STI Prevention: Comprehensive Strategies

External (Male) Condoms

When used consistently and correctly, external condoms are highly effective at preventing many STIs, including HIV, chlamydia, gonorrhea, and trichomoniasis.

Effectiveness:

• 98% effective at preventing HIV transmission when used correctly
• Highly effective against fluid-transmitted STIs
• Provides partial protection against STIs transmitted through skin-to-skin contact

Proper Usage Tips:

• Check the expiration date and ensure the package is intact
• Use a new condom for each sex act
• Put the condom on before any genital, oral, or anal contact
• Leave space at the tip to collect semen
• Unroll completely to the base
• Hold the rim when withdrawing after ejaculation
• Use only water-based or silicone-based lubricants with latex condoms

Internal (Female) Condoms

Internal condoms are inserted into the vagina or rectum before sexual contact. They give the receptive partner control over protection.

Advantages:

• Can be inserted up to 8 hours before sexual activity
• Covers more external genital area, potentially offering better protection against STIs transmitted through skin contact
• Can be used with oil-based lubricants
• Made of nitrile, so safe for people with latex allergies

Proper Usage Tips:

• Remove the condom from packaging carefully
• Hold the inner ring and squeeze it between your fingers
• Insert the compressed ring into the vagina or anus
• Push the inner ring up as far as it will go
• The outer ring should remain outside the body
• Guide the penis or sex toy into the condom, not beside it
• After sex, twist the outer ring to contain fluids and gently pull out

Dental Dams

Dental dams are thin sheets of latex or polyurethane that provide a barrier between the mouth and vagina or anus during oral sex.

Usage:

• Place the dam over the vulva or anus before oral contact
• Hold the dam in place during oral sex
• Use a new dam if you switch from oral-anal to oral-vaginal contact
• Never reuse or flip over a used dental dam

If commercial dental dams aren't available, you can make one from an external condom by:

1. Carefully unroll the condom
2. Cut off the tip and cut along one side to create a rectangular sheet
3. Place this over the genital or anal area for oral sex

Vaccinations

Safe and effective vaccines are available for certain STIs:

HPV (Human Papillomavirus) Vaccine

• Protects against strains of HPV that cause most cervical cancers, as well as many anal, penile, vaginal, vulvar, and oropharyngeal cancers
• Also protects against strains that cause most genital warts
• Recommended for all adolescents starting at age 11-12, but can be given through age 26
• Some adults ages 27-45 who weren't previously vaccinated might benefit from HPV vaccination after discussing with their healthcare provider

Hepatitis B Vaccine

• Protects against hepatitis B virus, which can be transmitted sexually
• Typically given as a series of 3-4 shots over 6 months
• Recommended for all infants, unvaccinated children and adolescents, and unvaccinated adults at risk

Hepatitis A Vaccine

• Protects against hepatitis A virus, which can be transmitted through certain sexual practices
• Particularly recommended for men who have sex with men and people with multiple partners
• Usually given as 2 shots, 6 months apart

Pre-Exposure Prophylaxis (PrEP)

PrEP is a medication taken by HIV-negative individuals to prevent HIV infection.

Key Information:

• When taken as prescribed, PrEP reduces the risk of getting HIV from sex by about 99%
• Available as a daily pill or, in some cases, as an injection every two months
• Requires regular medical check-ups, typically every 3 months
• Does NOT protect against other STIs or pregnancy
• Most effective when combined with other prevention methods, such as condoms

Who Should Consider PrEP:

• Men who have sex with men and engage in high-risk behaviors
• Transgender individuals who engage in high-risk behaviors
• Heterosexual men and women who have high-risk factors
• People who inject drugs
• People in relationships with HIV-positive partners

Post-Exposure Prophylaxis (PEP)

PEP is an emergency intervention to prevent HIV infection after a potential exposure.

Key Points:

• Must be started within 72 hours (3 days) of possible exposure, ideally as soon as possible
• Consists of a 28-day course of antiretroviral medications
• Available through emergency rooms, urgent care clinics, or some healthcare providers
• Not intended for regular use as a prevention strategy

Consider PEP if:

• You had unprotected sex with someone who is HIV-positive or whose HIV status is unknown
• You experienced sexual assault
• You shared needles or other injection equipment
• You experienced a condom breakage with a partner whose HIV status is positive or unknown

Partner Communication

Open, honest communication with sexual partners is essential for STI prevention:

Discussion Topics:

• STI testing history and status
• Sexual history and risk factors
• Prevention methods you prefer to use
• Boundaries and consent
• Monogamy expectations or agreements about other partners

Tips for Effective Conversations:

• Choose a private, comfortable setting
• Have the conversation before becoming intimate
• Be honest and direct, but non-judgmental
• Use "I" statements to express your needs
• Listen actively to your partner's perspective
• Be prepared with information about testing resources

Risk Reduction Behaviors

Certain behavioral choices can significantly reduce your risk of STIs:

• Limiting sexual partners - Having fewer partners reduces exposure risk
• Mutual monogamy - Having sex only with one person who only has sex with you
• Delayed sexual debut - Postponing first sexual experience until older
• Regular screening - Getting tested between partners
• Reducing substance use - Avoiding alcohol or drugs before sex, as they can impair judgment and reduce likelihood of using protection
• Considering lower-risk sexual activities - Some sexual activities carry less STI risk than others

Understanding Risk Levels of Different Activities:

During Pregnancy

Preventing STIs during pregnancy is particularly important as infections can affect both maternal and fetal health:

• Get comprehensive STI testing at your first prenatal visit
• Continue using condoms during pregnancy if you or your partner has other partners
• Consider repeat testing in the third trimester if you're at increased risk
• Discuss any symptoms with your healthcare provider immediately
• Ensure any diagnosed STIs are treated promptly with pregnancy-safe medications

For Adolescents and Young Adults

Young people aged 15-24 account for half of all new STI cases. Prevention strategies for this age group include:

• Comprehensive sexual education
• Access to confidential healthcare services
• Learning about consent and healthy relationships
• Annual screening if sexually active
• HPV vaccination
• Open communication with trusted adults

In Long-term Relationships

Even in long-term relationships, STI prevention remains important:

• Get tested together before stopping condom use
• Discuss and agree on monogamy expectations
• Consider periodic testing if either partner has outside sexual contacts
• Maintain open communication about sexual health
• Consider barriers if either partner has a chronic STI like herpes or HIV