Kinsey Confidential

Question:\n My boyfriend and I have been together for seven months. I'm on the pill, and we're wondering at what point it's okay to stop using condoms. We've both been tested and are totally clean. Thanks.\nAnswer:\nThe decision to stop using condoms is a huge one, and it's important to consider the effects on your relationship as well as your health and also to talk openly about these concerns with your partner. Here are some things you might consider: risk of unintended pregnancy, risk of sexually transmitted infections, the status of your relationship and your comfort level.\nBecause you're taking the birth control pill, I'm assuming that you two have decided that you don't want a pregnancy at this time in your life. While no method (aside from complete abstinence) is 100 percent effective at preventing pregnancy, the pill comes awfully close (more than 99 percent effective) when used correctly, though in typical use (e.g., taking a pill later than usual, etc.) it's only about 92-94 percent effective. By using a condom during sex, you're taking extra precautions to prevent pregnancy. By stopping condom use, your risk of pregnancy might increase slightly. \nThen there are STIs, which the pill does not protect against. While it's fantastic that you've both been tested for infections, what happens if one of you has sexual encounters with someone else? College students (like older adults) sometimes have sex with other people and feel too embarrassed or ashamed to tell their partner (or they're downright dishonest). You might feel like that would never happen in your relationship, but what if it does? Condoms -- when used correctly and consistently -- reduce the risk of transmitting infections like HIV, chlamydia and gonorrhea, though they don't offer similar protection from skin-to-skin transmitted infections such as the human papillomavirus (HPV, for which there is currently no test available for men) or herpes.\nConsider asking your healthcare provider how often you should get tested for STIs. Most people are aware of the devastating effects of HIV and syphilis, but infections like chlamydia and gonorrhea can lead to pelvic inflammatory disease and infertility if left untreated. Because they don't always show symptoms, particularly among women, it's important to get tested if there's any possibility that you're at risk.\nWhile many couples agree to a monogamous relationship (sexual contact only with each other), it's good to have this conversation rather than make assumptions about each other's behavior. Things you might discuss: What kinds of sexual behaviors with others are "off-limits"? What happens if one of you strays? How often will you get tested for infections? To what extent do you trust each other to stick to your agreements?\nTrust has a large influence on your comfort with having sex without a condom, though there are other factors, too. Some women simply don't like the feel of a man ejaculating inside of them. Others are more comfortable forgoing condoms after they've been in a committed relationship for a certain amount of time, are "in love" or have reached a desired level in their relationship (e.g., are monogamous, prepared to have children, have moved in together, become engaged or married). None of these reasons, however, guarantees protection against pregnancy or infection, though (if only being in love was protective ... but unfortunately it's not that easy).\nMen often really like the peace of mind of using condoms, particularly because it's a method of birth control that they can mostly control (unlike the pill, for example, which they trust their partner to take). Only you two can decide what will help you feel comfortable enough to make yourselves emotionally and physically vulnerable to each other by beginning to have sexual intercourse without a condom. If you stop using condoms, know that you can always return to condoms if you change your mind. If you stick with condoms, rest assured that it doesn't mean anything bad about your relationship -- it might mean something very good (that you want to be comfortable and careful with each other's health). Checking in with each other along the way is a great way to practice your communication skills with each other -- and enhance your safety as much as is possible. www.indiana.edu/~kisiss