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Abstinence, Monogamy and STD Screening 1) Don’t have sex (i.e., oral, vaginal, or
anal sex). Abstinence from sexual intercourse is crucial for
persons who are being treated for an STD (or whose partners are
undergoing treatment) and for persons who want to avoid the possible
consequences of sex. 2) Reduce the number of sexual partners and get into a long term, mutually monogamous relationship with a not infected partner. 3) People embarking on a mutually monogamous
relationship should have a Comprehensive
Screening for common STDs before initiating sex if they want to
reduce the risk for future transmission of asymptomatic STDs. Practicing Responsible Sexual Behavior Vaccinations ....before your sexual exposure At the present time
there are only three vaccines available to prevent STD's. Hepatitis A Hepatitis B Human Papilloma
Virus Pre-exposure vaccination is one of the most effective methods for
preventing transmission of some STDs. For example, because infection
from the Hepatitis B virus is frequently sexually transmitted, get a Hepatitis B vaccination if you are not vaccinated and not infected
when you are being evaluated for an STD. In addition, if you are a men
who have sex with men (MSM) and if you are an illicit drug user (both injecting and non injecting) get also a Hepatitis A
vaccine. A vaccine against Human Papilloma Virus (HPV types
6, 11, 16, 18) is now available and licensed for females aged 9–26
years. Condoms Male Condoms When used consistently and correctly, male latex condoms are highly
effective in preventing the sexual transmission of HIV infection. For
example studies have shown that when a partner of a heterosexual
relationships is HIV negative and the other is HIV positive and condoms
were consistently used that person was 80% less likely to become
HIV-infected compared with persons in similar relationships in which
condoms were not used. Furthermore the risk for other STDs, including
chlamydia, gonorrhea, and trichomonas and the risk of women
developing pelvic inflammatory disease (PID) can also be reduced Although data are more limited, condom use might
reduce the risk for transmission of Herpes Simplex virus-2 (HSV-2) and
the risk for HPV-associated diseases (e.g., genital warts and cervical
cancer) and mitigate the adverse consequences of infection with HPV, as
their use has been associated with higher rates of regression of
cervical intraepithelial neoplasia (CIN) and clearance of HPV infection
in women, and with regression of HPV-associated penile lesions in men. Latex Condoms Condoms are regulated as medical devices and are subject to random sampling and testing by the Food and Drug Administration (FDA). Each latex condom manufactured in the United States is tested electronically for holes before packaging. Rates of condom breakage during sexual intercourse and withdrawal are approximately two broken condoms per 100 condoms used in the United States. The failure of condoms to protect against STD transmission or unintended pregnancy usually results from inconsistent or incorrect use rather than condom breakage. Male condoms made of materials other than latex are available in the United States. However they have had higher breakage and slippage rates when compared with latex condoms and are usually more costly, Non Latex Condoms
Two general categories of non latex condoms exist:.
The first type is made of polyurethane or other synthetic material and provides protection against STD/HIV and pregnancy equal to that of latex condoms. These can be substituted for persons with latex allergy. The second type is natural membrane condoms (frequently called “natural” condoms or, incorrectly, lambskin condoms). These condoms are usually made from lamb cecum and can have pores up to 1500 nm in diameter. Whereas these pores do not allow the passage of sperm, they are more than 10 times the diameter of HIV and more than 25 times that of HBV and viral STD transmission can occur with natural membrane condoms. Therefore they are not recommended for protection against STDs. Condoms must be used consistently and correctly to be effective in preventing STDs, and you should be instructed in the correct use. The following recommendations ensure the proper use of male condoms:
Female Condoms Laboratory studies indicate that the female condom (Reality™), which consists of a lubricated polyurethane sheath with a ring on each end that is inserted into the vagina, is an effective mechanical barrier to viruses, including HIV, and to semen . There are only a limited number of clinical studies which have evaluated the efficacy of female condoms in providing protection from STDs, including HIV . If used consistently and correctly, the female condom might substantially reduce the risk for STDs. When a male condom cannot be used properly, sex partners should consider using a female condom. Female condoms are costly compared with male condoms. The female condom also has been used for STD/HIV protection during receptive anal intercourse. Whereas it might provide some protection in this setting, its efficacy is undefined. Vaginal Spermicides and Diaphragms
Vaginal spermicides containing nonoxynol-9 (N-9) are not effective in preventing cervical gonorrhea, chlamydia, or HIV infection. Furthermore, frequent use of spermicides containing N-9 has been associated with disruption of the genital epithelium, which might be associated with an increased risk for HIV transmission. Therefore, N-9 is not recommended by the CDC for STD/HIV prevention. Diaphragm and spermicide use have been associated with an increased risk for bacterial urinary tract infections in women.
Condoms and N-9 Vaginal Spermicides
Condoms lubricated with spermicides are no more effective than other lubricated condoms in protecting against the transmission of HIV and other STDs, and those that are lubricated with N-9 pose the concerns that have been previously discussed. Use of condoms lubricated with N-9 is not recommended for STD/HIV prevention because spermicide-coated condoms cost more, have a shorter shelf-life than other lubricated condoms, and have been associated with urinary tract infection in young women.
Rectal Use of N-9 Spermicides
WARNING !!!!
Non barrier Contraception, Surgical Sterilization, Hysterectomy Sexually active women who are not at risk for pregnancy might incorrectly perceive themselves to be at no risk for STDs, including HIV infection. Contraceptive methods that are not mechanical barriers offer no protection against HIV or other STDs. Women who use hormonal contraception (e.g., oral contraceptives, Norplant™, and Depo-Provera™), have intrauterine devices (IUD), have been surgically sterilized, or have had hysterectomies should get counseling regarding the use of condoms and the risk for STDs, including HIV infection. Adapted from CDC Morbidity and Mortality Weekly Report |
