How well do condoms protect? And do we even need them anymore? – Information and ideas to think about the use of condoms in the age of New Safer Sex

Information for men, who have sex with men* as well as trans- and inter-sex persons*

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Do we still need condoms today? – The condom has always been a cause of discussion. It used to be (more or less) the only way to prevent contraction of HIV during sex. Today there are other or additional strategies to using a condom. This can provoke unclear insecurities that raises questions: with this text we attempt an update on condoms in light of PrEP and UN­DE­TECT­ABLE as possibilities for Safer Sex without a condom as well as PEP as an emergency measure. We thoroughly discuss the question “What place does the condom have?” with the position that any personal decision for condom use is to be appreciated.

We ask this whilst knowing that condom use done correctly protects very well from HIV and other sexually transmitted infections (STIs). A condom alone can protect from HIV and STIs together far greater than other Safer Sex methods. However, there is little or often unobjective discussions about the real security vulnerabilities and perceived disadvantages of condoms. Also missing is a debate about accidental condom breakage or the act of deliberately refraining from condom use altogether. We aim to change this with this text, as only those who know the Pros and Cons can assess when condoms work well and when they don’t. What fits in which situations? Are there safe and practical alternatives? And is everything factually correct what we think about rubbers?

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Risks of infections during sex (HIV)

Every year new HIV infections occur through sexual contact. The numbers speak clearly: with men* who have sex with men* (MSM) there are constantly about 1,700 new infections (of ca. 3,400 in total) in Germany and in Switzerland also about half of the new infections (of ca. 550 in total). Even though the individual risk may vary greatly: for sexually active members of this group, these numbers prove a real risk of infection from HIV.

PEOPLE WHO ARE UNDETECTABLE CAN’T TRANSMIT HIV

Ever since treatment became widespread and effective, the viral load of many HIV positive persons is “below the detection limit” or “UNDETECTABLE”. The virus is not detectable in the blood of these persons and thus they are not infectious. This needs to be confirmed through blood tests and need to be checked regularly. As we know recently (from the Partner-2 study, 2018), this method is also safe if additionally another STI (that normally increases the risk of HIV transmission) is present.

 

No matter what practice: during sex with someone who is undetectable – transmission of HIV is impossible. The risk is zero.

 

UNDETECTABLE is thus next to using a condom an additional Safer Sex method!

NOT UNDETECTABLE: WHICH RISKS EXIST?

Whether the virus gets to the circulatory system or the lymphatic system depends heavily on the sexual practice. For example, during ass fucking, HIV transmission is more likely than during a blowjob, whether the risk is vanishingly low (this also applies to oral intake of sperm). Generally, the infection risk is lower during sex than for other transmission ways – like blood transfusions or exchanging of injecting equipment. The virus is not transmitted every time someone has unsafe sex (contrary to popular belief). The risk increases or decreases depending on the sexual practice and other factors.

Data on HIV transmission probabilities for individual practices can only be provided in a generalized way. You can find some statistical data here: hivandmore.de, bashh.org (p 10), rki.de. For your personal situation this might not always be meaningful, because lots of different factors can decrease or increase the transmission risk.

It is known today that due to an immune reaction of the human body, newly infected persons can have very high HIV viral load in the first weeks/months. This means that chances of infection can be many times higher. Someone who doesn’t know of their infection, can very easily transmit HIV. Moreover, HIV positive people who do not have an antiviral therapy or take their medication irregularly can transmit the virus.

Bottoms/Tops: Generally, the passive (receiving or ‘receptive’) participant is exposed to a higher risk than the active (penetrating or ‘insertive’) participant during anal sex. It is wrong that being active poses practically no HIV transmission risk – a myth that persists.

During active fucking, being uncut poses a risk of an HIV transmission that is two to three times as high as being cutgiven a healthy, intact foreskin. That is because the mucosa membrane of the glands become more robust and less permeable due to being exposed after the circumcision. A study that came to this conclusion however only surveyed men who practised vaginal sex. The conclusions cannot be adopted directly, but it is assumed that the risk for anal sex is probably a little higher (Source: hivandmore)

Circumcision can reduce the risk of infection by about 50%. Due to this, it is not a sufficient strategy to prevent infections. For some people, however, circumcision as an additional preventive measure can make sense.

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INFECTION RISK WITH OTHER STIs

The risk of infection with different sexually transmittable infections is hard to quantify. In recent years, STIs have shifted more into public debate and more and more is talked about it. Unfortunately, untreated STIs increase the probability of HIV transmission. With STIs like gonorrhea, syphilis or genital warts (no matter which participant is infected), the risk increases by two to five times, while with genital herpes the risk can increase by five to ten times (Source: hivandmore)

The media recently reported: +++ Syphilis cases have doubled in the past ten years. +++ Local outbreaks of particular STIs (e.g. Hepatitis A) in Berlin and other areas of high population density. +++ Warning of antibiotics resistances with gonorrhea (Tripper): in the future bacteria might not be treatable anymore. +++ DAs of now, health insurances cover the costs of vaccination against HPV (HPV = human papillomavirus) also for men. +++ More than two thirds of sexually active persons had an HPV infection in their life, a certain part of these is permanently infectious and can transmit HPV to others. +++

This incomplete list shows that sexually active persons are at risk of an STI infection. Even though estimating how high this chance is, it can be difficult for each individual case, you can significantly reduce this probability through your own actions.

Some more recent additions – according to some specialised practices, Hepatitis C is supposedly increasingly contracted through ass fucking without using a condom. This is more probable when the contracting partners` amount of bacteria (per ml bodily fluid) is high and blood is involved (due to injuries in the ass or on the dick).

It has also been noticed that rectally (in the ass) located STIs are diagnosed more often in PrEP users than in persons who do not use PrEP. This might be explained by the fact that due to increased testing more STIs are discovered. At the same time, STIs occur more often where condoms are used less.

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HOW WELL DO CONDOMS PROTECT?

“Protection” for many means: “always”, “completely” and “100%”. Unfortunately, the condom is unable to live up to these expectations. The condom reduces transmission risks only there, where it’s used. During sucking, kissing, licking, rimming – there, where the condom (usually) is not used, it does not have an effect. It can only have a protective effect if the condom is used at all. It decreases significantly or does not exist anymore for those who only sporadically or inconsistently use condoms.

RISK REDUCTION THROUGH THE USE OF CONDOMS (HIV)

If used consistently, condoms may reduce the risk of infection in HIV by 95%, as it was discovered in 2008. The Lancet Volume 372 issue 9635 2008) That percentage is very remarkable. Only PrEP (daily intake) and UN­DE­TECT­ABLE are to some extent safer. Improper/incorrect use – in most cases wrong condom size – as well as material damage very rarely leads to HIV infections.

STIs (syphilis, gonorrhea) increase the likelihood of transmission of HIV even if you use condoms! Conversely, the higher the viral load of HIV in the blood, the easier it is to transfer an existing STI (even with a condom).

RISK REDUCTION THROUGH CONDOMS (STI)

Most STIs (unlike HIV) are transmitted via smear infections (through body contact). In this case condoms only protect conditionally. How efficiently condoms protect is difficult to determine but some research help us to navigate: A study concluded that condom use reduces the risk to contract STIs as follows:

• by more than 90%: hepatitis B, gonorrhea;
• between 50 and 90%: chlamydia, syphilis and CMV
• between 10 and 50%: genital herpes and soft chancre

There was no measurable risk reduction for scabies, HPV or pubic lice, so condoms are no help. There was no data for Hep A, C, D, E in this study. Values refer to situations in which condoms were applied correctly and they refer to the body regions that were in contact with the condom.

Other research reveal slightly different results. However, the above values offer a good idea that in some STIs the efficacy of condoms is not as great as often thought. For example, against syphilis e.g. In fact, condoms do not provide adequate protection to effectively stop STIs from spreading. Nevertheless, the use of condoms makes sense on an individual level. Since STIs are continuously transmitted, it is especially important to go to Testing Centers (see below) on a regular basis.

It has been communicated for many years that “condoms protect”. If it is not communicated to what extent they protect it is misleading. Most people then understand that the condom is 100% protective against HIV and STI, and they believe they act safely. As we saw above, that’s not true. This is a reason to adopt a realistic approach and no cause for panic. Although this new approach looks a bit more complicated, anyone can understand that the use of condoms still remains reasonable.

Be aware: you can effectively reduce your risk with a condom, but it is not totally diminished. That’s why you need to know when it is the right time to get tested (see below), obtain treatment, talk to partners, and other strategies.

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SAFER SEX WITHOUT A RUBBER

For a long time, serosorting was the only (but actually an unsafe) method to individually reduce risk, in addition to the condom. Serosorting means that HIV negative individuals only engage with other (supposedly) negative partners for sex without a condom, and HIV-positive individuals, in turn, only with exclusively positive partners. Understandable from a human point of view (yet often ostracising), this strategy has not led to the desired results. People continued to get infected because not everyone was always aware of their immune status (neg or pos). This is still true today.

UN­DE­TECT­ABLE led to the completely new situation that HIV negative person with a positive person who is “undetectable” can have sex without a condom. The condom was also no longer needed in firm partnerships (pos + neg). The emergency treatment PEP and the drug-based prevention now give HIV negatives the opportunity to take control of the prevention of HIV infection for the first time independently of their sex partners. Since all measures are associated with (regular) tests, HIV / STDs are detected earlier and treated faster, so that others do not get infected as often anymore. And more people are being vaccinated against those STIs where it’ possible… (> Get tested)

With new options comes not only a new feeling of security, but new freedoms, more fun and hotter sex. For some, sex with condoms suddenly becomes more relaxed because the pressure that “it must work” is gone. Others combine different prevention methods to be extra safe.

Today, Safer Sex means: having the power to decide.. PEP, PrEP and being UNDETECTABLE have been added as prevention methods, and safe sex is generally possible without a condom. PrEP (when taken daily) and UNDETECTABLE are also at least as safe as condom use. Read our infos about PrEP, PEP and UN­DE­TECT­ABLE if you want to know more.

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WHAT ARE THE PROS FOR CONDOMS TODAY?

Condoms have many benefits and are efficient, that’s commonly known. But where are the advantages of condoms compared to other safer sex methods: Are there any new arguments today for the use of condoms? Is condom usage (still) the right strategy for me? Or can I (in certain situations, or completely) modify my Safer Sex (with PrEP or Undetectable)? To answer those questions, we have collected some fresh aspects that speak for condom use.

Topic STIs: With condoms you can avoid or reduce necessary antibiotic treatments (depending on the STI). Some STIs can only be treated effectively with antibiotics. Ingestion, which is often necessary for several days or weeks, is a burden on the body (especially for the intestinal flora, whose composition has an effect on health and well-being and is disturbed by antibiotics). All good doctors would advise against using antibiotics several times a year. Additionally, there is the problem of possible antibiotic resistances. The consequences of an infection with resistant germs kill about 23,000 people each year in Europe.

PrEP and Undetectable barely protect against STIs (although regular testing is always recommended). Condoms offer better protection, but not complete safety as described above (see chapter STIs) – regular testing is necessary as well.

If you consistently use condoms, you (in comparison to PrEP users) are safe from potential side effects, the expenses of procuring, taking, going to accompanying appointments and not least, costs.

With condoms you can live your sexuality independent of pharmaceutical companies. This is also a question of personal attitude for some. Some do not want to support pharmaceutical profit struggles (the profits of the condom industry are neglected here). Conversely, we of Love Lazers don’t object to the use of condoms as a form of resistance to neoliberal capitalism.

If you have a particularly high desire for safety, condoms have a great advantage: they can be used in addition to other methods – and without interactions. That’s great if you are slightly more careful than others. Combining strategies is also good if you want extra protection in certain situations: e.g. at a sex party with lots of partners or in situations when there is little conversation before sex (sauna, cruising, darkroom).

If you do not use or incorrectly apply condoms, you have no protection at all. That’s the difference to PrEP. If you forget to take a dose, you still have the full or to some extent reduced protection, because the drug level in the blood is delayed until it disappears. In this case, problems only occur if you take the medication very irregularly (some doctors say: less than 4 times a week).

If you forget to use condoms or apply them incorrectly, it’s easier to assess the risk after sex. A reasonably high risk then means: immediately go to the emergency room and start a PEP. This is not always as clear as in other safer sex methods.

For some, the feeling of hygiene plays an important role. Condoms are a material barrier and at the same time also a way to physically “keeping something at a distance”. This may be incomprehensible to lovers of bare, rubber-free sex, but the need for distance exists as well (maybe only in certain moments).

On travels abroad, condoms are available and well-known. Knowledge about PrEP or Undetectable, on the other hand, is rare (depending on the region). Especially when there are language problems, condoms are a proven method. And there are no problems at most customs.

And with a condom you show that you act responsibly to yourself and others. That deserves recognition. Pay the same respect to your counterpart, even if he*she prefers other safer sex methods. Perhaps the condom will also give you support in times when a lot is changing in terms of prevention and the old is no longer right for everyone. The fact that there is security in this situation is great!

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WHY CONDOMS ARE NOT USED

Condoms – subjectively perceived or objectively present – can have annoying side effects: itching or allergies (try latex-free condoms!), disconnect the blood supply (get bigger condoms!), be an unnaturally rubbery experience (try products with flavors taste) or reduce sensitivity and thus reduce lust (here too, thinner, latex-free condoms can help, use lubricants!). Some just see condoms as sexdrive killers. We accept all of these positions and do not judge.

Rolling on a condom is perceived by many as off-putting (that’s why the porn industry believes that they need to cut roll-on scenes from porn). You can try to be playful with it. Joint unpacking and spreading can also be fun! Pay attention to the right condom size.

And if you do not happen to be into scat (feces fetish): Thanks to the use of condoms you do not need to wash the shit off your dick after ass fucking – a disturbance less!

When it comes to erectile dysfunction due to condom use, it may be due to the interruption where you experience a change of attention, the wrong condom size or nicotine consumption during sex. This can also have psychological causes. Often the cause is related to your thoughts and is an expression of tension, nervousness or pressure to perform. Conversations (friends, counseling, therapy) or erection-promoting medications (Cialis®, Viagra® and Co) can help.

If you ask around, there is hardly anyone who uses condoms during a blowjob (except sexwork). In terms of HIV, the risk is negligible. One can neglect it even if sperm gets into the mouth.

In terms of HIV, an infection is not unlikely when sucking without a rubber is given (especially gonorrhea, chlamydia, syphilis, herpes). Practical tip: Rinse out the mouth and throat after oral intercourse with high-percentage alcohol or mouthwash (rinse, gargle, spit out). This significantly reduces the likelihood of STI transmission!

For some bottoms (passive sex partners) it feels as a loss of control to be dependent on the other whether he*she really uses the condom or just pretends to use it. Purposefully refraining from using the condom, called “stealthing” probably happens very rarely, but misunderstandings can also happen from time to time. Mutual agreement can help avoid these. There’s little use in just appealing to the responsibility or decency of the active part. If you feel burdened as a bottom, you have other (additional) protection options like for example PreP.

When you’re high, your ability to assess risk realistically changes. You might be more attempted to take risks or do not even think about them and refrain from using the condom. That is a big disadvantage. Think about protecting yourself in a reasonable way and set clear boundaries for yourself. Talk to your friends about this. During sex, try to consume only so much that you can still refuse unwanted advances and are still able to recognize signals of resistance in your partner. Clearly communicate your own intentions (before getting high and before the sex). Your partner knows what to expect and can support you in the situation to not overstep your boundaries. If this goes wrong (repeatedly), think about alternatives for the condom.

Inform yourself about Safer Use and use your own drug paraphernalia (tube, syringes, etc.). Think of changing the condom every 30 minutes during longer sex sessions.

For some, using a condom during sex prevents them from feeling united with the other. Instead of forgetting your fears, it reminds of them: the fear of contracting an STI, the fear of being rejected, the fear of talking openly about this. It reminds us of the things we’d like to suppress.

The price: condoms could be cheaper. They also should be available more easily in places, where sex is encouraged and happening (bars, parties, sex clubs etc.). That does not always work for free (although it would be good).

An affordable option for people with less money to get hold of condoms is desirable. Those who receive basic social security or other transfer payments can claim a greater need for condoms; in Berlin for example this currently amounts to 12,94 EUR per month.

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CAN I ABSTAIN FROM CONDOMS?

New Safer Sex today means that aside from the condom other measures to avoid HIV infections are available (and can be combined).This means that during sex without a condom at least one of the partners is either undetectable or on PrEP. It remains a matter of negotiation between all sex partners how to proceed in this cases. Note that there are many things to consider:

Make sure that you cannot transmit STIs (get tested)!

Then you can suggest not using a condom. Discuss this with your partner(s) and avoid risks. This only works if everybody remains the last ability to decide what constitutes a risk for him*her (even if the partner(s) cannot relate to this). For this, a fundamental trust in the situation and your partner(s) is necessary. It is on you all to build this trust. This only works by speaking (or chatting) about this. You will find out how well your opposite(s) knows about this matter.

If you’re positive, revealing your HIV status (and that you’re possibly undetectable) is a precondition for not using a condom. At the same time this is a big vote of confidence. Not revealing your status is only an option, if your opposite has voiced before that he*she does not insist on this: this can be the case when someone is using PrEP or is undetectable and finds the immune status of the other unimportant.

Ideally the best protection is the same for all persons involved. If this is not the case, “only” a compromise is possible. If you stay uncertain during the conversation: listen and trust your feelings! Strongly voice what constitutes minimal common ground for you. This can be using condoms are choosing a different practice. It is absolutely not ok to force somebody to do something that he*she doesn’t want. To demand this from somebody is the opposite of trust and consent.

If there’s uncertainties afterwards: ask your last date about their immune status (When was the last test? Was there sex or risk afterwards?)! Ask about viral load and STIs! That works best without any reproach. If this does not create certainty for you and you have legitimate concern about an HIV infection, you can do a PEP up to 48h after sex.

There will also be situations in which discussions are impossible or difficult: during cruising, in the dark room, in the sauna. If you want to make sure here, condoms and PrEP are the best solution.

Talking about condoms we are mainly talking about ass fucking. You don’t need to think about condoms when using other practices: because they’re not risky (like cuddling, kissing, jerking off or blowjobs) or because using a condom does not play a role (like during fisting, where other measures should be considered). If you don’t value anal sex so much or you don’t like it, there’s thousands of other things that are fun. This is not an advertisement for ass fucking.

On cruising apps profile mentions for Safer Sex (“always”, “never”, “negotiable”) raise questions how Safer Sex is actually defined today. If you want to have sex with an unknown person, you can only resort to finding out how the other person views this. To call condom sex the only safer way is completely antiquated. The term New Safer Sex highlights that today there are several methods to choose from. Even “bare/bareback” does not mean “unsafe”, when in spite of fucking without a condom other methods are used.

Whether you want to use condoms or not in some situations – this depends on many factors and is a very personal decision. There are few recommendations on this. We have voiced our opinion about sex without a condom before in our UNDETECTABLE text in the chapter DATES + ANONYMOUS SEX.

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CONDOMS DURING SEX: DIFFERENT OPINIONS

What if one person proposes not to use a condom but the other wants to use one (or vice versa)? – If there is no agreement, sex may not happen. That may be OK or just a pity. But if one part feels rejected, it might become a problem.

Sex partners are selected by some according to their HIV status (positive or negative) or according to whether they take or not take PrEP, or whether they practice sex with or without a condom. This is particularly clear on cruising apps, where clear statements are sometimes already in the profile text / chat. This sorting process is often experienced as exclusionary by those affected. On the other hand, people who consistently rely on methods other than condoms often experience “slut-shaming”. We hope that nobody has to experience one or the other. Can you contribute something to this?

Whenever both sides strictly rely on different methods and insist on them, they cannot come together for obvious reasons. At least not as long as one or both of them abandon their principles (nobody should ever be pushed). This can be a dilemma that is not resolvable. If this is the case, that’s ok, but it should not lead to discrimination. In addition to the well-known rejection of HIV-positive people and people who use PrEP, a new exclusion of condom users can be observed. To portray condom use as naive, yesterday or stale, better know-how, blanket condom bashing – this is inaccurate and invalid. People forget: Not every method is an option for everybody, not everybody on HIV treatment are undetectable, not everyone can do PrEP, not all are OK with / without condoms.

People forget: Not every method is an option for everybody, not everyone on HIV treatment are undetectable, not everyone can do PrEP, not all are OK with / without condoms.

If there is the option “condom use – yes or no”, disagreements are inevitable. That’s very clear. What to do? – Talk about what the lowest common denominator is! Try to understand your opposite. Talk about solutions! Do not lose sight of the fun. Be open. Avoid drama which resulted from an unbridgeable difference of opinion. Resort to practices that do not require a condom, etc., etc. – There are many strategies, but no definite solution!

If you want to talk to someone in private, go to the Aids-Hilfe (Aids help organisation) or one of the checkpoints (links below).

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THE RUBBER AND MORALS

“Those who have gay sex need to use condoms” – one would love to shove the double standards expressed in this often unsolicited order right back up the ass (without rubber and lube). It’s hard to express the anger about this neutrally. These vilifications at times are expressed by people, who, living in committed relationships and thanks to monogamous concepts or the contraceptive pill, never (have to) take condoms. Even gay men themselves raise them. Especially since the discussion about PrEP it became completely unacceptable for some of them that people can assess their risks independently, self-determinedly and on one’s own authority.

If no or only unobjective arguments are put forward, it often reveals homophobic or derogatory attitudes (even towards one’s self). The condom is misused and dirty, lust-focused sex with varying partners* vilified. Gay sexuality is only then tolerated, if it follows the norm of using condoms. Likewise this also applies to other areas of sexuality (sex work, hetero sex with varying partners*, fetish scene etc.). All of that interferes with the discussion, for what we actually need the condom.

Often using a condom is utilized as a proof of moralistic behavior: images of cleanliness as expressions of allegedly being non-infected or non-sick (being “healthy/clean/fit”) – that hurts and excludes. You can think about that and try to liberate yourself from it: be free for a self-determined sexuality. It’s not the condom’s fault that these images exist. The images are in our heads.

Here, we are able to discuss and decide whether to use condoms or not. This is not the case in many parts of the world. Religious or ideological leaders (mostly men) propagate abstinence from the condom or even voice moralistic bans (like the pope). This leads to not being able to decide how to prevent pregnancies and also has an impact on sex of men with men. Sex that does not serve a reproductive purpose is generally rejected and “homosexual acts” are sometimes punished by prison or in some countries even by death. Sex just out of fun (and the condom symbolically represents this here) – that cannot be.

We oppose this with the claim for self-determination. And this claim needs to be defended. Even in our “western liberal” world right-wing populists and clerically fundamentalistic (of whichever religion) groups try to restrict this right.

Teaching about condoms as part of education about sex in all its diversity belongs in every classroom! Even though for most young people the condom will be the preferred matter of choice, information about the liberty to choose between different Safer Sex options is important. For a certain group of (minor) adolescents for example, PrEP can be a possibility, but they have to know about it. It is not sufficient to end the HIV epidemic to teach about the condom as the only option.

Since 2017 it is a legal duty in Germany to use a condom during sex work. Section 32 (Paragraph 1, ProstitutionsSchutzGesetz – law for the protection of prostitution) is supposed to protect sex workers* by being directed – on paper – towards the customers*. Those who pay for sex are thus legally required to use a condom. In practice this is reviewed by people working for the authorities pretending to be a customer. The obligation to use a condom as well as the other sections of aforementioned law are meant to legitimize the expansive government supervision of people in sex work.

From “must” to “can”: nowadays deciding for condoms is more a decision of your own free will. That is good because the normative pressure that earlier often lead to not protecting one’s self at all, is less. At the same time there must not be a two-class prevention: for example not being able to afford PrEP and thus having to use condoms is degrading. We stand up against this.

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THE RIGHT CONDOM

The biggest mistake when using condoms is choosing too large or too small condoms, which can lead to the condom slipping off or tearing. Many don’t know that. Some over-estimate the size of their dick and buy too large condoms. To prevent this, determine the size of the condom that fits your/the respective dick. This value corresponds to the measured width of the rolled out and pressed flat condom. You can not measure this with dicks (because you can/should not press them flat), only calculate it.

This, however, is really easy: measure the girth of the hard dick in millimeters (with a measuring tape, on the bottom of the shaft, where the ring of the condom will be), subtract 7 and divide by 2 – there’s the right size. The length is not important.

Formula: (Girth in mm – 7) / 2 = size of the condom.

Example: you measure a girth of 113 mm, minus 7 equals 106, divided by 2 equals a condom size of 53 mm. That roughly equals the standard size of condoms (usually size M) of most vendors. MySize® offers condoms in seven sizes from 47 mm to 69 mm.

Unfortunately, often the exact size in millimeters is missing on the packaging or is incomprehensible. Sizes like S, M, L or other imaginative descriptions are declared inconsistently. The vendors have, unfortunately, not been able to agree upon consistent standards and there are different sizes. These even apply to the products provided by Aids-Hilfe organisations or other community projects, which often completely lack size indications.

This confusion leads to unnecessary usage mistakes and thus to avoidable infections. We call on the EU commissioner for consumer protection and the national ministries for regulative action: labeling obligation of the packaging of condoms using consistent measures (perimeter in mm!) and corresponding consumer information!

It’s best to try which condom is right for you.

 

 

A slightly smaller condom intensifies your erection, fits more tightly and is less slippery, which is more suitable for wilder sex, but not everyone likes this. With a slightly larger condom you feel more, because it sits more loosely on your dick, perhaps you come faster. For maximum grip (and security) calculate a little more tightly, so that the rubber doesn’t slip off so easily. For most this feels better.

Don’t overestimate your size! Often condoms slip off because too large condoms are used. For potential partners*, it is best to have condoms of different sizes at home. A perimeter of 49 to 53 mm is most likely to fit.

Also sharp objects/fingernails or air in the reservoir at the tip of the condom can lead to tearing or slipping off. Refrain from using scissors, knives or similar things when opening the packaging and be careful with sharp fingernails or teeth! Pinch the tip of the rubber using your thumb and index finger when rolling down, so that no air remains in the condom!

Thicker condoms (0,1 mm) are said to be more suitable for anal sex, because they are more tear-resistant. Research, however, has shown that condoms with regular thickness, tear as often as thicker ones, thus they are as safe. If normal condoms feel too thick for you, products made from very thin and tear-resistant materials (like skyn® for example) can be an alternative. Also if you have other problems with condoms you can try these for a change.

Whether it’s condoms made from natural rubber with reservoir and lubrication or condoms made from polyurethane (e.g. for allergic persons): in the EU only products with CE certificate that meet high security standards can be sold. All quality tests show that the tested condoms are safe or very safe. Independent of brand, price, material – all products get at least good safety ratings. This however does not apply to “fun condoms” (with funny knobs, forms or effects): they are not suitable for preventing infections.

If condoms are used incorrectly or were once already rolled up: do not use again, but use a new one! If you want to practice rolling on the condom, it’s best to do it in the dark so later you’ll be able to do it without watching.

Do not use a condom for more than half an hour when fucking for a long time.

Lube reduces the friction between skin and rubber. This feels better and decreases the chances of the condom ripping. Compared to lube, spit can transmit some STI germs. Read our article about lube

Storing correctly: never expose condoms to direct sunlight, heat or mechanical action (pockets of your pants, wallet)! A good storage place for on the go: just put the condom between the layers of a paper tissue! Don’t use the condom after the expiry date has passed (expect for sex toys that are used by more than one persons).

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GET TESTED!

It makes sense to test regularly for STIs and HIV, if you have at least once a month a different sex partner*. Then, it’s best to test every three months. (For HIV tests there are also suggestions to test every sex months).

Because there are minimal risks of an HIV infection for all safer sex methods (except for UNDETECTABLE), regular testing is advised. For STIs this applies in any case. Once a year is too infrequent: some STI/HIV infections can show a symptomless course, stay undetected without testing and will possibly be transmitted to others (for HIV: especially in the first weeks after the infection). Because of this and especially for your own health and so that STIs do not become chronic, it is important to start treatment immediately. This is nowadays also advised for HIV.

To only test for HIV after a clearly high risk situation (sex) is not advised anymore. Instead, consider immediately starting a PEP (during the first 48h) to subsequently prevent an infection. There will also be a test to detect an existing HIV infection.

It is important to know: for HIV tests it is necessary to adhere to a 6 week period after a risky contact. The body first needs to form antibodies, which can then be detected in the blood. Before that, in the so called diagnostic window, no meaningful test results can be obtained.

For STI tests, in addition to blood tests, urine samples and smear tests (mouth/throat, dick/vagina and ass) are often necessary. Because the costs are not always covered, it is often only possible to work on feelings or suspicion and to do only the presumed necessary. That’s not ideal. If you feel or see symptoms, procure medical assistance immediately! Report on the indications that you feel or see: your health insurance has to cover all costs for tests and treatment once symptoms become apparent.

Always inform your sex partners immediately when getting a positive sex result so that they can also go get a test!

On some cruising apps you can declare your last test result. You have to decide for yourself, if this is not too public for you on the internet. In any case, showing your status visibly for everybody shows your intention to communicate clearly from the start. In some way, you also shorten the clarifying talk during a later meeting: some facts are already present. Moreover, you are reminded to get tested again. These statements, however, require utmost privacy standards on the part of these apps regarding user data, especially concerning user data of people with positive HIV immune status.

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UPDATE YOUR ATTITUDE (CONCLUSION)

The condom before the ordeal? Or do we threaten to tear ourselves apart? Under the weight of demands (and all the freedoms) to do everything right and to please everyone, to have fun, to take care of ourselves and others, to stay healthy? – The rubber can endure a lot. It will not break because some do not use it – for conclusive reasons.

Assessing our risks and acting accordingly is often more complicated today than it used to be. The condom has become a means among others, which we may choose. It reduces risks of infection, whenever we decide to use it. Depending on needs and attitudes, the use of condoms is an interaction of communication, decisions and behavior. Sometimes being horny momentarily competes with the desire to stay healthy in the long term. It is in the nature of the thing (the sexuality), that it does not always work out. There are other options, such as PrEP, PEP, and Undetectable. Testing is also important. And next to them, condoms do a great job.

The condom is currently still the symbol of the AIDS trauma that we—and also those who know AIDS, death and grief only through stories—carry deep inside. Without working on this trauma individually and collectively, we will not get a fundamentally new relationship to this “condom” thing. It helped us and it will continue to help us not to break us.

Think afresh! Rethink! Condoms are not a protective shield against everything and they do not protect 100%. Despite consistent application, some STIs are still relatively easy to transfer. By contrast, they protect effectively (but not completely) against HIV. Regarding HIV, more/other safer sex measures exist. If no compromise is found, potential sex partners with different strategies are no longer getting together (for example, PrEP-only-users with condom-only-users. Is there a solution for this in the future? In any case, the effects of condom use also benefit those who do not (always) use them in our scenes. The same applies to other strategies. And: Regular HIV and STI tests are also useful for condom users.

Above all this we need an open discussion in our scenes, with our friends and especially with our sex partners:

from must to can — from kiss to man — from frustration to fun!

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Counseling & Links

Links (some in German)

• www.aidsmap.com/Do-condoms-work/page/1746203/
• cdc.gov/condomeffectiveness/brief.html
• hivreport.de/sites/default/files/documents/2015_04_hivreport.pdf
• queer.de/detail.php?article_id=26970
• aidshilfe.de/system/files_force/documents/2016_05_11_schwule_maenner_und_hiv_aids_2013.pdf p15 ff condom use
• de.statista.com/statistik/daten/studie/257698/umfrage/kondomverwendung-von-personen-mit-mehreren-sexualpartnern/

More info at

Mancheck in Berlin
+49 30 4466 8870
mancheck-berlin.de
&
Checkpoint in Zürich
+41 44 455 59 10
www.mycheckpoint.ch/de/standorte/zuerich

HIV specialized doctors (GER)
hivandmore.de/aerzteverzeichnis

and your local Aids-Hilfe in Germany
0180 33 19 411 (max. 9 ct/Min. dt. Festnetz bundesweit)
Mo-Fr 9-21h + Sa-So 12-14h

and at one of the Swiss Aids-Hilfen:
aids.ch/de/ueber-uns/verband/antennen.php

 

This leaflet/guide text is subject to constant professional and medical quality control. → LOVE LAZERS ADVISORY BOARD

 

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© LoveLazers, 2019. No liability for errors. Danke für Kommentare, Hilfe und Anregungen (Kondom- sowie Lube-Text Nov 2018): Sela Rostock, Doro, Schex, Sven, Timo + Robert (Mancheck Berlin), Päde, Peter, Übersetzung Lube-Text: Jérémy, Iván, Sergio, Gerrit, Jan. Unterstützt von: mikro­disko boom­box, Tunten­haus­hof­fest, Hot Club Zürich/­Koch Areal.

© Photo by Dorothée Krings at ://about blank club Berlin, 2017. Model: Tarek with a piece of the Colombian artist Juan Betancurth. Thank you all.

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What does the asterisk* mean?

* We strive towards an inclusive notation. The asterisk* is supposed to include all those who cannot or do not identify as male/female. It’s not always easy to include all individual preconditions and requirements – If we have overlooked something here, please notify us. A text about condoms is not only, but mostly, about fucking. “Inclusive” for us means that people that do not identify as “male”, can fuck (actively). That’s part of why this text is written in gender-inclusive notation.

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WHAT DOES RISK MEAN?

Actions are attended by the possibility (danger) of negative consequences/outcomes. The term risk says how probable the incidence of such an unwanted, harmful or even life-threatening event is. The probability for example to be poisoned, get infected by a pathogen or be struck by lightning depends on how often, how long and in which way we are subjected to the respective danger. This risk is calculated statistically from measurements/­counts and is given as a relative value: e.g. “the probability of infection lies at 1 to 100,000” or “the risk is 0%, 50%, 99%”; sometimes even only with words: average, very high, vanishingly small.

Since not all influencing factors are always known or depend on chance, actions are often accompanied by taking a risk. This hazard is colloquially sometimes equated with risk itself (“No risk, no fun!”).

A risk can be reduced deliberately through personal conduct. For this, initially an assessment of the risk and one’s own behaviour relating to the risk is necessary. Perceptions of this can vary greatly between different people. Often, risks can be reduced significantly but not completely eliminated, because entirely giving up riskful behaviour (e.g. sex, sports, consuming drugs, driving a car…) is not an option for most people.

Link: en.wikipedia.org/wiki/Risk

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Probability of HIV transmission: factors (selection)

FACTOR

LOWEST RISK

HIGHEST RISK

HIV STATUS

Being negative or no viral load

Unknown sero status

VIRAL LOAD

Below the detection limit (undetectable)

Seroconversion (Period shortly after an infection)

FREQUENCY

Having sex rarely

sexually active

CONDOMS

Consistent and correct usage

No usage/wrong usage

PrEP

Intake

No intake

BLOWJOB with cumming in mouth

Low viral load

High viral load (happens very rarely)

BODILY FLUIDS

No exchange

Exchange

DURATION

Minutes

Hours

FRICTION

Low (soft sex); much lube

High (rough sex); no lube

PORTAL OF ENTRY

Robust (e.g. oral cavity)

Vulnerable (e.g. ass)

GENETIC DISPOSITION

Protective

Vulnerable

FORESKIN (DICK)

Cut

Uncut

OTHER STIs

None (confirmed through testing)

Existent, potentially unknown/untreated

INTOXICATION

Without loss of control

With loss of control

STATISTICS

Being lucky

Being unlucky

WITHIN 48H OF RISK SITUATION

Used PEP

Did not use PEP

Graphics and examples i-base.info/guides/testing/tables-diagrams-and-illustrations (version extended and updated by us)

Transmission of HIV is affected by all of the listed factors. Every factor has an influence on every other factor:

Duration
Even though having sex for a longer duration means a higher risk, the general infection risk depends on all other factors. Fast sex with high risk factors carries much higher risk than hour-long Safer Sex, where all other factors pose a smaller risk.

HIV status
Two HIV negative persons cannot transmit HIV to each other. No other factor influences this, which is easy and comprehensible. Taking risks after a negative test result however is still difficult: if one of the partners has been infected recently, it has an influence on all risk factors. The probability of HIV transmission can increase dramatically.

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WHAT ARE STIs?

STI stands for sexually transmitted infections. Infections can be transmitted through viruses, bacteria, fungi or other germs and can eventually lead to disease. Some of these infections can live in the body without symptoms and thus can easily stay undiscovered. Ways of STI transmission during sex vary greatly. STIs can usually be treated easily , even though some infections can be complicated and lengthy to disappear. Vaccines are available against some of them (Hepatitis A and B, HPV) whilst against others not. HIV is sexually transmittable and is thus in the strict sense – also an STI. Because it can lead to AIDS and can pose as deathly and still leads to discrimination, HIV takes a unique position among the STIs.

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BASICS: HOW CONDOMS PROTECT

Condoms are easily obtainable for most people and with a little practice, they are easy to handle (you can learn how in this video). They are usually made of thin latex and are rolled onto the hard dick (or the sex toy) before fucking. A reservoir made of rubber on the tip absorbs the semen. It prevents semen and other bodily fluids from entering the ass or other orifices (and also from getting to your dick). This reduces the probability that it comes in contact with mucous membranes and that bodily fluids like sperm or blood are exchanged.

By the way: already in the 16th century, condoms were able to protect from then untreatable diseases like syphilis and also from getting pregnant.

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WHAT DOES RISK REDUCTION MEAN?

Relative Risk Reduction (RRR), is a technical term derived from medical statistics. It describes how effective (“efficient”) a protective measure is. Also, it states the percentage by which the risk decreases in relation to / relative to the risk of using no protective measures at all. This value is determined in studies comparing two groups: one used the protection measure, the other not. Both groups determine the proportion of people who have become infected.

Relative risk reduction is also referred to as protective effect of a certain preventive measure and is often stated as a percentage. This is often difficult to understand at first glance. Efficiency of 95% (which it also is with condom use) means that the protection measure reduces the risk of infection to 5% of the original (“normal”) risk – so it drops by 95%.

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MORE ABOUT TESTING

Symptoms for STI can be very generic: a burning sensation while peeing, discharge on dick/ass/vagina, redness of the mucous membranes (also in the mouth), sore throat, external skin changes, pain/itching on dick/testicles/vagina, swellings and ulcers. Often there are no or only very insignificant signs to see or feel. Even an HIV infection is often not noticed, sometimes it is shown by a high fever that lasts for days, but in many cases it is asymptomatic.

You can get tested at public health offices or at community projects (checkpoints). It’s also possible at your trusted medical practice. A rapid HIV rapid often costs 15EUR and comes with the benefit that your health insurance will not know that you got tested. At the aforementioned locations you can, to some extent, get the tests free of charge. Should a fee for the STI tests be charged, you can ask that these fees be waived, if you have low income (prepare to present a proof for this). Also ask for necessary smear tests!

We recommend that you discuss any questions regarding the assumption of costs for the STI tests in your GP’s practice or in an HIV specialist practice. Ask what your health insurance can cover. Ask for creative solutions. Also use free on-site test campaigns of checkpoints or AIDS consultancy centres.

Which tests should be done on a regular basis (without symptoms) is debatable. For example, it is estimated that up to one third of men who have sex with men have mycoplasma (an infection of the urinary tract). For the most part, this is pain-free and does not require antibiotic treatment. It is often useful to only test with symptoms, because a positive test result can lead to uncertainty and unnecessary treatments!

Certified HIV self tests are approved in Germany since fall 2018. You can buy them from the internet, in pharmacies or drug stores. After a positive test result an additional test is absolutely necessary. This is impossible with a self test, rather you should go to AIDS information centres, to your GP’s practice or to public health offices. With a positive test result, you are not left on your own there either. AIDS consultancy centres also inform about self tests (and a possibly positive test result) personally, via phone and online.
→ More information about self tests

If you are not sufficiently immunised against Hepatitis A+B, get tested for this regularly as well! Hepatitis A+B can also be transmitted in ways that a condom cannot protect. Get immunised or refresh your immunisation if necessary (the health insurance waives the costs for men who have sex with men).

HPV is also transmitted very easily. An immunization often makes sense, but the costs (for adults) are not waived.

Years of promoting the condom, supposedly protecting against everything, has unfortunately led to many people not getting tested often enough. This applies especially to HIV negative persons without symptoms and who usually use condoms/do not take PreP. Moreover, after a diagnosis with an STI, sex partners* are difficult or impossible to find.

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