Withdraw the penis immediately if the con dom breaks

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Withdraw the penis immediately if the con- dom breaks during sexual intercourse, and put on a new condom before resuming inter- course. When a condom breaks, use spermi- cidal foam or jelly and speak to a health care provider about emergency contraception. Communication D I M E N S I O N S Except for withdrawal, condoms have the greatest gap between perfect use (98% effectiveness) and typical use (82.6%–90% ef- fectiveness) of all the contracep- tive methods (see Table 7.1). Because this method is pop- ular and its use is increasing (the rate of condom use at first sex increased from 22% in the 1970s to 67% in 2002), factors associated with its use and consistency are im- portant to know (Guttmacher, 2008). Among teens, high rates of both STIs and unintended pregnancy could be reduced with condom use. A study examining condom use patterns among sexually experienced male adoles- cents, age 15–19, found multiple domains of influence. Those who had formal sex education, had positive atti- tudes about condoms, were younger, had a partner close in age, and were committed to a relationship had greater odds of correct and consistent condom use. Recommen- dations include providing programs with targeted ser- vices that address condom use attitudes and that help teens negotiate condom use decision making with sex- ual partners (Sonenstein, 2008). The following scenario could be helpful. You are on your third date in a nice restaurant with a new friend. You are attracted to each other; on the last date, you spent a pretty hot half hour kissing and touch- ing each other. You are pretty sure that you are ready to have intercourse and are hoping that your new friend feels the same way. But how do you know? And, how do you bring up condom use? The waiter just delivered dessert. Dinner is coming to an end. Your date says, “Hmmm, do you want to come back to my room?” You say, “I think there are a few things we need to talk about first.” Here’s how a successful discussion about condoms with a new partner might go. CHRIS : I really like you. I’ve been fantasizing a lot since our last date about us having sex. PAT : Me, too. But, it’s important to me that we use con- doms and practice safe sex. CHRIS : Of course. I always use condoms. And because I was hoping you were interested too, I bought some today. PAT : I bought some today, too! How about we skip dessert? But of course, it is not always that easy (although it should be). Chris might have said, “I hate condoms.” Here are some ways that Pat might answer. 1. “Not with me you won’t. I’ve learned how to make condom use really fun. I hope you want me to show you.” 2. “I’m really sorry to hear that. I would never have sex with someone unless he used a condom.” 3. “Tell me which condoms you’ve used. Maybe we can try a different brand or type.” 4. “Well, it looks as if we have an important decision to make. We can agree not to have any kind of in- tercourse and just mess around. Or, we can just be friends. But, I won’t have intercourse with you with- out a condom.”

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