter the room with a towel in one hand and a power cord in the other (not many battery-operated vibrators back then). The woman seductively crawls over Annie and rolls out from her towel dental dams, latex gloves, condoms and lube for the dildo. And the climax begins.
But this is not just any girl-on-girl porn, it also emphasizes “showing how”. For example, a close-up of Annie Sprinkle getting eaten-out shows how to use a dental dam. Another shot shows Joy Brown washing the dildo before it is her turn to use it on Annie. As Carlomusto writes,
“…in order to educate lesbians about safer sex we have to establish what it is. Saying, ‘use a dental dam’ is not the same as saying ‘use a condom’, since many women don’t know what a dental dam is” (1992: 82).
Current Flow is the first of it’s kind. Sexy and safe lesbian porn made by and for lesbians. It was made at a particular time during the HIV/AIDS crisis when the Centers for Disease Control refused to investigate data on woman-to-woman transmission of HIV. It was also a time when mass media and public health bureaucracies refused to produce explicit sex education or represent gay and lesbian sexuality. While the information today is made more available and inclusive of a wider public, we still do not see safe sex represented as often as we see sex in the media.
Safer sex should be not be limited to public health messages or HIV/AIDS activism. What would be powerful is normalization of safer sex in everyday media. Imagine music videos- the soft porn of daytime television- including condoms in a sexy, bootylicious way…
Dull Feeling in Bed Begins with Dull Attitude
You might think that the reason there are few representations of positive condoms in popular culture is simply because condoms are genuinely unfun and decrease pleasure. You might think that it is for this reason that younger people are using condoms less. I would argue that this belief is grounded more in attitude than it is in actual reality. Let me explain.
Some studies, such as “Sexual Pleasure and Condom Use” by Randolph et. al. (2007), have found that those who report sex with a condom as less pleasurable tend to be people who have not used condoms in a while or who don’t use them at all. They found that more men than women tend to believe condom use is less pleasurable even without actual experience. It is beliefs that influence experience with condoms and whether one wants to use them. It is true that many people reported that unprotected sex feels better than protected sex. Overall, people who are familiar with using condoms tend to report greater pleasure with protected sex than those who are likely to go without protection. As Heather Corinna at Scarleteen writes, “The more you use them, the more they feel good, and it’s people who don’t use them at all that tend to complain about them most.”
In other words, it is the attitude that one has towards condoms that greatly affects satisfaction. People who use condoms often do not express a decrease in overall pleasure because they learn what condoms suit them best and what ways they are most comfortable using them.
Know Your Condom
Which brings me to my next point. Part of the process of popularizing condoms is to increase understanding of the different types and ways of using them. Another study by Michael Reece and Debra Herbenick (2012) found that many people do not know how to use condoms properly and what can increase pleasure. For example, putting a drop of lube inside the condom before rolling it on can improve application and increase sensitivity. Also, the condom can be put on in sexy and tantalizing ways by you or your partner that make it a part of sex- not an interruption to it. Check out our post for some sexy tips on condom use.
Pediatrics and sex educators should know condoms too. Reece and Herbenick suggests that prevention providers can play a valuable role in alleviating negative perceptions of condoms by recommending different condoms made for specific needs. For example, for those men who feel condoms are too tight, a practitioner may recommend condoms which are designed with a more bulbous head or looser fit. The point is that there are hundreds of thousands of condom types out there and there needs to be more access and understating of choice and care.
If it’s true that sexual pleasure with a condom is all in the attitude than it is all the more important that there be representations of safe sex in pop media. How powerful would it be if Jake Gyllenhaal whipped out a condom during the famous sex scene in Broke Back Mountain!
What do you think? Would safer sex in the media help increase positive attitudes towards safe practices? What do you think should be done to get more youth practicing safer sex?
Source cited: Jean Carlomusto & Gregg Bordowitz (1992).“Do It! Safe Sex Porn for Girls and Boys Comes of Age.” A Leap in the Dark: AIDS, Arts and Contemporary Cultures. Allan Klusacek & Ken Morrison, eds. Montreal: Vehicule Press.
For the first time in history, the FDA has officially approved a drug shown to reduce the risk of contracting HIV. According to USA Today, the pill Truvada is approved as a preventative measure for people who are at high-risk of contracting the disease through sexual activity, like those with partners who are HIV positive. The drug was already on the market as a way to manage the virus for people living with HIV.
Since 2010, studies have reported that a daily dose of Truvada helps reduce the risk of transmission by 42% in non-heterosexual men, but of course this is not without the use of the ol’ condom. It seems no drug can surpass the protectiveness of this genius invention. Another study found that the Truvada reduced transmission by 75% among heterosexual couples, again accompanied with counseling and condoms, USA Today reports. FDA approval for this new use of Truvada will likely increase prescriptions. And it comes as timely news for the International AIDS Conference in Washington this month- the first time it’s been hosted in the U.S. in 22 years due to the Obama administration lifting the two decade ban that prevented people living with HIV to enter the country.
Still, there are HIV/AIDS activists who reacted to this news with cautious optimism. Some worry about a false sense of security that may arise with the prescription. Roland Johnson of the AIDS United told Linda Vilarosa from The Root news that while this is a step in the right direction, it is not a silver bullet. “…This isn’t something that you can take every once in a while when you’re going out. It does not replace safer sex and must be used in conjunction with consistent practices, including condom usage.”
This comes at a time when public, private, government and non-government organizations join together this month to re-engage in the fight to end the HIV/AIDS epidemic. According to the Center for Disease Control, an estimated 1.2 million in the U.S. live with HIV and one in five of American do not know about their infection. The AIDS epidemic continues to affect more than 34 million people worldwide, of which over two million are children under the age of 15. According to the United Nations, there were 1.7 million AIDS-related deaths last year, down from 2.3 million in 2005.
The Truvada pill is part of a medical strategy known as pre-exposure prophylaxis, or PrPE, to reduce the spread of the disease. How this pill will be accessed and made available, and how it is used across different communities around the world is yet to be understood.
It is startling that in 2012 it’s possible to ignite hysteria and spread ignorance about risks of transmitting HIV in public places. A daycare in Northland, New Zealand has removed a four year old boy from their Center because he is HIV positive. According to the NZ Herald, just 48 hours after the mother told the daycare that her son is HIV positive the Center prevented the child from returning until they establish a care plan.
However, the NZ AIDS Foundation and senior health officials have stated that there is no need for a “care plan” because the level of the virus in the child’s blood is so low it undetectable and cannot be transmitted, NZ Hearald reports. Nonetheless, the Center has responded by sending letters to all the parents that their children have been exposed to HIV, resulting in hysteria across some communities. TV 3NEWs Campbell Live reports that now parents at a school attended by the child’s older siblings are “raising fears about contamination even though the siblings don’t have HIV!”
Campbell Live confirmed on 9 May that neither the Ministry of Education or senior health officials have been able to persuade the daycare that there is no risk to any of the children or staff as a result of contact with the infected child. In an interview with the NZ AIDS Foundation executive director, Shaun Robinson explained that professionals with the AIDS Foundation and the child’s doctors have attempted to meet with the daycare and explained that there is no risk. “[The center has] been very well informed…[but have] chosen instead to act completely irresponsibly…It’s a case of willful ignorance – not just gross ignorance but willful ignorance – which is leading adults to essentially bully and pick on a 4-year-old boy.”
The Day Care has now taken legal action against the NZ AIDS Foundation over allegations of expelling the child from the Center. Meanwhile, the boy has been accepted into another Day Care and will commence education in July 2012.
Whether allegations of expulsion are true or false, the point is that the community responded in fear and exclusion of the boy and his family. In responds to this story of ignorance and discrimination, we’ve complied facts about HIV/AIDS transmission that any parent and child care professional should know. Knowledge is power. If everyone understood these basic facts there should be no alarm.
BASIC FACTS: Caring for Children with HIV/AIDS
How is the virus transmitted? 1) Congenital and perinatal transmission is the most common way children are infected. This is when HIV is transmitted from the infected mother to her child during pregnancy, labor, or delivery (Child Care Law Center, 2005: 3). According to the CDC, transmission rates have dropped due in part by HIV testing of pregnant women, antiretroviral drugs, and cesarean delivery before the onset of labor. However, perinatal exposure still occurs.
2) Blood transfusions have infected children. According to the American Red Cross, today the risk of receiving HIV positive blood through a blood transfusion is about 1 in 2,000,000.
3) HIV can only be transmitted through certain bodily fluids (blood and semen). HIV cannot be transmitted from saliva, nasal mucus, tears, urine, feces, sweat, vomit or breast milk. In the child care setting, blood is the main type of bodily fluid which requires standard and universal precautions.
4) There are no reported cases of HIV transmission through daily household contact, like food preparation, eating, hugging, kissing, sharing toys, diapering. Even biting has never resulted in HIV transmission.
A child with HIV or AIDS poses virtually no risk to the health of other children or adults, especially when standard precautions are taken on a regular basis with all children. Without taking these simple routine precautions, children are far more likely to contract blood-borne or fecal-borne diseases like hepatitis B and hepatitis C, pinworms, giardia, and common diarrhea than HIV (Child Care Law Center, 2005: 4).
Read the Child Care Law Center pdf for further information about universal infection control measures, child care legal responsibilities to admit and care for a child with HIV/AIDS and issues of confidentiality regarding the child’s status. The Center for Disease Control and Prevention‘s website has extensive pediatric information on HIV/AIDS.
A recent 