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close this bookGuidelines for HIV Interventions in Emergency Settings (Joint United Nations Programme on HIV/AIDS - United Nations High Commission for Refugee - World Health Organisation, 1996, 62 p.)
View the document(introduction...)
View the documentAknowledgements
View the document1. Introduction
View the document2. Why is HIV/AIDS a priority in emergencies?
View the document3. The importance of advocacy
Open this folder and view contents4. Stages of an emergency
Open this folder and view contents5. The essential minimum package
View the document6. Mobilization of the minimum package
View the document7. HIV/AIDS-Related human rights and ethics during emergencies
View the document8. Comprehensive care for people with HIV/AIDS in the post-acute phase
View the document9. Needs assessment for HIV interventions in emergencies
Open this folder and view contentsAppendix 1
Open this folder and view contentsAppendix 2
Open this folder and view contentsAppendix 3
View the documentAppendix 4 - How to use the right condoms the right way4
View the documentAppendix 5 - Example of a brochure on safer sexual behaviour
View the documentAppendix 6 - Needs assessment: continuous and discontinuous data
View the documentReferences

Appendix 4 - How to use the right condoms the right way4

4Extracted from GPA briefing document for United Nations Peacekeeping Forces (document WHO/GPA/DIR/95.3).

1. First pick the right condoms

· The best ones to use are made of latex rubber. These are less likely to break or leak than animal-skin condoms or the thinner “more sensitive” condoms.

· If you have a choice, pick condoms with lubrication (slippery liquid or gel) already on them. This makes them less likely to tear during handling or use. NEVER USE AN OIL-BASED LUBRICANT WITH A CONDOM.

· Some condoms are packaged with spermicide (such as nonoxyl-9), a chemical designed to kill sperm. Most spermicides also kill viruses. Although they are not available everywhere, condoms that include a spermicide may provide an additional barrier against the AIDS virus.

· New condoms are stronger than old ones. If you keep a condom for too long, the rubber loses its strength. Store them in a cool, dry place out of direct sunlight. Heat quickly damages rubber, so do not store condoms in hot spots such as the glove compartment of a car. Many condom packages will have either a manufacturing date or an expiry date on them. This is helpful since it provides an indication of age. Older condoms are likely to be weaker, and should be thrown out. A condom should also be thrown out if it feels brittle, dried out or very sticky, or if it looks discoloured or was in a torn or damaged package - so take a look at them as you use them.

· Condoms should never be re-used - use a new condom each time you have sex. So, keep a supply of condoms on hand.

· Carry some condoms whenever you go out. Even if you do not use them, you can give a spare one to a friend who may have forgotten his.

2. Next, using condoms should be discussed with the person you are planning to have sex with

· Waiting to pull out a condom until the moment before you have sex is the WORST possible time to bring up the subject. Your partner may get angry that you have waited so long and may feel tricked, or not trusted.

· The best time to introduce the subject of using condoms is the first time you think about having sex with someone. Planning to protect yourself and your partner from getting a sexually transmitted disease, especially AIDS, shows that you care about your health and about your partner’s health. It also shows that you are aware of the risks of unprotected sex at a time when AIDS is a serious epidemic all over the world.

· The person you are thinking about having sex with may not agree at first when you say that you want to use a condom when you have sex. You may need to offer some arguments about why you feel that way, using facts you learned from this brochure. If the person still resists, then the smart thing to do is not to have sex. If that person cares so little about his/her health - or yours - then you should find someone else who does care.

3. Once you and your partner are comfortable with the idea of using a condom and are ready to have sex, here is how to use a condom the right way:

· Only open the package containing the condom when you are ready to use it. Otherwise, the condom will dry out. Be careful not to tear or puncture the condom when you open the package. If it does get torn, throw it away and open a new package.




· Condoms come rolled up into a flat circle. They can only be unrolled onto an erect (“hard”) penis.

· Before the penis touches the other person, place the rolled-up condom, right side up, on the end of the penis.






· Hold the tip of the condom between your thumb and first finger to squeeze the air out of the tip, or teat. This leaves room for the semen to collect after ejaculation (“cumming”).




· Keep holding the top of the condom with one hand. With the other hand (or your partner’s hand), unroll the condom all the way down the length of the erect penis to the pubic hair. If the man is uncircumcised, he should first pull back the foreskin before unrolling the condom.

· Always put condom on before entering partner.




· If the condom is not lubricated enough for you, you may choose to add a “water-based” lubricant, such as silicone, glycerin, or K-Y jelly. Even saliva works well for this. Lubricants made from oil (cooking oil or shortening, mineral or baby oil, petroleum jellies such as Vaseline, most lotions) should NEVER be used because they can damage the condom.




· If you feel the condom slipping off during sex, hold it at the base to keep it in place DURING THE REST OF THIS SEXUAL ACT. It would be safest for the man to pull his penis out and put on a new condom, following all the steps again.




4. After sex, you need to take the condom off the right way:




· Right after the man ejaculates (“cums”), while still inside his partner, he must hold onto the condom at the base, near the pubic hair, to be sure the condom does not slip off.

· Now, the man must pull out WHILE THE PENIS IS STILL ERECT. If you wait too long, the penis will get smaller in size, and the ejaculate (“cum”) will spill out of the condom.




· When the penis is completely out, take off the condom and throw it away.




5. If you are going to have sex again, use a new condom and start the whole process over again!


Remember:

· Do not use grease, oils, lotions, or petroleum Jelly (Vaseline) to make condoms slippery. These make condoms break. Only use a jelly or cream that does not have oil in it.

· Use a condom each time you have sex.

· Only use a condom once.

· Store condoms in a cool, dry place.

· Do not use condoms that may be old or damaged.

Do not use a condom if:

- the package is broken
- the condom is brittle or dried out
- the colour is uneven or changed

- it is unusually sticky.