A Penn State researcher expects to see a major spike in sexually transmitted infections, or STI cases by March. Casey Pinto, assistant professor of public health at Penn State University, told The Confluence that she plans to research STI rates next month.
Showing posts with label Human sexual behaviour. Show all posts
Showing posts with label Human sexual behaviour. Show all posts
Friday, February 19
Friday, December 17
Human sexual behaviour
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| Human sexual behaviour, |
Human sexual activities or human sexual practices or human sexual behavior refers to the manner in which humans experience and express their sexuality. People engage in a variety of sexual acts from time to time, and for a wide variety of reasons. Sexual activity normally results in sexual arousal and physiological changes in the aroused person, some of which are pronounced while others are more subtle. The objective of sexual activity in humans is typically to achieve orgasm. Sexual activity also includes conduct and activities which are intended to arouse the sexual interest of another, such as strategies to find or attract partners (mating and display behavior), and personal interactions between individuals, such as flirting and foreplay.
Human sexual activity has biological, physical and emotional aspects. Biologically, it refers to the reproductive mechanism as well as the basic biological drive that exists in all species and can encompass sexual intercourse and sexual contact in all its forms. Emotional aspects deal with the intense personal bonds and emotions generated between sexual partners by a sexual activity. Physical issues around sexuality range from purely medical considerations to concerns about the physiological or even psychological and sociological aspects of sexual behaviour.
In some cultures sexual activity is considered acceptable only within marriage, although premarital and extramarital sex are universal. Some sexual activities are illegal either universally or in some countries, and some are considered against the norms of a society. For example, sexual activity with a person below some age of consent and sexual assault in general are criminal offenses in many jurisdictions.
Types of sexual activity
Sexual activity can be classified in a number of ways. It can refer to acts which involve one person, such as masturbation, or to two people, such as sexual intercourse, oral sex, or mutual masturbation. If there are more than two participants in the sex act, it may be referred to as group sex. Autoerotic sexual activity can involve use of dildos, vibrators, anal beads, sybian machines, and other sex toys,[citation needed] though these devices can also be used with a partner.
Sexual activity can be classified into the gender and sexual orientation of the participants.
Sexual activity can also be classified according to the relationship of the participants. For example, the relationships can be ones of marriage, intimate partners, casual sex partners or anonymous. Sexual activity can be regarded as conventional or as alternative, involving, for example, fetishism and/or BDSM activities.
Sexual activity can be consensual or under force or duress. It may be lawful or illegal or otherwise be contrary to social norms or generally accepted sexual morals.
Reasons for sexual activity
People engage in sexual activity for any of a multitude of possible reasons.
Most people engage in sexual activity because of the sexual pleasure they derive from the activity, in which the most heightened pleasure is derived through orgasm. Erotic pleasure can also be experienced during foreplay and from flirting, and from fetish or BDSM activities. The most common pleasurable sexual activities are sexual intercourse (including foreplay) and masturbation.
Most commonly, people engage in sexual activity with a person to whom they are sexually attracted; but at times, a person may engage in a sexual activity solely for the sexual pleasure of the partner, such as because of an obligation they may have to the partner or because of sympathy or pity they may feel for the partner.
Also, a person may engage in sexual activity for purely monetary considerations, or to obtain some advantage from either the partner or the activity. Furthermore, a man and woman may engage in sexual intercourse with the objective of conception. Some people engage in hate sex, which occurs between two people who strongly dislike or annoy each other. It is related to the idea that opposition between two people can heighten sexual tension, attraction and interest.
Aspects of human sexual behavior
Cultural aspects
As with other behaviors, human intelligence and social complexity have yielded the most complicated sexual behavior of any animal. Most people experiment with a range of sexual activities during their lives, though they tend to engage in only a few of these regularly. Most people enjoy some sexual activities. Some people enjoy many different sexual activities, while others avoid sexual activities altogether for religious or other reasons (see chastity, sexual abstinence, asexuality). Some prefer monogamous relationships for sex, and others may prefer many different partners throughout their lives.
Social aspects
See also Sex education
Alex Comfort and others propose three potential social aspects of intercourse in humans, which are not mutually exclusive: reproductive, relational, and recreational. The development of the contraceptive pill and other highly effective forms of contraception in the mid- and late 20th century has increased people's ability to segregate these three functions, which still overlap a great deal and in complex patterns. For example: A fertile couple may have intercourse while using contraception to experience sexual pleasure (recreational) and also as a means of emotional intimacy (relational), thus deepening their bonding, making their relationship more stable and more capable of sustaining children in the future (deferred reproductive). This same couple may emphasize different aspects of intercourse on different occasions, being playful during one episode of intercourse (recreational), experiencing deep emotional connection on another occasion (relational), and later, after discontinuing contraception, seeking to achieve pregnancy (reproductive, or more likely reproductive and relational).
Frequency of sexual activity
The frequency of sexual intercourse might range from zero (sexual abstinence) to 15 or 20 times a week. In America, the average frequency of sexual intercourse for married couples is 2 to 3 times a week. It is generally recognized that postmenopausal women experience declines in frequency of sexual intercourse and that average frequency of intercourse declines with age. According to the Kinsey Institute, average frequency of sexual intercourse in US is 112 times per year (age 18-29), 86 times per year (age 30-39), and 69 times per year (age 40-49).
Safety aspects
A rolled up male condom
There are three main types of risks that arise from sexual activity. These are an unwanted pregnancy, contracting a sexually transmitted disease, or a physical injury.
Sexual activity that involves sexual intercourse or even contact of semen with the vagina or vulva carries the chance of pregnancy. People who want to engage in such behaviors with a reduced chance of pregnancy employ any of a variety of available contraception methods, such as birth control pills, the use of a condom, diaphram, spermicides, hormonal contraception, and sterilization.
Sexual activity that involves contact with another person's bodily fluids carries the risk of contracting a sexually transmitted disease such as those arising from HIV/AIDS, chlamydia, syphilis, gonorrhea, and HPV. Safer sex practices try to reduce these risks. These precautions are often seen as less necessary for sex partners in committed relationships, if they are known to be free of disease. Some people require potential sex partners to be tested for sexually transmitted diseases before engaging in sex.
Physical risks vary with the type of sexual activity being engaged in. The medical condition and physical limitations of the participants must be kept in mind.
The risk factors are increased by a condition (temporary or permanent) which impairs a person's judgment, such as excess alcohol or other drugs, or emotional states such as loneliness, depression or euphoria. Age and mental capacity of the participants can also effect the risks of sexual activity.
Sexual morality and social norms
Main articles: Sexual morality, Religion and sexuality, and Norm (sociology)
Most world religions have sought to address the moral issues that arise from people's sexuality in society and in human interactions. Each major religion has developed moral codes covering issues of sexuality, morality, ethics etc. Though these moral codes do not address issues of sexuality directly, they seek to regulate the situations which can give rise to sexual interest and to influence people's sexual activities and practices. However, the impact of religious teaching has at times been limited. For example, though most religions disapprove of extramarital sexual relations, it has always been widely practiced. Nevertheless, these religious codes have always had a strong influence on peoples' attitudes to issues of modesty in dress, behaviour, speech etc.
On the other hand, some people adopt the view that pleasure is its own justification for sexual activity. Hedonism is a school of thought which argues that pleasure is the only intrinsic good.
Human sexual activity, like many other kinds of activity engaged in by humans, is generally influenced by social rules that are culturally specific and vary widely. These social rules are referred to as sexual morality (what can and can not be done by society's rules) and sexual norms (what is and is not expected).
Sexual ethics, morals, and norms relate to issues including deception/honesty, legality, fidelity and consent. Some activities, known as sex crimes in some locations, are illegal in some jurisdictions, including those conducted between (or among) consenting and competent adults (examples include sodomy law and adult-adult incest).
Some people who are in a relationship but want to hide homosexual or heterosexual activity from their partner, may solicit consensual sexual activity with others through personal contacts, online chat rooms, or, advertising in select media.
Some people engage in various sexual activities as a business transaction. When this involves having sex with, or performing certain actual sexual acts for another person in exchange for money or something of value, it is called prostitution. Other aspects of the adult industry include (for example) telephone sex operators, strip clubs, pornography and the like.
Legal issues
Sex and the law
There are many laws and social customs which prohibit, or in some way have an impact on sexual activities. These laws and customs vary from country to country, and have varied over time. They cover, for example, a prohibition to non-consensual sex, to sex outside of marriage, to sexual activity in public, besides many others. Many of these restrictions are non-controversial, but some have been the subject of public debate.
Most societies consider it a serious crime to force someone to engage in sexual acts or to engage in sexual activity with someone who does not consent. This is called sexual assault, and if sexual penetration occurs it is called rape, the most serious kind of sexual assault. The details of this distinction may vary among different legal jurisdictions. Also, what constitutes effective consent in sexual matters varies from culture to culture and is frequently debated. Laws regulating the minimum age at which a person can consent to have sex (age of consent) are frequently the subject of debate, as is adolescent sexual behavior in general. Some societies have forced marriage, where consent may not be required.
Same sex laws
See also Same sex marriage
Many countries used to have laws prohibiting same-sex sexual activity, though these have been largely removed by many countries.
Minimum age of sexual activity (age of consent)
The laws of each jurisdiction set the minimum age at which a young person is allowed to engage in sexual activity. The median age of consent seems to range from 16 to 18 years, but laws stating ages ranging from 9 to 21 do exist. In many jurisdictions, age of consent is a person's mental or functional age. As a result, victims can be of any chronological age if their mental age is below the age of consent. Many jurisdictions regard any sexual activity by an adult involving a child as child sexual abuse.
Some jurisdictions forbid sexual activity outside of legal marriage completely. The relevant age may also vary by the type of sexual act, the sex of the actors, or other restrictions such as abuse of a position of trust. Some jurisdictions may also make allowances for minors engaged in sexual acts with each other, rather than a hard and fast single age.
Incestuous relationships
Most jurisdictions prohibit sexual activity between certain close relatives. These laws vary to some extent, such acts are called incestuous.
Sexual abuse
See also Child sex abuse
Non-consensual sexual activity or subjecting an unwilling person to witnessing a sexual activity are forms of sexual abuse, as well as (in many countries) certain non-consensual paraphilias such as frotteurism, telephone scatophilia (indecent phonecalls), and non-consensual exhibitionism and voyeurism (known as "indecent exposure" and "peeping tom" respectively).
Sexual activity and orientations
Heterosexuality
Heterosexual sexual practices are subject to laws in many places. In some countries, mostly those where religion has a strong influence on social policy, marriage laws serve the purpose of encouraging people to have sex only within marriage. Sodomy laws were seen as discouraging same-sex sexual practices, but may affect opposite-sex sexual practices. Laws also ban adults from committing sexual abuse, committing sexual acts with anyone under an age of consent, performing sexual activities in public, and engaging in sexual activities for money (prostitution). Though these laws cover both same-sex and opposite-sex sexual activities, they may differ in regard to punishment, and may be more frequently (or exclusively) enforced on those who engage in same-sex sexual activities.
Different-sex sexual practices may be monogamous, serially monogamous, or polyamorous, and, depending on the definition of sexual practice, abstinent or autoerotic (including masturbation).
Different religious and political movements have tried to influence or control changes in sexual practices including courting and marriage, though in most countries changes occur at a slow rate.
Homosexuality
People with a homosexual orientation can express their sexuality in a variety of ways, and may or may not express it in their behaviors. Some have sexual relationships predominately with people of their own gender identity, another gender, bisexual relationships or they can be celibate. Research indicates that many lesbians and gay men want, and succeed in having, committed and durable relationships. For example, survey data indicate that between 40% and 60% of gay men and between 45% and 80% of lesbians are currently involved in a romantic relationship.
It is possible for a person whose sexual identity is mainly heterosexual to engage in sexual acts with people of the same sex. For example, mutual masturbation in the context of what may be considered normal heterosexual teen development. Gay, lesbian, and bisexual people who pretend to be heterosexual are often referred to as being closeted, hiding their sexuality in "the closet". "Closet case" is a derogatory term used to refer to people who hide their sexuality. Making that orientation (semi-) public can be called "coming out of the closet" in the case of voluntary disclosure or "outing" in the case of disclosure by others against the subject's wishes. Among some communities (called "men on the DL" or "down-low"), same-sex sexual behavior is sometimes viewed as solely for physical pleasure. Men on the "down-low" may engage in sex acts with other men while continuing sexual and romantic relationships with women.
The definition of homosexuality is a preference to members of one's own sex, though people who engage exclusively in same-sex sexual practices may not identify themselves as bisexual, gay or lesbian. In sex-segregated environments, individuals may seek relationships with others of their own gender (known as situational homosexuality). In other cases, some people may experiment or explore their sexuality with same (and/or different) sex sexual activity before defining their sexual identity. Despite stereotypes and common misconceptions, there are no forms of sexual activity exclusive to same-sex sexual behavior that can not also be found in opposite-sex sexual behavior, save those involving contact of the same sex genitalia such as tribadism and frot.
Alternative practices
Some people derive sexual pleasure from engaging in variety of alternative sexual practices, such as fetishism and/or BDSM activities.
BDSM often involves a consensual power exchange, whereby one person submits to the control of a dominating partner. These practices can include spanking, bondage, role playing, role reversals, and raising endorphins through the use of whips, floggers and other implements.
Fetishism can take many forms ranging from the desire for certain body parts, for example large breasts, armpits or foot worship. The object of desire can often be shoes, boots, lingerie, clothing, leather or rubber items.
Some non-conventional autoerotic practices can be dangerous. These include erotic asphyxiation and self-bondage. The potential for injury or even death that exists while engaging in the partnered versions of these fetishes (choking and bondage, respectively) becomes drastically increased in the autoerotic case due to the isolation and lack of assistance in the event of a problem.
(source:wikipedia)
Tuesday, September 28
Sexual intercourse
The missionary position of human sexual
intercourse depicted by Édouard
-Henri Avril
Sexual intercourse, also known as copulation or coitus, commonly refers to the act in which the male reproductive organ enters the female reproductive tract. The two entities may be of opposite sexes, or they may be hermaphroditic, as is the case with snails. Over time, the definition expanded and may now include other penetrative sexual acts, such as penetration of non-sexual organs (oral intercourse, anal intercourse) or by non-sexual organs (fingering, etc.). For example, penetrative acts between same-sex individuals can also be regarded as sexual intercourse.
Sexual intercourse typically plays a powerful role in human bonding, often being used solely for pleasure and leading to stronger emotional bonds. Non-penetrative sex (oral sex may or may not be penetrative) and mutual masturbation have been referred to as "outercourse", as it contrasts "outer" with "inter" (though the "inter" in "intercourse" means between two beings rather than being inside or outside of the body), but may also be among the sexual acts contributing to human bonding and considered intercourse. Despite strict definitions of sex, in the context of sexual intimacy (such as ones relating to "technical virginity"), it can be taken to mean any mutual genital stimulation (i.e. all forms of intercourse and outercourse). As with most forms of sexual interaction, individuals are at risk for contracting sexually transmitted diseases, and thus safe sex practises are advised.
Modern Judaism, Christianity, and Islam view sexual intercourse between husband and wife as a spiritual and edifying action. The limits of marriage and concubinage within these traditions has changed over time, along with corresponding views of acceptable sexual behavior. The teachings of Hinduism and Buddhism on sexuality have differing interpretations. Buddhism's injunction to "refrain from sexual misconduct" finds its interpretation and practical definitions at the level of the individual. However, within each of these major religious traditions exists subgroups with varying stances on acceptable sexual practices, and some religious groups prohibit monks and nuns from engaging in sexual intercourse altogether.
Mating is the term most often used to refer to sexual intercourse between animals other than humans; for most, mating occurs at the point of estrus (the most fertile period of time in the female's reproductive cycle), which increases the chances of successful impregnation. However, bonobos, dolphins,and chimpanzees are known to engage in sexual intercourse even when the female is not in estrus, and to engage in sex acts with same-sex partners. Like humans engaging in sex primarily for pleasure, this behavior in the above mentioned animals is also presumed to be for pleasure, and a contributing factor to strengthening their social bonds.
Practices of human relations
Bonding and affection
Human sexual behavior and Human sexuality
In animals, sexual intercourse ranges from a purely reproductive activity to one of emotional bonding between mated pairs. It typically plays a powerful role in human bonding. In many societies, for example, it is normal for couples to have frequent intercourse while using birth control, sharing pleasure and strengthening their emotional bond through sex even though they are deliberately avoiding pregnancy.
In humans and bonobos, the female undergoes relatively concealed ovulation so that both male and female partners commonly do not know whether she is fertile at any given moment. One possible reason for this distinct biological feature may be formation of strong emotional bonds between sexual partners important for social interactions and, in the case of humans, long-term partnership rather than immediate sexual reproduction.
Humans, bonobos, dolphins, and chimpanzees are all intelligent social animals, whose cooperative behavior proves far more successful than that of any individual alone. In these animals, the use of sex has evolved beyond reproduction, to apparently serve additional social functions. Sex reinforces intimate social bonds between individuals to form larger social structures. The resulting cooperation encourages collective tasks that promote the survival of each member of the group.
The concept of "love" belongs to the domain of the virtues and to higher cognitive function, and is thus generally reserved for humans. When applied to animals, "love" is used largely for its colloquial meaning. In certain contexts, such as scientific research into emotional bonding, "love" is given a neuroscientific or neurochemical definition (rather than a human or a virtuous definition), and in such contexts human and animal intercourse are considered equivalent.
Reproduction and sexual practices
Vaginal sexual intercourse, also called coitus, is the human form of copulation. While its natural purpose and result is reproduction, it is often performed entirely for pleasure and/or as an expression of love and emotional intimacy. Coitus is the basic reproductive method of humans. During ejaculation, which usually accompanies male orgasm, a series of muscular contractions delivers semen containing male gametes known as sperm cells or spermatozoa from the penis into the vagina. The subsequent route of the sperm from the vault of the vagina is through the cervix and into the uterus, and then into the fallopian tubes. Millions of sperm are present in each ejaculation, to increase the chances of one fertilizing an egg or ovum (see sperm competition). When a fertile ovum from the female is present in the fallopian tubes, the male gamete joins with the ovum, resulting in fertilization and the formation of a new embryo. When a fertilized ovum reaches the uterus, it becomes implanted in the lining of the uterus, known as endometrium, and a pregnancy begins. Unlike most species, human sexual activity is not linked to periods of estrus and can take place at any time during the reproductive cycle, even during pregnancy.
Penetration by the hardened erect penis is additionally known as intromission, or by the Latin name immissio penis (Latin for "insertion of the penis"). Coitus may be preceded by foreplay, which leads to sexual arousal of the partners, resulting in the erection of the penis and natural lubrication of the vagina. To engage in coitus, the erect penis is inserted into the vagina and one or both of the partners move their hips to move the penis backward and forward inside the vagina to cause friction, typically without fully removing the penis. In this way, they stimulate themselves and each other, often continuing until orgasm in either or both partners is achieved. For females, stimulation of the clitoris plays a huge role in sexual intercourse; most can only achieve orgasm through clitoral stimulation.
Where a sperm donor has sexual intercourse with a woman who is not his partner, for the sole purpose of impregnating the woman, this practice may be known as natural insemination, or NI.
Sexual intercourse may also be defined as referring to other forms of insertive sexual behavior, such as oral sex and anal intercourse. Sexual acts, other than as a means of reproduction, are varied: Oral sex consists of all the sexual activities that involve the use of the mouth, tongue, and possibly throat to stimulate genitalia. It is sometimes performed to the exclusion of all other forms of sexual activity, and may include the ingestion or absorption of semen or vaginal fluids. While there are many sexual acts involving the anus, anal cavity, sphincter valve and/or rectum, the most common meaning of anal sex is the insertion of a man's penis into another person's rectum. Non-penetrative sex acts are also common. These acts are sometimes seen among heterosexuals as maintaining "technical virginity." Some gay men view frotting and oral sex as maintaining their virginity as well. The phrase to have sex can mean any or all of these behaviors (intercourse and outercourse).
Duration
Intercourse often ends when the man has ejaculated. Thus the woman might not have time to reach orgasm. In addition, many men suffer from premature ejaculation. Conversely, many women require a substantially longer duration of stimulation than men before reaching an orgasm.
According to a Kinsey study, just under half of men reported a time to ejaculation from intromission of five minutes or less.[citation needed] About a fifth claimed that coitus lasted 10 minutes or longer. Others may have taken over one hour.
A survey of Canadian and American sex therapists said that the average time for intromission was 7 minutes and that 1 to 2 minutes was too short, 3 to 7 minutes was adequate and 7 to 13 minutes desirable, while 10 to 30 minutes was too long.
Coitus difficulties
Anorgasmia is regular difficulty reaching orgasm after ample sexual stimulation, causing personal distress. This is much more common in women than men. The physical structure of the act of coitus favors penile stimulation over clitoral stimulation. The location of the clitoris then often necessitates manual stimulation in order for the female to achieve orgasm. About 15 percent of women report difficulties with orgasm, and as many as 10 percent of women in the United States have never climaxed. Even women who orgasm on a regular basis only climax about 50 to 70 percent of the time.
Vaginismus is involuntary tensing of the pelvic floor musculature, making coitus distressing, painful, and sometimes impossible for women. It is a conditioned reflex of the pubococcygeus muscle, sometimes referred to as the "PC muscle". Vaginismus can be a vicious cycle for women, they expect to experience pain during intercourse, which then causes a muscle spasm, which leads to painful intercourse. Treatment of vaginismus often includes both psychological and behavioral techniques, including the use of vaginal dilators. A new medical treatment using Botox is in the testing phase. Some women also experience dyspareunia, a medical term for painful or uncomfortable intercourse, of unknown cause.
About 40% of males suffer from some form of erectile dysfunction (ED) or impotence, at least occasionally. For those whose impotence is caused by medical conditions, prescription drugs such as Viagra, Cialis, and Levitra are available. However, doctors caution against the unnecessary use of these drugs because they are accompanied by serious risks such as increased chance of heart attack. Moreover, using a drug to counteract the symptom—impotence—can mask the underlying problem causing the impotence and does not resolve it. A serious medical condition might be aggravated if left untreated.
A more common sexual disorder in males is premature ejaculation (PE). The American Urological Association (AUA) estimates that premature ejaculation could affect 21 percent of men in the United States. The U.S. Food and Drug Administration is examining the drug dapoxetine to treat premature ejaculation. In clinical trials, those with PE who took dapoxetine experienced intercourse three to four times longer before orgasm than without the drug. Another ejaculation-related disorder is delayed ejaculation, which can be caused as an unwanted side effect of antidepressant medications such as Fluvoxamine.
Although disability-related pain and mobility impairment can hamper intercourse, in many cases the most significant impediments to intercourse for individuals with a disability are psychological. In particular, people who have a disability can find intercourse daunting due to issues involving their self-concept as a sexual being, or partner's discomfort or perceived discomfort.
Temporary difficulties can arise with alcohol and sex as alcohol initially increases interest (through disinhibition) but decreases capacity with greater intake.
Health effects of human relations
Benefits
In humans, sex has been claimed to produce health benefits as varied as improved sense of smell, stress and blood pressure reduction, increased immunity, and decreased risk of prostate cancer; however, there is insufficient research to support these claims. Sexual intimacy, as well as orgasms, increases levels of the hormone oxytocin, also known as "the love hormone", which helps people bond and build trust.
Risks
In contrast to its benefits, sexual intercourse can also be a disease vector. There are 19 million new cases of sexually transmitted diseases (STD) every year in the U.S., and worldwide there are over 340 million STDs a year. More than half of all STDs occur in adolescents and young adults aged 15–24 years. At least one in four U.S. teenage girls has a sexually transmitted disease. In the US, about 30% of 15–17 year old adolescents have had sexual intercourse, but only about 80% of 15–19 year old adolescents report using condoms for their first sexual intercourse. More than 75% of young women age 18–25 years felt they were at low risk of acquiring an STD in one study.
Chlamydia is particularly dangerous because there are many infected individuals who experience no symptoms. Left untreated, chlamydia can lead to many complications, especially for women.
Hepatitis B can also be trasmitted through sexual contact. The disease is most common in China and other parts of Asia where 8–10% of the adult population is infected with Hepatitis About a third of the world's population, more than 2 billion people, have been infected with the hepatitis B virus.
Syphilis infection are on the rise in all parts of the United States and is related to about 21% of fetal and newborn deaths in sub-Saharan Africa. Syphilis causes genital sores that make it easier to transmit and contract HIV.
AIDS is caused by HIV which is spread primarily via sexual intercourse. The World Health Organization reported that in 2008, approximately 33.4 million people had HIV (about 2/3 in sub-Saharan Africa and 1.1 million in the United States ) , and 2 million died of AIDS worldwide.
Safe sex is a relevant harm reduction philosophy. Condoms are widely recommended for the prevention of STDs. According to reports by the National Institutes of Health (NIH) and World Health Organization, correct and consistent use of latex condoms reduces the risk of HIV/AIDS transmission by approximately 85%–99% relative to risk when unprotected.
Social effects
Alex Comfort and others posit three potential advantages of intercourse in humans, which are not mutually exclusive: reproductive, relational, and recreational.While the development of the Pill and other highly effective forms of contraception in the mid- and late 20th century increased people's ability to segregate these three functions, they still overlap a great deal and in complex patterns. For example: A fertile couple may have intercourse while contracepting not only to experience sexual pleasure (recreational), but also as a means of emotional intimacy (relational), thus deepening their bonding, making their relationship more stable and more capable of sustaining children in the future (deferred reproductive). This same couple may emphasize different aspects of intercourse on different occasions, being playful during one episode of intercourse (recreational), experiencing deep emotional connection on another occasion (relational), and later, after discontinuing contraception, seeking to achieve pregnancy (reproductive, or more likely reproductive and relational).
Ethical, moral, and legal issues of human relations
Sexual ethics
Sex and religion
Erotic painting from India, 18th century
Erotic painting on ancient Greek kylix
While sexual intercourse is the natural mode of reproduction for the human species, we also have intricate moral and ethical guidelines which regulate the practice of sexual intercourse and that vary according to religious and governmental laws. These guidelines relate to the following areas:
Consent, age and mental capacity
Sexual intercourse with a person against their will, or without their informed legal consent, is referred to as rape, and is considered a serious crime in most countries. More than 90% of rape victims are female, 99% of rapists male, and only about 5% of rapists are strangers to the victims.
Most 'developed' countries have age of consent laws specifying the minimum legal age a person may engage in sexual intercourse with substantially older persons, usually set at about 16–18, while the legal age of consent ranges from 12–20 years of age or is not a matter of law in other countries. Sex with a person under the age of consent, regardless of their stated consent, is often considered to be sexual assault or statutory rape depending on differences in ages of the participants.
Some countries codify rape as any sex with a person of diminished or insufficient mental capacity to give consent, regardless of age.
Marital status
Sexual intercourse is commonly considered a 'marital right' by many religions, permissible to married couples generally for the purpose of reproduction. Today there is wide variation in the opinions and teachings about sexual intercourse relative to marriage by the world's religions. Examples:
Christianity commonly views sex in marriage as holy and for the purpose of reproduction.
Islam views sex within marriage as something pleasurable, a spiritual activity, and a duty.
In Shi'ia Islam, men are allowed to enter into an unlimited number of temporary marriages, which are contracted to last for a period of minutes to multiple years and permit sexual intercourse. Shi'ia women are allowed to enter only one marriage at a time, whether temporary or permanent.
Pagans believe that the Charge of the Goddess instructs that "...all acts of love and pleasure are [the Goddess'] rituals and by the Wiccan Rede: "An it harm none, do as thou wilt", which is interpreted by many as allowing and endorsing responsible sexual relationships of all varieties.
Hinduism has varied views about sexuality, but Hindu society, in general, perceives extramarital sex to be immoral and shameful.
Buddhist ethics, in its most common formulation, holds that one should neither be attached to nor crave sensual pleasure.
In the Bahá'í faith, sexual relationships are permitted only between a husband and wife.
Unitarian Universalists, with an emphasis on strong interpersonal ethics, do not place boundaries on the occurrence of sexual intercourse among consenting adults.
Shakers believe that sexual intercourse is the root of all sin and that all people should therefore be celibate, including married couples. Predictably, the original Shaker community that peaked at 6,000 full members in 1840 dwindled to three members by 2009.
Religious leadership
In some cases, the sexual intercourse between two people is seen as counter to religious law or doctrine. In many religious communities including the Roman Catholic Church and Mahayana Buddhists, religious leaders are expected to refrain from sexual intercourse in order to devote their full attention, energy, and loyalty to their religious duties.
Sexual orientation and gender
There is considerable legal variability regarding definitions of and the legality of sexual intercourse between persons of the same sex and/or gender. For example, in 2003 the New Hampshire Supreme Court ruled that female same-sex relations did not constitute sexual intercourse, based on a 1961 definition from Webster's Third New International Dictionary, in Blanchflower v. Blanchflower, and thereby an accused wife in a divorce case was found not guilty of adultery based on this technicality. Some countries, such as Islamic countries, consider homosexual behavior to be an offense punishable by imprisonment or execution.
Types
Some governments and religions also have strict designations of "appropriate" and "inappropriate" sexual behavior, which include restrictions on the types of sex acts which are permissible (see Sex and religion). A historically prohibited and/or regulated sex act is anal sex.
In other animals
Animal sexuality
A pair of lions copulating in the Maasai Mara, Kenya
Mating houseflies
Many animals which live in the water use external fertilization, whereas internal fertilization may have developed from a need to maintain gametes in a liquid medium in the Late Ordovician epoch. Internal fertilization with many vertebrates (such as reptiles, some fish, and most birds) occur via cloacal copulation (see also hemipenis), while mammals copulate vaginally, and many basal vertebrates reproduce sexually with external fertilization.
However, some terrestrial arthropods do use external fertilization. For primitive insects, the male deposits spermatozoa on the substrate, sometimes stored within a special structure, and courtship involves inducing the female to take up the sperm package into her genital opening; there is no actual copulation. In groups such as dragonflies and spiders, males extrude sperm into secondary copulatory structures removed from their genital opening, which are then used to inseminate the female (in dragonflies, it is a set of modified sternites on the second abdominal segment; in spiders, it is the male pedipalps). In advanced groups of insects, the male uses its aedeagus, a structure formed from the terminal segments of the abdomen, to deposit sperm directly (though sometimes in a capsule called a "spermatophore") into the female's reproductive tract.
Humans, bonobos, chimpanzees and dolphins are species known to engage in heterosexual behaviors even when the female is not in estrus, which is a point in her reproductive cycle suitable for successful impregnation. These species, and others, are also known to engage in homosexual behaviors. Humans, bonobos and dolphins are all intelligent social animals, whose cooperative behavior proves far more successful than that of any individual alone. In these animals, the use of sex has evolved beyond reproduction, to apparently serve additional social functions. Sex reinforces intimate social bonds between individuals to form larger social structures. The resulting cooperation encourages collective tasks that promote the survival of each member of the group.
(source:wikipedia)
Condom
In the modern age, condoms are most often made from latex, but some are made from other materials such as polyurethane, polyisoprene, or lamb intestine. A female condom is also available, most often made of polyurethane. As a method of birth control, male condoms have the advantage of being inexpensive, easy to use, having few side effects, and of offering protection against sexually transmitted diseases. With proper knowledge and application technique—and use at every act of intercourse—women whose partners use male condoms experience a 2% per-year pregnancy rate.
Condoms have been used for at least 400 years. Since the nineteenth century, they have been one of the most popular methods of contraception in the world. While widely accepted in modern times, condoms have generated some controversy, primarily over what role they should play in sex education classes.
History
A page from De Morbo Gallico (The French Disease), Gabriele Falloppio's treatise on syphilis. Published in 1564, it describes what is possibly the first use of condoms.
Main article: History of condoms
Before the 19th century
Whether condoms were used in ancient civilizations is debated by archaeologists and historians.:11 In ancient Egypt, Greece, and Rome, pregnancy prevention was generally seen as a woman's responsibility, and the only well documented contraception methods were female-controlled devices.:17,23 In Asia before the fifteenth century, some use of glans condoms (devices covering only the head of the penis) is recorded. Condoms seem to have been used for contraception, and to have been known only by members of the upper classes. In China, glans condoms may have been made of oiled silk paper, or of lamb intestines. In Japan, they were made of tortoise shell or animal horn.:60-1
In 16th century Italy, Gabriele Falloppio wrote a treatise on syphilis.:51,54-5 The earliest documented strain of syphilis, first appearing in Europe in a 1490s outbreak, caused severe symptoms and often death within a few months of contracting the disease. Falloppio's treatise is the earliest uncontested description of condom use: it describes linen sheaths soaked in a chemical solution and allowed to dry before use. The cloths he described were sized to cover the glans of the penis, and were held on with a ribbon.:51,54-5 Falloppio claimed that an experimental trial of the linen sheath demonstrated protection against syphilis.
After this, the use of penis coverings to protect from disease is described in a wide variety of literature throughout Europe. The first indication that these devices were used for birth control, rather than disease prevention, is the 1605 theological publication De iustitia et iure (On justice and law) by Catholic theologian Leonardus Lessius, who condemned them as immoral.:56 In 1666, the English Birth Rate Commission attributed a recent downward fertility rate to use of "condons", the first documented use of that word (or any similar spelling).:66-8
A condom made from animal intestine circa 1900.
In addition to linen, condoms during the Renaissance were made out of intestines and bladder. In the late 15th century, Dutch traders introduced condoms made from "fine leather" to Japan. Unlike the horn condoms used previously, these leather condoms covered the entire penis.:61
Giacomo Casanova tests his condom for holes by inflating it
Casanova in the 18th century was one of the first reported using "assurance caps" to prevent impregnating his mistresses.
From at least the 18th century, condom use was opposed in some legal, religious, and medical circles for essentially the same reasons that are given today: condoms reduce the likelihood of pregnancy, which some thought immoral or undesirable for the nation; they do not provide full protection against sexually transmitted infections, while belief in their protective powers was thought to encourage sexual promiscuity; and they are not used consistently due to inconvenience, expense, or loss of sensation.:73,86-8,92
Despite some opposition, the condom market grew rapidly. In the 18th century, condoms were available in a variety of qualities and sizes, made from either linen treated with chemicals, or "skin" (bladder or intestine softened by treatment with sulfur and lye).:94-5 They were sold at pubs, barbershops, chemist shops, open-air markets, and at the theater throughout Europe and Russia.:90-2,97,104 They later spread to America, although in every place there were generally used only by the middle and upper classes, due to both expense and lack of sex education.:116-21
1800 through 1920s
The early nineteenth century saw contraceptives promoted to the poorer classes for the first time. Writers on contraception tended to prefer other methods of birth control. Feminists of this time period wanted birth control to be exclusively in the hands of women, and disapproved of male-controlled methods such as the condom.:129,152-3 Other writers cited both the expense of condoms and their unreliability (they were often riddled with holes, and often fell off or broke), but they discussed condoms as a good option for some, and as the only contraceptive that also protected from disease.:88,90,125,129-30
Many countries passed laws impeding the manufacture and promotion of contraceptives.:144,163-4,168-71,193 In spite of these restrictions, condoms were promoted by traveling lecturers and in newspaper advertisements, using euphemisms in places where such ads were illegal.:127,130-2,138,146-7 Instructions on how to make condoms at home were distributed in the United States and Europe.:126,136 Despite social and legal opposition, at the end of the nineteenth century the condom was the Western world's most popular birth control method.:173-4
During World War I, the U.S. military was the only one that did not promote condom use. Posters such as these were intended to promote abstinence.
Beginning in the second half of the nineteenth century, American rates of sexually transmitted diseases skyrocketed. Causes cited by historians include effects of the American Civil War, and the ignorance of prevention methods promoted by the Comstock laws.:137-8,159 To fight the growing epidemic, sex education classes were introduced to public schools for the first time, teaching about venereal diseases and how they were transmitted. They generally taught that abstinence was the only way to avoid sexually transmitted diseases.:179-80 Condoms were not promoted for disease prevention because the medical community and moral watchdogs considered STDs to be punishment for sexual misbehavior. The stigma against victims of these diseases was so great that many hospitals refused to treat people who had syphilis.:176
The German military was the first to promote condom use among its soldiers, beginning in the later 1800s.:169,181 Early twentieth century experiments by the American military concluded that providing condoms to soldiers significantly lowered rates of sexually transmitted diseases.:180-3 During World War I, the United States and (at the beginning of the war only) Britain were the only countries with soldiers in Europe who did not provide condoms and promote their use.:187-90
In the decades after World War I, there remained social and legal obstacles to condom use throughout the U.S. and Europe.:208-10 Founder of psychoanalysis Sigmund Freud opposed all methods of birth control on the grounds that their failure rates were too high. Freud was especially opposed to the condom because he thought it cut down on sexual pleasure. Some feminists continued to oppose male-controlled contraceptives such as condoms. In 1920 the Church of England's Lambeth Conference condemned all "unnatural means of conception avoidance." London's Bishop Arthur Winnington-Ingram complained of the huge number of condoms discarded in alleyways and parks, especially after weekends and holidays.:211-2
However, European militaries continued to provide condoms to their members for disease protection, even in countries where they were illegal for the general population.:213-4 Through the 1920s, catchy names and slick packaging became an increasingly important marketing technique for many consumer items, including condoms and cigarettes.:197 Quality testing became more common, involving filling each condom with air followed by one of several methods intended to detect loss of pressure.:204,206,221-2 Worldwide, condom sales doubled in the 1920s.:210
Rubber and manufacturing advances
In 1839, Charles Goodyear discovered a way of processing natural rubber, which is too stiff when cold and too soft when warm, in such a way as to make it elastic. This proved to have advantages for the manufacture of condoms; unlike the sheeps' gut condoms, they could stretch and did not tear quickly when used. The rubber vulcanization process was patented by Goodyear in 1844. The first rubber condom was produced in 1855. The earliest rubber condoms had a seam and were as thick as a bicycle inner tube. Besides this type, small rubber condoms covering only the glans were often used in England and the United States. There was more risk of losing them and if the rubber ring was too tight, it would constrict the penis. This type of condom was the original "capote" (French for condom), perhaps because of its resemblance to a woman's bonnet worn at that time, also called a capote.
For many decades, rubber condoms were manufactured by wrapping strips of raw rubber around penis-shaped molds, then dipping the wrapped molds in a chemical solution to cure the rubber.:148 In 1912, a German named Julius Fromm developed a new, improved manufacturing technique for condoms: dipping glass molds into a raw rubber solution. Called cement dipping, this method required adding gasoline or benzene to the rubber to make it liquid.:200 Latex, rubber suspended in water, was invented in 1920. Latex condoms required less labor to produce than cement-dipped rubber condoms, which had to be smoothed by rubbing and trimming. The use of water to suspend the rubber instead of gasoline and benzene eliminated the fire hazard previously associated with all condom factories. Latex condoms also performed better for the consumer: they were stronger and thinner than rubber condoms, and had a shelf life of five years (compared to three months for rubber).:199-200
Until the twenties, all condoms were individually hand-dipped by semiskilled workers. Throughout the decade of the 1920s, advances in the automation of the condom assembly line were made. The first fully automated line was patented in 1930. Major condom manufacturers bought or leased conveyor systems, and small manufacturers were driven out of business.:201-3 The skin condom, now significantly more expensive than the latex variety, became restricted to a niche high-end market.:220
1930 to present
In 1930 the Anglican Church's Lambeth Conference sanctioned the use of birth control by married couples. In 1931 the Federal Council of Churches in the U.S. issued a similar statement.:227 The Roman Catholic Church responded by issuing the encyclical Casti Connubii affirming its opposition to all contraceptives, a stance it has never reversed.:228-9
In the 1930s, legal restrictions on condoms began to be relaxed.:216,226,234But during this period Fascist Italy and Nazi Germany increased restrictions on condoms (limited sales as disease preventatives were still allowed).:252,254-5 During the Depression, condom lines by Schmid gained in popularity. Schmid still used the cement-dipping method of manufacture which had two advantages over the latex variety. Firstly, cement-dipped condoms could be safely used with oil-based lubricants. Secondly, while less comfortable, these older-style rubber condoms could be reused and so were more economical, a valued feature in hard times.:217-9 More attention was brought to quality issues in the 1930s, and the U.S. Food and Drug Administration began to regulate the quality of condoms sold in the United States.:223-5
Throughout World War II, condoms were not only distributed to male U.S. military members, but also heavily promoted with films, posters, and lectures.:236-8,259 European and Asian militaries on both sides of the conflict also provided condoms to their troops throughout the war, even Germany which outlawed all civilian use of condoms in 1941.:252-4,257-8 In part because condoms were readily available, soldiers found a number of non-sexual uses for the devices, many of which continue to this day.
After the war, condom sales continued to grow. From 1955–1965, 42% of Americans of reproductive age relied on condoms for birth control. In Britain from 1950–1960, 60% of married couples used condoms. The birth control pill became the world's most popular method of birth control in the years after its 1960 début, but condoms remained a strong second. The U.S. Agency for International Development pushed condom use in developing countries to help solve the "world population crises": by 1970 hundreds of millions of condoms were being used each year in India alone.:267-9,272-5 (This number has grown in recent decades: in 2004, the government of India purchased 1.9 billion condoms for distribution at family planning clinics.)
In the 20th century the invention of plastic and other man-made materials did not lead to an improvement in the quality of condoms. However the deterioration of the rubber became less rapid. Condoms became not only thinner but also more reliable. In 1995, plastic condoms went on the market in the USA.
In the 1960s and 1970s quality regulations tightened, and more legal barriers to condom use were removed.:276-9 In Ireland, legal condom sales were allowed for the first time in 1978.:329-30 Advertising, however was one area that continued to have legal restrictions. In the late 1950s, the American National Association of Broadcasters banned condom advertisements from national television: this policy remained in place until 1979.:273-4,285
After learning in the early 1980s that AIDS can be a sexually transmitted infection, the use of condoms was encouraged to prevent transmission of HIV. Despite opposition by some political, religious, and other figures, national condom promotion campaigns occurred in the U.S. and Europe.:299,301,306-7,312-8 These campaigns increased condom use significantly.:309-17
Due to increased demand and greater social acceptance, condoms began to be sold in a wider variety of retail outlets, including in supermarkets and in discount department stores such as Wal-Mart.:305 Condom sales increased every year until 1994, when media attention to the AIDS pandemic began to decline.:303-4 The phenomenon of decreasing use of condoms as disease preventatives has been called prevention fatigue or condom fatigue. Observers have cited condom fatigue in both Europe and North America. As one response, manufacturers have changed the tone of their advertisements from scary to humorous.:303-4 New developments continue to occur in the condom market, with the first polyurethane condom—branded Avanti and produced by the manufacturer of Durex—introduced in the 1990s:324-5 and the first custom sized-to-fit condom, called TheyFit, introduced in 2003. Worldwide condom use is expected to continue to grow: one study predicted that developing nations would need 18.6 billion condoms by 2015:342 Condoms have become an integral part of modern societies.
In March 2010, Switzerland announced that its government was planning to manufacture smaller condoms meant for boys of 12–14 years old. Called the Hotshot, the condom has been produced after government research showed 12 to 14-year-olds did not use sufficient protection when having sex. A standard condom has a diameter of 2 inches (5.2 cm) in comparison with the Hotshot's diameter of 1.7 inches (4.5 cm). Both are the same length – 7.4 inches (19 cm). According to a German study of 12,970 13 to 20-year-olds, a quarter of those surveyed said a standard condom was too large. Family planning groups and the Swiss Aids Federation campaigned to have the Hotshot produced after a number of studies, including the government study researched at the Centre for Development and Personality Psychology at Basel University
Etymology and other terms
The term condom first appears in the early 18th century. Its etymology is unknown. In popular tradition, the invention and naming of the condom came to be attributed to an associate of England's King Charles II, one "Dr. Condom" or "Earl of Condom". There is however no evidence of the existence of such a person, and condoms had been used for over one hundred years before King Charles II ascended to the throne.:54,68
A variety of unproven Latin etymologies have been proposed, including condon (receptacle), condamina (house), and cumdum (scabbard or case).:70-1 It has also been speculated to be from the Italian word guantone, derived from guanto, meaning glove. William E. Kruck wrote an article in 1981 concluding that, "As for the word 'condom', I need state only that its origin remains completely unknown, and there ends this search for an etymology." Modern dictionaries may also list the etymology as "unknown".
Other terms are also commonly used to describe condoms. In North America condoms are also commonly known as prophylactics, or rubbers. In Britain they may be called French letters. Additionally, condoms may be referred to using the manufacturer's name.
Varieties
Most condoms have a reservoir tip or teat end, making it easier to accommodate the man's ejaculate. Condoms come in different sizes, from oversized to snug and they also come in a variety of surfaces intended to stimulate the user's partner. Condoms are usually supplied with a lubricant coating to facilitate penetration, while flavored condoms are principally used for oral sex. As mentioned above, most condoms are made of latex, but polyurethane and lambskin condoms are also widely available.
Materials
Natural latex
An unrolled latex condom
Latex has outstanding elastic properties: Its tensile strength exceeds 30 MPa, and latex condoms may be stretched in excess of 800% before breaking. In 1990 the ISO set standards for condom production (ISO 4074, Natural latex rubber condoms), and the EU followed suit with its CEN standard (Directive 93/42/EEC concerning medical devices). Every latex condom is tested for holes with an electrical current. If the condom passes, it is rolled and packaged. In addition, a portion of each batch of condoms is subject to water leak and air burst testing.
While the advantages of latex have made it the most popular condom material, it does have some drawbacks. Latex condoms are damaged when used with oil-based substances as lubricants, such as petroleum jelly, cooking oil, baby oil, mineral oil, skin lotions, suntan lotions, cold creams, butter or margarine. Contact with oil makes latex condoms more likely to break or slip off due to loss of elasticity caused by the oils. Additionally, latex allergy precludes use of latex condoms and is one of the principal reasons for the use of other materials. In May 2009 the U.S. Food and Drug Administration granted approval for the production of condoms composed of Vytex, latex that has been treated to remove 90% of the proteins responsible for allergic reactions.[28] An allergen-free condom made of synthetic latex (polyisoprene) is also available.
Synthetic
The most common non-latex condoms are made from polyurethane. Condoms may also be made from other synthetic materials, such as AT-10 resin, and most recently polyisoprene.
Polyurethane condoms tend to be the same width and thickness as latex condoms, with most polyurethane condoms between 0.04 mm and 0.07 mm thick. Polyurethane is also the material of many female condoms.
Polyurethane can be considered better than latex in several ways: it conducts heat better than latex, is not as sensitive to temperature and ultraviolet light (and so has less rigid storage requirements and a longer shelf life), can be used with oil-based lubricants, is less allergenic than latex, and does not have an odor. Polyurethane condoms have gained FDA approval for sale in the United States as an effective method of contraception and HIV prevention, and under laboratory conditions have been shown to be just as effective as latex for these purposes.
However, polyurethane condoms are less elastic than latex ones, and may be more likely to slip or break than latex, and are more expensive.
Polyisoprene is a synthetic version of natural rubber latex. While significantly more expensive, it has the advantages of latex (such as being softer and more elastic than polyurethane condoms) without the protein which is responsible for latex allergies.
Lambskin
Condoms made from sheep intestines, labeled "lambskin", are also available. They provide more sensation and are less allergenic than latex. However, there is an increased risk of transmitting STDs compared to latex because of pores in the material, which are thought to be large enough to allow infectious agents to pass through, albeit blocking the passage of sperm. Lambskin condoms are also significantly more expensive than other types.
Spermicidal
Some latex condoms are lubricated at the manufacturer with a small amount of a nonoxynol-9, a spermicidal chemical. According to Consumer Reports, condoms lubricated with spermicide have no additional benefit in preventing pregnancy, have a shorter shelf life, and may cause urinary-tract infections in women. In contrast, application of separately packaged spermicide is believed to increase the contraceptive efficacy of condoms.
Nonoxynol-9 was once believed to offer additional protection against STDs (including HIV) but recent studies have shown that, with frequent use, nonoxynol-9 may increase the risk of HIV transmission.[38] The World Health Organization says that spermicidally lubricated condoms should no longer be promoted. However, it recommends using a nonoxynol-9 lubricated condom over no condom at all. As of 2005, nine condom manufacturers have stopped manufacturing condoms with nonoxynol-9 and Planned Parenthood has discontinued the distribution of condoms so lubricated.
Textured
Textured condoms include studded and ribbed condoms which can provide extra sensations to both partners. The studs or ribs can be located on the inside, outside, or both; alternatively, they are located in specific sections to provide directed stimulation to either the g-spot or frenulum. Many textured condoms which advertise "mutual pleasure" also are bulb-shaped at the top, to provide extra stimulation to the male. Studded condoms should be avoided with anal intercourse as they can irritate and possibly tear the walls of the anus. Some women experience irritation during vaginal intercourse with studded condoms.
Other
The anti-rape condom is another variation designed to be worn by women. It is designed to cause pain to the attacker, hopefully allowing the victim a chance to escape.
A collection condom is used to collect semen for fertility treatments or sperm analysis. These condoms are designed to maximize sperm life.
Some condom-like devices are intended for entertainment only, such novelty condoms may not provide protection against pregnancy and STDs.
Female condom
Female condom
Male condoms have a tight ring to form a seal around the penis while female condoms typically have a large stiff ring to keep them from slipping into the body orifice. The Female Health Company produced a female condom that was initially made of polyurethane, but newer versions are made of nitrile. Medtech Products produces a female condom made of latex.
Effectiveness
In preventing pregnancy
See also: Comparison of birth control methods#Effectiveness of various methods
The effectiveness of condoms, as of most forms of contraception, can be assessed two ways. Perfect use or method effectiveness rates only include people who use condoms properly and consistently. Actual use, or typical use effectiveness rates are of all condom users, including those who use condoms incorrectly or do not use condoms at every act of intercourse. Rates are generally presented for the first year of use.Most commonly the Pearl Index is used to calculate effectiveness rates, but some studies use decrement tables.:141
The typical use pregnancy rate among condom users varies depending on the population being studied, ranging from 10–18% per year. The perfect use pregnancy rate of condoms is 2% per year. Condoms may be combined with other forms of contraception (such as spermicide) for greater protection.
In preventing STDs
A giant condom on the Obelisk of Buenos Aires, Argentina, part of an awareness campaign for the 2005 World AIDS Day
Safe sex
Condoms are widely recommended for the prevention of sexually transmitted diseases (STDs). They have been shown to be effective in reducing infection rates in both men and women. While not perfect, the condom is effective at reducing the transmission of organisms that cause AIDS, genital herpes, cervical cancer, genital warts, syphilis, chlamydia, gonorrhea, and other diseases. Condoms are often recommended as an adjunct to more effective birth control methods (such as IUD) in situations where STD protection is also desired.
According to a 2000 report by the National Institutes of Health (NIH), correct and consistent use of latex condoms reduces the risk of HIV/AIDS transmission by approximately 85% relative to risk when unprotected, putting the seroconversion rate (infection rate) at 0.9 per 100 person-years with condom, down from 6.7 per 100 person-years. Analysis published in 2007 from the University of Texas Medical Branch and the World Health Organization found similar risk reductions of 80–95%.
The 2000 NIH review concluded that condom use significantly reduces the risk of gonorrhea for men. A 2006 study reports that proper condom use decreases the risk of transmission of human papillomavirus to women by approximately 70%. Another study in the same year found consistent condom use was effective at reducing transmission of herpes simplex virus-2 also known as genital herpes, in both men and women.
Although a condom is effective in limiting exposure, some disease transmission may occur even with a condom. Infectious areas of the genitals, especially when symptoms are present, may not be covered by a condom, and as a result, some diseases can be transmitted by direct contact. The primary effectiveness issue with using condoms to prevent STDs, however, is inconsistent use.
Condoms may also be useful in treating potentially precancerous cervical changes. Exposure to human papillomavirus, even in individuals already infected with the virus, appears to increase the risk of precancerous changes. The use of condoms helps promote regression of these changes. In addition, researchers in the UK suggest that a hormone in semen can aggravate existing cervical cancer, condom use during sex can prevent exposure to the hormone.
Causes of failure
Condoms may slip off the penis after ejaculation, break due to improper application or physical damage (such as tears caused when opening the package), or break or slip due to latex degradation (typically from usage past the expiration date, improper storage, or exposure to oils). The rate of breakage is between 0.4% and 2.3%, while the rate of slippage is between 0.6% and 1.3%. Even if no breakage or slippage is observed, 1–2% of women will test positive for semen residue after intercourse with a condom. "Double bagging," using two condoms at once, also increases the risk of condom failure.
Different modes of condom failure result in different levels of semen exposure. If a failure occurs during application, the damaged condom may be disposed of and a new condom applied before intercourse begins — such failures generally pose no risk to the user. One study found that semen exposure from a broken condom was about half that of unprotected intercourse; semen exposure from a slipped condom was about one-fifth that of unprotected intercourse.
Standard condoms will fit almost any penis, although many condom manufacturers offer "snug" or "magnum" sizes. Some manufacturers also offer custom sized-to-fit condoms, with claims that they are more reliable and offer improved sensation/comfort. Some studies have associated larger penises and smaller condoms with increased breakage and decreased slippage rates (and vice versa), but other studies have been inconclusive.
Condom thickness is not associated with condom breakage, thinner condoms are as effective as thicker ones. Nevertheless, it is recommended for condoms manufactures to avoid very thick, or very thin condoms, because they are both considered less effective. Some authors even encourage users to choose thinner condoms "for greater durability, sensation, and comfort", but others warn that "the thinner the condom, the smaller the force required to break it".
Experienced condom users are significantly less likely to have a condom slip or break compared to first-time users, although users who experience one slippage or breakage are more likely to suffer a second such failure. An article in Population Reports suggests that education on condom use reduces behaviors that increase the risk of breakage and slippage. A Family Health International publication also offers the view that education can reduce the risk of breakage and slippage, but emphasizes that more research needs to be done to determine all of the causes of breakage and slippage.
Among people who intend condoms to be their form of birth control, pregnancy may occur when the user has sex without a condom. The person may have run out of condoms, or be traveling and not have a condom with them, or simply dislike the feel of condoms and decide to "take a chance." This type of behavior is the primary cause of typical use failure (as opposed to method or perfect use failure).
Another possible cause of condom failure is sabotage. One motive is to have a child against a partner's wishes or consent. Some commercial sex workers from Nigeria reported clients sabotaging condoms in retaliation for being coerced into condom use. Using a fine needle to make several pinholes at the tip of the condom is believed to significantly impact their effectiveness.:306-307
Prevalence
The prevalence of condom use varies greatly between countries. Most surveys of contraceptive use are among married women, or women in informal unions. Japan has the highest rate of condom usage in the world: in that country, condoms account for almost 80% of contraceptive use by married women. On average, in developed countries, condoms are the most popular method of birth control: 28% of married contraceptive users rely on condoms. In the average less-developed country, condoms are less common: only 6-8% of married contraceptive users choose condoms.
Condom use for disease prevention also varies. Among gay men in the United States, one survey found that 35% had used two condoms at the same time, a practice called "double bagging".[76] While intended to provide extra protection, double bagging actually increases the risk of condom failure.
Use
How to put on a condom
Male condoms are usually packaged inside a foil wrapper, in a rolled-up form, and are designed to
Male condoms are usually packaged inside a foil wrapper, in a rolled-up form, and are designed to be applied to the tip of the penis and then unrolled over the erect penis. It is important that some space be left in the tip of the condom so that semen has a place to collect; otherwise it may be forced out of the base of the device. After use, it is recommended the condom be wrapped in tissue or tied in a knot, then disposed of in a trash receptacle.
Some couples find that putting on a condom interrupts sex, although others incorporate condom application as part of their foreplay. Some men and women find the physical barrier of a condom dulls sensation. Advantages of dulled sensation can include prolonged erection and delayed ejaculation; disadvantages might include a loss of some sexual excitement. Advocates of condom use also cite their advantages of being inexpensive, easy to use, and having few side effects.
Role in sex education
Condoms are often used in sex education programs, because they have the capability to reduce the chances of pregnancy and the spread of some sexually transmitted diseases when used correctly. A recent American Psychological Association (APA) press release supported the inclusion of information about condoms in sex education, saying "comprehensive sexuality education programs... discuss the appropriate use of condoms", and "promote condom use for those who are sexually active."
In the United States, teaching about condoms in public schools is opposed by some religious organizations. Planned Parenthood, which advocates family planning and sex education, argues that no studies have shown abstinence-only programs to result in delayed intercourse, and cites surveys showing that 76% of American parents want their children to receive comprehensive sexuality education including condom use.
Infertility treatment
Common procedures in infertility treatment such as semen analysis and intrauterine insemination (IUI) require collection of semen samples. These are most commonly obtained through masturbation, but an alternative to masturbation is use of a special collection condom to collect semen during sexual intercourse.
Collection condoms are made from silicone or polyurethane, as latex is somewhat harmful to sperm. Many men prefer collection condoms to masturbation, and some religions prohibit masturbation entirely. Also, compared with samples obtained from masturbation, semen samples from collection condoms have higher total sperm counts, sperm motility, and percentage of sperm with normal morphology. For this reason, they are believed to give more accurate results when used for semen analysis, and to improve the chances of pregnancy when used in procedures such as intracervical or intrauterine insemination. Adherents of religions that prohibit contraception, such as Catholicism, may use collection condoms with holes pricked in them.:306-307
However, one problem with the use of a collection condom is that semen is not normally produced in a fertility clinic or at a sperm bank, and it has to be transported in order to be processed and used. This in turn reduces the fecundity of the sperm. Specially designed containers can be used which may extend the life of the sperm and enable it to be transported to a clinic or a recipient woman.
Condom therapy is sometimes prescribed to infertile couples when the female has high levels of antisperm antibodies. The theory is that preventing exposure to her partner's semen will lower her level of antisperm antibodies, and thus increase her chances of pregnancy when condom therapy is discontinued. However, condom therapy has not been shown to increase subsequent pregnancy rates.
Other uses
Condoms excel as multipurpose containers because they are waterproof, elastic, durable, and will not arouse suspicion if found. Ongoing military utilization begun during World War II includes:
Tying a non-lubricated condom over the muzzle of the rifle barrel in order to prevent barrel fouling by keeping out detritus.
The OSS used condoms for a plethora of applications, from storing corrosive fuel additives and wire garrotes (with the T-handles removed) to holding the acid component of a self-destructing film canister, to finding use in improvised explosives.
Navy SEALs have used doubled condoms, sealed with neoprene cement, to protect non-electric firing assemblies for underwater demolitions—leading to the term "Dual Waterproof Firing Assemblies."
Other uses of condoms include:
Covers for endovaginal ultrasound probes. Covering the probe with a condom reduces the amount of blood and vaginal fluids that the technician must clean off between patients.
Condoms can be used to hold water in emergency survival situations.
Condoms have also been used to smuggle cocaine, heroin, and other drugs across borders and into prisons by filling the condom with drugs, tying it in a knot and then either swallowing it or inserting it into the rectum. These methods are very dangerous and potentially lethal; if the condom breaks, the drugs inside become absorbed into the bloodstream and can cause an overdose.
In Soviet gulags, condoms were used to smuggle alcohol into the camps by prisoners who worked outside during daylight. While outside, the prisoner would ingest an empty condom attached to a thin piece of rubber tubing, the end of which was wedged between his teeth. The smuggler would then use a syringe to fill the tubing and condom with up to three liters of raw alcohol, which the prisoner would then smuggle back into the camp. When back in the barracks, the other prisoners would suspend him upside down until all the spirit had been drained out. Aleksandr Solzhenitsyn records that the three liters of raw fluid would be diluted to make seven liters of crude vodka, and that although such prisoners risked an extremely painful and unpleasant death if the condom burst inside them, the rewards granted them by other prisoners encouraged them to run the risk.
In his book entitled Last Chance to See, Douglas Adams reported having used a condom to protect a microphone he used to make an underwater recording. According to one of his traveling companions, this is standard BBC practice when a waterproof microphone is needed but cannot be procured.
Condoms are used by engineers to keep soil samples dry during soil tests.
Condoms are used in the field by engineers to initially protect sensors embedded in the steel or aluminum nose-cones of Cone Penetration Test (CPT) probes when entering the surface to conduct soil resistance tests to determine the bearing strength of soil.
Condoms are used as a one-way valve by paramedics when performing a chest decompression in the field. The decompression needle is inserted through the condom, and inserted into the chest. The condom folds over the hub allowing air to exit the chest, but preventing it from entering.
Debate and criticism
While condom use has many proven benefits, a few detractors—notably the Roman Catholic Church—believe condoms cause negative social effects that outweigh the protection they provide to individuals who use them. Some researchers have expressed concern over certain ingredients sometimes added to condoms, notably talc and nitrosamines. In addition, the large-scale use of disposable condoms has resulted in concerns over their environmental impact.
Disposal and environmental impact
Used condom thrown on the street
Experts, such as AVERT, recommend condoms be disposed of in a garbage receptacle, as flushing them down the toilet may cause plumbing blockages and other problems.
While biodegradable, latex condoms damage the environment when disposed of improperly. According to the Ocean Conservancy, condoms, along with certain other types of trash, cover the coral reefs and smother sea grass and other bottom dwellers. The United States Environmental Protection Agency also has expressed concerns that many animals might mistake the litter for food.
Condoms made of polyurethane, a plastic material, do not break down at all. The plastic and foil wrappers condoms are packaged in are also not biodegradable. However, the benefits condoms offer are widely considered to offset their small landfill mass. Frequent condom or wrapper disposal in public areas such as a parks have been seen as a persistent litter problem.
Position of the Roman Catholic Church
See also: Catholic teachings on sexual morality#Use of condoms
The Roman Catholic Church opposes all sexual acts outside of marriage, as well as any sexual act in which the chance of successful conception has been reduced by direct and intentional acts (e.g., surgery to prevent conception) or foreign objects (e.g., condoms).
The use of condoms to prevent STD transmission is not specifically addressed by Catholic doctrine, and is currently a topic of debate among theologians and high-ranking Catholic authorities. A few, such as Belgian Cardinal Godfried Danneels, believe the Catholic Church should actively support condoms used to prevent disease, especially serious diseases such as AIDS. However, the majority view—including all statements from the Vatican—is that condom-promotion programs encourage promiscuity, thereby actually increasing STD transmission. This view was most recently reiterated in 2009 by Pope Benedict XVI.
The Roman Catholic Church is the largest organized body of any world religion. The church has hundreds of programs dedicated to fighting the AIDS epidemic in Africa, but its opposition to condom use in these programs has been highly controversial.
Health issues
Dry dusting powders are applied to latex condoms before packaging to prevent the condom from sticking to itself when rolled up. Previously, talc was used by most manufacturers, but cornstarch is currently the most popular dusting powder. Talc is known to be toxic if it enters the abdominal cavity (i.e. via the vagina). Cornstarch is generally believed to be safe, however some researchers have raised concerns over its use.
Nitrosamines, which are potentially carcinogenic in humans, are believed to be present in a substance used to improve elasticity in latex condoms. A 2001 review stated that humans regularly receive 1,000 to 10,000 times greater nitrosamine exposure from food and tobacco than from condom use and concluded that the risk of cancer from condom use is very low.[ However, a 2004 study in Germany detected nitrosamines in 29 out of 32 condom brands tested, and concluded that exposure from condoms might exceed the exposure from food by 1.5- to 3-fold.
Cultural factors
Cultural attitudes toward gender, contraception, and sex affect condom use and perceptions about condoms around the world. In less-developed countries and among less-educated populations, misperceptions about how disease transmission and conception work may negatively affect the use of condoms. In cultures with more traditional gender roles, women may feel uncomfortable demanding that their partners use condoms.
Latino immigrants in the United States often face barriers to condom use. A study on female HIV prevention published in the Journal of Sex Health Research asserts that Latino women often lack the attitudes needed to negotiate safe sex due to traditional gender-role norms in the Latino community, and may be afraid to bring up the subject of condom use with their partners. Women who participated in the study often reported that their male partners would be angry or possibly violent at the suggestion that they use condoms. A similar phenomenon has been noted in a survey of low-income African-American women; the women in this study also reported a fear of violence at the suggestion that condoms be used.
A telephone survey conducted by Rand Corporation and Oregon State University and published in the Journal of Acquired Immune Deficiency Syndromes showed that belief in AIDS conspiracy theories among black men is linked to rates of condom use; as conspiracy beliefs grew, consistent condom use dropped. Female use of condoms was not similarly affected.
In Africa, condom promotion in some areas has been impeded by anti-condom campaigns by some Muslim and Catholic clerics. Some women in Africa believe that condoms are "for prostitutes" and that respectable women should not use them. A few clerics even promote the idea that condoms are deliberately laced with HIV.
Among the Massai in Tanzania, condom use is hampered by an aversion to "wasting" sperm, which is given sociocultural importance beyond reproduction. Sperm is believed to be an "elixir" to women and to have beneficial health effects. Massai women believe that, after conceiving a child, they must have sexual intercourse repeatedly so that the additional sperm aids the child's development. Frequent condom use is also considered by some Massai to cause impotence.
In much of the Western world, the introduction of the pill in the 1960s was associated with a decline in condom use:267-9,272-5 In Japan, oral contraceptives were not approved for use until September 1999, and even then access was more restricted than in other industrialized nations. Perhaps because of this restricted access to hormonal contraception, Japan has the highest rate of condom usage in the world: in 2008, 80% of contraceptive users relied on condoms.
Major manufacturers
History of condoms#Major manufacturers
One analyst described the size of the condom market as something that "boggles the mind". Numerous small manufacturers, nonprofit groups, and government-run manufacturing plants exist around the world.:322,328 Within the condom market, there are several major contributors, among them both for-profit businesses and philanthropic organizations. Most large manufacturers have ties to the business that reach back to the end of the 19th century.
Julius Schmid, Inc. was founded in 1882 and began the Sheik and Ramses brands of condoms.:154-6 The London Rubber Company began manufacturing latex condoms in 1932, under the Durex brand.:199,201,218 Both companies are now part of Seton Scholl Limited.:327
Youngs Rubber Company, founded by Merle Youngs in late nineteenth century America, introduced the Trojan line of condoms:191 now owned by Church and Dwight.:323-4
Dunlop Rubber began manufacturing condoms in Australia in the 1890s. In 1905, Dunlop sold its condom-making equipment to one of its employees, Eric Ansell, who founded Ansell Rubber. In 1969, Ansell was sold back to Dunlop.:327 In 1987, English business magnate Richard Branson contracted with Ansell to help in a campaign against HIV and AIDS. Ansell agreed to manufacture the Mates brand of condom, to be sold at little or no profit in order to encourage condom use. Branson soon sold the Mates brand to Ansell, with royalty payments made annually to the charity Virgin Unite.:309,311 In addition to its Mates brand, Ansell currently manufactures Lifestyles for the U.S. market.:333
In 1934 the Kokusia Rubber Company was founded in Japan. It is now known as the Okamoto Rubber Manufacturing Company.:257
In 1970 Tim Black and Philip Harvey founded Population Planning Associates (now known as Adam & Eve). Population Planning Associates was a mail-order business that marketed condoms to American college students. Black and Harvey used the profits from their company to start a non-profit organization Population Services International,:286-7,337-9 and Harvey later also founded another nonprofit company, DKT International, that annually sells millions of condoms at discounted rates in developing countries around the world.:286-7,337-9
Research
Male contraceptive
A spray-on condom made of latex is intended to be easier to apply and more successful in preventing the transmission of diseases. As of 2009, the spray-on condom was not going to market because the drying time could not be reduced below two to three minutes.
The Invisible Condom, developed at Université Laval in Québec, Canada, is a gel that hardens upon increased temperature after insertion into the vagina or rectum. In the lab, it has been shown to effectively block HIV and herpes simplex virus. The barrier breaks down and liquefies after several hours. As of 2005, the invisible condom is in the clinical trial phase, and has not yet been approved for use.
Also developed in 2005 is a condom treated with an erectogenic compound. The drug-treated condom is intended to help the wearer maintain his erection, which should also help reduce slippage. If approved, the condom would be marketed under the Durex brand. As of 2007, it was still in clinical trials.:345 In 2009, Ansell Healthcare, the makers of Lifestyle condoms, introduced the X2 condom lubricated with "Excite Gel" which contains the amino acid l-arginine and is intended to improve the strength of the erectile response.
(source:wikipedia)
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