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External Condoms

PrEP is incredible tool in making sex safer, but condoms remain the most effective for curbing STI infections and is the cheapest method for stopping the spread of HIV.

In fact, each year ACT gives out tens of thousands of condom and lube packs in and around Toronto’s queer Village! This means gay men are continuing to utilize this HIV prevention method, over 35 years since it was adopted, to keep themselves safer during sex.

Do External Condoms Work?
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The efficacy of an intervention is how well it works in a scientific trial or when people use it precisely as indicated; its effectiveness is how well it actually works to prevent disease or infection in a given population, based on actual levels of use.

Therefore, while a condom’s efficacy is 100%, in the real world when condoms are used 100% of the time, though not necessarily 100% perfectly (i.e. with usual rates of breakage and slippage) they provide protection of about 80% against HIV (via frontal hole/vaginal sex) and 70% against HIV (via anal sex). Or, put another way, condoms stop 7 out of 10 new HIV infections acquired through anal sex between men.

It’s further estimated condoms provide protection of about 80% to 85% against gonorrhea, about 50% to 66% against syphilis, and 26% to 86% against chlamydia.


Why Do External Condoms Sometimes Fail?
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During frontal hole/vaginal intercourse condoms break about 2% of the time. During anal intercourse condoms break 4% of the time.

Condoms "fall off" 3% to 5% of the time.

Condoms slip down (but not off) 13% of the time.

For these reasons it’s important to make sure you are holding the base of the condom when pulling out to make sure it stays in place, removing the condom while still erect, and using condoms that are properly fitted. 

Lots of lube will also decrease chances of breakage, as will changing your condom to a new one every 12-15 minutes.

You also want to make sure you’re checking the expiration date on your condoms and storing your condoms in a cool place where they won’t risk getting punctured.



Why Still Use External Condoms If I’m On PrEP?
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While PrEP is 99.9%* effective when taken correctly, it does not prevent STI transmission from occurring. Therefore, condoms are our most effective tool for warding off unwanted infections. Canadian Guidelines on HIV Pre-Exposure Prophylaxis recommend condoms as part of a combination prevention strategy for this reason.

You may also just be getting started on PrEP, returning to it, have missed several doses, or are using PrEP-On-Demand which does not offer the same protection. In these situations, a partner may want to incorporate condoms into your sexual encounter.

*we can’t say anything is 100%, but breakthrough cases are extremely rare.

Condoms also provide functions outside the scope of serving as a barrier against STI and HIV. Thick condoms for instance can help reduce sensitivity and help extend your fuck sessions, ribbed condoms can help create a different sensation when fucking, and bottoms who haven’t had a chance to douche may want to use a condom to reduce concerns about mess and cleanup. At ACT we have a range of condoms available for free, including: ribbed, large, snug, latex-free, thin, flavored, glow-in-the-dark, internal and standard external condoms.

Lastly, it can take time getting comfortable going condomless. Especially after over 30 years of safer sex messaging telling you to always use a condom! So if you still want to use condoms while getting used to the idea of being on PrEP, that’s ok too.


Using An External Condom
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Male Condom Diagram


Turning Your External Condom Into A Dental Dam
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To obtain free dental dams, e-mail, or make your own using an external condom and scissors as laid out below. 

Dental Dam