by Matthew Hodson @Matthew_Hodson

The grand authorities on HIV data reckon that about 80,000 people in the UK have avoided contracting HIV as a result of condom use. That’s pretty impressive. That’s more than the number of gay men who have contracted HIV to date. But is it good enough?

Condom use is not the only weapon in the HIV prevention armoury. Although too often it can go wrong, selecting a partner on the basis of a shared HIV status has also prevented many infections (I’ve not heard an estimate on how many). And people with diagnosed HIV who have an undetectable viral load are unlikely to transmit the virus to their partners. But despite there now being many more men diagnosed, the number of new infections is not going down. It seems that the benefits from decreases in viral load are being balanced by increases in unprotected sex. I believe we should be aiming for better than this. So, while we continue our efforts to get people diagnosed as early as possible (better health for them, better health for their sexual partners), we need to continue to promote other ways of reducing HIV infections. Yup, thirty years into this epidemic, and it looks like we still need to use condoms.

So what’s the big deal anyway?

Condoms are readily available, relatively easy to use and also prevent a whole range of other STIs. ‘Use a condom every time’ and we’re job done and time to go home, right? You see it on the message boards of gay news sites: ‘For fuck’s sake, just use a condom’, people scream into the ether. For some people it really is that easy, for others it’s not. If we pretend it’s easy for everyone, then we fail to address the reasons why so many gay men (and straight men too) struggle with condom use.


I’ve read stuff which categorically denies that there is any loss of sensation from using condoms. If that’s the way you feel, that’s great for you. It’s not how it feels for me. Finding the condom that’s the right fit and thickness is going to help but most of us will have to accept that it feels different.


I saw a (ahem) art-film the other day that showed a willing bottom in doggy position, reaching between his legs and skilfully rolling a condom on to the top. It was all very slick, quick and sexy. For the rest of us the condom moment usually requires some break in the action, reaching into the bedroom drawer, tearing the packet, peering (often in dim lighting, often when not sober) to ensure you’ve got it the right way round, holding the teat and rolling it down. Practice makes perfect and all that, but it’s still an interruption.


In relationships, or even just to show someone that you really like them, some choose to forsake condoms. Is this a sensible strategy? Well, from the number of times I’ve heard people say that they became HIV-positive as a result of sex with a partner, I’d have to say ‘no’. Is it an understandable thing to do? Well, yes, I get it. Perhaps, if you don’t use condoms you have some other reason. I suspect the truth is often that condom use just didn’t happen – I said nothing, they said nothing and then (in terms of condom use) nothing happened. The rest is mainly justifying it after the act.  For most of us, if the choice is between a little less sensation, spontaneity and intimacy and a lifetime of the physical, social and emotional disadvantages that HIV infection brings, we’d choose the condoms. For those of us living with HIV, we don’t want to pass it on. But, in the heat of the moment, and perhaps lubricated with drugs, alcohol or the rush that you get from sex with a really hot man, we don’t always think entirely sensibly and it’s easy to tell yourself, “Just this one time it will be fine.”

If they make no discernible difference to your sexual pleasure – stick with them – easy. If you really can’t get on with them, find another way round it (a partner of the same HIV status or who isn’t likely to transmit his virus). But unless you have accurate knowledge of status and viral load or use condoms the price can be a heavy one. You know what the risks are.

The truth is that if we’re going to bring down the number of men in our community who go through the trauma of an HIV diagnosis (and make no mistake, for most it’s a shattering event) we need to increase early diagnosis, reduce infectiousness AND maintain or, even better, increase condom use. That’s what’s going to turn this situation around. So, what’s the problem with condoms They’re not perfect – but then neither is life.

Matthew is the Executive Director of NAM