The most effective way to prevent sexual transmission of STIs is to avoid contact of body parts or fluids which can lead to transfer, not necessarily any sexual activity with an infected partner. (No contact equals no risk, not all sexual activities involve contact, like cybersex, masturbation from a distance, etc) Abstinence is one method of avoiding contact. Ideally, both partners should get tested for STIs before initiating sexual contact, or if a partner engaged in contact with someone else, but even then, certain STIs, particularly certain persistent viruses like HPV, may be impossible to detect with current medical procedures as they may be asymptomatic. Prevention is also key in addressing viral STIs such as HIV & herpes, as they are currently incurable. Many diseases that establish permanent infections can so occupy the immune system that other diseases become more easily transmitted.
The Innate immune system led by
defensins against HIV can prevent transmission of
HIV when viral counts are very low, but if busy with
other viruses or overwhelmed, HIV can establish itself.
Certain viral STI's also greatly increase the risk of
death for HIV infected patients.
Condoms only provide protection when used properly as a barrier and to and from the area that it covers. Uncovered areas are still susceptible to many STD's. In the case of HIV, sexual transmission routes almost always involve the penis, as HIV cannot spread through unbroken skin, thus properly shielding the insertive penis with a properly worn condom from the vagina and anus effectively stops HIV transmission. An infected fluid to broken skin borne direct transmission of HIV would not be considered "sexually transmitted", but can still theoretically occur during sexual contact, this can be avoided simply by not engaging in sexual contact when having open bleeding wounds. However, other STI's, usually persistent viral ones like Herpes and HPV, invade skin and mucous membranes, so a condom in that case may do little to stop transmission.
Condoms are designed, tested, and manufactured to never fail if used properly. There has not been one documented case of an HIV transmission due to an improperly manufactured condom. However, there have been cases of condom recall, as in a case in South Africa.
Proper usage entails:
- Not putting the condom on too tight at the end, and leaving 1.5 cm (3/4 inch) room at the tip for ejaculate. Putting the condom on snug can and often does lead to failure.
- Wearing a condom too loose can defeat the barrier.
- Avoiding inverting, spilling a condom once worn, whether it has ejaculate in it or not, even for a second.
- Avoiding condoms made of substances other than latex or polyurethane, as they don't protect against HIV.
- Avoiding the use of oil based lubricants (or anything with oil in it) with latex condoms, as oil can eat holes into them.
Not following the five guidelines above perpetuates the common misconception that condoms aren't tested or designed properly.
In order to best protect oneself and the partner from STI's, the old condom and its contents should be assumed to be still infectious. Therefore the old condom must be properly disposed of. A new condom should be used for each act of intercourse, as multiple usage increases the chance of breakage, defeating the primary purpose as a barrier. Defeated barrier equals potential transmission.
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