Lesson 14

· Describe how the spread of HIV can be prevented through (a) safe sex; and b) sexual abstinence; and

· Teach your pupils how to prevent the spread of HIV by transmission through sexual activity in a non-offensive manner.

Any risk of HIV can be avoided if one practices abstinence (not having sex). A person is also not infected if the penis, mouth, vagina or rectum do not touch anyone else's penis, mouth, vagina, or rectum.

When we talk about safe sex, we normally talk about practising sex in a way that will not put any of the partners at risk. It is safe to have sex with one partner on the condition that:

Oral sex has a lower risk of infection than anal or vaginal sex, especially if there are no open sores or blood in the mouth. You can reduce the risk of infection with HIV and other sexually transmitted diseases by using barriers like condoms. Traditional condoms go on the penis, and a new type of condom goes in the vagina or in the rectum. Let us consider some things worth knowing about condoms and their use.

Condom use can be traced back several thousand years. It is known that around 1000 BC the ancient Egyptians used a linen sheath for protection against disease. The first known published description and trials regarding prophylactic condom use were recorded in Italy in the 1500s. Gabrielle Fallopius claimed to have invented a sheath made of linen, and conducted trials amongst 1,100 men using the condom, none of whom became infected with Syphilis. Having been found useful for prevention of infection, it was only later that the usefulness of the condom for the prevention of pregnancy was recognised. In 1844, Goodyear and Hancock began to mass produce condoms made out of vulcanised rubber. Vulcanisation is a process which turns crude rubber into a strong elastic material. In the 1880s, the first latex condom was produced, although it was to be the 1930s before these were in widespread use. In the laboratory, latex condoms are very effective at blocking transmission of HIV because the pores in latex condoms are too small to allow the virus to pass through.

Condoms are the only form of protection which can both help to stop the transmission of viruses such as HIV and prevent pregnancy.

A number of different types of condom are now available. What is generally called a condom is the 'male' condom, a sheath or covering which fits over a man's penis, and which is closed at one end.

There is also now a female condom, or vaginal pouch, which is used by a woman and which fits inside her vagina. The rest of this section is about the male condom.

Condoms are usually made out of latex or polyurethane. If possible you should use a latex condom as these are the most effective against viruses such as HIV, and in most countries they are the type most readily available.

Condoms come in a variety of shapes. Most have a reservoir tip although some do have a plain tip. Condoms may be regular shaped (with straight sides), form fit (indented just below the glans or "head" of the penis), or they may be flared (wider over the glans).

Ribbed condoms are textured with ribs or bumps, which can increase sensation for both partners. Condoms also come in a variety of colours.

The lubrication on condoms also varies. Some condoms are not lubricated at all, some are lubricated with a silicone substance, and some condoms have a water-based lubricant. The lubrication on condoms aims to make the condom easier to put on and more comfortable to use.

You need to use a new condom every time you have sexual intercourse. Never use the same condom twice. Put the condom on after the penis is erect and before any contact is made between the penis and any part of the partner's body. If you go from anal intercourse to vaginal intercourse, you should consider changing the condom.

Condoms can deteriorate if not stored properly. They can be affected by both heat and light. So it is best not to use a condom that has been stored in your back pocket, your wallet, or the glove compartment of your car.

Open the condom package at one corner being careful not to tear the condom with your fingernails, your teeth, or through being too rough. Make sure the package and condom appear to be in good condition, and check that if there is an expiry date that the date has not passed.

Place the rolled condom over the tip of the hard penis, and if the condom does not have a reservoir top, pinch the tip of the condom enough to leave a half inch space for semen to collect. If the man is not circumcised, then pull back the foreskin before rolling on the condom.

Pinch the air out of the condom tip with one hand and unroll the condom over the penis with the other hand. Roll the condom all the way down to the base of the penis, and smooth out any air bubbles. (Air bubbles can cause a condom to break).

If you want to use some extra lubrication, put it on the outside of the condom. But always use a water-based lubricant as oil-based lubricant will cause the latex to break.

Pull out before the penis softens, and hold the condom against the base of the penis while you pull out, so that the semen does not spill. Then tie a knot in the condom and throw it away. It is not good to flush condoms down the toilet – they are bad for the environment.

If a condom breaks during sexual intercourse, then pull out quickly and replace the condom. Whilst you are having sex, check the condom from time to time, to make sure it has not split or slipped off.

If used properly, a condom is very effective at reducing the risk of being infected with HIV during sexual intercourse. Using a condom also provides protection against other sexually transmitted diseases, and protection against pregnancy. In the laboratory, latex condoms are very effective at blocking transmission of HIV because the pores in latex condoms are too small to allow the virus to pass through. However, outside of the laboratory condoms are less effective because people do not always use condoms properly.

EXCUSE	ANSWER
Don't you trust me?	Trust isn't the point, people can have infections without realising it
I can't feel a thing when I wear a condom	Maybe that way you'll last even longer and that will make up for it
I don't stay hard when I put on a condom	I'll help you put it on, that will help you keep it
I don't have a condom with me	I do
I'm on the pill, you don't need a condom	I'd like to use it anyway. It will help to protect us from infections we may not realise we have.
But I love you	Then you'll help us to protect ourselves.
Just this once	Once is all it takes

Resources: Charts depicting (A) safe sex; and (B) male and female condoms. Packets of condoms.

(Note: Care needs to be taken not to indulge your `pupils in details about sex. Only language and terminologies that are permissible within the school’s socio-cultural context should be used).

Review the three major ways of HIV transmission with pupils – sexual intercourse, contact with infected blood through blood transfusion and sharing of needles, and mother-to-child transmission.

Through interactive class discussions, lead pupils to enhance their understanding of prevention of transmission of HIV through sexual activities.

For the unmarried youth, emphasise abstinence. You also won't get infected if your penis, mouth, vagina or rectum don't touch anyone else's penis, mouth, vagina, or rectum.

Conclude the lesson by asking pupils to share the message of the lesson with their friends and relations.

· the spread of HIV can be prevented through (a) safe sex; and b) sexual abstinence;

· Oral sex has a lower risk of infection than anal or vaginal sex, especially if there are no open sores or blood in the mouth. You can reduce the risk of infection with HIV and other sexually transmitted diseases by using barriers like condoms.