• Barriers & STDs

Barriers against the risk of getting STDs and STIs (Sexually Transmitted Diseases and Sexually Transmitted Infections) come in many forms and include various items such as latex and non-latex (lamb skin is not effective) male and female condoms, gloves, finger condoms (or cots), and dental dams (including non-microwavable kitchen plastic wrap such as Saran wrap since the microwave variety has tiny holes that STDs/STIs can get through).

Other barriers to STDs/STIs include abstaining from certain sexual activity, or even keeping pubic hair intact (some science has shown that shaving prior to sex may cause an increased risk for some STDs/STIs such as herpes and the human papillomavirus).

There are different opinions whether certain devices work as barriers against STDs like HIV. The FDA, in an article titled “Barrier Products,” lists diaphragms or cervical caps as “barrier products used to prevent the transmission of HIV,” but sources like the Mayo Clinic and Department of Health & Human Services say they are not effective against STDs/STIs.

While such barriers properly used can substantially reduce the chance of STDs, they cannot reduce 100% of the risk for various reasons, such as a tear or hole in a device, defective product or improper use.

The difficulties people face in learning about and getting tested for STDs is another issue. Some STD prevention and testing barriers include language barriers, access to transportation, lack of public awareness, lack of perceived risk, lack of health worker training, stigma, legal, financial and privacy issues.

The sourced articles below should provide you with more information on STD/STI barriers like condoms and dental dams, and barriers some face to STD/STI prevention and treatment resources. (Also see the SexEd.net Topic STD)

    1. Male Condom / Female Condom

      Male/Female condoms: “Available in latex, polyurethane, polyisoprene, and lamb skin. Lamb skin condoms do not protect against sexually transmitted infections (STIs).”

      American Sexual Health Association, ashasexualhealth.org, accessed on 4/30/2019

    2. What Do I Need To Know About STDs?

      “How do I prevent STDs? Safer sex means using condoms, internal condoms, or dental dams. These barriers help block fluids and some skin-to-skin touching that can pass STDs. You can use condoms for vaginal sex, anal sex, and oral sex on a penis. You can use internal condoms for vaginal sex and anal sex. And you can use dental dams for oral sex on a vulva or anus. … How are STDs spread? So basically: any type of sexual contact that involves body fluids or touching genitals can put you at risk for STDs. That’s why using condoms and other barriers (like dental dams) makes sex safer — they help block skin and fluids that can spread STDs.”

      Planned Parenthood Federation of America Inc., plannedparenthood.org, accessed on 4/25/2019

    3. Types Of Barriers That Protect Against STDs

      “Types of Sexual Barriers: …
      -Gloves are used to cover the hands, wrists, and nails during manual penetration (i.e. fingering or fisting) of the mouth, vagina, or anus. Using gloves protects both partners. The penetrating partner is protected from the bodily fluids of the person they are penetrating. The person being penetrated is being protected from any unfortunate fomites under their partner’s nails. …
      -Finger cots are like gloves, but for only a single finger. You can get them from health supply stores or make them yourself by cutting the finger off of a glove. …
      -Diaphragms and cervical caps are technically barrier methods of contraception. They do put a physical barrier between semen and the cervix/uterus. However, these types of devices provide little to no protection against sexually transmitted diseases. The exceptions may be some reduction in risk of gonorrhea and chlamydia transmission from the male to the female partner since these diseases primarily infect the cervix. That said, these devices are not considered effective ways to prevent STDs. They should not be used for that purpose.”

      Elizabeth Boskey, PhD, verywellhealth.com, 4/23/2019

    4. Prevention Of STIs: Counselling And Behavioural Approaches

      “In addition, counselling can improve people’s ability to recognize the symptoms of STIs and increase the likelihood they will seek care or encourage a sexual partner to do so. Unfortunately, lack of public awareness, lack of training of health workers, and long-standing, widespread stigma around STIs remain barriers to greater and more effective use of these interventions.
      Barrier methods: When used correctly and consistently, condoms offer one of the most effective methods of protection against STIs, including HIV. Female condoms are effective and safe, but are not used as widely by national programmes as male condoms.”

      World Health Organization, who.int, 2/28/2019

    5. To Go Bare Down There?

      “There is also emerging data that links pubic hair removal with an increased risk of some sexually transmitted infections (S.T.I.s), such as herpes and the human papillomavirus (HPV). The microtrauma of hair removal may facilitate transmission or change the environment of the area in other ways that facilitate infection.”

      Jen Gunter, nytimes.com, 1/3/2019

    6. Dental Dams: Everything You Need To Know

      “Another option is to use a sheet of kitchen plastic wrap. Plastic wrap is not designed for this purpose but can add protection if a person does not have access to a condom. Plastic wrap is readily available in many grocery stores, and a person can use it with either water- or oil-based lubricants. However, plastic wrap is delicate and can rip easily.”

      Nicole Galan, reviewed by Janet Brito, PhD, LCSW, CST, medicalnewstoday.com, 11/21/2018

    7. How Do I Use A Finger Condom?

      “Finger condoms offer a safe and sanitary way to engage in the form of sexual penetration known as fingering. Fingering can also be referred to as digital sex or heavy petting. Finger condoms are often called finger cots. Fingering is a relatively low-risk form of sexual intercourse. Fingering cannot result in pregnancy as long as sperm is not introduced into a vagina via the fingers.”

      Ana Gotter, medically reviewed by Janet Brito, PhD, LCSW, CST, healthline.com, 10/24/2018

    8. Preventing Sexual Transmission Of HIV

      “Use condoms. Condoms are highly effective at preventing HIV infection if you use them the right way every time you have sex.”

      U.S. Department of Health & Human Services and supported by the Secretary’s Minority AIDS Initiative Fund, hiv.gov, 10/12/2018

    9. Expedited Partner Therapy: With STDs At An All-Time High, Why Aren’t More People Getting A Proven Treatment?

      “But despite these record-high infection rates for chlamydia and gonorrhea, most patients only receive treatment for their own infection — when they probably could get antibiotics or a prescription for their partner at the same time. The Centers for Disease Control and Prevention has recommended this approach — called ‘expedited partner therapy’ — since 2006, as a way to slow the growing STD epidemic. Most states have laws allowing doctors who diagnose a patient with an STD to write a prescription or provide medications for their partner, sight unseen. The laws also allow clinics and pharmacies to distribute STD treatment for partners. In a new paper in the American Journal of Public Health, three University of Michigan physicians describe the barriers that stand in the way of getting expedited partner therapy to more people. Overcoming those barriers, they say, could prevent many STD infections, including reinfections of people who have already gotten tested and treated.”

      Michigan Medicine, sciencedaily.com, 9/13/2018

    10. DIY Dental Dam

      “How to make three different dental dams? … Use plastic wrap from the kitchen. Cut out a square and use it as you would a dental dam. Must use non-microwaveable plastic wrap. Microwaveable plastic wrap has pores that STIs can pass through.”

      Online Resource, stdtriage.com, accessed on 6/21/2018

    11. Dental Dams

      “Dental dams are not technically birth control, as they are not used to prevent pregnancy, but they do prevent against STIs. … Some types of saran wrap can also be used as dental dams, although the microwave safe verities [sic] are not effective in the prevention of STIs.”

      Online Resource, kinseyconfidential.org, accessed on 6/20/2018

    12. HIV And Opportunistic Infections, Coinfections, And Conditions

      “Sexual abstinence (never having vaginal, anal, or oral sex) is the only way to eliminate any chance of getting an STD. But if you are sexually active, you can take the following steps to lower your risk for STDs, including HIV.
      Avoid risky behaviors.
      -Reduce the number of people you have sex with.
      -Don’t drink alcohol or use drugs before and during sex.
      -Use condoms every time you have vaginal, anal, or oral sex.
      -Use latex or polyurethane condoms. …”

      U.S. Department of Health and Human Services, aidsinfo.nih.gov, 6/15/2018

    13. As Rates Of Common STDs Rise, Young Women Face Unique Challenges

      “First, not enough women are tested regularly. Many women often do not show any symptoms of STDs and therefore may not seek testing or treatment. In fact, recent research found that only 27 percent of sexually experienced females ages 15–25 reported being tested for an STD in the past year. Concerns about confidentiality, lack of perceived risk, and cost were cited as barriers to testing.”

      Brooke Whitfield and Elizabeth Wildsmith, Child Trends, childtrends.org, 4/4/2018

    14. Am I Allergic to Condoms? Symptoms and Treatment

      “Although most condoms are made with latex, there are many alternatives available. Discuss your allergy with your sexual partners and choose the best non-latex option for both of you.
      – Try: Polyurethane – Made from plastic, polyurethane condoms effectively prevent pregnancy and protect you and your partner from sexually transmitted infections (STIs). They come in both male and female varieties. Polyurethane is thinner than latex. It conducts heat well, so they can feel fairly natural. But polyurethane doesn’t stretch the same way as latex, so these condoms may not fit as well. Because of this, they may be more likely to slip off or break. …
      – Try: Polyisoprene – These condoms are the newest development in non-latex protection. Some people even prefer them to latex. Polyisoprene is a synthetic rubber. This material conducts heat better than latex, which can make for a more natural feel. It also stretches better than polyurethane. Polyisoprene condoms protect against STIs and pregnancy, but they’re only available for men. They can be used with water- or silicone-based lubricants.”

      Corinne O’Keefe Osborn, medically reviewed by Janet Brito, PhD, LCSW, CST, healthline.com, 2/26/2018

    15. 5 Things You Should Know About STI Transmission, Testing, And Prevention

      “Most STI awareness campaigns you see say the same things: Talk to your partners about safer sex, use condoms, get tested. It’s good advice, but you’ve heard it all before, and it’s not working as well as it should: STI rates are rising. Infections that were virtually extinct, for example syphilis, have come back. There’s a giant problem, and traditional approaches to STI prevention aren’t fixing it. Many discussions about safer sex are, unfortunately, clinical and boring. Too few people are talking about it realistically, in the context of how we date and hook up today. It’s time we looked at comprehensive safer sex from a practical standpoint. Here’s what you should know. …
      [1.] Condoms are great, but they’re not the only barrier method. …
      [2.] Lube can reduce your risk of infection. …
      [3.] Consider getting tested every three to six months or before and after each new partner, whichever point comes first — and know what you’re getting tested for. …
      [4.] The safer sex conversation with your partners shouldn’t be a one-time deal — it should be ongoing. …
      [5.] Understand the role personal care plays in STI transmission. …”

      Jenelle Marie Pierce, allure.com, 11/19/2017

    16. You Asked It: Do Lesbians Get STIs?

      “Dental dams: A dental dam is a thin piece of latex that you put over a partner’s genital area for oral sex or analingus. This creates a physical barrier to avoid the transmission of STIs, much like a condom. You can even make a dental dam from a condom. Just cut off the tip and then cut the condom lengthwise! You can put a little lube on the vulva side of the dental dam to make it more pleasurable for the receiver.”

      Mount Sinai Adolescent Health Center, teenhealthcare.org, 9/29/2017

    17. Drawbacks Of The Diaphragm And Cervical Cap

      “The diaphragm and cervical cap do not protect against STDs, including HIV. Always use a condom to reduce the risk of STDs.”

      U.S. Department of Health & Human Services, hhs.gov, 8/25/2017

    18. States That Allow Doctors To Treat A Patient’s Sexual Partner Without An In-Person Visit May Find More Success Lowering Rates Of Sexually Transmitted Diseases

      “‘We know that to most effectively treat and prevent STDs, we have to consider both the infected patient and his or her partners,’ says lead author Okeoma Mmeje, M.D., assistant professor of obstetrics and gynecology at Michigan Medicine and a member of the University of Michigan Institute for Healthcare Policy and Innovation. ‘There are many barriers preventing people from making an office visit, from transportation and inconvenience to access to a free clinic,’ she says. ‘Allowing doctors to treat both patients and their partners in this way has proven to be effective at preventing reinfection and the spread of infections such as chlamydia and gonorrhea. Long term, there are many societal benefits both in health and cost.'”

      Okeoma Mmeje, MD, MPH, umich.edu, 6/2/2017

    19. How To Prevent Sexually Transmitted Infections (STIs)

      “How can I reduce the risk of getting an STI? … Know your sexual partners and limit their number—Your partner’s sexual history is as important as your own. The more partners you or your partners have, the higher your risk of getting an STI.
      -Use a latex condom—Using a latex condom every time you have vaginal, oral, or anal sex decreases the chances of infection. Condoms lubricated with spermicides do not offer extra protection. Frequent use of some spermicides can increase the risk of HIV. …
      -Get immunized—Vaccinations are available that will help prevent hepatitis B and some types of HPV …”

      American College of Obstetricians and Gynecologists, acog.org, 6/2017

    20. Going Bare Down There May Boost The Risk Of STDs

      “Frequent removal of pubic hair is associated with an increased risk for herpes, syphilis and human papillomavirus, doctors at the University of California, San Francisco, reported Monday [12/5/2016] in the journal Sexually Transmitted Infections. … ‘We were surprised at how big the effect was,’ says Benjamin Breyer, a urologist at the University of California, San Francisco, who led the study. ‘Right now, we have no way knowing if grooming causes the increase in risk for infections. All we can say is that they’re correlated. But I probably would avoid an aggressive shave right before having sex.'”

      Michaeleen Doucleff, npr.org, 12/6/2016

    21. Condom Effectiveness

      “Correctly using male condoms and other barriers like female condoms and dental dams, every time, can reduce (though not eliminate) the risk of sexually transmitted diseases (SCondom EffectivenessTDs), including human immunodeficiency virus (HIV) and viral hepatitis. They can also provide protection against other diseases that may be transmitted through sex like Zika and Ebola.”

      National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, cdc.gov, last reviewed 8/12/2016

    22. Planned Parenthood Marks Men’s Health Week, Encourages Men to Prioritize Their Health with Regular Checkups and STD Testing

      “‘Everyone deserves a sex life that’s as fun and healthy as possible, and part of that means taking care of your body. Just like regular exercise, regular checkups are important for your health,’ said Dr. Vanessa Cullins, vice president of external medical affairs at Planned Parenthood Federation of America. ‘The truth is that not enough men get the checkups and preventive care they need. It can be easy to take our health for granted, but preventive care is an important part of staying safe, healthy, and happy.'”

      Planned Parenthood Federation of America Inc., plannedparenthood.org, 6/15/2015