11/13/24, 8\:16 PM Guide | Condom counselling

Condom counselling

Table of contents
/
0\:00 6\:11

Introduction

Condom counselling often features in OSCEs, so it’s important to be familiar with the various methods of
contraception available and forms of sexual health promotion.
This article focuses on counselling patients about the external condom (also called the male condom), including the common
questions patients ask, the information you’ll be expected to give and how best to structure the consultation.

Opening the consultation

Wash your hands and don PPE if appropriate.
Introduce yourself to the patient, including your name and role.
Con
Explain the reason for the consultation\:
t h a t c o r r e c t ?”
.
“ I u n d e r s t a n d y o u a r e i n t e r e s t e d i n l e a r n i n g a b o u t u s i n g c o n d o m s f o r c o n t r a c e p t i o n . I s
It is important to establish a good rapport and an open line of communication with the patient early in the consultation\:
h a v e a n y q u e s t i o n s a t a n y p o i n t , o r i f s o m e t h i n g i s n o t c l e a r , p l e a s e f e e l f r e e t o i n t e r r u p t a n d a s k m e .
”
“ I f y o u
Make sure to check the patient’s understanding at regular intervals throughout the consultation and provide opportunities to
ask questions (this is often referred to as ‘chunking and checking’).

Ideas, concerns and expectations

https\://app.geekymedics.com/osce-guides/counselling/condom-counselling/ 1/511/13/24, 8\:16 PM Guide | Condom counselling
A key component of a counselling station involves exploring a patient’s ideas, concerns and expectations (often referred to as
ICE).
In a contraceptive consultation, it is important to explore ICE, as many patients will have researched or have prior experience
with contraceptive methods. This will help you tailor the consultation and the advice you give regarding speci
important to identify any patient concerns and expectations early in the consultation, as this may a
method and subsequent contraceptive e
It can sometimes be challenging to use the ICE structure in a way that sounds natural in your contraceptive consultation, but
we have provided some examples for each of the three areas below.
Ideas
Explore what the patient currently understands about condoms\:
“ W h a t d o y o u a l r e a d y k n o w a b o u t u s i n g c o n d o m s ?”
Concerns
Ask if the patient has any concerns about using condoms\:
“ I s t h e r e a n y t h i n g t h a t w o r r i e s y o u a b o u t u s i n g c o n d o m s ?”
Expectations
Explore the patient’s expectations of using condoms and the consultation\:
“ W h a t f a c t o r s h a v e m a d e y o u c o n s i d e r u s i n g c o n d o m s ?”
“ I s t h e r e a n y t h i n g y o u w a n t m e t o f o c u s o n t o d a y ?”

What is a condom?

Using patient-friendly language, explain that condoms are rubbery sheaths that are worn over the penis to protect against
pregnancy and/or sexually transmitted infections. Condoms are designed to be used for all penetrative sexual activity
including oral, vaginal and anal sex.
As a contraceptive method, condoms provide a physical barrier which prevents semen from entering the vagina during sexual
activity. As the sperm cannot pass through the latex or alternative material, this prevents the sperm from fertilising an egg.
Condoms are also used to reduce the risk of transmission of sexually transmitted infections, as the barrier reduces skin and
genital contact between sexual partners.
Condoms come in various sizes, colours, textures and
preference. While they’re usually made of latex, other materials such as polyurethane are available for those with allergies or
di
Explain to the patient that while there are a wide variety of contraceptives available, barrier methods, including condoms, are
the only methods that prevent both pregnancy and sexually transmitted infections.
Example
“ C o n d o m s a r e s t r e t c h y , r u b b e r y s h e a t h s t h a t c a n b e w o r n o v e r a p e n i s , a b i t l i k e a s o c k . T h e y a c t a s a p h y s i c a l b a r r i e r t o
s t o p s p e r m f r o m e n t e r i n g t h e v a g i n a , w h i c h h e l p s t o p r e v e n t p r e g n a n c y . T h e y a l s o p r o v i d e a b a r r i e r b e t w e e n y o u a n d
y o u r p a r t n e r' s g e n i t a l s k i n , h e l p i n g t o s t o p t h e s p r e a d o f s e x u a l l y t r a n s m i t t e d i n f e c t i o n s .
"
" C o n d o m s c o m e i n a l l s o r t s o f s i z e s , c o l o u r s , t e x t u r e s , a n d e v e n
a n d f e e l c o m f o r t a b l e u s i n g . S o m e p e o p l e h a v e a l l e r gi e s t o l a t e x , w h i c h i s a c o m m o n m a t e r i a l u s e d i n c o n d o m s s o t h e r e
a r e n o n-l a t e x o p t i o n s a v a i l a b l e a s w e l l .
"
https\://app.geekymedics.com/osce-guides/counselling/condom-counselling/ 2/511/13/24, 8\:16 PM Guide | Condom counselling

How e

When counselling patients regarding contraception, it is very important to explain how e
any factors which may impact e
Preventing pregnancy
Explain to the patient that with perfect use, external condoms are 98% e
typical ('real world') use, they are around 82% e
Example
“ W h e n u s e d p e r f e c t l y , c o n d o m s a r e 9 8 % e
"
" H o w e v e r , w i t h t y p i c a l u s e , w e
"
T h i s m e a n s t h a t i n a y e a r , o n l y a r o u n d 2 o u t o f
T h i s m e a n s 1 8 o u t o f 1 0 0 p e o p l e w h o u s e
Preventing sexually transmitted infections
Explain to the patient that condoms are highly esexually transmitted infections, especially those
transmitted via genital
However, they can be less escabies) as areas of skin
not covered by a condom may still transmit the infection.
Example
“ C o n d o m s , a r e v e r y e
H o w e v e r ,

Advantages and disadvantages of condoms

When discussing contraceptive options, it is important to give the patient enough information to make an informed
decision and direct them to reputable sources of further information.
When explaining potential advantages and disadvantages, you should consider the patient’s ideas, concerns and
expectations (identi
Signposting is important to help you structure the consultation\:
u s i n g c o n d o m s a n d s o m e o f t h e p o t e n t i a l d i s a d v a n t a g e s . “ N e x t , I’ d l i k e t o t a l k a b o u t s o m e o f t h e a d d i t i o n a l b e n e
I s t h a t o k ? .
”
Advantages of condoms
Advantages of condoms include\:
Prevent both pregnancy and sexually transmitted infections
Easily accessible and can often be collected for free from sexual health clinics
Only need to be used at the time of intercourse
Non-hormonal method of contraception
No long-term side e
Accessible to any gender for purchase/collection
No pre-planning is needed, meaning they are suitable for unplanned sex
https\://app.geekymedics.com/osce-guides/counselling/condom-counselling/ 3/511/13/24, 8\:16 PM Guide | Condom counselling
Example
“ A s w e' v e d i s c u s s e d , c o n d o m s c a n p r e v e n t s e x u a l l y t r a n s m i t t e d i n f e c t i o n s a n d p r e gn a n c y . T h i s i s u n l i k e o t h e r f o r m s o f
c o n t r a c e p t i o n , s u c h a s t h e p i l l o r i m p l a n t , w h i c h o n l y p r e v e n t p r e g n a n c y . O t h e r a d v a n t a ge s a r e t h a t c o n d o m s a r e e a s i l y
a c c e s s i b l e t o a n y o n e , n o n-i n v a s i v e , a n d h a v e n o s i d e e
”
Disadvantages of condoms
Potential disadvantages of condoms include\:
Some people feel putting on condoms interrupts the
condom part of foreplay
Some people feel condoms are uncomfortable
External condoms can only be placed on a penis; internal condoms (also known as female condoms) are available but are
less e
Greater failure rate than in some other forms of contraception
May break or leak, especially with incorrect use
Not suitable for those with latex allergy (however, there are alternative materials available)
Example
“ T h e r e a r e s o m e d i s a d v a n t a g e s o f c o n d o m s , t h e y a r e l e s s e
c o n t r a c e p t i o n s u c h a s t h e i m p l a n t a n d t h e I U D . T h e y a l s o n e e d t o b e u s e d c o r r e c t l y t o b e e
c o v e r h o w t o u s e a c o n d o m s h o r t l y . T h e r e i s a r i s k o f t h e c o n d o m b r e a k i n g o r l e a k i n g , e s p e c i a l l y i f t h e y a r e n o t u s e d
c o r r e c t l y . S o m e p e o p l e c a n
”

Demonstrate how to use a condom

Ensure you clearly explain and demonstrate each of the following steps to the patient using condoms and a training model of
an erect penis.
Applying a condom
1. Inspect the condom packaging\:
There should be no breaks, tears or evidence of tampering
Check the expiry date to ensure the condom is in date
Check for a BSI kite mark and European CE mark
2. Tear open the packet and remove the condom\:
Condoms can tear easily- do not use teeth, and be careful with nails and jewellery
3. Check you are holding the condom the right way up\:
You need to be able to roll the condom downwards- if you have tried to to apply the condom upside down, discard and use
a new condom.
4. Pinch the tip of the condom to expel any air
5. Pull back the foreskin if the penis is uncircumcised
6. Place the condom on the tip of the erect penis and roll it down the shaft using your other hand until it is fully unrolled. The
should be snug.
Tip
https\://app.geekymedics.com/osce-guides/counselling/condom-counselling/ 4/511/13/24, 8\:16 PM Guide | Condom counselling
Condoms should only be applied to an erect penis.
Whilst water or silicon-based lubricants are safe to be used with a condom, oil-based lubricants are NOT. Oil based
lubricants can degrade latex and damage a condom's integrity.
Removing a condom
1. When withdrawing the penis, secure the condom at the base of the penis to ensure the condom does not slide o
2. It is good practice to check the condom after intercourse for any breakages. If a break or tear is noted after sex, advice
should be sought regarding whether any treatment is required or advised to prevent pregnancy or STI transmission.
3. Remove the condom from the penis, taking care not to spill any semen or allow the penis to touch the other person’s genitals
4. Discard the condom in a bin (condoms should not be put down the toilet as they can cause a blockage)
Tip
Once removed, condoms should never be reused, and a new condom should be used for each sexual encounter.

Assess the patient’s condom technique

Observe the patient's technique using the condom training model.
Provide feedback to allow the patient to re
Continue to repeat the cycle of observation and feedback until the patient can use a condom e

Closing the consultation

Close the consultation by summarising what you have discussed. This allows you to emphasise the key points of the
consultation to ensure patient understanding.
Ask the patient if they have any further questions or concerns that haven’t been addressed.
If relevant, o
Finally, thank the patient for their time and o
how to access condoms locally (e.g. Sexwise condom lea).
Dispose of PPE appropriately and wash your hands.

Reviewer

Dr Grace Farrington

References

British Association for Sexual Health and HIV (BASHH). C o n d o m s . Available from\: [LINK]
Contraception Choices. C o n d o m s . Available from\: [LINK]
Faculty of Sexual and Reproductive Healthcare (FSRH). P r e v e n t i o n . Published in 2015. Available from\: [LINK]
F S R H C l i n i c a l G u i d e l i n e \: B a r r i e r M e t h o d s f o r C o n t r a c e p t i o n a n d S T I
Source\: geekymedics.com
https\://app.geekymedics.com/osce-guides/counselling/condom-counselling/ 5/5