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Table of Contents
- Condoms and HIV
- Benefits of Using Condoms
- Know What Condoms Are Available and How to Use Them
- Talking with Your Partner about Condoms
- Taking Care of Yourself
Using male and internal (formerly female) condoms can be an important and pleasurable part of having safer sex. Sex with condoms can be fun, exciting, and very enjoyable. And using them correctly and consistently – every time you have sex – can prevent unwanted pregnancies and reduce the spread of sexually transmitted infections or diseases (STIs or STDs), including HIV. Choosing to use a condom is one way of showing that you care about your own health and the health of your sexual partner(s).
Whether you have a steady or casual sexual partner, using a condom is an important part of taking care of yourself and your health.
Research has shown that using latex (nitrile), polyisoprene (synthetic rubber), or polyurethane (plastic) condoms is one of the most effective ways of preventing the spread of HIV and other STIs. Some studies have shown that among couples in which one person is living with HIV and the other is HIV-negative, condoms – if used correctly all the time – can help the HIV-negative partner stay negative 98 percent of the time. Recent research has shown that people living with HIV who are taking HIV drugs and whose viral load is undetectable cannot transmit the virus to their sexual partners, even if they are not using condoms. However, condoms are not only for preventing the transmission of HIV. For people living with HIV, using condoms can keep them from getting other sexually transmitted infections. Such infections can be more challenging to treat when you are living with HIV. If all partners are living with HIV, safer sex can also reduce the chances of getting a different strain of HIV that is resistant to the HIV drugs you are taking.
Sex with condoms can be fun, exciting, and very pleasurable. It can decrease your worry about getting or transmitting STIs, HIV, and getting pregnant, which can in turn make your sex life more relaxed and satisfying. It is also a great chance to add variety to your sex life and to build trust and intimacy with your partner by talking about each other's desires.
Whether you have a steady or casual sexual partner, using a condom is an important part of taking care of yourself and your health. Since you cannot tell if someone has an STI by his or her physical appearance, and since it is possible for someone to have an STI without even knowing it, it is important to protect yourself every time.
Condoms have come a long way and newer versions can enhance the sexual experience through their design, material and texture. There is evidence that some condoms may even create more stimulation during sex than using no condoms at all. Condoms are now available in many different flavors, colors, textures (e.g., studded, ribbed), and shapes. Some are even edible and glow in the dark!
There are two main types of condoms: male condoms and internal ('female') condoms.
Most male condoms are made of latex; some are made of polyurethane (a type of plastic), polyisoprene (a manufactured equivalent of natural rubber), or lambskin. Lambskin condoms can prevent pregnancy; however, they do NOT prevent the transmission of HIV or other viral STIs such as herpes, hepatitis B, and hepatitis C. Only latex, plastic, and polyisoprene condoms prevent the spread of HIV and viral STIs.
Male condoms come in a variety of shapes, sizes, colors, textures, and even tastes. They are generally inexpensive and can be found at pharmacies, grocery stores, sex stores, and many online stores. Sometimes they are available for free at certain health clinics, AIDS service organizations and other locations.
They are also quite small and easy to carry so that you can always be prepared to protect yourself. It is important to keep condoms away from heat and check the expiration date. Condoms that have been exposed to heat and are too old are more likely to break. That's why it is important not to store condoms in your car or other hot location. Condoms can also tear fairly easily, so it's best not to store them in your wallet.
Internal ("Female") Condoms
Internal condoms are made of polyurethane or nitrile (synthetic rubber) and can be put inside the vagina or anus ('butt') before you have sex. The condom looks like a pouch, with a flexible ring at each end (click here to see an example). In women, the ring at the closed end goes inside the vagina and covers the cervix (opening to the womb). The other ring sits outside the vaginal opening and partially covers the labia (lips). You can also use the internal condom for anal sex by removing the inner (smaller) ring and inserting the condom with fingers (or another non-sharp object) such that the large outer ring lies outside the anal opening. It can also be placed on an erect penis and inserted into the anus.
Internal condoms usually cost a bit more than male condoms and are available at pharmacies, grocery stores, and sex stores. They are also available for free at certain health clinics and AIDS service organizations. They can be an excellent choice for several reasons: you can insert them up to several hours before having sex, you are in control of putting them in and taking them out, and you can use one if your partner does not use a male condom (e.g., he refuses, he complains about sensation, or has trouble staying hard with a male condom).
To make sex even safer and more pleasurable, consider using lubricant ('lube'). Lube can prevent the condom from breaking and also helps prevent small cuts or tears in the vagina or anus and on the penis during penetration. Lube is good whether or not the condom comes pre-lubricated; sometimes the lubrication on the condom is not enough.
When using latex condoms, use only water- or silicone-based lube. Do not use oil-based lubes like Vaseline, Crisco, shea butter, coconut oil or baby oil with latex condoms because they weaken the condom and make it more likely to break. Silicone-based lube will last longer than water-based lube. Lube can also make the condom feel better. There are several types and brands of lubes, with a variety of different feels and tastes. Some also contain substances that 'warm' or enhance sensation.
Preparing to talk about condoms
You may also consider having a 'sexual agreement' with your partner to work out expectations for condom use.
Even if you have access to condoms and know how to use them, getting your partner to agree to use one can be tricky! Talking about using condoms can be difficult or awkward, especially in the heat of the moment. It can be helpful to think about your personal views and cultural attitudes about sex, condoms, and relationships before trying to talk about condoms with a partner. Once you are clear on what is important to you and what you are willing or not willing to do with a partner sexually, it will be easier to say those things to another person.
Sometimes discussions about sex and condoms are difficult because women and girls:
- May not feel empowered in their relations with partners, especially men: if you depend on a partner for food, shelter, money, safety, or feeling valued as a person, you may not feel you have the power to protect your health or ask that your sexual desires be recognized
- Are often taught that it is not 'their place' to 'speak up' and protect themselves
- Feel uncomfortable talking about sex – sometimes this is from lack of information, and sometimes this is simply because it can be awkward talking about something so personal or intimate
- May fear rejection – if you feel your partner may leave you or think poorly of you if you talk about using condoms, or if you feel that your partner will interpret your request to use a condom as a lack of trust or an indication that you are in another relationship
- May fear a partner's violent reaction – if you feel threatened, please read our fact sheet on Violence Against Women and HIV. If you are feeling threatened right now, call 911 or the National Domestic Violence hotline in the US at 800-799-SAFE [1-800-799-7233; or 1-800-787-3224 (TTY)]. You can also search for a safe space online at Domestic Shelters.
In some cultures, 'good' women are not supposed to talk about sex, be passive during sex, and not question the faithfulness of their partners. These assumptions can make it difficult to talk about condom use. In heterosexual relationships, it can also be difficult to discuss barrier methods for safer sex when a woman is expected to bear children or her value in the community is based on her ability to become pregnant.
It may be equally difficult for a woman living with HIV to talk about safer sex if she wants to have children herself. For more information on living with HIV and having children, see our fact sheet on Getting Pregnant and HIV.
Regardless of what country or culture you live in, it is important to remember that you and your health deserve to be respected and protected. Whether you think of yourself as a wife, businesswoman, mother, provider, or friend, your health is valuable – to you, your family, and your community.
It can also be helpful to identify things that might make you feel pressured to go against your values or better judgment – and to prepare responses in advance. You may want to try talking through or rehearsing some of these situations with a friend. Click here for an example (PDF).
Some tips about how to talk with your partner
Now that you are prepared with information about yourself and different kinds of condoms, you are ready to have an honest conversation. Talking about your needs can help strengthen a relationship, both in and out of the bedroom.
Plan to have the talk when you are not getting ready to have sex. When it comes time to have the conversation, let your partner know that you want to talk about condoms because you care about him or her and you care about yourself. Be honest about what you are willing to do with a condom and what you are not willing to do without one.
You may also consider having a 'sexual agreement' with your partner to work out expectations for condom use. This agreement includes discussing if you are sexual only with one another or have sexual relationships outside your partnership. The terms of these relationships can include strict condom use to protect you both from bringing STIs into your relationship.
If you have sex with another woman, you can still pass on HIV, especially during oral sex or when sharing sex toys. For more information, see our fact sheet on HIV Transmission.
If your male partner says he does not want to put on a condom and you still want to have sex, you have options:
- Offer to put a condom on him or be ready with an internal condom
- Reinforce the boundaries that you agreed upon. If you agreed to always wear condoms, tell him you will not have sex without a condom
- Try a less risky way of being intimate – such as erotic massage or mutual masturbation
- Explore taking pre-exposure prophylaxis, or PrEP (for HIV prevention only)
Safer sex is an ongoing practice, and condom use can be an important part of that, whether or not you are living with HIV. Here are some ideas to make condom use an easier, smoother, and more pleasurable part of sex:
- Think of how you would ask someone to use a condom. Practice some of the lines on your own or with friends, so you will be ready to say them when the time comes.
- Carry condoms with you, so you will be ready for any unexpected sexual situation, but don't store them in your wallet or a hot car.
- Practice! Before being sexual with a partner, practice putting on and taking off a male condom. Try rolling one on and off a banana, dildo, or vibrator. Also try inserting and removing an internal condom to see how it feels and how it fits. Studies show that using an internal condom at least four times is important before people are completely comfortable with it. It may take some practice, but it’s worth it.
It can be difficult to talk about things like safer sex, especially when you are just getting to know someone. You may be worried that you will lose your partner or potential partner. However, it is important to make the health and safety of yourself and your partner top priorities. Even if you have trouble at first asking for what you need, do not give up. Your health and well-being are worthy of respect and protection, at any time and all the time.