When abstinence is not an option, the proper use of barrier protection such as latex or polyurethane condoms (male or female), with a water based lubricant, is the next best thing for vaginal or anal sex.
Note: Some water-based lubricants (including those already on some condoms) contain a spermicide called Nonoxynol-9. Many people are allergic to N-9 and the resulting genital irritation can increase the risk of HIV and STD transmission by providing a direct entry point.
You can test for a N-9 allergy by rubbing N-9 lubricant on the inside of the elbow the day before you plan to use the product for sex. If there is no irritation, there is likely no allergy.
The best way to reduce the risk of HIV transmission while performing oral sex is to maintain good oral hygiene. That, in addition to not flossing or brushing your teeth right before or after sex, will also reduce the risk of transmission.
Performing Oral Sex on a Woman
When performing oral sex on a woman, a dental dam or common kitchen plastic wrap can be used as a barrier to protect from HIV transmission. If you do not have a dental dam, you can also use a new, unused, non-lubricated or flavored condom by stretching it out and cutting it down the side, then stretching it out in the same way you would a dental dam or plastic wrap.
Performing Oral Sex on a Man
In addition to good oral hygiene, proper use of a non-lubricated or flavored condom on a man can significantly decrease risk of HIV transmission. If a condom is not available or an option, not accepting semen into the mouth or spitting rather than swallowing will help to reduce the risk. You can also use the “harmonica method” by focusing on the shaft of the penis while avoiding the head.
Performing Oral Sex on the Anus (Rimming)
For oral to anal contact, or rimming, a dental dam, plastic wrap, or a condom can be used in the same way described above under the heading “Performing Oral Sex on a Woman.” This can be a great barrier against not only HIV, but possible Hepatitis A exposure.
How Do I Use Male and Female Condoms?
Most male condoms are made of latex. Since some people are allergic to latex (your doctor can test for it if you’ve ever experienced irritation from latex) there are also polyurethane condoms available. When used properly, both latex and polyurethane condoms are effective ways of significantly reducing the risk of HIV transmission. Note: Lambskin, or “natural” condoms will not protect against HIV or other sexually transmitted infections (STI’s).
When using either latex or polyurethane condoms for vaginal or anal sex, water-based lubricants on the outside of the condom will help to reduce friction that could cause the condom to tear. If desired, a small amount can be placed inside the tip of the condom as well.
Important Note: Use of oil-based lubricants such as Vaseline, can deteriorate latex condoms and significantly increase their chance of breaking; oil-based lubricants should only be used with polyurethane condoms.
When Using a Male Condom:
- Keep it fresh! Always store condoms in a cool dry place (not a wallet) and check the expiration date.
- Check it! Squeeze the package gently to make sure there are no punctures and be sure to not use your teeth to open the package (or your teeth could rip the condom)!
- Heads Up! Unroll the condom a little before putting it on and make sure it’s able to roll easily down the penis. Squeeze the tip (so semen can collect) and roll the condom from the tip of the penis all the way to the base. If uncircumsized, pull the foreskin back before putting the condom on.
- Don’t Double Up! Be sure to never use more than one condom at a time. Doubling up can lead to friction and possibly the condom breaking. One condom is sufficient.
- Lube it Up! Apply lots of water-based lubricant to the condom to prevent friction which could cause breakage.
- Take It Easy! After ejaculation (cumming), remove the penis from the vagina/anus/mouth while still erect and carefully unroll and remove the condom. Be careful not to spill any semen on your partner.
- Never use a condom for more than one session. Always use a new condom each time you have sex, or when you switch from oral to vaginal or anal sex. This will reduce the risk of the condom breaking.
When using a Female Condom:
Make sure to put it into place before your partner’s penis comes into contact with the vagina or anus. Once in place, carefully guide the penis into the condom, making sure to enter the condom and not outside of the condom’s external rim.
For Vaginal Sex:
- Press the inner ring between your fingers to narrow it and make it easier to insert.
- Hold the condom with its open end pointing down, and insert the closed end into the vagina, letting the wider end remain around the opening of the vagina (it’s easier to insert if the knees are spread apart).
- Push the condom up into the vagina, until it is just past the pubic bone (you can tell where the pubic bone is by curving the index finger when it has gone a couple inches into the vagina).
- When removing the female condom, squeeze the end, twist the condom to keep the semen inside, and pull out. DO NOT FLUSH.
For Anal Sex:
- Remove the internal ring (for Reality condom) and place the condom on the partner’s erect penis or a dildo.
- Use the penis/dildo to carefully insert the condom into the anus of the receptive partner.
- To remove, squeeze the end of the condom, twist to hold the semen inside and remove.