MALE CONDOM

DEFINITION

A male condom is a latex, polyurethane, polyisoprene or animal tissue sheath used to cover thepenis and trap the ejaculate during intercourse. Condoms are available in different materials, styles, and sizes with or without spermicidal coating. The spermicidal coating does not increase protection against pregnancy or sexually transmitted infections. In typical use, the male condom has a first year failure rate of 18%, but if used correctly and consistently, the pregnancy rate is 2%. The latex male condom is the most effective method available to reduce the risk of sexually transmitted infections (STIs) and Zika virus infection in at-risk couples. It is thought that the polyurethane and polyisoprene condoms also provide the same level of protection against protozoan, bacterial and viral sexually transmitted infections. Condoms made of animal tissue (“natural” condoms) do not provide protection against viral STDs, including Zika virus. Condom failure may be reduced by selecting the correct size and by using additional water-based external lubricant or spermicide vaginally or on the outside of the condom.

SUBJECTIVE

Mustinclude:

1. Willingnessofmantousecondomsconsistently.

2. Zika Risk Assessment

a.Travel-self and partner(s)

1)Past travel –last 8 months –where and when

2)Plans for future travel –where and when

Mustexclude:

Contraindications:

1. Allergy inpatientorpartnertoanycomponentofthecondom

(e.g.,latex,polyurethane,polyisopreneorNonoxynol-9). (CDC3)

2. Personalhistoryofhighslippageorbreakagerates,unlesscauseidentified.

OBJECTIVE

Not applicable

LABORATORY

Consider Zika screening if indicated by Zika assessment.

ASSESSMENT

Candidateforcondomuseasprimaryand/orback-upcontraceptivemethodand/orasmethodtoreducetheriskoftransmittingoracquiringsexuallytransmittedinfections, HIV and the Zika virus.

PLAN

  1. Determinesize/shapeofcondomsandappropriatecondommaterialneeded.
  2. Providecondomsandinstructionsoncondomuse.
  3. Offeremergencycontraceptioninadvanceofneed(seeEmergencyContraception[EC]protocol).
  4. Ifmanisunwillingtousemalecondomsforcontraception,suggestcoupleconsideranother method.

PATIENT EDUCATION

1. AdvisepatientthatcondomsareavailableOTCwithvariousfeaturesandindifferent sizes.

  1. Latexcondomswithreservoirtipsarehighlyrecommended(inabsenceoflatexallergy).
  2. The spermicidalcoatingofferedonsomemalecondomsdoesnotaddanyadditionalprotectionfrompregnancyorSTI.However,useofvaginalspermicidesorwater-based externallubricantmayreducecondomfailure.
  3. Polyurethaneandpolyisoprenecondomsarenotbiodegradablebutarepreferredifeither partnerhasalatexallergyorifwomanisusinga vaginalproductwithapetroleumbase (e.g.,antifungalorhormonalvaginalcreams).
  4. Lambcecum(AKA“skin”)condomsare rarelyrecommended.Theyshouldnotbeusedby anyoneatriskforSTDs, including Zika virus (not adequate barrier).

2. Instructpatientonproperstorageandcondomuse:

  1. Avoidsunlight,heat,andhumidityforstorageoflatexcondoms.
  2. Openpackagecarefullytoavoidtearingcondom.
  3. Placeanewcondomonpenisbeforeeachsexact,beforeanygenitalcontactandbeforeentryintoanyorificeinpartner’sbody(mouth,vagina,orrectum).
  1. Inanon-reservoirtipcondom,instructpatienttoleavea halfinchspaceemptyatendof condom to capture the ejaculate.
  2. Placenewcondomiforaloranalpenetrationoccurspriortovaginalpenetration.
  3. Lubricateoutsideofcondomadequatelywithspermicideorwater-solubleproduct(avoid petroleum-basedlubricantsorvaginalproductswithlatexcondomuse).
  4. Promptlyafterejaculation,graspthecondomatitsbase,andholditagainstthepenisand withdrawtheunitfromthewoman’svagina.
  5. Examinecondomafteritsremovalfromthepenistolookforevidenceofbreakageor spillage.
  6. Advisepatienttousetwolatexmalecondomsifpatientorpartnerhasanyvisiblelesions orifinfectionissuspectedandabstinenceisnotpossible.
  7. Advisepatienttoavoidplacinglubricantinsidethecondom.
  1. Instructpatientthatifthecondombreaksorspillsorisnotproperlyapplied,thewomanshould immediatelyplacespermicidalfoamin hervaginaand/orconsiderusingemergency contraception(seeEmergencyContraception[EC]protocol).
  2. Counselpatientthatcondomsmustbeplacedonpenisbeforeanygenitalcontactisallowed.
  3. Advisepatienttheuseoflatex(andprobablyalsopolyurethaneandpolyisoprene)condomscan significantlyreducetheriskoftransmission/acquisitionofSTDssuchasgonorrhea,chlamydia, herpes,HI,HPV, Zikavirus, andsyphilis,especiallyiftheyareusedcorrectlyandconsistently,even thoughthecondomsdonotcoverall areasatriskforinfectionortransmission.
  4. Instructpatientnottousemalecondomwithfemalecondom (increases the risk of breakage).
  5. Zika virus education and prevention strategies

a)Avoid traveling to impacted areas

b)Avoiding mosquito bites if traveling to impacted areas

c)Using condoms to prevent transmission of virus

d)Avoiding pregnancy if infected or partner infected

1)Risk to unborn fetus

REFER TO MED/ER

Not applicable.

REFERENCES

  1. CentersforDiseaseControlandPrevention.U.S.medicaleligibilitycriteriaforcontraceptiveuse, 2016.Availableat
  2. HatcherRA,etal(editors).ContraceptiveTechnology,20thEd.NewYork:ArdentMedia,Inc. 2010:50,371-90.
  3. Centers for Disease Control and Prevention (CDC). Zika Virus Homepage-

Reviewed/Revised 2017

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