In 2000 the National Institutes for Health (NIH) published the first thorough review of the scientific research on condom effectiveness. The study examined eight STDs and demonstrated that condoms reduce the risk of contracting or transmitting two of them: HIV and gonorrhea (in men). The studies revealed that, when consistently and correctly used, condoms provide an 85 percent risk reduction for the transmission of HIV in males and females and a 45 to 75 percent risk reduction for the transmission of gonorrhea in males.
While the condom may reduce the likelihood of contracting HIV, yearly cases of this virus are much less than 1 percent of all the yearly STD cases. Gonorrhea is a much more common problem, but there was not sufficient evidence to determine how much protection condom use offered women. This is not good news for women, because they suffer much greater consequences from being infected by this disease. It can lead to ectopic pregnancy, pelvic inflammatory disease, and infertility. In regard to the other specific diseases, the report stated that “there was no evidence that condom use reduced the risk of HPV infection.”
Furthermore, the data were unable to determine how effective the condom is in reducing the risk of the other STDs. In spite of all the talk today about condoms and safe sex, they could not say what degree of protection condoms offered for most of the STDs reviewed! This is troubling, considering that these diseases infect millions of people each year and can make them at least two to five times as likely to transmit HIV.
While the NIH study does not prove that the condom is useless in protecting against the STDs mentioned above, it does mean that twenty-eight expert panel members scouring through 138 peer reviewed studies on condom effectiveness were unable to determine its effectiveness. Since the publication of this study, others have determined that the condom use reduces STD risks only by about half.
In the wake of the NIH report, politicians who favor promotion of “safe” sex were livid, arguing that the publication of such information could contribute to a rise in STDs because it undermines public confidence in the condom. What they didn’t want to admit was that the outdated message of “safe sex” causes people to be overconfident in the condom. One scientist noted:
“Some fear that informing the public of how little we know about condom effectiveness would lead to nonuse of condoms. Although it is improbable that any scientific evidence supports this hypothesis, the question remains. Is it ethical for health care professionals, including physicians and pharmacists, to hide the truth from the public? As in every other area of health care, we must give accurate data as we attempt to steer our patients toward the healthiest and safest choices. Ultimately, each individual must decide how much risk he or she is willing to take. But such a decision can be made responsibly only if individuals are accurately informed about the degree of risk they face (or may face) if they choose to be sexually active.”
Determining the effectiveness of condoms in preventing STDs is a complicated matter. For example, some STDs, such as chancroid or gonorrhea, transmit very easily, while others, such as HIV, are not as contagious. Some STDs, such as herpes, change their infectivity over time. One week the person could be shedding the virus, and a week later, not shedding. Factors such as gender, stress, drug interactions, pregnancy, and the presence of another STD also play a role in STD transmission. In fact, each person’s immune system is unique in how well it resists infections. For all of these reasons and more, it is difficult to pinpoint a precise level of condom effectiveness for STDs in general.
When determining the effectiveness of the condom in preventing the spread of STDs, it’s enlightening to examine how well the condom prevents pregnancy. According to the research institute of Planned Parenthood, the failure rate of the condom in preventing pregnancy is 15 percent during the first year of use. Considering that a woman can get pregnant only a few days of the month and STDs can be contracted any day, the condom is by no means adequate protection. No matter what STD we are speaking about, the condom does not guarantee protection even when used consistently and correctly. On the other hand, chastity guarantees 100 percent protection.
. National Institutes of Health, “Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention” (June 2000).
. John Diggs, M.D., “NIH[National Institutes of Health] Report Collapses Foundation of Comprehensive Sex Education,” Abstinence Clearinghouse, August 6, 2001.
. NIH, “Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention,” 26.
. U.S. Department of Health and Human Services. “Scientific Review Panel Confirms Condoms Are Effective Against HIV/AIDS, But Epidemiological Studies Are Insufficient for Other STDs,” by HHS News, press release, July 20, 2001.
. L. Manhart, L. Koutsky, “Do Condoms Prevent Genital HPV Infection, External Genital Warts, or Cervical Neoplasia? A Meta-Analysis,” Sexually Transmitted Diseases29:11 (2002), 725–735; S. Vaccarella, et al., “Sexual Behavior, Condom Use, and Human Papillomavirus: Pooled Analysis of the IARC Human Papillomavirus Prevalence Surveys,” Cancer Epidemiology Biomarkers & Prevention 15:2 (2006), 326–333; R.Winer, et al., “Condom Use and the Risk of Genital Human Papillomavirus Infection in Young Women,” The New England Journal of Medicine 354:25 (2006), 2645–2654; S. Ahmed S, et al., “HIV Incidence and Sexually Transmitted Disease Prevalence Associated with Condom Use: A Population Study in Rakai, Uganda,” AIDS 15:16 (2001), 2171–2179; J. Baeten, et al., “Hormonal Contraception and Risk of Sexually Transmitted Disease Acquisition: Results from a Prospective Study,” American Journal of Obstetrics & Gynecology 185:2 (2001), 380–385; J. Shlay, et al., “Comparison of Sexually Transmitted Disease Prevalence by Reported Level of Condom Use Among Patients Attending an Urban Sexually Transmitted Disease Clinic,” Sexually Transmitted Diseases 31:3 (2004), 154–160; A. Wald, et al., “Effect of Condoms on Reducing the Transmission of Herpes Simplex Virus Type 2 from Men to Women,” Journal of the American Medical Association 285:24 (2001), 3100–3106.
. Nancy Pelosi et al., “Pelosi and House Colleagues Criticize Administration Report for Undermining Condom Effectiveness: Members Request Study Guided by Science Not Ideology,” press release, Washington, D.C. (July 24, 2001) as referenced in note 10, “The NIH Condom Report: The Glass is 90% Full,” by Willard Cates, Jr., Family Planning Perspectives 33:5 (September/October 2001), 232.
. J. Thomas Fitch, “Are Condoms Effective in Reducing the Risk of Sexually Transmitted Disease?” The Annals of Pharmacotherapy 35:9 (September 2001), 1137.
. Haishan Fu, et al., “Contraceptive Failure Rates: New Estimates From the 1995 National Survey of Family Growth,” Family Planning Perspectives 31:2 (March/April 1999), 60.