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Referral and warning signs
When to refer
Refer for severe allergic reaction.
Red flags
- Signs of severe allergic reaction (anaphylaxis) - rare.
Signs and symptoms
- Side Effects/Disadvantages: Occasional hypersensitivity to latex or lubricants (rarely severe allergic reaction), May cause decreased penile sensitivity, May slip off or break if used incorrectly, Requires correct use with every act of sex.
- Potential difficulty maintaining erection for some men.
Risk factors
- Latex allergy (consider non-latex alternatives or female condom).
Diagnosis
Clinical assessment
Method choice based on client preference and need for STI/HIV protection.
Diagnostic criteria
Suitable for most couples needing immediate protection or dual protection.
Management
Non-pharmacological management
- Counseling on correct and consistent use, storage, and disposal.
- Demonstration of application.
- Supply adequate quantities (e.g., 100 condoms for 3 months per UCG).
Monitoring
Assess consistent and correct use at follow-up. Address any problems (breakage, slippage, sensitivity issues).
Complications
- Unintended pregnancy if used incorrectly or inconsistently, or if breakage/slippage occurs.
- Allergic reaction (latex).
Prevention
- Using a new condom for every act of intercourse.
- Using water-based or silicone-based lubricants (oil-based lubricants damage latex).
- Checking expiration date.
- Storing properly (away from heat/sharp objects).
Patient education
- Dual protection benefit (pregnancy and STI/HIV).
- Correct application technique (leaving space at tip, rolling down fully).
- Withdrawal technique (holding base of condom).
- Need for use with every act of sex.
- Storage and disposal.
- What to do if condom breaks (consider Emergency Contraception).
Uganda-specific notes
Widely promoted for dual protection. Various brands available (free donation condoms, socially marketed, commercial). Consistency of use can be challenging.
References
- Uganda Clinical Guidelines (UCG) 2023
Chapter 15, Section 15.2.1