Wednesday, February 18, 2009

Committment and Condoms

As much as I laud the benefits of dual protection - using condoms in addition to a more effective form of birth control - I know that many women don't want to use condoms forever. For many of us, sex does really feel nicer without the latex barrier. And when you're in a mutually monogamous relationship, you don't need the condoms anymore...in theory. Of course, the cynical side of me says that just because my patient says they’re both monogamous, doesn’t mean that he is saying the same thing to his doctor, or friends, or the woman in the bar. I joke with my patients that it's my job to always believe what they tell me...and never trust their partners, as the best way to keep them safe and healthy.

So how do you balance trust and health? This is what I tell my patients who are going steady and want to deep-six the Trojans:

• Use condoms EVERY TIME you have sex for the first six months.
• After six months, both of you should be tested for STDs—HIV, Chlamydia, hepatitis, the works. If you both test negative, you may decide to forgo the condoms.
• If you don’t want to get pregnant, you’ll need to use a very effective method of birth control, very consistently.
• You have to trust that your partner is truly monogamous—if you have any doubts, back on with the latex.

Nothing is foolproof, but this seems to be the best compromise. What do you think? When do you stop using condoms in a monogamous relationship?

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