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Ten condom commandments
IRIN News
February 29, 2012

http://www.irinnews.org/Report/94980/HIV-AIDS-Ten-condom-commandments

Condoms are widely promoted as one of the most effective ways of preventing the transmission of HIV and other sexually transmitted infections, but a recent study has found that incorrect use of condoms is common and affects their effectiveness.

Indiana University's Kinsey Institute for Research in Sex, Gender, and Reproduction conducted a review of global literature on condom errors and problems from 1995 to 2011. IRIN/PlusNews has put together a list of suggestions based on some of the common errors reported:

Use it from beginning to end - Sometimes the condom is applied once intercourse has already started, or removed before intercourse has ended. The review found that this error was frequently reported; another common mistake was starting sex before the condom was unrolled to the base of the penis. Condoms should be fully applied before intercourse has begun and should only be removed once intercourse is finished.

Do not completely unroll the condom before putting it on - A 2002 study of 158 US college men found that 25 percent completely unrolled the condom before putting it on, rather than the correct method, which involves rolling the condom on to an erect penis.

Leave a space at the tip of the condom - Generally, it is recommended that a space of about 1cm be left at the top of the condom to collect semen; if no space is left, there is a risk that the semen may run down the sides of the condom and leak out before the penis is withdrawn. Three studies reviewed reported prevalence rates for not leaving space at the tip, ranging from 24.3 percent to 45.7 percent.

Squeeze air from the tip before use - Excess air should be removed from a condom before use, as it can cause breakage. In a 2005 US study, 41.6 percent of men and 48.1 percent of women reported that air was not squeezed from the tip before use.

Put the condom on right way up - The study found that another common condom error was putting the condom on inside out and then flipping it over and using it the right way round; this poses risks because it potentially exposes the sexual partner to pre-ejaculate once the condom is flipped to the correct side. If the condom is put on inside out, it is best to discard it and use a fresh one.

Be careful not to damage the condom - The study reported the use of sharp objects to open the packet, knowingly using a damaged condom or not checking for physical damage. Condom packets should not be opened with fingernails, scissors or other sharp objects.

Use the right lubricant - Some common lubrication issues include the use of un-lubricated condoms, which increases the risk of breakage, and oil-based lubricants, which break down the latex and make it more likely to break. If lubricant is required, water-based lubricants are preferable to reduce the risk of breakage.

Withdraw correctly - Not holding the base of the condom during withdrawal can lead to leakage. Incorrect withdrawal was reported in as many as 57 percent of condom-use events in one study.

Store safely and check expiration dates - Ideally, condoms should be kept in a cool, dry place; condoms in wallets or in back pockets for long periods are not a good idea, as body heat can weaken them. Incorrect storage was reported by 19.1 percent of participants in a 2003 US study.

Do not re-use - Condoms are intended for single use, and should be disposed of after intercourse. Re-use of condoms was rarely reported in the studies in this review, but may be more common in less economically developed countries or among the poor. In Kenya, at least one community reported washing and re-using condoms due to the long distance between villages and health centres providing free condoms.

How to use a condom

• Check the expiration date
• Make sure you can feel the air bubble in the closed packet
• Carefully open the condom
• Ensure it is the right side up
• Ensure there is about 1cm of space at the tip
• Place the condom on the penis
• Roll it all the way to the base
• Hold on to the base of the condom when withdrawing
• Dispose of the condom

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