If you are sexually active, the best way to protect yourself against HIV and STI is to use condoms. There are many different types of condoms but not all will protect you against HIV and STI.

Condoms

Latex and Nitrile (formerly polyurethane) condoms reduces the risk of most STI,  HIV and  pregnancy. Nitrile condoms can be used by people who are allergic to latex.  Natural condoms (sheepskin or lambskin) will protect against pregnancy, but they are not effective in the prevention HIV and STI.

Treat condoms gently and keep them out of the sun and cold.

With latex condoms, never use lotions, baby oil, Vaseline®: or cold cream -- the oil in these products weakens the condom. If you use a lubricant, use with a water-based lubricant (such as K-Y®: jelly or glycerin).

Use of spermicidal lubricants should be avoided as they may cause skin irritation.

For more information see "Should I use a spermicide or virucide with a condom?" below.

Usage:

1. When choosing a condom, be sure that it is a brand that protects against HIV and STI.

2. Check the expiry date on the backside of the condom wrapper.

3. The condom wrapper/packaging should have an air pocket, to ensure there are no leaks or punctures in the packaging, squeeze the condom package between your fingers to  feel for pressure. If there is no pressure (air) within the packaging, do not use it.

4. To open the condom package, tear open with your fingers being careful not to puncture the condom.

5. Put the condom on before the penis or sex toy touches the vagina/front hole, mouth or anus.

6. To put the condom on, hold the condom by the tip to squeeze out the air. Leave some space at the tip to hold the ejaculate (cum). Unroll the condom all the way over the penis/sex toy. The condom is to only be used once.

7. To properly dispose of the condom, twist or tie a knot in the condom to contain fluid. Dispose of condom into a garbage can.

Internal condoms:

The internal condom (Female condom) is the first and only female initiated barrier that is safe and effective if used correctly and consistently. It has can be used by both male-bodied (anally)  and female-bodied (anally and vaginally/front-hole) and provides dual protection against sexually transmitted infections, including HIV and AIDs, as well as unintended pregnancy.

The internal condom is made of nitrile polymer, is non-allergenic and has a soft ring on each end. The internal condom’s outer ring covers more skin than the traditional condom, thereby providing increased STI protectionUsage: Vaginally/front hole.

1. To use in the vagina/front hole, apply water-based or oil-based lubricant to the outside of the condom.

2. Squeeze the inner ring of the condom and insert (with the condom) into the vagina/front hole.

3. With your finger, push the inner ring as far into the vagina/front-hole as it will go. The outer ring stays outside the body.

4. To remove the condom, twist the outer ring and gently pull the condom out.

5. Dispose of condom into a garbage can.

Usage: Anally

1. To use in the anus, remove the inner ring and apply lubricant and with finger(s)/penis/sex toy, gently guide into the anus.

2. The outer ring of the condom stays outside the body. For increased ease and pleasure, apply lubricant to finger(s)/penis/sex toys that are being inserted.

3. To remove the condom, twist the outer ring and pull out condom gently.

4. Dispose of condom into a garbage can.

Should I use a spermicide or virucide with a condom?

No.

HIV prevention information often includes references to Nonoxynol-9, a spermicide that functions mainly as a backup in helping to prevent pregnancy. However, because of the irritation that it can cause, lubricants that contain Nonoxynol-9 should not be used during intercourse.

Most spermicides and some brands of condoms contain  Nonoxynol-9, which was once thought to help prevent HIV transmission. Recent data has shown that nonoxynol-9 does not reduce the risk of HIV transmission and may actually contribute to the increase of transmission as it may irritate the mucous membranes of the genitalia and rectal/vaginal linings.

According to the World Health Organization, the use of spermicides is questionable due to the irritation and potential breakdown of rectal/vaginal linings, that may increase risk for HIV & STI transmission.

You can speak to your health care provider for other sexual health & reproductive health options.

How does the government ensure the quality of condoms?

Condoms sold in Canada are regulated by Health Canada. Public health professionals set regulations that condom manufacturers and importers must meet in order to distribute or sell in Canada. This involves meeting standards for design, length, width, and tests for leakage and bursting.

For further information:

www.phac-aspc.gc.ca

How effective are condoms?

Condom breakage rates can be less than 2% when used correctly. Tips for using condoms correctly include:

• Leaving an air space in the tip of the condom to allow for ease in movement & collection of fluids
• Proper storage of condom
• Protect condom from tearing by fingernails or jewelry when opening package
• Check expiry date before use
• Using adequate water based lubrication
• Using the proper  type of lubricant and avoiding the use of oil based lubricant (also including the use of lipstick or oil based chapstick) on latex condoms

Will other contraceptives protect me against HIV and STI?

Diaphragm, Cervical Cap, Sponge

A diaphragm is a round, flexible disk that covers the cervical area and is inserted into the vagina/front hole before intercourse. Although the diaphragm is reusable, it must be properly cleaned and disinfected after usage. The diaphragmcan be fitted by a doctor, nurse or health care provider. Manufacturers recommend the use of spermicide with a diaphragm, however, it is not necessary and as aforementioned, spermicide may increase the risk of HIV and STI transmission.

The cervical cap is smaller than the diaphragm and covers only the cervix, but it is used in the same way as the diaphragm.

The vaginal contraceptive sponge is a sponge that contains spermicide that may protect against some STI but may increase the risk for HIV transmission and yeast infections. The sponge may also lead to an increase in rectal/vaginal irritation.

Although they may offer some protection against STI, diaphragms, cervical caps, and sponges should not be relied on to protect against HIV infection. A latex, polyurethane/nitrile condom will offer better protection than these methods.

How can I protect myself when having oral sex?

If you are going to be performing oral sex or rimming, the best way to protect yourself is to use a latex or nitrile/polyurethane  condom or dam/barrier.

Flavoured and scented condoms and dams/barriers are also an option and are available at many community health centres and businesses. It is important to make sure the brand of condom you are using protects against HIV & STI. .

Dental dam or Oral sex barrier

A dental dam/oral sex barrier is a thin square of latex that can be used to prevent the spread of HIV and STI (sexually transmitted infections) during oral sex and rimming.

1. The dam is placed directly over the vagina/front hole or anus while performing oral sex (cunnilingus and analingus).

2.To increase sensitivity and pleasure, apply water based lubricant to genitalia/rectum. Flavoured water based lubricant can also be added to the outside of the barrier.

 3. Do not use the same dam to perform cunnilingus that you use for anilingus or vise versa.

4. Dental dams should be discarded after single use.

Do it yourself dams

Condom → dam

A condom can also be made into a dam by cutting of the tip and the end, and then cutting lengthwise, so it opens up into a square.

Make sure your mouth only touches one side of the dental dam, and the anus or genitals of the other person touches only the other side. Do not use the same dam to perform cunnilingus that you use for anilingus or vise versa.

Dental dams should be discarded after single use.

Glove → dam

A latex or vinyl glove can also be made into a dam by:

1. Cutting off the four fingers, leaving the thumb

2. Cut up the side opposite the thumb

3. The glove can be opened and placed over the genitals/rectum

4. Water based lubricant can be used aforementioned