Sexual Health

Condoms and other barrier methods

Condoms
Condoms can protect against both sexually transmitted diseases and pregnancy. If used properly they are 98% effective in preventing pregnancy (NHS Choices 2015), but average use has an 18% pregnancy rate (Centre for Disease Control 2015).  

When people start having sex they are often more concerned about pregnancy than sexually transmitted infections, but condoms can protect against pregnancy and STIs including Chlamydia, HPV and HIV.

One woman, who had caught chlamydia and genital warts after unprotected sex with her boyfriend, said that she was now really careful to avoid any genital contact without a condom.

Condoms are free from GP surgeries, sexual health clinics, school and college nurses, and many young people’s/community centres. They can also be bought from shops. There is a condom card (c-card) scheme in many cities, that young people can sign up for, which allows them to get free condoms from participating chemists.

So why don't people use condoms every time they have sex? Sometimes people think it's OK not to use them each time or forget about the risks of STI or pregnancy after drinking alcohol

Having sex without condoms could also be due to a lack of awareness about STIs and HIV and pressure from male partners to have sex without a condom.

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Many people use condoms at the beginning of a relationship, but stop using them when they know each other better, or when they've both had an STI check-up. People we interviewed who were in their 20's were more confident about discussing sexual history and using condoms than younger people.

Some people we interviewed remember being embarrassed asking for condoms from their GPs, family planning or Brook clinics when they were teenagers. Other said that they didn't like the feel of the free condoms which they thought were 'too thick' or 'too boring'. Wider ranges of condoms are now usually available free from clinics and youth centres.

Many buy their own condoms, but find them expensive. Cost is another reason why people may stop using them.

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Many people have experienced a condom splitting or falling off, and in such cases they usually get emergency contraception

A father of two said that he doesn't mind using condoms at all, although he knows that other men have very different attitudes. Some people don't like condoms and say that they are a 'hassle', 'a pain', or that they spoil the moment.

There are many different types of condoms (non-latex, different textures, sizes, colours, and flavours as well as the female condom) available so there's usually one to suit. 

The National Screening Chlamydia Programme has the following recommendations to help people enjoy sex and keep healthy:

  • Use condoms every time you have sex. This can reduce your risk of getting or passing on chlamydia and other sexually transmitted infections (STIs) including HIV.
  • If you have oral sex, cover the penis with a condom or the female genitals with a latex or polyurethane (plastic) square (dam).
  • If you are not sure how to use condoms correctly, there are normally instructions in the packet. Alternatively, see the information on condoms, on NHS Choices
  • Each time you have a new sexual partner, both of you should get a chlamydia test.
  • Have a chlamydia test every year while you are under 25.
  • Avoid sharing sex toys. If you do share sex toys, wash them or cover them with a new condom before anyone else uses them.

Female condoms are also widely available but are not often used.

Other barrier methods

Diaphragms and caps 
These are both barrier methods of contraception, and are usually made of silicone or latex. They fit inside the vagina and cover the cervix (entrance to the uterus – womb) so that sperm can't get into the womb. They both need to be used with spermicide (chemicals that kill sperm).

They can be inserted up to 3 hours before having sex and should be left in place at least 6 hours after sex. They can be left in longer than this but should not be left in longer than the recommended maximum time (check leaflet for details). They are reusable and once they have been removed should be washed with warm water and mild, unperfumed soap. They come in different shapes and sizes and must be fitted for the correct size by a trained doctor or nurse.

“If diaphragms and caps are always used according to instructions they are 92–96 per cent effective when used with spermicide.” - FPA 2015

Most women are able to use a diaphragm or a cap but they are not suitable for all women and this should be discussed with a doctor or nurse. The diaphragm or cap only provides limited protection against STIs and is only used to prevent pregnancy.
 
Sponges and spermicides
The sponge is a doughnut-shaped device made of soft foam coated with spermicide inserted into the vagina to cover the cervix. Spermicides come in a wide variety of forms, including jellies, creams, foams, films and suppositories and they are used to coat the vagina and cervix in a chemical barrier killing the sperm.

Last reviewed January 2016.
Last updated January 2016.

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