Prevention

Make sure you and your partner are tested and treated for any STD prior to sexual activity. Correct usage of latex condoms greatly reduces your risk of getting or spreading STDs, but does not completely eliminate it. Abstinence and having mutually monogamous relationships are other effective measures for preventing STDs.

The vaccine for hepatitis B is recommended for all unvaccinated, uninfected persons who are being evaluated for an STD. In addition, the Centers for Disease Control and Prevention recommends that men who have sex with men and illicit drug users get the hepatitis A vaccine.

Don'ts:

• Don't let bodily fluids enter the vagina, anus or mouth if you are with a partner whose sexual history you are unsure about. Bodily fluids to be concerned about are blood, semen, vaginal fluids and any discharge from sores caused by STDs.
• Don't have sex if you or your partner have sores or other signs of infection.
• Don't assume all birth control methods will prevent STDs. (The pill and IUD can prevent pregnancy, but not sexually transmitted infections.)
• Do not share items such as razors that might have blood on them.

Using Condoms

Use a latex condom for anal, oral or vaginal sex, particularly if you are having sex with multiple partners. Although this won't guarantee you won't get an STD, using a latex condom reduces your risk for certain diseases. Spermicides are not recommended. Condoms are not 100 percent effective and may not protect you from herpes, genital warts or HBV. Female condoms are not nearly as effective as male condoms in protecting against STDs. Also note that male and female condoms should not be used together.

Because HIV is smaller than sperm or bacteria, it can pass through certain types of condoms. The Food and Drug Administration (FDA) recommends only latex condoms labeled for protection against STDs should be used. Other types of condoms may not provide enough protection. Ask your doctor about alternatives if you have a latex allergy. Use a new condom for every act of intercourse (vaginal and anal) and oral sex.

What to do ahead of time

Here are some guidelines from the FDA on proper use of condoms:

• Be a label reader. Make sure the label says the condom is made of latex, protects against STDs and that the expiration date has not passed.
• Store condoms in a cool dry place and out of direct sunlight. Cars, pockets, wallets and purses may expose condoms to extreme temperatures, compromising their effectiveness.
• Don't rip open the package. Handle it gently. The last thing you want to do is tear the condom with your teeth or a sharp instrument.

What to do when you're ready

These tips help ensure that you are using your condoms most effectively:

• Place the rolled condom over the tip of the erect penis. Leave half an inch of space at the tip to collect semen. If you are not circumcised, pull back the foreskin before placing the condom on the penis.
• Pinch the air out of the tip with one hand. (Friction against air bubbles causes most condom breaks.)
• Unroll the condom over the penis with the other hand.
• Roll it down to the base of the penis.

Afterwards

• After ejaculation and before the penis gets soft, grip the rim of the condom and carefully withdraw. Otherwise, semen may spill out.
• To remove, gently pull the condom off the penis, being careful not to spill the semen.
• Don't flush it.
• Wash your hands with soap and warm water.

How to use a female condom

• Read the directions carefully.
• Make sure the inner ring goes as far back into the vagina as possible.
• Guide the penis into the condom.
• After sex, remove the condom before you stand up. Be careful not to spill semen.
• Gently pull it out.
• Don't flush it.
• Wash your hands with soap and warm water.

If you're pregnant

• If you are pregnant and have a chronic disease such as herpes, your doctor may advise a caesarean section (C-section) to protect your baby. Genital warts may obstruct the birth canal and may require a C-section or surgical removal of the warts.
• If you are pregnant, tell your doctor. Infants born to HBV-infected mothers should be given the HBV vaccine within 12 hours after birth.
• The risk of transmitting herpes to a baby during delivery can be avoided by using acyclovir during the last month of pregnancy.

Help your child stay safe

There are several vaccines available to prevent sexually transmitted diseases that children should have.

• The CDC recommends that Gardisil, a vaccine that can prevent HPV infection, be given routinely to girls at age 11 to 12. The National Advisory Committee on Immunization Practices recommends that Gardasil be given to girls beginning at age 9 (at her doctor's discretion) and in young women up to the age of 26.
• All children should get an HBV vaccine.

In addition, teens who are close to their parents are less likely to engage in risky activities. Parents need to get to know their teen's friends, be involved in their children's academic and personal lives, and know how their teens spend their free time. Studies show educating children about condoms before they become sexually active leads to greater use of condoms as they grow older.

More on Sexually Transmitted Diseases

In the Encyclopedia:

This article was reviewed and updated June 2007.