Using a condom to help prevent sexually transmitted infections (STIs) and/or unintended pregnancy can seem pretty straightforward—until you’re standing in the condom aisle looking at all the options. What kind should you buy? What type of protection works best for the sex you’re having?
This guide will walk you through what kind of barriers (e.g., condoms and dental dams) to use depending on what kind of sex you want to have, in addition to some general tips on how to get the most out of your protection.
To recap: STIs (sexually transmitted infections) and STDs (sexually transmitted diseases) are essentially different terms for the same thing—the bacteria, viruses, parasites, and other organisms that can infect people through oral, vaginal, and anal sex. They’re spread through the exchange of bodily fluids (including semen and vaginal fluid) and skin-to-skin contact.
Young people ages 15–24 account for half of all new STI infections, according to the latest report from the Centers for Disease Control and Prevention, so for sexually active young adults, STI prevention is a big deal. One of the best ways to reduce your risk of getting or spreading STIs is to use barrier methods like condoms. Barriers create a literal wall between your skin and your partners’ to reduce skin-to-skin contact and bodily fluid exchange. When having vaginal sex, barriers can also reduce your risk of pregnancy by preventing the semen from entering the vagina. In fact, external condoms can prevent 98 percent of pregnancies with consistent and correct use—but as with STI prevention, correct usage is key.
No matter what kind of sex you’re having, make sure to follow these tips:
Use barriers every time
A barrier method doesn’t work if it isn’t on, so if you’re planning to use barriers as your primary form of protection, you want to make sure you have them with you. This might mean making a plan to carry condoms or discussing with any partners ahead of time who will be responsible for bringing the barriers. (Note: People can forget, so carrying them yourself is always your best option.) Make sure you know how to store them correctly—proper condom storage can help prevent breakage.
- Store in a cool, dry place, out of direct sunlight.
- Check the expiration date and discard any that are out of date.
- Feel for an air bubble in the condom package by gently squeezing it. If there is no air bubble, replace it, as the condom may be punctured.
- Use your oldest condoms first since they are closer to their expiration date.
- Avoid keeping condoms in your wallet for long periods of time. Instead, try a bag, purse, or bedside container.
Use barriers correctly
Most condom failures actually result from user error, or the mistakes people make when they aren’t sure how to use barriers most effectively. So if you’ve never used one, practice putting one on yourself or your partner until you get it right. A study involving college men found the following common errors: putting on the condom after starting sex, taking it off before ejaculating, and not leaving a reservoir tip at the end—resulting in condom breakage and slippage.
- Wash your hands.
- Open the condom package carefully with your hands (rather than anything sharp—including teeth), ensuring you don’t accidentally tear the condom.
- Make sure it’s right side up (like a sombrero) and can roll down easily. If you accidentally put it on upside down, throw it away and grab a new one.
- Before putting the condom on, unroll it slightly and pinch the tip to leave a reservoir for semen. (This and the following step are unnecessary when using a condom over a toy.)
- Keep your fingers pinched on the tip of the condom while you unroll it all the way up the shaft of the erect penis. Make sure the reservoir tip is still there and there isn’t an air bubble once the condom is fully in place. If there is an air bubble or no space in the tip, discard the condom and get a new one.
- After ejaculation or when sex is finished, hold onto the base of the condom as you remove the penis from the vagina, anus, or mouth.
- If the condom remains inside your partner, twist the opening shut to try to contain any semen/secretions before removing it.
- Throw the condom away in a trash can, not a toilet (condoms are not meant to be flushed). If you have roommates, wrap the used condom in a tissue or toilet paper before disposing as a courtesy.
- Wash your hands again.
Add lube and make it fun!
Using a water-based or silicone-based lubricant can increase sensation and make sex more pleasurable for all parties. Avoid using a DIY oil-based lubricant (like baby oil or Vaseline®) since that can degrade your condom and make it more likely to break. If wearing a condom is uncomfortable, try a different brand or size. Condoms come in lots of different shapes and sizes, many of which are intended to increase pleasure or sensation; you can also make putting on a condom a part of foreplay.
For vaginal sex
When having vaginal sex, you can use either an external condom or an internal condom to reduce the risk of STI transmission and accidental pregnancy. Whichever kind of condom you choose, you can add water-based or silicone-based lube to increase sensation and reduce potential pain.
An external condom, also called a male condom, goes on the outside of a penis or toy. For STI prevention, make sure to avoid those made out of lambskin; these do not prevent the transmission of STIs. External condoms are widely accessible at drug stores and are often available on campus for free or low cost. Putting lubrication inside the condom increases sensitivity for both partners and can make the condom easier to put on.
A lesser-known option, the internal condom, is also great for vaginal sex. These pouch-shaped condoms are made from a soft, plastic material and contain a ring at each end. These can be a little harder to find but are still available on some campuses for free or low cost, or they can be found in some health clinics like Planned Parenthood; specialty stores, such as sex toy or condom stores; or online. Note that the only FDA approved brand of internal condoms in the US is the FC2 Female Condom®.
Some advantages of using internal condoms include being able to put them in up to eight hours before use, a potential pleasure boost from clitoral stimulation during sex, that they are latex-free for those with allergies, and simply the fun of experimentation.
For oral sex
Yes, you can and should use barriers for oral sex too! Many sexually transmitted infections, such as human papillomavirus (HPV), herpes (HSV), gonorrhea, and chlamydia can be transmitted through unprotected oral sex.
For oral sex involving a penis, you can use a dry, lubricated, or flavored external condom. Again, adding lube to the inside of the condom can increase sensation.
For oral sex on a vulva or anus, you can use an oral dam (also sometimes called a dental dam). An oral dam is a thin piece of latex placed over the vulva or anus for oral sex. Oral dams are available on some campuses for free or at a low cost, and you can also find them in some health clinics like Planned Parenthood; specialty stores, such as sex toy or condom stores; or online for about $1.50 each. For a more accessible DIY (and still safe) alternative, you can cut a condom or latex glove down one side and unfold to cover a wider area, or simply use plastic wrap as an oral dam.
For anal sex
To help prevent STI transmission during anal sex, you can use an external or internal condom with the same guidelines as those above. If you use an internal condom, make sure to remove the inner ring first.
Because the anus does not naturally lubricate, it can tear easily, raising the risk of being infected with HIV, chlamydia, gonorrhea, and other STIs. No matter what kind of condom you choose, make sure to add plenty of extra lube. Silicone-based lubricants tend to be best for anal sex, but water-based ones work well too. Never use an oil-based lubricant (like baby oil, massage oil, or Vaseline®) since this can degrade your condom, making it less effective at preventing the transmission of STIs. Most lubricants sold near condoms in the drug stores are water- or silicone-based and are generally safe.
Lizzy Appleby, MA, Pride/Share director at Youth Services, an organization providing sexual health education for youth, Glenview, Illinois.
Joleen Nevers, MA Ed, CHES, AASECT Certified Sexuality Education, sexuality educator, health education coordinator, University of Connecticut, Mansfield.
Tara R. Schuster, MS, MCHES, coordinator of health promotion, Rensselaer Polytechnic Institute, Troy, New York.
Pierre-Paul Tellier, MD, family physician, CLSC de Côte-des-Neiges, McGill University, Montréal, Canada.
Avert. (2019, October 7). Treatment as prevention (TASP) for HIV. https://www.avert.org/professionals/hiv-programming/prevention/treatment-as-prevention#footnote2_wthsiya
Avert. (2020, April 14). Condoms & lubricants fact sheet. https://www.avert.org/learn-share/hiv-fact-sheets/condoms-lubricants
Bedsider. (n.d.). Internal condom. https://www.bedsider.org/methods/internal_condom
Benotsch, E. G., Zimmerman, R. S., Cathers, L., Heck, T., et al. (2016). Use of the internet to meet sexual partners, sexual risk behavior, and mental health in transgender adults. Archives of Sexual Behavior, 45(3), 597–605. https://doi.org/10.1007/s10508-014-0432-x
Boskey, E. (2020, August 17). How to use a condom: 9 steps for safety. Verywell Health. https://www.verywellhealth.com/how-to-use-a-condom-4020370
Centers for Disease Control and Prevention. (2015). Gonorrhea. https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea.htm
Centers for Disease Control and Prevention. (2015). STDs in women and infants. https://www.cdc.gov/std/stats18/womenandinf.htm
Chan, J., & Ghose, A. (2013). Internet’s dirty secret: Assessing the impact of online intermediaries on HIV transmission. MIS Quarterly, 38(4), 955–976. https://doi.org/10.2139/ssrn.2164350
Cichocki, M. (2016, February 19). A 12-step guide to proper condom use. Verywell Health. https://www.verywell.com/proper-condom-use-48686
Cohen, M. S., Chen. Y. Q., McCauley, M., Gamble. T., et al. (2011). Prevention of HIV-1 infection with early antiretroviral therapy. New England Journal of Medicine, 365(5), 493–505. https://doi.org/10.1056/NEJMoa1105243
Crosby, R., Sanders, S., Yarber, W. L., & Graham, C. A. (2003). Condom-use errors and problems: A neglected aspect of studies assessing condom effectiveness. American Journal of Preventive Medicine, 24(4), 367–370. https://doi.org/10.1016/s0749-3797(03)00015-1
Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. (2020, May 13). Pre-exposure prophylaxis (PrEP). Centers for Disease Control and Prevention. http://www.cdc.gov/hiv/risk/prep/
Egendorf, L. (Ed.). (2007). Sexually transmitted diseases. Thompson Gale.
Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2017, January 31). How do sexually transmitted diseases and sexually transmitted infections (STDs/STIs) affect pregnancy? National Institutes of Health. https://www.nichd.nih.gov/health/topics/stds/conditioninfo/Pages/infant.aspx
Fleming, D. T., & Wasserheit, J. N. (1999). From epidemiological synergy to public health policy and practice: The contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sexually Transmitted Infections, 75(1), 3–17. https://doi.org/10.1136/sti.75.1.3
French, V. (2015, July 13). Can you get an STD from oral sex? https://bedsider.org/features/734-can-you-get-an-std-from-oral-sex
Go Ask Alice! (n.d.). Lube for anal sex? http://goaskalice.columbia.edu/answered-questions/lube-anal-sex
Grinstead, O. A., Faigeles, B., Comfort, M., Seal, D., et al. (2008). HIV, STD, and hepatitis risk to primary female partners of men being released from prison. Women and Health, 41(2), 63–80. https://doi.org/10.1300/J013v41n02_05
School of Public Health. (2020). National Survey of Sexual Health and Behavior. Indiana University Bloomington. http://www.nationalsexstudy.indiana.edu/
Joffe, G. P., Foxman, B., Schmidt, A. J., Farris, K. B., et al. (1992). Multiple partners and partner choice as risk factors for sexually transmitted disease among female college students. Sexually Transmitted Diseases, 19(5), 272–279. https://doi.org/10.1097/00007435-199209000-00006
Johns Hopkins Bloomberg School of Public Health. (2013, March 13). Study identifies ways to increase HIV testing, reduce HIV infection and detect previously undiagnosed HIV infections. [Press release]. http://www.jhsph.edu/news/news-releases/2013/Celentano-HIV-Testing.html
LifeStyles. (n.d.) Proper condom storage. http://www.lifestyles.com/article/proper-condom-storage/
Nusbaum, M. R. H., Wallace, R. R., Slatt, L. M., & Kondrad, E. C. (2004). Sexually transmitted infections and increased risk of co-infection with human immunodeficiency virus. Journal of the American Osteopathic Association, 104(12), 527–535.
Planned Parenthood. (n.d.) How do I buy internal condoms? https://www.plannedparenthood.org/learn/birth-control/internal-condom/how-do-i-buy-internal-condoms
Planned Parenthood. (2011, May 25). Why can’t you use baby oil with a condom? https://www.plannedparenthood.org/learn/teens/ask-experts/why-cant-you-use-baby-oil-with-a-condom
Pulerwitz, J., Amaro, H., DeJong, W., Gortmaker, S. L., et al. (2002). Relationship power, condom use, and HIV risk among women in the USA. AIDS Care, 14(6), 789–800. https://doi.org/10.1080/0954012021000031868
Robertson, J. E. (2003). Rape among incarcerated men: Sex, coercion and STDs. AIDS Patient Care STDs, 17(8), 423–430. https://doi.org/10.1089/108729103322277448
Rosengard, C., Anderson, B., & Stein, M. D. (2004). Intravenous drug users’ HIV-risk behaviors with primary/other partners. American Journal of Drug and Alcohol Abuse, 30(2), 225–236. https://doi.org/10.1081/ada-120037375
Ryder, J. J., Pastok, D., Hoare, M. J., Bottery, M., et al. (2013). Spatial variation in food supply, mating behavior, and sexually transmitted disease epidemics. Behavioral Ecology, 24(3), 723–729. https://doi.org/10.1093/beheco/ars209
Sexton, J., Garnett, G., & Rottingen, J.-A. (2005). Metaanalysis and metaregression in interpreting study variability in the impact of sexually transmitted diseases on susceptibility to HIV infection. Sexually Transmitted Diseases, 32(6), 351–357. https://doi.org/10.1097/01.olq.0000154504.54686.d1
Shrage, L. (2016). African Americans, HIV, and mass incarceration. Lancet, 388(10049), e2–e3. https://doi.org/10.1016/S0140-6736(16)30830-3
Sifris, D., & Myhre, J. (2016, September 9). 10 condom mistakes you should never make. Verywell Health. https://www.verywell.com/condom-mistakes-to-never-make-49174
Sifris, D., & Myhre, J. (2016, September 22). The real reasons why people don’t use condoms. Verywell Health. https://www.verywell.com/the-real-reasons-why-people-dont-use-condoms-49669
Stacey, D. (2015, October 1). What are polyurethane condoms? Verywell Health. https://www.verywell.com/polyurethane-condoms-906781
Sznitman, S. R., Carey, M. P., Vanable, P. A., DiClemente, R. J., et al. (2010). The impact of community-based STI screening results on sexual risk behaviors of African American adolescents. Journal of Adolescent Health, 47(1), 12–19. https://doi.org/10.1016/j.jadohealth.2009.12.024
Tyndall, M. W., Patrick, D., Spittal, P., Li, K., et al. (2002). Risky sexual behaviours among injection drugs users with high HIV prevalence: Implications for STD control. Sexually Transmitted Infections, 78 Suppl 1(Suppl 1), i170–i175. https://doi.org/10.1136/sti.78.suppl_1.i170
University of the Sunshine Coast. (2014, October 29). Koalas face brighter future thanks to vaccine field trial success. http://mysunshinecoast.com.au/news/news-display/koalas-face-brighter-future-thanks-to-vaccine-field-trial-success,36252
Wasserheit, J. N. (1992). Epidemiologic synergy: Interrelationships between human immunodeficiency virus infection and other sexually transmitted diseases. Sexually Transmitted Diseases, 19(2), 61–77.
World Health Organization. (2020, June 22). Family planning/contraception methods. https://www.who.int/en/news-room/fact-sheets/detail/family-planning-contraception
Ybarra, M. L., & Mitchell, K. J. (2016). A national study of lesbian, gay, bisexual (LGB), and non-LGB youth sexual behavior online and in-person. Archives of Sexual Behavior, 45(6), 1357–1372. https://doi.org/10.1007/s10508-015-0491-7