Updated

To use or not to use, that is the question.

Unfortunately, for many Americans, when it comes to safer sex, many are opting not to use a condom during the act. The result: Sexually transmitted diseases continue to run rampant.

Case in point: A recent study by New York City’s Department of Health found that, with the city’s STD rates on the rise, one-fourth of New Yorkers are infected with genital herpes. Go figure, since the same study found that 40 percent of New Yorkers with multiple partners are not practicing safe sex.

You might be thinking, “I don’t live in New York City, so it’s not my problem.” Think again. STDs are on the rise nationwide, especially in Southern and Western states. According to the Centers for Disease Control, 19 million Americans contract a sexually transmitted disease annually. Half of these cases are found in individuals between the ages of 15 to 24. Teen girls, young women, African-Americans, and men who have sex with men face the greatest risk.

Of particular concern is not only the fact that HIV can be fatal, but that these infections can lead to permanent damage, for example, infertility, if left untreated. In cases like chlamydia, syphilis, and gonorrhea -- which is becoming more drug resistant -- most individuals don’t even know they are infected and end up passing the infection along to their sexual partner(s).

Given the threats involved, a rational mind would determine that risky sex -- namely unprotected sex -- isn’t a good idea. Most people, when in their right frame of mind, would reason that using a barrier method, like the condom, is a brilliant idea in protecting yourself and your partner when choosing to be sexually active. Yet many people throw caution to the wind when sex is on the brain.

So why are people taking chances? Here are the major reasons:

It feels good

People like to argue that sex without a condom is better (though I always challenge this in asking if their orgasm experience is necessarily any better). Many guys in particular will complain that a condom not only decreases their sensation, but their ability to reach climax as well.

'It can’t happen to me'

There are two primary factors at play when it comes to this mentality. First, there’s the invulnerability factor, which young people in particular suffer from. This is the notion that “nothing bad is ever going to happen to me.” Second, is the presumption that STDs only happen to “other” people – people who are “bad,” “dirty,” and “immoral.” And most of us don’t see ourselves that way.

Not in the right frame of mind

Whether high, drunk, or drugged up on substances like cocaine, even lovers with the best of safer sex intentions will easily forget about such when under the influence.

Ignorance

Many people think that the birth control pill not only protects them from pregnancy, but STDs as well. It doesn't.

Denial

Some people simply aren’t willing to acknowledge the reality of the negative consequences of sex. Denial is our most immature defense mechanism and helps us to rationalize why we don’t always make the smartest decisions.

Opportunity is knocking

You have the chance to have sex – but wait for protection?! Eager and rearing to go, some people think “No way!” when it comes to that one. Why wait when you can have pleasure now?!

For some people, sex may be seen as an opportunity to initiate, cement, or lengthen a relationship with someone they’re interested in or as a means of receiving affection. It’s also a way to relieve peer pressure, gain social status, and/or acceptance.

Risky sex is rational

Believe it or not, for some people, under certain circumstances, risky sex may be viewed as rational. This is in the sense that the perceived physical, emotional, and psychological benefits of sex outweigh the threat of acquiring HIV or other STDs or getting pregnant. Given a certain set of values and perceptions, engaging in unsafe behaviors may appear to an individual as a reasonable gamble.

Self-esteem issues

Sadly for some people, self-worth is dependent on pleasing their partner. A guy might worry that protection will lessen his partner’s desire for him and reduce his chances of scoring. A gal may fear rejection if she pushes using protection and, thus, doesn’t stand up for herself or her health. Both of these situations threaten pleasing the partner and one’s self-esteem.

Love

Risk-taking and self-sacrifice are often idealized as romantic and realistic demonstrations of your love for somebody. In mistaking themselves for Romeo and Juliet, some couples feel that a demonstration, like foregoing the condom, can make them feel very satisfied and fulfilled. They may also make your partner feel gratified and reassured of your affections.

Protective barriers, such as condoms, can seem like barriers to intimacy and pleasure. So some people naively and idealistically sacrifice their own well-being to show their romantic devotion, thinking, “By protecting myself from him, I would be rejecting him and denying my love,” or “A contraceptive keeps us from totally being one and would deny my love for her,” or “My love is so immense that I want to totally surrender myself during sex – give every part of my being!”

Guilt

Some people get really distressed over having contraception readily available. They think that it makes them look sexually accessible and promiscuous, and not the sort that a partner would bother to romantically seduce and love. They feel guilty about having a contraceptive around, fearing that it looks like they planned the entire sexual activity. This is too bad since, by having contraception within reach at a moment’s notice, you are only protecting yourself.

Shame

Some people may feel embarrassed to talk to their partner, friends, or doctors about contraceptives. Therefore, they do nothing.

Entrapment

Pregnancy has been and often still is a way to trap a partner into a closer commitment, marriage, or family. I’m sure I don’t need to explain the complexity of that one any further.

Sexpert Q & A: How can I keep up on my kegels routine? Click here to find out.

In the Know Sex News . . .

— HIV Risk Behaviors Among Teens Declining. A study in the CDC's Morbidity and Mortality Weekly Report found the percentage of U.S. high school students engaging in sexual behaviors that spread HIV and other sexually transmitted diseases declined between 1991 and 2007. The article also reported the percentage of students who have multiple partners has decreased by 20 percent.

— British Campaign Highlights Right to Sex. "It's My Right!" is a new campaign highlighting the rights of those with learning disabilities to sex and relationships. Launched by the Family Planning Association, the educational effort hopes to empower those with learning disabilities so they can enjoy intimate relationships without putting themselves at risk.

— Prostitutes in South Africa Better Off Financially. A new study, conducted by the Institute of Security Studies and the Sex Work Education and Advocacy Task Force, has found that sex workers, especially those with little education, are better off financially than they would be in the formal sector. A number of them remain prostitutes for that reason.

Dr. Yvonne Kristín Fulbright is a sex educator, relationship expert, columnist and founder of Sexuality Source Inc. She is the author of several books including, "Touch Me There! A Hands-On Guide to Your Orgasmic Hot Spots."

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