Sexually transmitted infections

Catdoor

There seems to be an awful lot of unprotected sex going on. Recurring lapses in judgment. That little voice that says “wear a condom” was silenced by what? Alcohol (the usual suspect). The heat of the moment. Sometimes just embarrassment.

An irksome patient: Uses withdrawal as her form of birth control and comes to my office desperate for STI screening. Both situations could be remedied by using condoms. I tell her, first and foremost: USE A CONDOM (in this voice, too). IT’S IMPORTANT. Then the questions start. Here are the most common ones

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stuff that gets up around the sides of condoms

If a question like this comes up twice in one week, it’s a sign.

First, my brother … recently single and “ready to mingle”. I gently remind him to use condoms, but more importantly, make smart choices. He asks me “but if you use condoms you can’t get STDs, right?”

Second, watching reruns of the HBO show Girls, the phrase “What about the stuff that gets up around the sides of condoms?” is asked of friends, googled, and eventually asked of an obgyn.

So, yes, what about that “stuff”? Can any of that “stuff” get you if you use condoms?

That “stuff” is sexually transmitted infections, or sexually transmitted diseases. The two terms are used interchangeably.

As a reminder – the “sex” I’m talking about with sexually transmitted infections is not only standard intercourse. It can basically include any activity that involves contact with the genitals. For (a descriptive – sorry) example: when someone with herpes of the mouth performs oral sex on someone else, that person (the recipient) can get genital herpes.

Also, condoms were invented to protect against pregnancy. There is still skin to skin contact, even when a condom is used correctly.

STDs can be separated into 2 different categories, based on how they are transmitted from one person to the next:

*** FIRST WAY***

Infected secretions come in contact with mucosal surfaces. To flush this out a bit: secretions come from a woman’s vagina or urethra, or a man’s urethra. If this person has the infection, it gets in these secretions, ready to infect someone else’s mucosal surface. A mucosal surface is a woman’s vagina or cervix, or a man’s urethra.
These are the STDs that can usually be prevented using a condom. Seems pretty obvious. If you put a barrier between a woman’s vagina and a man’s urethra, and that’s the way the infection spreads, you are preventing that spread.

These STDs include:
chlamydia
gonorrhea
trichomonas
HIV

 

*** SECOND WAY***

Transmitted through contact with infected skin or mucosal surface. So this is the skin on skin action I was talking about above. Or it can be skin on mucosal surface action also.
These are the STDs that condoms can’t always protect against.

These STDs include:
HPV (human papilloma virus) – causes warts and cervical cancer
HSV (herpes simplex virus) – otherwise known as herpes
syphillis
chancroid

I wish there were statistics and studies to show how using condoms helps prevent STDs, versus not using condoms. Unfortunately there is no way to study this precisely. You can’t exactly prove a condom was used correctly.  You have to ask. People may report using condoms, but use them incorrectly. People may say they used a condom because they are embarrassed to say they forgot. People might not know to use condoms for foreplay as well as intercourse.

The closest I could get to knowing how effective condoms are at preventing an STD? The Center for Disease Control says condoms are “highly effective” in preventing the spread of HIV and other STDs. So use one, but also understand the limitations.

Do you think that answers my brother’s question? If he would ever read my blog I could find out.

 

Source: Center for Disease Contol website (www.CDC.gov)