A nurse updates her STD prevention teaching plan with new guidelines from the Centers for Disease Control and Prevention. Which statement reflects updated information?

• A. Always use spermicides with condoms to reduce the risk of contracting chlamydia or gonorrhea.
• B. Condoms can be effective in preventing infections transmitted by fluids from mucosal surfaces but are not always effective in preventing infections transmitted by skin-to-skin contact.
• C. Condoms should not be used during oral sex, because they are not effective in preventing transmission of infection.
• D. When genital ulcers are present, condoms should be used to prevent the spread of infection.

Answer: (B)

Understanding how condoms work in preventing STIs starts with the mode of transmission. Condoms are highly effective at reducing infections that are spread through fluids and contact with mucosal surfaces, such as HIV, chlamydia, gonorrhea, and trichomonas, when used consistently and correctly. However, many STIs are transmitted by skin-to-skin contact in areas not covered by the condom, including infections like HPV and herpes simplex virus, so condoms do not provide complete protection in those cases. The updated CDC guidance highlights this distinction: condoms help against fluid-borne infections but are not always protective against skin-to-skin transmitted infections. This makes the statement the best reflection of the new information. While condoms can be used during oral sex or when genital ulcers are present to reduce risk, the key update is recognizing their limitation with skin-to-skin transmission.