insist on using a condom. Note, however, that condoms are never 100% safe because they can leak or tear. Condoms tear easily if they are used incorrectly.

Research
The effectiveness of condoms was tested in a two-year study of "discordant couples" (couples where one partner is infected and the other is not) in Europe. It was found that, among the 124 couples who reported consistent use of latex condoms, none of the uninfected partners became infected. However, among the 121 couples who used condoms inconsistently, 10% of the uninfected partners became infected.
In those cases where condoms break or slip off, this is almost always caused by user errors such as using a petroleum-based lubricant, the use of deteriorated or out-of-date condoms, or storing condoms at a high temperature over a long period of time in places such as a car glove compartment or a wallet. Only tested, high-quality condoms should ever be used. As people's knowledge about using condoms increases, breakage and slippage decreases.

Tips to prevent condoms from breaking or leaking:
• Choose pre-lubricated condoms that are specially packed in wrappers that keep light out
• Use a brand of condom that shows it has been tested for reliability. Always check the information on the packet before buying condoms
• Store condoms away from excessive heat, light, and moisture, as these cause them to deteriorate and perhaps break. Store condoms in a cool, dark, dry place if possible. Don't store condoms in the glove compartment of a car where they will be damaged by excessive heat. Condoms can also easily become damaged in a wallet
• Check the expiry date on the condom wrapper. Don't use condoms after the expiry date or more than five years after the manufacturing date because they may break
• Do not use condoms that are sticky, brittle, discoloured or otherwise damaged. Open the wrapper carefully so that the condom does not tear. Be careful not to tear condoms with long nails, teeth, other sharp objects or jewellery
• Make sure that the type of condom you use is strong enough for the type of sexual practice you engage in. Use extra strong condoms (e.g. Durex Extra Strong) for anal penetration as ordinary condoms are generally made for vaginal intercourse
• Don't ever use two condoms (i.e. one pulled over the other) as the friction will tear the condoms.

Lubrication
If extra lubrication is needed with latex condoms, use only lubricants with a water-base such as KY Jelly, glycerine or lubricants specially made for use with condoms. Lubricants with an oil base should never be used, because they weaken, dissolve and break latex condoms. Never use Vaseline or petroleum jelly, baby oil, massage oil, body lotions with an oil base, cooking or vegetable oil, butter or fats as lubricants with latex condoms. Saliva should also not be used because it is not very effective as lubricant. KY Jelly or other water-based lubricants can be bought at any pharmacy or at some supermarkets.

deadlines and lack of employment
• Nutritional factors such as poor eating habits, poor nutritional intake and dieting
• Substance abuse such as caffeine, alcohol, medications, smoking and drugs
• Financial stress
• Physical inactivity
• Chronic disease and pain.

The stress response
The 'stress response' is naturally inherent in all living things; it is directly connected to the instinct for survival. In humans it is what alerts us to danger, and is often called the 'fight or flight response'.
The body's resources are mobilised for a primarily immediate physical response. This process of stimulus and response has a training effect that allows adaptation over time.

However, when we perceive that the life stressors increase beyond our control, and/or our ability to cope diminishes, the stress response starts to negatively impact on health and well being.

It is these two differing factors (perception of stressful event and coping mechanism) that determines why similar stressors affect people differently, and why stressors of seemingly differing magnitude can evoke high levels of stress.

Stress has become the defining feature of the modern western world as the pace of life increases while the innate abilities of humans have remained relatively the same. Stress is on a continuum. At a positive level it is known as 'eustress'. At an excessive or negative level it is known as 'distress'.

The relaxation response
Dr Herbert Benson in the 1970s used this term to describe a response that is opposite to the stress response. The stress response is regulated by the sympathetic nervous system, whereas the relaxation response is regulated by the parasympathetic nervous system, and can be conditioned by the individual.

It is a response that is designed for repair and maintenance of the body and so is vital to well being. The involuntary stress response can be changed to a relaxation response by the use of voluntary deep breathing. In this way the stress response can be reconditioned through various techniques such as meditation, progressive relaxation, self-hypnosis, biofeedback and prayer.

This conditioned ability for us to actively relax can bring a measure of control over the way stress affects us.

Stress conditioning
The nature and type of stress has changed over the last few hundred years. Life stressors are more long term and imaginary today. Most of the things that stress people

out in modern life, never happen; it is more related to 'what if that happens'.

The subconscious mind cannot discern the difference between this real stressful event or a mental preoccupation of a stressful event, and so the physical body reacts in a manner as if it is real.

An imaginary stressor repeated long enough can filter through and alter perception of the event, thereby creating a form of conditioned response. Stress conditioning will eventually lead to a negative hyper-response in the face of minimal stressors. This is often what triggers anxiety, insomnia, and other symptoms of chronic stress. This is also the reason that many people have to relearn the 'relaxation response'.

Stress resilience/ stress competency
Stress resilience is our 'fitness' to cope with stress. It is largely dictated by our physical, mental and emotional state of well being, by our perception/paradigm of the stressful event, the environment and support structure, and by the healthiness of our stress-coping habits. Effective stress competency can be developed, and will increase stress resilience.

Positive coping mechanisms
Certain stress-coping habits allow for positive coping of stress without negative consequences, providing they are done at a safe and effective level for the individual. These include:
• A positive mindset
• Rest and relaxation
• Regular exercise
• Adequate and balanced nutrition
• Good communication
• Emotional support
• Physical contact
• Humour
• Time planning
• Financial planning.

Negative coping mechanisms
People also use certain habitual ways to cope with distress. These habits, while dealing with the immediate stress, will of themselves over time create more stress and negatively affect health.

Examples of negative coping mechanisms include:
• Chemical dependence in the form of illicit drugs, medications, alcohol, caffeine and smoking
• Overeating
• Too much television
• Emotional outbursts
• Victim behaviour
• Overspending
• Manic behaviour.

Stress is a term we use to explain the experience felt in mind and body when we encounter, respond or react to challenging life stressors.

The scale of the reaction known as the 'stress response' is determined primarily by how we perceive the stressful event, our ability to cope with the stressor, and by the scale of the event. How an individual perceives and handles stress therefore plays a major role in determining their well being.

Life stressors can be physical, mental or emotional stimuli, and include both imaginary or real events. The 'stress response' has a very physical component that is mediated via complex interactions between the nervous, hormonal and immune systems.

What are the most common life stressors?
• Major life events such as loss of a loved one, retrenchment or divorce
• Trauma such as sexual abuse, earthquakes and military combat.
• Socio-economic stressors such as malnutrition, poverty and bureaucracy
• Social stressors such as relationship issues, family changes, sexuality, loneliness and social phobia
• Occupational stress such as work overload,