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A discussion about condoms

HIGHLIGHTS:

  • Condoms are 98% effective in preventing pregnancies when used properly.
  • Condoms can provide protection against contracting HIV 70–87% of the time when used during homosexual male sex and 90% of the time when used by heterosexual partners. Moreover, condoms offer 50–90% protection against a number of sexually transmitted diseases, including herpes, hepatitis B, genital warts, gonorrhea, chlamydia and syphilis.

 

A discussion about condoms

Data gathered between 2015 and 2017 by the Department for Disease Control, Ministry of Public Health, show that condom usage among teenagers is on a continuous upward trajectory. In 2017, 75% of males and 77% of females who had their first sexual encounter in grade 5 of high school reported using a condom, while the percentages were 69.5% and 74.6% respectively among teenagers who had their first sexual encounter during their second year of technical college.

Although the rate of condom usage is on the rise among teens, the rate of regular usage remains lower due to factors such as couples placing their trust in one another after their relationship reaches a certain point and disregarding condoms altogether. Such thinking has led to a number of sexually transmitted disease outbreaks, including HIV, syphilis, chlamydia, gonorrhea, genital warts, genital herpes and canker.

The condoms we see for sale in shops across the country tend to be those favored by males as they are both easy to use and disposable. This male domination in terms of condom availability means that female condoms are a lot rarer in Thailand. This article will focus on male condoms, which are capable of preventing the transmission of sexually transmitted disease, whether used during vaginal, anal or oral sex.

Q: How many types of condom are there?

A: Condoms currently come in two main types: those made from natural latex and those made from artificial materials. Condoms made from animal products are no longer as popular as they once were.

  • Natural rubber or latex condoms: Benefits include being cheap and more flexible than those made from animal products, meaning they are more tight-fitting and therefore suitable as a form of birth control and disease prevention. One disadvantage of natural latex is that petroleum oil-based lubricants or mineral-oil based lubricants will damage the structure, thereby impacting the quality and protection they would otherwise afford the user. However, water-based lubricants can be used with this type of condom.
  • Condoms made from man-made materials usually contain polyurethane (plastic), making them more durable and a viable solution to the disadvantage posed by natural rubber condoms. These condoms are suitable for those who may be worried about a latex allergy, and they can be used together with petroleum oil-based or mineral oil-based lubricants. Crucially, these condoms can be as thin as just 0.01mm, giving the wearer a feeling of not wearing anything, although they are generally more expensive than latex alternatives.

Q: How can we ensure that we get the correct size of condom? (males)

A: Men can ensure they are selecting the right size of condom by observing how large their penis gets when they become sexually aroused. Generally, the penis will grow to around 3–5 times its normal length as the tissue in the corpora cavernosa (penis shaft) acts like a sponge, getting harder as more blood reaches this area during times of arousal.

Men should opt for a condom size based on its fit, meaning it is neither too loose nor too tight as you don’t want the condom to slip off or break during intercourse. The sizes of condoms differ from brand to brand but are usually classified based on the penis circumference rather than the length, which tends to be similar across all brands of condom at approximately 6–7 inches. Men with a penis longer than the stated length may therefore struggle to find a condom that fits over the whole penis. Condom circumference will be stated in millimeters, as follows:

  • 49mm condoms (equal to a penis circumference of 11–12cm or around 4.5 inches).
  • 52mm condoms (equal to a penis circumference of 12-13cm or around 5 inches).
  • 54mm condoms (equal to a penis circumference of 13-14cm or around 5.5 inches).
  • 56mm condoms (equal to a penis circumference of 14-15cm or around 6 inches).

Q: What form of protection do condoms provide?

A:

Q: What causes condoms to break?

A: Condoms can break for a number of reasons, although some couples may continue having sex despite knowing that their condom has broken due to them being caught up in the moment. However, there are some occasions when couples are unaware that the condom has been compromised, which could be due to a lack of care being taken, being drunk, or being high on drugs.

Condoms may break in any of the following ways:

  • Extra thin condoms (thinner than 0.03mm) used by homosexual male couples are at greater risk of breaking or tearing during anal sex.
  • The condom may break as it is being placed on the penis, either by the nail of the user piercing it or, for couples who use their mouth to put on the other person’s condom, by teeth or braces which may cause a tear in the condom as it is being put on.
  • Cutting open the condom packet with scissors may lead to a tear without the user’s knowledge.
  • Using an incorrect lubricant can compromise the condom. For example, when latex condoms are used in conjunction with  petroleum oil-based or vegetable oil-based lubricants, it could lead to a 90% decrease in effectiveness and flexibility. Therefore, only water-based lubricants should be used with latex condoms. A silicone-based lubricant may be used if the user feels that the lubrication is not sufficient. Otherwise, you can select a lubricant by looking at its label to check whether it contains the words, “suitable for use with condoms.”
  • Forgetting to squeeze the end of the condom before putting it on could lead to air becoming trapped in the end that may result in a breakage during intercourse.
  • A condom that is too tight or the wrong size for the penis can make it more susceptible to breaking.
  • Condoms stored in wallets or pockets could break when sat upon or put under pressure.
  • A condom that is past its use-by date, or has been stored somewhere hot or exposed to sunlight for a long time, may have become compromised. Condoms should be stored in a cool, dry place.

HPV: An oft overlooked disease among males

The human papillomavirus (HPV) has over 150 strains and can infect both males and females. Infections rarely cause symptoms and they often go away without the person being at all aware of their presence. However, in people with weak immune systems, the virus can result in warts appearing on the skin, genitalia, pharynx or anus. Moreover, some strains of HPV, namely the 16th and 18th strains, are capable of causing some forms of cancer, including cervical cancer, throat cancer (contracted via oral sex), penis cancer and anus cancer.

An article published in the Journal of Lower Genital Tract Disease in 2011 revealed that 90% of anus cancer cases were caused by the 16th and 18th strains of HPV, while 6 out of every 10 penis cancer cases and 7 in 10 throat cancer cases were also associated with HPV infections. Furthermore, the group most at risk of these forms of cancer were found to be men who have sex with men.

Although condoms cannot provide 100% protection against contracting HPV, administering HPV vaccinations to boys and girls at age 9 has been found to prevent against the most serious strains of the disease. Vaccinations can still be given up to the age of 26. Should recipients be older than 26, the vaccine will only provide protection against strains of the disease which have not yet been contracted. People older than 26 should consult with a doctor before receiving such a vaccination.


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