Unsafe condoms and other unsafe sex accessories.

Condoms remain the sole effective method of prevention of HIV. However, in some places--including Cambodia and China--condoms have been modified to add so-called pearls, hard rubber studs or even bristles that are painful and dangerous to the receptive partner, causing injury to the vagina and anus. Such injuries contribute to the transmission of disease, so these condoms are not useful for prevention of STIs or HIV. In addition to unsafe condoms, accessories such as the "tiger's moustache" penis ring have bristles and are as dangerous in the same way as unsafe condoms. Public health officials have outlawed the sale of unsafe condoms in Thailand, a step that should be taken in all places where both they and other unsafe accessories are available.