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The Condom Conundrum: What Good Are They Anyway?

September 26, 2014

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Before you get the wrong idea, this is not a call for the abandonment of rubbers in favour of uninhibited sex. It's an attempt to place condoms in the context of a world where sexually transmitted infections (STIs) are out to get us at every turn.

God forbid we should have endless fun, so the gods invented unpleasant little bacteria and viruses to spoil the party and make sure we don't all have too good a time until we slide off this earth. Actually, the original intention behind STIs was probably to make sure we didn't procreate the earth so rapidly, that we would have starved ourselves into extinction years ago! I'm kidding, really, and I have no wish to bring the wrath of religion down on my head, but you do wonder at the sort of twist of natural fate that caused nature to bring STIs into the world! Why disease and sex for goodness sake? Keeping our bodies hale and hearty is hard enough without bringing the threat of disease into one of life's true pleasures. However, whatever the reason, STIs exist and are here to stay and the accepted truth is that a condom is a traditional and long-trusted method of keeping both them and unwanted children at bay.

That said, in the modern developed world, the Pill has pretty much removed the need for birth control prophylactics anyway, (unless your faith forbids birth control, too) so instead, the only thing standing in the way of lots of physical pleasure and procreation, apart from moral judgement, is sexually transmitted disease. And let's face it, since the Middle Ages, the accepted way of preventing both disease and babies, has been a protective sheath between egg and sperm.

But how efficient are condoms anyway?

For the purposes of this article and given that its target readership is LGBT, we can leave procreation out of the equation. How good are condoms in preventing sexually transmitted viruses and microbes?

The current hot potato is whether they are necessary to prevent the most deadly STI -- and that is HIV. Let nobody be under any illusion here; condoms still have a major part to play if you are HIV negative and sexually active and not on a strict daily PreP treatment. They are also important for HIV-positive people who do not have an undetectable viral load and a healthy immune system but arguably, less important for those who have achieved that Holy Grail and are healthy and undetectable ... but only as far as HIV is concerned! However for both groups, if you want to avoid a host of other STIs, plus hepatitis C and other viral problems, then a condom will go a long way to preserving your safety. For those very reasons, those who are questioning whether condoms are necessary any more, or have already abandoned them altogether, may need to look at the facts and ask themselves whether it's worth the risk.

There is a tiny ray of light, side effect, for people living with HIV, in that recent research seems to prove that Truvada (the basis of many HIV combos) reduces the risk of herpes by about a third... who knew! But nobody in their right mind would abandon the condom for that reason alone.

So I seem to pushing the condom agenda pretty successfully here but many sexually active men are arguing that condoms are only a partial protection against disease and maybe they're right. After all, strictly speaking, if you use condoms for anal sex, you should also use them for oral sex. Why? Because STIs can be transmitted via the mouth and its fluids... and your fingers and hands. The truth is that apart from LGV (Lymphogranuloma venereum -- infection of the lymphatic system and lymph nodes) and Trichomoniasis (infection of the uro-genital tract and a cause of vaginitis), almost all other infections can be passed via the mouth, or skin to skin, or mucous to mucous. Are we suggesting using dental dams and rubber gloves every time we have sex? No of course not, that just isn't practical but remember, the vast majority of sexual activities do not end in penetration.

So is using a condom nothing more than harm-reduction, or damage limitation and do you still play the percentages game every time you go in for the clinch?

Well it's a fair assumption that if you use a condom with every new partner, you're reducing your risk of an STI considerably. However, a dangerous argument frequently heard in gay circles is, that if you assume that the risk of infection via the mouth is 100%, then adding anal sex to the mix doesn't increase that risk! The problem is, no STI can possibly have 100% risk of infection; it's a question of the circumstances you're in and what you're doing. For instance, if you meet someone and start off with heavy kissing, followed by heavy petting (sounds exactly what our parents warned us against eh!); then touching and exploring with fingers in every orifice and various fluids being excrete in the process; you're going to come in contact with an STI presence if it exists. Yet that behaviour is nothing short of normal, wouldn't you say? And we haven't even touched upon oral sex and penile penetration yet. Yet none of the above require a condom.

There are three major risk sites associated with sexual contact: the mouth, the penis or vagina and the anus and the more you expose your part to another's parts, the more risk there is of infection. It's a sort of cumulative risk and depends totally on the extent of your activity. Condoms actually only come into play in creating a barrier between the penis and the rectum or vagina and if you must, the penis and the mouth, so in that case, you can minimise risk by using them. I think you can see, though, that the condom only provides limited protection in the grand scale of things.

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This article was provided by TheBody.
See Also
Quiz: Are You at Risk for HIV?
Ten Common Fears About HIV Transmission
Condom Basics
More Personal Views on Condoms


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HIV, Neuropathy and More: Avoiding Becoming a Nervous Wreck

Dave R.

Dave R.

English but living since 1986 in Amsterdam, the Netherlands. HIV+ since 2004 and a neuropathy patient since 2007. I've seen quite a bit, done quite a bit and bought quite a few t-shirts if you know what I mean; but all that baggage makes me what I am today: a better person I believe, despite it all.

Arriving on, originally, was the end result of getting neuropathy as a side effect of the medication, or the virus, or both. I found it such a vague disease and discovered very little information that wasn't commercially tinged, or scientifically impenetrable, so I decided to create a daily Blog and a website where practical information, hints, tips and experiences for patients could be gathered together in one place.

However, I was also given the chance to write about other aspects of living with HIV and have now contributed more articles about those than about neuropathy. That said, neuropathy remains my 'core subject' although one which unfortunately dominates both my life and that of many other HIV-positive people.

I'm not a doctor or qualified medical expert, just someone with neuropathy and HIV who has spent the last few years researching the illness and trying to create information sources for people who want to know more.

I also have my own personal website and write for

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