Canadian STI Guidelines

Pages 35-36: Recommendations for the proper use of condoms to reduce the transmission of STD

1. Latex condoms should be used because they offer greater protection against viral STD than natural skin condoms.

2. Condoms should be stored in a cool, dry place out of direct sunlight and not under pressure (i.e., do not store in wallet, in automobile or any place where condoms will be exposed to extreme heat or cold).

3. Condoms in damaged packages or those that show obvious signs of age (e.g., those that are brittle, sticky or discoloured) should not be used because they cannot be relied upon to prevent infection.

4. Condoms should be handled with care to prevent puncture by fingernails, rings, teeth, etc.

5. Condoms should be put on before any genital contact to prevent exposure to body fluids that may contain infectious agents.

6. Make sure that the condom is placed on the penis so that it will readily unroll and that it is not placed on the penis in "backwards" position which will make it impossible to unroll.

7. Hold the tip of the condom and unroll it onto the erect penis, leaving space at the tip of the condom to collect semen, yet ensuring that no air is trapped in the tip.

8. Adequate lubrication should be used. If exogenous lubrication is needed, only water-based lubricants such as K.Y. JellyT should be used. Petroleum or oil-based lubricants (such as petroleum jelly, cooking oils, shortening, and lotions) should not be used since they weaken the latex.

9. Use of condoms with spermicides has been advocated to provide some additional protection against STD; however, if used repeatedly, spermicides may also cause mucous membrane inflammation and facilitate infection and therefore cannot be recommended unequivocally.

10. If a condom breaks, it should be replaced immediately. If ejaculation occurs after condom breakage, the immediate use of spermicide has been suggested. However, the protective value of post-ejaculation application of spermicide in reducing the risk of STD transmission is unknown.

11. After ejaculation, care should be taken so that the condom does not slip off the penis before withdrawal; the base of the condom should be held while withdrawing. The penis should be withdrawn while still erect.

12. Condoms should never be reused.

Note:

It is possible to communicate many of these points to patients clearly in a simple demonstration by putting a condom over two fingers.