I always use a condom surely I don’t need a test?

Condoms are obviously an effective physical barrier against the risk of sexually transmitted infections, although they are much less protective when used incorrectly or inconsistently.

Usually when talking about condoms we mean either the male latex condom or the female (insertive or internal) condom. By its very nature the latex, or sometimes synthetic latex (nitrile) condom doesn't let infection through. But you need to consider the correct use of the condom itself to know know whether you are getting the full protection.

Research shows that incorrect condom use is surprisingly common. Types of incorrect use can include letting the condom break, slip or leak; using one that is too large or too small; using damaged condoms; reusing them; not pinching the tip before putting it on; using sharp objects to open the package or not holding the rim of the male condom when pulling out.

Even if the condom itself doesn't break or slip you could be putting yourself at risk by not using one right from the start of intercourse, or by putting it on the wrong way and then putting it back on. All of these things can increase your risk of contracting an STI.

Male and female condoms

Using a female condom can go wrong in other ways, for example the penis can go into the wrong place, entering the gap between the vaginal wall and the condom; or the outer ring of the condom can be pushed inside.

It is important to remember that most STIs, including HIV, are contracted through contact with body fluids. Male condoms can reduce the risk of STI transmission through oral and vaginal sex but the effectiveness of the female condom in this respect has not been studied.

In studies, many couples who reported using condoms on a regular basis were not necessarily using them correctly every time. For couples who used condoms, their rate of infection was on average 80% lower than couples who said they never used condoms.

The research also shows that many couples are not comfortable being honest about how they use condoms, either not remembering their condom use in detail or not wanting to say. It is quite likely that they didn't use a condom for every single sex act or they there were engaging in risky behaviours with other casual partners.

Skin to skin contact

It may not be widely known, but not all STIs are contracted the same way. Whilst gonorrhoea, chlamydia and trichomoniasis are primarily transmitted through contact with infected fluids, such as semen, vaginal fluid and rectal fluid. Genital herpes (herpes simplex Type 2 or HSV-2), syphilis and genital warts (human papillomavirus or HPV) are primarily transmitted through contact with infected skin.

Several studies suggest male condoms can reduce, but not eliminate, the transmission of genital warts, genital herpes, syphilis, chlamydia, gonorrhoea and trichomoniasis.

However, other studies have found that condom use did not reduce the risk of STI transmission. These results were likely due to inconsistent and incorrect use of condoms.

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