Condom

Birth Control Safe and effective options.

More about Condom: Purpose Precautions Resources

Definition

Male condoms are thin sheaths of latex (rubber), polyurethane (plastic), or animal tissue that are rolled onto an erect penis immediately prior to intercourse. They are commonly called "safes" or "rubbers." Female condoms are made of polyurethane and are inserted into the vaginal

canal before sexual relations. The open end covers the outside of the vagina, and the closed ring fits over the cervix (opening into the uterus). Both types of condoms collect the male semen at ejaculation, acting as a barrier to fertilization. Condoms also perform as barriers to the exchange of bodily fluids and are subsequently an important tool in the prevention of sexually transmitted diseases (STDs).

Description

Male condoms made from animal tissue and linen have been in use for centuries. Latex condoms were introduced in the late 1800s and gained immediate popularity because they were inexpensive and effective. At that time, they were primarily used to protect against STDs. A common complaint made by many consumers is that condoms reduce penis sensitivity and impair orgasm. Both men and women may develop allergies to the latex. Consumer interest in female condoms has been slight.

Male condoms may be purchased lubricated, ribbed, or treated with spermicide (a chemical that kills sperm). To be effective, condoms must be removed carefully so as not to "spill" the contents into the vaginal canal. Condoms that leak or break do not provide protection against pregnancy or disease.

If used correctly, male condoms have an effectiveness rate of about 90% for preventing pregnancy, but this rate can be increased to about 99% if used with a spermicide. (Several types of spermicides are available; they can be purchased in the form of contraceptive creams and jellies, foams, or films.) Benefits associated with this type of contraceptive device include easy availability (no prescription is required), convenience of use, and lack of serious side effects. The primary disadvantage is that sexual activity must be interrupted in order to put the condom on.

Female condoms, when used correctly and at every instance of intercourse, were shown to prevent pregnancy in over 95% of women surveyed over the course of six months. When used inconsistently, the female condom was shown to have a failure rate of 21% in the same study. One benefit of the female condom is that it may be inserted immediately before sexual intercourse or up to eight hours prior, so that sexual activity does not need to be interrupted for its insertion. One study performed by a manufacturer of the female condom indicated that 50–75% of couples in numerous countries found the barrier acceptable for use.

Condoms provide better protection against STDs than any other contraceptive method. One study conducted in the 1990s indicated that out of 123 couples with one HIV-positive partner, not one healthy individual contracted the disease when condoms were used with every instance of sexual intercourse. A similar 1993 study showed that out of 171 couples with one HIV-positive partner, all but two individuals were protected against HIV transmission with condom use. In addition to HIV, condoms provide effective transmission against gonorrhea, chlamydia, syphilis, chancroid, and trichomoniasis. A measure of protection is also provided against hepatitis B virus (HBV), human papillomavirus (HPV), and herpes simplex virus (HSV).

Before purchasing a condom, check the expiration date. Prior to use, examine the condom for holes. If a lubricant is going to be used, it should be water soluble because petroleum jellies, such as Vaseline, and other oil based lubricants can weaken latex. It is also important to note that condoms made from animal tissue or plastic are not recommended as a protection against STDs.

— Stephanie Dionne

Dictionary: con·dom  (kŏn'dəm)

1. A flexible sheath, usually made of thin rubber or latex, designed to cover the penis during sexual intercourse for contraceptive purposes or as a means of preventing sexually transmitted diseases.
2. A similar device, consisting of a loose-fitting polyurethane sheath closed at one end, that is inserted intravaginally before sexual intercourse. Also called female condom.

[Origin unknown.]

Background

Condoms are thin sheaths worn by men during sexual intercourse to prevent pregnancy and venereal infections. According to the 1995 National Survey of Family Growth, conducted by the National Center for Health Statistics in Hyattsville, Maryland, male condoms or prophylactics are the third most popular form of birth control—preceded only by female sterilization (29.5%) and birth control pills (28.5%)—with usage at 17.7%. They are also one of the most effective: research indicates that with correct use, failure rates are 2-3%. Most condoms are made of latex rubber, but they can also be made from lamb cecum or polyurethane.

In addition to their contraceptive value, condom use has been found effective in preventing the spread of sexually transmitted diseases. In 1986, the U.S. Surgeon General endorsed the use of condoms as the only currently available effective barrier against the transmission of Acquired Immunodeficiency Syndrome (AIDS). The spread of many other sexually transmitted diseases, such as chlamydia and gonorrhea, can also be virtually eliminated with the use of a latex condom. With the government touting the health benefits of condom use, manufacturers openly advertise their products, and retailers stock condoms in visible, accessible locations. Condoms, previously kept behind the prescription counter, are now found on most store shelves. Today in the U.S., 450 million condoms are sold each year.

Despite the wide variety of styles, there are few differences among the many latex condoms available on the market today. They can be straight-sided, contoured, ribbed, sensitive, or smooth. They may be treated with lubricants or spermicides. They can be blunt-ended or have a reservoir tip. Because the condoms undergo stringent testing before they are sold, quality is generally not a marketable issue. Hence, manufacturers attempt to build brand loyalty and market their products to specific target consumers.

Condoms made from lamb cecums—the blind pouch in which the intestines begin and into which the ileum opens from one side—are also available. However, they are more expensive than latex condoms, and while they prevent pregnancy, "skin" condoms are ineffective in preventing the transmission of sexually transmitted diseases. In 1994, the Food and Drug Administration (FDA) approved a polyurethane condom for sale in the U.S. The new condom has not been extensively tested for effectiveness in preventing pregnancy and sexually transmitted diseases.

History

The first recorded use of condoms was in Egypt in 1350 b.c. In 1564, the Italian anatomist Fallopius described a linen condom used to prevent venereal disease. The term condom is actually a corruption of the name of an 18th-century British physician, Dr. John Conton, who provided condoms to France's King Charles II. The legendary lover Giovanni Casanova (1725-1798) used pieces of sheep intestine to protect himself against venereal disease. The first condom manufacturer in the U.S. was Schmid Laboratories. In 1883, Julius Schmid, a former sausage skin-maker, acquired a business that manufactured bottle seals from animal membranes. Five years later, Schmid used his experience with sausage casings and capping skins to manufacture prophylactic sheaths from lamb cecum.

Even as Schmid was marketing his skin condoms, technology was progressing to allow thinner, more pliable, and less expensive condoms to became available. Vulcanization, the chemical linking of rubber particles that was originally developed in 1839 for use in automobile tires, made condoms strong, durable, and fit for consumer use. A form of rubber called latex was developed in the 1930s; this new material, combined with a mechanized dipping process, facilitated the mass production of condoms and lowered manufacturing costs.

Raw Materials

The first condoms manufactured by Julius Schmid were formed from the cecum of lambs. As of 1990, condoms made from lamb cecum accounted for 5.5% of the market, and because of their higher price, for 20% of retail sales. This manufacturing process remains relatively unchanged since Schmid first manufactured condoms: the cecums are washed, defatted, and salted. The raw skins are then shipped to the finishing plants. New Zealand, which raises large numbers of sheep, is the primary source and initial processing center for most "skin" condoms.

Latex condoms account for most of today's market. Because rubber latex is a natural material, it can vary greatly in strength and elasticity. Manufacturers add chemicals to the latex to stabilize and standardize the composition of the latex. Many brands also add talc, lubricants, or spermicides to the condoms before they are packaged.

The Manufacturing
Process

Collecting the raw materials

• Rubber latex is obtained from the milky fluid produced by various tropical plants. Latex is actually an emulsion or dispersion of tiny rubber particles in water, and ingredients added to the latex must be able to attach to the rubber particles during compounding.

Compounding

• Next, chemical additives are mixed to form a paste. This paste is then blended with the liquid latex in a process called compounding.

Storage

• The latex and chemical compound is then unloaded into drums for storage, where it remains for approximately seven days. During this period, vulcanization chemically strengthens the bonds of the rubber. The storage time also allows any air, which might have been trapped in the mixture during compounding, to escape.

Dipping

• The compound is then added to the dipping or condom-forming machine. The dipping machine is a long, hooded machine approximately 100 feet (30.5 m) in length. Thick tempered glass rods move along a closed belt between two circular gears. The belt drags the rods, which are called mandrels, through a series of dips into the latex compound. The mandrels rotate to spread the latex evenly. Several coats are required to build the condom to its required thickness. Between each dip, the latex is hot air dried.
• After the final dipping and drying, the condoms automatically roll off the mandrels. A machine shapes and trims the ring of latex at the base of each condom.

Tumbling

• Next, the condoms are put in a tumbling machine, where they are coated with talc or another similar powder to prevent the rubber from sticking to itself.

Testing

• After a curing period of several days, the condoms are sampled by batch and tested for leaks and strength. The first such test is the inflation test, in which the condom is filled with air until it bursts. Condoms are required to stretch beyond 1.5 cubic feet, about the size of a watermelon, before bursting. This test is considered most important because the elasticity of the condom keeps it from tearing during inter-course.
• In the water-leakage test, the condom is filled with 10 ounces (300 ml) of water and inspected for pin-sized holes by rolling it along blotter paper.
• Condoms are also tested electronically. This involves mounting each condom on a charged stainless steel mandrel. The mandrel is passed over by a soft, conductive brush. If pin holes are present, a circuit will be established with the mandrel, and the machine will automatically reject the condom.

Packaging

• Condoms that have successfully passed these tests are rolled by a machine. Rolling the condom makes it easier to package and use. Lubricant and spermicide may be applied by a metering pump just before the top wrap is added in the foiling process.

Quality Control

Condoms are classified as Class II Medical Devices. According to the Medical Device Amendments of 1976 of the FDA, the FDA is required to inspect each condom manufacturing plant at least once every two years. All electrical and mechanical equipment must be impeccably maintained. Condom-dipping machines are designed to operate continuously; if they remain idle, their mechanisms can get clogged and rust. During any downtime, partially cured compound cannot be left in the dip tank because it could contaminate future production.

All condoms sold in the U.S. must comply to specifications that were voluntarily developed by condom manufacturers and adopted by the FDA. Condom measurements can range from 5.8-7.8 inches (150-200 mm) in length, 1.8-2.1 inches (47-54 mm) in width, 0.001-0.003 inches (0.03-0.09 mm) in thickness (although most condoms range between 0.002 and 0.0024 inches), and the weight cannot exceed 0.07 ounces (2 grams). Additionally, physical characteristics must include a minimum tensile strength of 15,000 pounds psa and elongation before breakage of 625%.

The FDA reviews U.S. company records and spot checks batches for cracking, molding, drying, or sticking latex. The organization also tests every lot of imported condoms. Upon sampling, lots will not pass inspection if they reveal greater than 4% failure with respect to the above dimensions, 2.5% failure with respect to tensile strength and elongation, and 0.4% failure due to leakage.

The Future

Manufactured by Chicago-based Female Health Co., the Reality condom for women has been on the market and available through family-planning clinics in the U.S. since August 1994. It has been sold in 12 European countries since 1993. The female condom is a long polyurethane sheath with one open ring and one closed ring that is anchored between the women's cervix and vagina. According to Female Health Co., these condoms are 40 times stronger than latex; each costs approximately $3, compared to about $.64 for male latex condoms.

Research, started in 1988, lead to the development of the new polyurethane male condom, which also went on the market in 1994. The new condom is said to be just as strong but only one-tenth as thick as the latex condom. It is recommended for people who are sensitive to latex condoms.

Where To Learn More

Book

Murphy, James S. The Condom Industry in the United States. McFarland and Company, Inc., 1990.

Periodicols

"How Reliable Are Condoms?" Consumer Reports, May 1995, pp. 320-25.

Goldberg, Stephanie B. "Birth Control Update: Specialists Recommend Reviewing Choices As Life Changes." Chicago Tribune, March 5, 1995, pp. 1, 6.

[Article by: Susan Bard Hall]

The wearing of penile sheaths made from a diversity of substances — linen, gourds, tortoiseshell, leather, silk, oiled paper — has been known in numerous societies from distant antiquity. But it is less certain that these were employed either as a protection against sexually transmitted disease or for contraceptive purposes, rather than for magical or decorative purposes or modesty. It was the Italian anatomist Gabriello Fallopio (1523-62) who, in a posthumously published work De morbo gallico (‘on the French disease’ — syphilis), recommended as a protection against venereal disease a linen sheath of which he claimed to be the inventor. The manner of fitting it — over the glans but under the foreskin, or inserted into the urethra — sounds neither comfortable nor particularly practicable. A little later, Hercules Saxonia described a larger linen sheath, soaked in a chemical or herbal preparation, which covered the entire penis.

The invention of the sheep-gut sheath has been persistently attributed to a certain Dr Condom, Cundum, or even Quondam, an almost certainly apocryphal figure, during the reign of Charles II. Archaeological evidence, however, suggests that, far from being a product of the licentious Restoration era, gut condoms were already available over 20 years earlier during the height of the English Civil War. Five fragments of shaped animal gut were discovered during the excavation of the garderobe (lavatory) of the keep at Dudley Castle, which had been filled in in 1647. These prototype condoms (baudruche, french letters, capotes anglaises, etc.), both animal and vegetable, were primarily employed as prophylactics against venereal disease, although there is some literary evidence that their dual purpose as contraceptives was also recognized. There are a number of literary allusions throughout the eighteenth century, most notoriously in the memoirs of Casanova and the diary of James Boswell, to the use of ‘armour’, or ‘implements of safety’. Madame de Sevigné, however, writing of their contraceptive use, considered them ‘an armour against enjoyment and a spider-web against danger’. They were manufactured from the caecum or blind gut of sheep, which was soaked, turned inside out, macerated in an alkaline solution, scraped, exposed to brimstone vapour, washed, blown up, dried, cut, and given a ribbon tie. It was necessary to soak them to render them supple enough to put on. The labour-intensive process meant that the products were correspondingly expensive (though reusable) and thus only available to a limited proportion of the population.

The next major technological innovation affecting the condom was the vulcanization of rubber, enabling the production of cheaper condoms in great quantity. The first rubber condoms had a seam, but around the beginning of the twentieth century a new method of manufacture was introduced, whereby glass moulds were dipped into liquid rubber. Variant forms developed, such as the teat-ended condom and the ‘American tip’, which covered the glans only. Even these, however, were still beyond the reach of the poorest in the community; moreover they were also coarse and clumsy and perceived as unaesthetic, quite apart from the very pervasive feeling that the condom represented an immoral attempt to interfere with the laws of God and Nature. The device was associated with libertinism, and even the attempts of neo-Malthusian propagandists to promote the social benefits of birth control were tainted by their association with free-thinking secularism.

It is often stated that condoms gained, as it were, a certain currency through being distributed to troops during World War I in an attempt to control the appallingly high rate of venereal diseases. Many approved official prophylactic packs in fact contained antiseptic ointment. With the rise of an articulate birth control movement during the 1920s, condoms became more discussed. They were not the favoured method of most birth control advocates, being seen as unreliable and unaesthetic, and furthermore requiring not merely co-operation but action by the male partner. However, since they did not require expert fitting (as the female pessary did) and could be purchased over the counter and even from slot machines, they were probably the most popular appliance method of birth control until the advent of hormonal contraception in the 1960s.

The technology improved further: the latex process simplified manufacture to the point where it could be automated, making the product cheaper, and created a thinner, more elastic, and more reliable condom. There has been little additional technical innovation, though some brands now include added lubricant or spermicide. Novelty condoms (with no practical value) are produced as sex toys, with a variety of supposedly stimulating excrescences, in different colours, and even flavours.

The reliability of condoms has been a matter of much concern. There was a persistent belief that there was a law requiring one in 10 or 12 to be faulty, or that Catholic workers in rubber-goods factories pricked a certain proportion with a pin. Quality testing, however, gradually made its way into this marginalized industry, in Great Britain stimulated by the possibility of winning the commercially useful accolade of a place on the National Birth Control Association's ‘Approved List’ of reliable products.

With the advent of the contraceptive pill in the 1960s, the condom lost a good deal of its popularity as a birth control method, while antibiotics meant that venereal disease was no longer perceived as a risk. The condom retained rather louche associations with male promiscuity rather than male responsibility (even though the vast majority were probably used to manifest the latter). The current estimate of its reliability in preventing pregnancy runs from 85-98%, much depending on the user.

The condom has made a comeback, since the advent of the Human Immunodeficiency Virus, as a means of preventing the dangerous exchange of bodily fluids. How extensive condom use actually has become is still moot. The subject is still capable of arousing considerable embarrassment.

— Lesley A. Hall

See also contraception.

1. The protective plastic bag that accompanies 3.5-inch microfloppy diskettes. Rarely, also used of (paper) disk envelopes. Unlike the write protect tab, the condom (when left on) not only impedes the practice of SEX but has also been shown to have a high failure rate as drive mechanisms attempt to access the disk — and can even fatally frustrate insertion.

2. The protective cladding on a light pipe.

3. keyboard condom: A flexible, transparent plastic cover for a keyboard, designed to provide some protection against dust and programming fluid without impeding typing.

4. elephant condom: the plastic shipping bags used inside cardboard boxes to protect hardware in transit.

5. n. obs. A dummy directory /usr/tmp/sh, created to foil the Great Worm by exploiting a portability bug in one of its parts. So named in the title of a comp.risks article by Gene Spafford during the Worm crisis, and again in the text of The Internet Worm Program: An Analysis, Purdue Technical Report CSD-TR-823.

Definition

A condom is a device, usually made of latex, used to avoid pregnancy and/or sexually transmitted diseases such as gonorrhea, syphilis, and human immunodeficiency virus (HIV). Condoms are also known as prophylactics, as well as the popular slang term "rubbers." There are male and female versions of condoms.

Description

Condoms were originally used as a contraceptive to prevent unwanted pregnancies. In the early 2000s, however, condoms are just as important as a device for preventing the spread of sexually transmitted diseases (STDs), especially HIV, the virus that causes acquired immune deficiency syndrome (AIDS).

Male condoms have been in use in varied forms for at least three thousand years. Female condoms are relatively new, first being approved in Europe in 1992 and by the U.S. Food and Drug Administration (FDA) in the United States in 1993. An improved female condom became available in Europe in 2002. As of mid-2004, it was under review by the FDA but had not been approved for use in the United States.

Male condoms, by far the most popular, consist of a disposable one-time-use tube-shaped piece of thin latex rubber or lambskin. The condom is unrolled over the erect penis before sexual intercourse. The tip of the condom usually has an open space to collect and hold the semen. The condom is a barrier that prevents sperm from entering a woman's uterus. It is also used in anal sex by males with females and other males to prevent transmission of STDs.

Male condoms are available in a wide variety of sizes, styles, textures, colors, and even flavors. Condoms are also recommended for use on a male when oral sex is being performed on him.

Condoms are about 85 percent effective in preventing pregnancies. That means that out of 100 females whose partners use condoms, 15 will still become pregnant during the first year of use, according to the non-profit advocacy group Planned Parenthood. Unwanted pregnancies usually occur because the condom is not used properly or breaks during intercourse.

More protection against pregnancy is possible if a spermicide is used along with a condom. Spermicide is a pharmaceutical substance used to kill sperm, especially in conjunction with a birth-control device such as a condom or diaphragm. Spermicides come in foam, cream, gel, suppository, or as a thin film. The most common spermicide is called nonoxynol-9, and many condoms come with it already applied as a lubricant.

However, spermicides alone do not kill HIV or other sexually transmitted viruses and do not prevent the spread of HIV and other STDs. Also, nonoxynol-9 can irritate vaginal tissue and thus increase the risk of getting an STD. In anal sex, especially between two males, spermicides also can irritate the rectum, increasing the risk of getting HIV. Spermicides are specifically discouraged for use by gay or bisexual males for anal sex.

Latex condoms are also recommended over condoms made from other materials, especially lambskin, because they are thicker and stronger and have less risk of breakage during sex. Non-latex condoms do not prevent the spread of STDs, including HIV, and should not be used by gay or bisexual men or men who have HIV or other sexually transmitted diseases.

Condoms are available over-the-counter, meaning they do not require a prescription, and there are no age restrictions on purchasing condoms. They are available at a variety of locations, including drug stores, convenience stores, supermarkets, and family planning clinics. They are also available for purchase on the Internet.

How to Use a Male Condom

PUTTING IT ON. Many people, especially teens, are misinformed or uninformed on how to properly use a condom. In a 2001 study of youths ages 15 to 21, researchers found 33 to 50 percent of youth said it was important for the condom to fit tightly, leaving no air space at the tip, and that petroleum jelly, such as Vaseline, is a good lubricant. Another 20 percent said lamb-skin condoms offer better protection against HIV than latex condoms. All three beliefs are false.

For pleasure, ease, and effectiveness, both partners should know the correct way to put on and use a condom. Put the condom on before the penis touches the vulva, rectum, or mouth. Men leak fluids from their penises before and after ejaculation that can cause pregnancy and carry STDs. Use a condom only once and use a new one for each erection.

Condoms usually come rolled in a ring shape and are individually sealed in an aluminum foil, cardboard, or plastic pack. Carefully open the package to insure the condom does not tear. Do not use a condom if it is torn, brittle, stiff, or sticky.

To properly put on a male condom, follow these steps:

• Put several drops of lubricant inside the condom.
• Pull back the foreskin of an uncircumcised penis before putting on the condom.
• Place the rolled condom over the tip of the erect penis. Leave a half-inch (1 cm) of space at the tip to collect semen. Pinch the air out of the tip with one hand while placing it on the penis.
• Unroll the condom over the penis with the other hand, rolling it all the way down to the base of the penis. Smooth out any air bubbles since they can cause condoms to break.
• Lubricate the outside of the condom.

TAKING IT OFF. To properly remove a male condom, follow these steps:

• Remove the penis from the vagina, rectum, or mouth soon after ejaculation and before the penis becomes soft.
• Hold the condom at the base of the penis while pulling out to prevent semen from leaking or spilling.
• Throw the condom away. It is not recommended that it be flushed down a toilet.

Female Condom

The female condom is a seven-inch (17-cm) polyurethane pouch that fits into the vagina. It collects semen before, during, and after ejaculation, keeping semen from entering the uterus, thus protecting against pregnancy. In one year of use, it is 79 percent effective in preventing pregnancies. It also reduces the risk of many STDs, including HIV.

There is a flexible ring at the closed end of the thin, soft pouch of the female condom. A slightly larger ring is at the open end. The ring at the closed end holds the condom in place in the vagina. The ring at the open end rests outside the vagina. When the condom is in place during sexual intercourse, there is no contact of the vagina and cervix with the skin of the penis or with secretions from the penis. It can be inserted up to eight hours before sex.

To insert the female condom, follow these steps:

• Find a comfortable position, such as standing with one foot on a chair, squatting with knees apart, or lying down with legs bent and knees apart.
• Hold the condom with the open end hanging down. Squeeze the inner ring with a thumb and middle finger.
• With the inner ring squeezed together, insert the ring into the vagina and push the inner ring and pouch into the vagina past the pubic bone.
• When inserted properly, the outer ring will hang down slightly outside the vagina.
• Adding a water-based lubricant to the inside of the condom or to the penis may be helpful.

There are no age restrictions and no prescription is needed to purchase female condoms. They can be used only once, and each costs $2.50 to $5.

School Age

In a 2001 study by the Youth Risk Behavior Surveillance System, nearly 46 percent of American high school students reported they had had sexual intercourse at least once. Nearly 7 percent of students surveyed said they had engaged in their first sexual intercourse before age 13.

Of these sexually active students, 42 percent reported they did not use a condom the last time they had sex. Nationwide, male students (65.1%) were significantly more likely than female students (51.3%) to report condom use. This significant sex difference was identified for white and black students and students in grades 10, 11, and 12. Overall, black students (67.1%) were significantly more likely than white and Hispanic students (56.8% and 53.5%, respectively) to report condom use. This significant ethnic difference was identified for both female and male students.

Students in grades 9, 10, and 11 (67.5%, 60.1%, and 58.9%, respectively) were significantly more likely than students in grade 12 (49.3%) to report condom use, and students in grade 9 (67.5%) were significantly more likely than students in grade 11 (58.9%) to report condom use. The 2001 survey was published in the October 2002 issue of the Journal of School Health.

Common Problems

The most common problems associated with condoms are breakage during use and improper knowledge on how to use condoms. These problems can lead to pregnancy and sexually transmitted diseases, especially HIV.

Parental Concerns

Parents of adolescents often are concerned that distribution of condoms leads to increased sexual activity. However, a study of 4,100 high school students published in the June 2003 issue of the American Journal of Public Health found that students who had access at school to condoms and instructions on their proper use were no more likely to have sexual intercourse than students at schools without condom distribution programs.

When to Call the Doctor

It is not well known nor publicized, but having a condom break or leak while having sex is not necessarily a health disaster, even if the condom wearer has HIV. The risk of HIV transmission during vaginal sex between a female and a male who has the virus is low, estimated at one-tenth to one-fifth of a percent, according to the Centers for Disease Control and Prevention. The risk for a single exposure through anal sex is estimated at one-tenth of a percent to 3 percent, according to the CDC.

Once exposed to the virus, the person can begin a therapy called post-exposure prophylaxis (PEP). The newly exposed person must begin four weeks of treatment with antiretroviral drugs, which usually prevents the virus from taking hold, according to the CDC. The treatment must begin within 72 hours after exposure but is more effective if begun within 24 hours of exposure. The exposed person should contact a physician immediately or go to the nearest hospital emergency room. The CDC does not have data on the effectiveness of PEP treatment on persons other than healthcare workers.

Pregnancy can also be prevented should a condom break or leak during sex. Emergency contraceptive pills (ECP), also called "morning-after pills," have been available since 1997. The pills have high levels of regular birth control hormones and are effective in preventing pregnancies following unprotected sex 75 to 94 percent of the time. They should be taken within 72 hours of unprotected sex.

As of August 2004, there were two ECPs available: Preven and Plan B. However, 11 brands of regular oral contraceptive pills in varying regimens can be effective in preventing post-sex pregnancies. Prescriptions are required for ECPs except in Washington State, where they can be dispensed without a prescription by selected pharmacies, doctors' offices, and hospital emergency rooms.

There are often financial, legal, and social barriers to persons under 18 getting ECPs. The group Advocates for Youth recommends young women always keep ECPs on hand (in advance) so they can be used as soon as possible following unprotected sex, such as when a condom breaks during sexual intercourse.

Resources

Books

Condoms: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References. San Diego, CA: Icon Group International Inc., 2003.

Female Condoms: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References. San Diego, CA: Icon Group International Inc., 2004.

Richardson, Justin, and Mark A. Schuster. Everything You Never Wanted Your Kids to Know about Sex, but Were Afraid They'd Ask: The Secrets to Surviving Your Child's Sexual Development from Birth to the Teens. New York: Crown Publishers, 2003.

Periodicals

"Condom Availability has Positive Impact on Teen Health." The Brown University Child and Adolescent Behavior Letter (July 2003): 4.

"Condom Errors are Common." Men's Fitness (February 2003): 55.

"Condom Failure Depends on Experience of the User and Frequency of Use." Obesity, Fitness & Wellness Week (July 31, 2004): 80.

Eisenberg, Maria E. "The Association of Campus Resources for Gay, Lesbian, and Bisexual Students with College Students' Condom Use." Journal of American College Health (November 2002): 109–116.

Jancin, Bruce. "Despite Guidelines, U.S. Condom Use Still Low." Clinical Psychiatry News (January 2004): 66.

"Teens Often Misinformed about Proper Condom Use." Contraceptive Technology Update (January 2002): 9–10.

Organizations

Advocates for Youth. 2000 M St. NW, Suite 750, Washington, DC 20036. Web site: www.advocatesforyouth.org.

Planned Parenthood Federation of America Inc. 434 W. 33rd St., New York, NY 10001. Web site: www.plannedparenthood.org.

Web Sites

"Male Latex Condoms and Sexually Transmitted Diseases." Centers for Disease Control and Prevention, January 23, 2003. Available online at www.cdc.gov/hiv/pubs/facts/condoms.htm (accessed November 9, 2004).

"Teens and Condoms." Available online at www.avert.org/teencondoms.htm (accessed November 9, 2004.).

[Article by: Ken R. Wells]

A condom is a prophylactic sheath that is used to cover the male penis. It acts as a barrier to prevent sperm from entering a sexual partner, as well as to prevent transmission of disease-causing bacteria or microorganisms between partners during sexual activity. The first condoms, invented hundreds of years ago, were probably made of lambskin. Although effective in blocking sperm transmission, their relatively large pores did not impede the transmission of sexually transmitted infections. Most contemporary condoms are made of latex, which effectively impedes the transmission of both sperm and disease-causing agents.

(SEE ALSO: Contraception; Sexually Transmitted Diseases)

— CHRIS H. PARTIS

Tutor's tip: Knowing that society would also "contemn" (look down on, treat with contempt) him, she felt able to "condemn" (criticize strongly) him for not using a "condom" (a protective sheath used in sexual activity).