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HUMAN SEXUALITY:

OBJECTIVE INFORMATION ON CONDOMS

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Sponsored link.


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A NIH meeting to discuss condom effectiveness:

The U.S federal government's National Institute of Allergy and Infectious Diseases, held a meeting on 2000-JUN-12 & 13 in Herndon, VA to discuss their survey of existing studies on the effectiveness of condom usage on the prevention of sexually transmitted disease (STD) transmission. A 27 page worship summary, titled "Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention" is available online. They concluded that adequate studies have only been published for the effectiveness of condoms in preventing pregnancies and preventing the transmission of HIV infection -- the virus that causes AIDS. They found that the design of studies of other STDs rendered them essentially useless. 1

As part of their drive to ban comprehensive sex-ed classes in public schools, many religiously conservative and pro-life web sites have distorted the findings of this study. They have concluded that condoms are not particularly effective in limiting unwanted pregnancies and in preventing the transmission of STDs. In fact, the NIH study found condoms to be quite effective at preventing pregnancy and HIV transmissions. Unfortunately, the design of most condom effectiveness studies is inadequate to allow precise conclusions about other STDs.

Rather than interpret the findings of this meeting, we will simply quote passages from their online workshop summary:

bulletThe purpose of the workshop was: "to answer the following question: 'What is the scientific evidence on the effectiveness of latex male condom-use to prevent STD transmission during vaginal intercourse?'."
bullet"Focused research studies have documented the high effectiveness of condoms for prevention of pregnancy."
bulletConsistent "...users of the male condom significantly reduced the risk of HIV infection in men and women. These data provided strong evidence for the effectiveness of condoms in preventing HIV transmission in both men and women who engage in vaginal intercourse."
bullet"...studies...have demonstrated that condoms provide a highly effective barrier to the transmission of particles of similar size to those of the smallest STD virus."
bullet"...the Panel found the published epidemiology literature to be inadequate to definitively answer the question posed to the workshop participants."
bulletConcerning other STDs including gonorrhea in women, chlamydial infection and trichomoniasis: "...because of limitations in study designs there was insufficient evidence from the epidemiological studies on these diseases to draw definite conclusions about the effectiveness of the latex male condom in reducing the transmission of these diseases.
bullet"....the absence of definitive conclusions reflected inadequacies of the evidence available and should not be interpreted as proof of the adequacy or inadequacy of the condom to reduce the risk of STDs other than HIV transmission in men and women and gonorrhea in men. To definitely answer the remaining questions about condom effectiveness for preventing STD infections will require well-designed and ethically sound clinical studies."
bullet"HIV infection is the only STD for which formal meta-analyses have been published....consistent condom use decreased the risk of HIV/AIDS transmission by approximately 85%."

Their report does estimate condom effectiveness on the basis of the volume of semen deposited in the woman's vagina. They note that even if the condom breaks or is defective, the woman's exposure is very much reduced. For latex condoms:

Event Volume of semen released Likelihood of release
No condom used

3.3 ml (milliliters)

 100 in 100

Condom used, but it breaks 1 ml 1 in 50
Condom used, but has a hole detectable by a water leak test 1/100 ml 1 in 400
Condom used with no break or holes but still passes virus 6/1,000,000 ml 1 in 43
Condom used with no break or leaks 0.0 ml about 95 in 100

Of course, a simple measure of exposure to semen does not necessarily predict the chances of transmitting an STD. However, in the absence of adequate studies, they may give a vague indication of condom effectiveness for some STDs.

The Human Papillomavirus (HPV) is a special case because it is not transmitted by genital secretions or through contact with open sores. It is particularly of concern because it is widespread, and because a few of its 100 types can develop into cervical cancer.

"HPV is probably transmitted through contact with infected epithelial surfaces and/or genital fluids containing infective viruses.....An estimated 20 million Americans are currently infected with genital HPV (170). More than 50% of sexually active adults are estimated to have once been infected with one or more genital HPV types, significant majorities of which are subclinical, unrecognized and benign."

There is a possibility that HPV transmission can occur by contact of two skin surfaces not covered by a condom. 

They concluded that:

"...study results did suggest that condom use might afford some reduction in risk of HPV-associated diseases, including genital warts in men and cervical neoplasia in women."

In Heather Boonstra's article in the 2003-MAR issue of the Guttmacher Report on Public Policy, she wrote:

"The ideal study, a randomized controlled clinical trial, has not been used because it would require control-group participants to be counseled not to use condoms. Such counseling is not considered ethically acceptable—itself an implicit acknowledgement of condom effectiveness in STD prevention within the scientific community. As a result of these standards for study design, none of the studies reviewed by the workshop panel was considered optimal, and any future studies will face similar challenges." 1

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Subsequent research findings:

Family Health International reported in their annual journal Network 2002:

In a study published June 27, 2001 in the Journal of the American Medical Association, scientists concluded that condom use during more than 25 percent of coital acts was associated with protection against genital herpes transmission to susceptible women.

Other encouraging recent studies that are nearing publication include research in Peru that found consistent condom use protected sex workers against gonorrhea and, to a lesser extent, against chlamydia.

And more recent follow-up data have become available from an important study that led the panel to conclude that consistent condom use protects men against gonorrhea. The more recent findings also suggest substantial protection against chlamydia. 3

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Disclaimer:

All information is general in nature and is not intended to be used as a substitute for appropriate professional advice.

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References:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

  1. "Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention," National Institute of Allergy and Infectious Diseases, 2000-JUN-12-13, at: http://www.niaid.nih.gov/
  2. Heather Boonstra "Public Health Advocates Say Campaign to Disparage Condoms Threatens STD Prevention Efforts," Guttmacher Report on Public Policy, Vol. 6, Nbr. 1, 2003-MAR, at: http://www.guttmacher.org/
  3. "Contraceptive Update: U.S. Study Panel Confirms Condoms Are Effective against HIV/AIDS," Network: 2002, Vol. 21, No. 2, at: http://www.fhi.org/

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Copyright © 2006 by Ontario Consultants on Religious Tolerance
Originally written: 2006-APR-24
Latest update: 2006-APR-24
Author: B.A. Robinson

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