QUESTION
How safe is being a bottom with my boyfriend using a condom and pulling out prior to ejaculation? Are there any prescribed methods to using a condom more safely, i.e. using lubricants, testing condom, etc.?

ANSWER
Using condoms regularly and correctly works very well to prevent HIV and most STDs during anal sex. Pinch the air out of the tip, unroll the condom to the base of the penis and use plenty of lube (i.e. reduced friction = less likely to break or tear the condom). Remove the condom after ejaculation while the penis is still erect. To ensure the condom does not come off prematurely, hold the condom at the base of your penis when pulling out of your partner. Many couples where one man is positive and the other negative have been having safer, protected sex for years without HIV transmission. You are wise to be using protection and an example for us all in our safer sex efforts.

Since ejaculate (cum) is where HIV is, reducing contact with ejaculate (cum) makes sense. Pulling out prior to ejaculation makes the chance of contacting cum less likely. This is about the best you can do. The addition of a good quality, water based lube will of course mean less risk of breakage to the condom. Always be sure to check the expiration date on the condom. Don't use any that have worn or torn wrappers. The extreme heat or cold can affect the quality of the latex - so don't store them in the car, sun, or your pockets for long periods of time. For more information on condoms, click here.

To your health,
Dr. K