How Effective are Condoms Really at Preventing Pregnancy and Sexually Transmitted Infections?
For many people, when you think about safe sex, you immediately think about condoms. According to The Guttmacher Institute, they're the third most common form of contraception in the US, behind the pill and tubal sterilization. But how effective are condoms really? And are there things you should be doing in order to further prevent your risk of an unwanted pregnancy or contracting a sexually transmitted infection? I talked to Natasha Bhuyan, MD and family physician at One Medical, about all things condoms and how to make sure your safe sex is actually safe.
So, how effective are condoms?
There are a lot of variables that can make a condom less effective (like if they are expired or not stored appropriately). When discussing the effectiveness of condoms, it's also important to distinguish what you are trying to prevent. "The reality is, condoms are not great at preventing pregnancy," Dr. Bhuyan says. "But they're certainly much more effective at preventing STIs."
If a heterosexual couple uses a condom the correct way every single time they engage in intercourse, Dr. Bhuyan says the condom will be 98% effective at preventing pregnancy. Most couples don't use them every time, however, or they don't use them correctly.
"Someone might take the condom off in the middle, and, of course, we know that condoms can also break," she says. "So, the real life statistic for condom effectiveness is that they're actually 85% effective at preventing pregnancies."
That being said, when it comes to preventing STIs, like chlamydia and gonorrhea, condoms are actually 98% effective. However, they aren't as great for infections transmitted through skin to skin contact, like herpes or genital warts. "While condoms can reduce the risk of contracting those infections, they can't eliminate it entirely," Dr. Bhuyan says. "Condoms can reduce the risk of herpes from male to female by 96% and from female to male to 65%." That means it's necessary to know your partner's sexual history and to get tested regularly in order to avoid contracting an infection.
Still, it is important to wear a condom when having sex with your partner, especially if you are trying to prevent pregnancy, or if you don't know your partner's sexual history. They may not be perfect, but they are an important defense against STIs and other sexual risks.
What else should I do to prevent pregnancy?
If you want to lower your risk of pregnancy, you should still always wear a condom but, Dr. Bhuyan suggests a long-acting contraceptive method like IUDs, implants, shots, or the pill to help lower your risk of pregnancy.
"It's definitely important to see your primary care provider so they can help you navigate what birth control method is right for you," she says.
What should I do to prevent HIV?
As for those who are at risk of contracting HIV, there are steps you can take, as well. Again, still wear a condom, but Dr. Bhuyan also suggests talking to your doctor to find out if you are at a higher risk of contracting the virus, and if so, there are options like pre-exposure prophylaxis, or PREP as it's commonly called.
"PREP is something that's actually gaining a lot of traction now and thankfully so because it's this amazing medication that, if you use it daily and regularly, it can reduce your risk of HIV by 98%," Dr. Bhuyan says. If you come in contact with HIV—whether through condomless sex, or if the condom breaks, or through various other ways—the virus can't replicate in your system thanks to PREP. Still, even if you are on PREP, it's important to wear a condom every time you have intercourse because you can never be too safe.
How can I make my condoms more effective?
Dr. Bhuyan also has many tips for how to use a condom correctly, so as to reduce the risks that can arise during sex. She warns that condoms can actually expire, so make sure you check the expiration date, which is on the individual packaging, before you use one. You should also be storing your condoms in a room temperature environment. "They shouldn't be stored in really hot places like in your car and they shouldn't be stored in really cold places," Dr. Bhuyan warns.
And of course, don't ever wear two condoms. You won't get twice the coverage. Instead, the friction between the two layers makes the condom more at risk of breakage, defeating the purpose of wearing condom all together.
Finally, make sure you are using the right lube. Dr. Bhuyan suggests you stay away from oil-based lubricant like Vaseline, because it will wear down the condom. Instead, try something that is water-based.
What if I have more questions?
Safe sex can be a tricky subject, and it's so important to be well-prepared before you engage in intercourse because the risks are so high. If you have more questions, or if you just want to talk out your options with someone, Dr. Bhuyan suggests heading to your doctor.
"I don't want people to be living in fear and I want them to know that you can be empowered to control your own sexual health," she says. "There are so many options out there for us and it's important to learn about them."
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