By Heather Corinna

At some point, you have probably heard someone -- perhaps even a school or community or health group -- say that condoms are not effective when it comes to safer sex and preventing the spread of sexually transmitted disease and infection. Unfortunately, some myths are propagated about condom use in this way.

You might hear someone say that latex condoms have "holes" in them which are small enough to let disease, infection or semen through. This is very much not so. You may have heard someone say that condoms aren't at all effective because they break all of the time. This is also not often the case. In fact, when used correctly, and for ALL genital and/or oral contact, it's actually quite rare for condoms to break.

However, myths and misinformation aside, there are instances in which condom use alone - or the use of dental dams and gloves -- cannot offer the same level of protection they can in other instances, with STIs which are transmitted not via fluid exchange, but by skin-to-skin contact, namely two of the most common STIs, HPV and Herpes.

A condom does not cover the entire genital area, and these infections can be transmitted via sores or warts (which may or may not always be visible or readily apparent) and by contact with parts of the genitals NOT covered by the condom (in other words, the genital anatomy besides the penile shaft and vaginal canal). Condom use for vaginal, oral or anal sex and dental dam use for anal/oral play or female oral sex certainly DOES make a difference -- around 70% of one, which is a whole lot better than 0% -- and cut the chances of transmitting or contracting those infections (and others for which condoms and latex barriers are greatly effective). But it's important to realize that in the cases of infections like HPV and Herpes, safer sex tools and practices cannot provide complete protection.

In other words, even when using condoms, dams or gloves, you may still be at a considerable risk of transmitting or contracting HPV (human papillomabvirus, some strains of which cause genital warts) or HSV-2 (genital herpes).

HPV is one of the most common STIs among young, sexually active people under 22. At any one time, an estimated 20 million people in the United States have genital HPV infections that can be transmitted to others. Every year, about 6 million people acquire a genital HPV infection (CDC). A recent U.S. study among female college students found that an average of 14 percent became infected with genital HPV each year. About 43 percent of the women in the study were infected with HPV during the three-year study period (Ho, 1998). Typical prevalence of HPV for women under the age of 25 is between 28 and 46 percent of all women (Burk, 1996; Bauer, 1991).

Most estimates suggest that one out of every three sexually active young adults may carry HPV, yet far fewer have visible, active warts they could recognize or self-diagnose (as little as only 1-2%), though they are infected and CAN and likely will still transmit HPV. Some strains of HPV may cause cervical cancer and make a person with the infection more susceptible to other infectious diseases, like HIV. It is not yet curable. Some people may shed or suppress the virus, but there is no accurate way of knowing who has and who has not at this time.

For more on HPV, see the Infection Section file. For information about Gardasil, the HPV Vaccine, see Scarleteen's HPV Vaccine FAQ.

HSV-2 -- Genital Herpes -- is one of the most common sexually transmitted diseases in the United States, with as many as one million people in the United States becoming infected each year. While genital herpes continues to spread across all social, economic, racial and ethnic boundaries, prevalence of infection increased most dramatically in teens and young adults in the late 1980s and early 1990s (Fleming, 1997). In a national household survey, less than 10 percent of people who tested positive with herpes knew they were infected (Fleming, 1997 - from the CDC). 45 million people are infected with genital herpes, about one in every five people have it. In addition, HSV-1 (oral herpes/cold sores) is carried by about one in two people in the United States (that's at least 50%), and can be spread via oral or oral/genital contact, creating a genital herpes infection with HSV-1. Like HPV, there is currently no cure for herpes infections. For more on HSV, see the Infection Section file.

This does NOT mean the smart thing to do is to say, "Then why bother with safer sex?" and not practice at all, because there are both other diseases and infections out there they DO offer protection from, and use still DOES greatly decrease your risk (by 50% at a minimum) of contracting HPV and Herpes as well.

We don't say these things to scare you, but rather so that you can just make informed choices based on what level of risk feels manageable to you.

And the truth right now in time is that should you choose to engage in manual ("hand jobs" or "fingering"), oral ("giving head" or "eating out"), vaginal or anal sex right now, even when you do so safely (with safer sex practices and regular testing for you and your partner, and by limiting the number of partners), you are taking a decent risk of contracting HPV or Herpes Simplex. While both of these infections can be treated -- and thus, you can reduce or decrease your symptoms -- they cannot be cured. So, while one can feel just fine with either infection in many cases with certain treatments and medications, the infection itself may not go away and may remain transmissible to all the sexual partners of an infected person (and in the case of oral Herpes, can also be, and is, transmitted by nonsexual contact as well) for the whole of their life. If you know you or a partner have either of these infections, even with safer sex, you have a risk of contracting or transmitting them.

HPV and Herpes infections become further complicated by the fact that there are presently not good tests or screenings which can be done to discover either accurately in many cases, unless there are active sores or warts which are visible. Such is the case in terms of HPV, where there often are not visible symptoms, especially in men (and there currently is no approved HPV test for men), and in women as well -- or unless an infection has created other symptoms or complications in the body.

What's the answer? There isn't an easy one. In most cases, if you simply chose to abstain from all sexual activities, forever, you could likely avoid HPV and HSV-2. But very few people are going to do that, and we do have to consider in making sexual choices how they will impact our quality of life. Cutting off sexual or affectionate contact with all people, or with sexual partners within reasonable limits (those of their and our own physical, emotional safety and health, in general) for all of our lives would, for many of us, greatly impact and reduce our quality of life, potentially more than an infection would. But to make informed choices, we should consider that even with safer sex practices in play -- even with only one sexual partner -- we may still be taking a substantial risk at contracting or transmitting skin-to-skin STDs and STIs.

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If you're going to be sexually active knowing and accepting that, then there are some steps you can take to help heighten your safety levels.

• If you're a young woman under the age of 26, even if you've already become sexually active, you can talk to your doctor about and consider getting the HPV vaccine, which can offer protection from four common strains of HPV.
• Practice safer sex, especially for oral, vaginal and manual sex. Practicing safer sex protects you greatly from all STDs and STIs, and even in terms of HPV and Herpes, using condoms and other latex barriers does decrease your risk substantially.
• Read up on skin-to-skin STDs and STIs to find out what noticeable symptoms might be when they are present, and have yourself and your partner(s) be on the lookout for those symptoms, primarily: warts, which often are small, whitish or pinkish, and raised with a cauliflower-like texture, and Herpes zoster sores which look a bit like red, raw blisters (see examples of both above), or may crust over slightly on the top. In addition, at the sign of any unusual itching burning or tingling of the genitals, check in with your doctor. As well, don't accept that a lack of symptoms or partners for intercourse means you or your partner are not carrying any STDs or STIs -- that is simply not intelligent. Instead, have annual or biannual sexual health visits at your local clinic, or with your OB/GYN and get full STD and STI screens, without fail, at least every year.
• Reduce the number of sexual partners you have. This is not a ploy to say everyone needs to be or should be monogamous. However, if you are with sexual partners who you cannot trust, do now know well over time, and with whom you cannot both check in on your sexual health together and with your doctors openly and regularly, you are greatly increasing your risks. Math alone is enough to tell us that keeping track of all of those things between two or three people just over one year can be a serious challenge -- trying to do it for real with more can be difficult if not impossible for most people.
• Don't let ignorance or denial drive your car. Thinking you and yours can't have HPV, Herpes or any other infection doesn't offer any protection, and it can't make existing infections, or the likelihood of transmitting them, go away. Sizing up your risk factors for these things is a Big Life Decision. You wouldn't blow off similar life choices that could impact the rest of your life, like finishing high school, or becoming pregnant, so be just as wise here. take the time to give these things thought, and really weigh your options, needs and wants. It's your choice, but only if you actively make it.

Related Books

Our Bodies, Ourselves: A New Edition for a New Era author: Boston Women's Health Book Collective,Judy Norsigian asin: 0743256115