Patricia Yarberry Allen, M.D. is a Gynecologist, Director of the New York Menopause Center, Clinical Assistant Professor of Obstetrics and Gynecology at Weill Cornell Medical College, and Assistant Attending Obstetrician and Gynecologist at New York-Presbyterian Hospital. She is a board certified fellow of the American College of Obstetrics and Gynecology. Dr. Allen is also a member of the Faculty Advisory Board and the Women’s Health Director of The Weill Cornell Community Clinic (WCCC). Dr. Allen was the recipient of the 2014 American Medical Women’s Association Presidential Award.

April is Sexually Transmitted Diseases Awareness month. The Incidence of sexually transmitted infections in the United States continues to rise.(Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2015. Atlanta: U.S. Department of Health and Human Services; 2016.)

The total number of cases of chlamydia (more than 1.5 million), gonorrhea (nearly 400,000), and syphilis (nearly 24,000) reported to the Centers for Disease Control and Prevention in the United States in 2015 was the highest ever recorded in a single year. The surveillance data highlight the importance of efforts to prevent sexually transmitted infection, screening, and treatment among at-risk individuals. (Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2015. Atlanta: U.S. Department of Health and Human Services; 2016.) Other frequently contracted sexually transmitted diseases include HIV/AIDS, HPV, and herpes,

Behavioral risk factors for acquiring a sexually transmitted infection include:

• New sex partner in past 60 days.
• Multiple sex partners or sex partner with multiple concurrent sex partners.
• No or inconsistent condom use outside a mutually monogamous sexual partnership.
• Meeting anonymous partners on the Internet.
• Unmarried status.
• Partner having sexual relationship outside the marriage or presumably monogamous relationship.

The most effective way to avoid getting a STI is to not have sex. Another way is to limit sex to one partner who also limits his or her sex in the same way. Consistent and correct use of male latex condoms can reduce (though not eliminate) the risk of STD transmission. To achieve the maximum protective effect, condoms must be used both consistently and correctly.

The failure of condoms to protect against STD/HIV transmission usually results from inconsistent or incorrect use, rather than product failure. Incorrect use diminishes the protective effect of condoms by leading to condom breakage, slippage, or leakage. Incorrect use more commonly entails a failure to use condoms throughout the entire sex act, from start of sexual contact to finish (after ejaculation).

“Grown-Up, but Still Irresponsible.” The findings from a National Survey of Sexual Health and Behavior — which reported that men and women over 40 are careless about condom use and rarely get tested for sexually transmitted diseases — were not news to gynecologists like me, who know that it’s sometimes hard to convince women past the childbearing years just how important it is to use — and keep using — condoms in new relationships, or relationships that are not monogamous. Women in their 40s who still know that contraception needs to be used are prepared to be responsible for prevention of unintended pregnancy but that often never include condoms.

The general reasons that women report that condoms are not used are:

Sex Isn’t Fun With A Condom. If you are relaxed, with someone you are attracted too, sex is going to be fun. Plus condoms can help some guys last longer. You know what’s really not fun? Regretting unprotected sex later.

Condoms Don’t Work. When used consistently and correctly, condoms are very effective at preventing STIs and unwanted pregnancy. They work!

Just This Once Is OK. It only takes one time!

The excuses that I have been given for no-condom use are almost unimaginable.

One patient: “We met on Match.com and had such great email and phone communication. No wonder on our first date I felt like I had known him forever. We went back to my apartment and had great sex all night.” After finding out that no condoms were involved,  I asked, “How can this be? Why not?!” “Oh”, she replied, “he went to Yale, so I wasn’t worried.”

This from a woman of 55, the director of a division of a big ad agency.

You can’t make up a story like that.