Health The A-Z of condoms By Liam Murphy | @liamwaterloo I bet you think there’s a limited amount of information about condoms, don’t you? Well you’re wrong. There’s lots to know about using condoms for safer sex and protecting yourself from HIV and STIs. Not an A-Z worth of information, agreed, so it might get a little tenuous towards the end. But stick with it, at least you didn’t have to write the bloody thing. So here it is (because my editor hates me) the A-Z of condoms! A is for Anal Let’s face it, we’re only using condoms for one place: the arse (unless you use them for blow jobs, which you don’t, you liar). The majority of HIV transmission occurs through unprotected anal sex, and condoms – with the right water-based lube – happen to be super good at preventing that. B is for Bottoming Just because you’re the bottom, it doesn’t mean you don’t have to think about condoms too. I KNOW as a bottom you’re doing most of the hard work already, but don’t rely on the top to be packing. Always have some condoms and lube to hand. Unless you’re at a funeral or something. That’s just inappropriate. C is for Condoms Duh. D is for drugs Drugs – particularly the chemsex trio of meph, G and crystal meth – lower your inhibitions and can make you feel hornier than me after watching Luke Cage in Jessica Jones (an admittedly niche reference). Condom use isn’t always a priority, but by making sure you always have them to hand if you’re having chemsex, going for regular HIV tests and setting limits, you can curb the risk. E is for Erections Condoms are often cited as the enemy of the erection, with such complaints as ‘loss of sensation’ or ‘it ruins the mood’. First, find the right condom for you. They come in all shapes (kinda), sizes and thicknesses. As for the insertus interruptus, keep the condoms close at hand. Nothing kills the mood more than having to get up and go to the cupboard to get them. F is for Failure Condoms are currently the most effective way of preventing HIV transmission (particularly now we won’t be getting PrEP on the NHS) and other STIs. However, condoms can fail. They can break, slip off, you can damage the condom by using the wrong type of lube. The effectiveness of condom use as a way of preventing HIV is around 86%. That’s why having a back-up plan or combining different safer sex strategies can keep you safer. G is for GUM clinic Even though you’re using condoms consistently, it’s still advisable to get a sexual health check-up at least once a year (for reasons cited above). Plus, you can stock up on free condoms while you’re there. Avoid the flavoured ones. Trust me. H is for HIV & STIs As stated before, condoms currently represent the best way of preventing transmission of HIV (THANKS, THE NHS) and STIs, at least anally. But unless you’re also using condoms for oral sex, regular sexual health screenings are wise. I is for Inconsistency If you’re using condoms some of the time but not all of the time, you’re still putting yourself at risk. It can be easy to convince yourself that occasional ‘slip-ups’ don’t count but always make sure you go for sexual health check-ups. If you think you’ve been exposed to HIV, then PEP (emergency medication) can be obtained from clinics and certain A&E departments. J is for Johnnies People call condoms many things – rubbers, sheaths, johnnies. Actually, no one has called a condom a ‘johnny’ since the mid-90s but I’ve got a whole alphabet to get through, so give me a break. The point is, whatever you call them, condoms can help prevent against HIV and STIs. And can make the occasional water balloon. K is for Keeping them close Wherever you are – in a pub, club, sauna, bedroom, office, alleyway, toilet, plane, train, miscellaneous automobiles – keep condoms and lube on you. You never know when your sexual hunger may strike. L is for Lube When you’re fucking with condoms, use lube and plenty of it. Water-based lube will mean that the condom is less likely to slip off or tear. M is for Mental Health Someone with low self-esteem or issues with depression can struggle with personal boundaries and negotiating safer sex. If this is the case, your local GUM clinic can put you in touch with a counsellor and help you devise a safer sex plan, which could include condoms. N is for Numerous There are lots of different types of condoms out there, so you just need to find the one that suits you. From ribbed to flavoured and large to luminous, finding the right condom will enhance your sex life magnificently. O is for Oral The majority of guys don’t use condoms for blow jobs and if anyone reading this does, then please get in touch with me so we can prove you’re not a myth. The risk of HIV transmission through giving head is fairly low, especially if he doesn’t blow his wad in your mouth. If you’re the suckee, the the risk is practically non existent. However, please go for regular sexual health check-ups, as STIs such as chlamydia and gonorrhoea can be transferred through oral sex. P is for PEP PEP (Post-Exposure Prophylaxis) is an emergency medication that could stop you becoming HIV-positive if you think you’ve been exposed. When it comes to PEP, the sooner you take it the better, as there’s a 72-hour window of effectiveness. So if your condom breaks (or you didn’t use one) and you’re worried, head to your local clinic or A&E department and ask for it. (‘P’ was going to be for PrEP but since the NHS has refused to fund it...). Q is for Quality Unsure if your condom is a reputable and safe brand? Check for the British Standard kitemark (CE) on the box. R is for Respect If your partner/lover/guy you just met at the gym is a stickler for condoms, then respect his decision. You may have both tested negative for HIV the last time you went for a check-up, but that doesn’t mean you have a right to insist he ditch the condoms. It’s his body, his sexual health and ultimately his decision. S is for Stigma Now to flip the above coin. You may insist on using condoms but that doesn’t mean you can shame or stigmatise someone who doesn’t always use them. It also doesn’t mean you should make assumptions about someone living with HIV – to assume they became positive because they “just didn’t wear a condom” is inaccurate, insulting and stigmatising. T is for Testing Condoms or not, we should all be getting tested for HIV at least once a year. Maybe more depending on the type(s) of sex you have. The riskier the sex you’re having, the more often you’ll need to get tested. U is for Unsafe Condoms are a choice, but whenever you have unprotected sex with someone, there’s always a risk. V is for Vaseline And anything else that isn’t a water-based lubricant. Anything oil-based with a latex condom could cause it to break. Other ‘terrible to use as lube’ brands are available. W is for Wanking Not a fan of condoms? Here’s a tip: having a wank while wearing a condom could help programme your mind into thinking it’s a pleasurable thing. It’s a low pressure environment to experiment with condoms and condom types. X is for Cross infection If you’re HIV-positive and having unprotected sex with other HIV-positive guys, there is a chance you could contract a different strain of the virus, or pick up other STIs. Y is for Yanking Once you’ve finished your session and expunged your juices into the condom: Pull. Your. Dick. Out. Slowly. Yanking it out too fast could cause the condom to slip off as your cock deflates, depositing its contents in an undesirable location. Z is for ...oh there’s nothing for this one. Leave me alone. How risky is fucking without condoms? Most gay men who have HIV caught it from getting fucked without a condom. As far as gay sex goes, getting fucked without a condom, and having your partner cum inside you, is the riskiest thing you can do. This is because the lining of the arse can absorb liquids directly into your bloodstream. If there’s HIV in his cum, and it goes up your arse, that will be absorbed too. Getting fucked without him cumming inside you is lower risk but, as there is HIV in pre-cum too, there is still a risk of HIV transmission. In group sex it’s theoretically possible to catch HIV from getting fucked even if your partner is HIV-negative, if he has fucked someone who is HIV-positive and then fucks you immediately afterwards. This is because there could be traces of HIV-infected anal mucus or blood on his cock. Getting fucked is also high risk for most other STIs, including chlamydia, gonorrhoea, herpes, syphilis, warts, hepatitis B and it is now thought that you can catch hepatitis C as well. Condoms provide an effective barrier against most STIs, including HIV, although some STIs, such as syphilis and warts, can still be transmitted if the condom does not cover the entire infected area, such as the base of the cock. If you are infected with an STI in your arse, it will increase the chances of you being infected with HIV if you are HIV-negative. If you are HIV-positive and have an STI, it is likely that there will be higher concentrations of HIV in all of your body fluids, including blood and anal mucus, and so you will be more infectious. If the person doing the fucking is HIV-positive and has an undetectable viral load the risk of transmission will be greatly reduced. What if I fuck without a condom? Fucking someone without a condom is less risky than getting fucked without a condom, but it is still one of the riskiest sexual practices that gay men do. If you are HIV-negative, fucking someone bareback is more likely to lead to infection than sucking cock. This is because the anal mucus that lines the arse (we all have it) can contain a very high concentration of HIV. The mucous membrane just inside the tip of the penis and the foreskin can absorb liquids, like anal mucus, directly into the bloodstream. HIV experts used to think that infection from the receptive partner (bottom) to the insertive partner (top) was as a result of bleeding in the arse. Although it’s possible that blood is responsible for transmission in some cases, we now think that anal mucus is the body fluid that enables the man doing the fucking to become infected. Other infections in or around his arse, such as chlamydia, gonorrhoea, herpes, syphilis, warts and hepatitis B can be passed to the guy fucking through his urethra (the tube you piss through). Condoms can prevent most of the infections that you can get from fucking, although it’s worth remembering that some STIs can be transmitted even if you use condoms. If the guy getting fucked is HIV-positive and has an undetectable viral load the risk of transmission is greatly reduced, however the levels of virus in anal mucus may not match the level of virus in the blood (which is how viral load is usually measured). How risky are fucking and getting fucked with condoms? While it is rare, condoms can break during fucking and this could make it possible for HIV or other STIs to be transmitted. Condom breaks usually occur because condoms are used incorrectly or are used for long sessions without changing them. If you use condoms correctly with plenty of water-based lube, it will greatly reduce the chances of them breaking. If you are having group sex, it’s also important to change condoms for each partner. This is because it’s theoretically possible that traces of HIV-infected anal mucus or blood could remain on a condom after a guy with HIV gets fucked. This is also true for other STIs, including hepatitis C. While condoms offer protection against HIV and most STIs, they cannot prevent them all. Even if you always use condoms for fucking we recommend that you get regular sexual health screens at a GUM clinic and continue to test for HIV on an annual basis. The STI guide Click here to learn more about STIs and how to prevent catching them Useful links Erection problems: www.gmfa.org.uk/erection-problems. Condoms and lube: www.gmfa.org.uk/condoms-and-lube. Cumming too quickly: www.gmfa.org.uk/cumming-too-quickly To buy cheap condoms and lube, visit the Freedoms shop at: www.freedoms-shop.com.