Safety First: Safer Sex Works!

Staying healthy is a goal for many of us, but when it comes to sexual health, it’s not as clear how to get there. Especially when it comes to preventing pregnancy or avoiding sexually transmitted infections, there is little consistent, clear, and transparent information provided in school or by doctors other than simplistic statements like, “Always use a condom,” or “Practice safe sex every time.” While they are well meaning, they don’t really tell us anything.

There are so many products available that fall under the “safe sex” category. Everything from drugstore shelves full of condoms, lubricants, and emergency contraception choices to mail-order healthcare websites that deliver STI kits and birth control to your door. But how do we know what works, or at least what will work for us?

Let’s get clearer about what “safe sex” really means; what products and behaviors truly reduce rates of sexually transmitted infections, unintended pregnancies, and other outcomes we’re hoping to avoid; and what options are available to us over the counter without having to get a prescription or referral.

What is safe(r) sex?

First things first, what do we really mean when we say “safe sex”? It’s something of a misnomer because, frankly, there is no such thing as truly “safe sex.” As with many things in life, having sex always carries some level of risk. For example, among the many possible symptoms of sexually transmitted infections are no symptoms at all¹. What might cause a rash, fever, or discomfort in one person might not cause anything in someone else² – which is also the case for many bacterial or viral infections that are not labeled as “sexually transmitted.” We or a sexual partner may have an infection in our bodies that we simply don’t know is there (because it is asymptomatic) before we meet up.

Another example is the fact that there is no 100% effective way to prevent pregnancy or STIs other than not having sexual contact with others (or sharing needles). So if you desire sex and plan to have it with someone else, there will always be some level of risk even if you use the prevention methods available to you.

If we can recognize that reality, we can shift from trying to eliminate all undesirable outcomes (not realistic!) to focusing on accepting the risks and making changes or adjustments that reduce their chances of happening. This is a form of harm reduction, and products like external or internal condoms are harm reduction tools!

How does safer sex work?

The first step is to get clear on what risk factors apply to you and your partner. For example, if you plan on having anal sex or your partner is in menopause, pregnancy is not a risk factor – but STIs are. The next step would be to get on the same page about what level of risk you both are OK with and then choose the necessary risk reduction tools.

In the case of STI prevention, here are some key pieces of information that can help with that decision-making process:

STIs can be passed via contact or exchange with these bodily fluids: pre-ejaculate (aka precum), vaginal fluids, anal fluids, semen, and blood. HIV specifically can also be passed through breast milk.³
Some STIs, like syphilis, HPV, and herpes, can be passed via skin-to-skin contact.
You cannot tell if you or your partner has an STI just by looking at skin or genitals.
The only way to know for sure if you or a partner has an STI is by having a recent STI test and sharing the results with each other.
Barrier methods like external condoms, internal condoms, and dental dams can reduce the risk of exchanging bodily fluids or having skin-to-skin contact during sex.
Medications like PrEP can reduce the risk of HIV by about 99%, so it is recommended to combine PrEP with barrier methods to even further reduce the risk.¹⁰
A way to enjoy sexual activity without any risk of contact with skin or bodily fluids is something called mutual masturbation – being together but pleasuring yourselves individually while enjoying seeing and hearing your partner’s pleasure.

In the case of pregnancy prevention, here are some key pieces of information that can help with that decision-making process:

The only kind of sex that can result in a pregnancy is “penis in vagina” sex (aka PIV sex).
If you are having sex that does not involve a penis going into a vagina, pregnancy is not a concern. But STIs still are!
Barrier methods like external and internal condoms can reduce the chance of pregnancy happening. Dental dams are not made for pregnancy prevention!
Prescription birth control, like the pill (93%-99% effective)¹¹ or intrauterine device (99% effective)¹², can reduce the risk of pregnancy, so it is recommended to combine it with external or internal condoms to even further reduce the risk.
Emergency contraception with levonorgestrel¹³, like Plan B, can help prevent pregnancy 75%-89% if it’s taken within 5 days of exposure to sperm and ovulation hasn’t happened yet. It is more effective when taken within 3 days. This kind of emergency contraception can be used along with birth control and barrier methods, since neither are 100% effective and they sometimes don’t work. Think of it like a backup plan [LINK TO ARTICLE 3]!

Different barrier methods are made for different parts of the body and different kinds of sexual activity, so to ensure they are as effective as possible, be sure to use the appropriate kind.

Here are the different options available today along with their effectiveness⁴:

External condoms: 87%-98% effective⁵ – tube-like barriers made of stretchy latex, polyisoprene, polyurethane, or animal membrane (which can only prevent pregnancy, NOT STIs!). These are made to be worn on penises or anything cylindrical, like an insertable sex toy. External condoms are commonly referred to as “male” condoms.
Use these for:
– Any kind of sex that involves a penis (oral, vaginal, anal, or hand sex)
– Safer insertive sex with a sex toy or something else cylindrical
Internal condoms: 79%-95% effective⁶ – larger tube-like barriers of nitrile made to be worn inside an orifice, most commonly the vagina. These can also be used for anal sex. Internal condoms are commonly referred to as “female condoms” because of their brand name.
Use these for:
– Safer insertive sex with a vagina or anus
Dental dams: no confirmed statistics (as of posting)⁷ – sheets of latex or polyurethane made to cover anything relatively flat, like a vulva, clitoris, or anus. These are also sometimes used for kissing or licking other parts of the body that are not cylindrical.
Use these for:
– Safer oral sex on a vulva or anus
– Kissing or licking flat areas on the body
Dental dams are less commonly used partly because people haven’t heard of them, or they have trouble finding them in a store. They are widely available in adult stores, but that means anyone under the age of 18 cannot go inside. Fortunately, it is possible to make a dental dam out of a few different items⁸:

DIY Dental Dams Using External Condoms
Step 1: Take an external condom and unroll it completely.
Step 2: With scissors, cut the tip of the condom off.
Step 3: Cut the base of the condom off. At this point, you will have a simple cylinder.
Step 4: Cut one side of the cylinder lengthwise so that you end up with a wide square.
DIY Dental Dams Using Latex or Nitrile Gloves⁹
Step 1: Take a glove (nitrile is ideal because it is hypoallergenic) and cut off all the fingers except for the thumb.

Step 2: Cut the pinky side of the glove lengthwise, from wrist to the other end.
Step 3: Use the thumb part to make it easier to hold while using, or try putting your tongue inside of it. It also can act like a mini condom for larger or longer clitorises.

Choosing your external condom

When shopping for external condoms, you will notice there are lots of things to think about, including material, size, and features.

MATERIAL: External condoms are made using a few different materials in order to provide options, especially for those who have latex allergies or plan to use oil-based lubricants.

Latex, as found in ONE Condoms, is the most common condom material. Latex is a natural rubber (from rubber trees) and is incredibly durable and stretchy. Latex condoms tend to be the most affordable option.

KEEP IN MIND:

– Latex condoms are not compatible with oil-based lubricants.

– Some people are allergic to latex or experience a skin reaction to it.

– Latex does not transfer body heat as effectively as other materials.

Polyisoprene, as found in Lifestyles SKYN, is a latex-free option that is made from a synthetic rubber. It is durable with some stretch, and it transfers body heat well.

KEEP IN MIND:

– Polyisoprene condoms are not compatible with oil-based lubricants.

– Polyisoprene condoms tend to have a higher price point.
– Polyisoprene is slightly less stretchy than latex.

Polyurethane, as found in Trojan Supra Bareskin, is a latex-free option made of durable plastic. The material tends to be thinner than latex or polyisoprene and it is compatible with all lubricants, including oil based.

KEEP IN MIND:

– Polyurethane condoms have a looser fit, so they may move or shift during use if the wearer isn’t paying attention.

– Purchasing the correct size is important.

– Polyurethane does not stretch as much as polyisoprene or latex.

– Polyurethane can make a crinkly sound.

Lambskin, which is a latex-free option made from sheep intestines and used exclusively to prevent pregnancy. This material is compatible with all lubricants, including oil based, can warm to body temperature, and is biodegradable.

KEEP IN MIND:

– Lambskin condoms will not prevent STIs. Do not use them without knowing your and your partner’s STI status.

– Lambskin is not an animal-friendly or vegan option.

– Lambskin condoms tend to have a higher price point.

– Lambskin condoms may be harder to find in stores compared to other materials.

Resin, which is a less-common latex-free material made from polyethylene synthetic resin that is thinner than most other materials and offers a close-to-the-skin fit. It is compatible with all lubricants, including oil based.

KEEP IN MIND:
– Resin condoms are less commonly sold in grocery stores or drugstores.

– Resin condoms tend to have a higher price point.

– Purchasing the correct size is important.

SIZE: External condoms come in a wide range of sizes for the sake of comfort and effectiveness, and each brand and style has a different fit. It is essential to wear the size that fits you the best.

The three most common sizes you will see on shelves are snug/slim, like Trojan Ultrafit Freedom Feel; standard; and large, like Kimono Maxx Large Flare. Typically, slim, snug, and large condoms are labeled accordingly while standard size condoms are not labeled.

So how do you know what size to wear? Kind of like shopping for a suit or jeans, it depends on your body’s unique shape – more specifically, your penis’s unique shape. Believe it or not, width plays a bigger role than length! Here is a general breakdown of condom sizing:

- Snug/slim fit: Length: up to 6.5 inches, Width: up to 1.8 inches
- Standard: Length: up to 8 inches, Width: up to 2 inches
- Large: Length: over 6.5 inches, Width: greater than 2 inches

FEATURES: External condoms can come with all sorts of features! Lubricated (which most are), ribbed, flavored, glow in the dark – even different shapes for different sensations. Variety packs from brands like Trojan or Lifestyles can make it easy to test out different styles to see what you and your partners like the best without having to commit to a full box of just one kind.

When it comes to safer sex, you have options – and barrier methods like external condoms are one of the most affordable and easy to find. Not only are they effective and accessible, they also offer fun and creative ways to make using them feel exciting and spark curiosity. We know that safer sex leads to more pleasurable, enjoyable sex, and that’s what we’re in business for!

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References

¹https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/in-depth/std-symptoms/art-20047081

²https://www.theatlantic.com/science/archive/2021/04/why-coronavirus-can-infect-us-without-making-us-sick/618530/

³ https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/symptoms-causes/syc-20351240

⁴ https://www.cdc.gov/condomeffectiveness/index.html

⁵ https://www.plannedparenthood.org/learn/birth-control/condom/how-effective-are-condoms

⁶ https://www.plannedparenthood.org/learn/birth-control/internal-condom/how-effective-are-internal-condoms

⁷ https://my.clevelandclinic.org/health/drugs/22887-dental-dam

⁸ https://www.medicalnewstoday.com/articles/323768#making-a-homemade-dental-dam

⁹ https://www.youtube.com/watch?v=H6n79RdE7eg

¹⁰ https://hivinfo.nih.gov/understanding-hiv/fact-sheets/pre-exposure-prophylaxis-prep