How Effective Are Condoms?
When used consistently and correctly, latex condoms are highly effective in preventing the sexual transmission of HIV (during vaginal, oral, or anal intercourse).[1,2] Latex condoms are also effective in preventing pregnancy and several sexually transmitted infections (STI's).[2,4] Using condoms lowers women's risk of developing cervical cancer, a disease associated with HPV. Consistent use of condoms can also help people clear HPV infection and/or reduce their risk of re-infection.[4,5]
Condoms Are Highly Effective in Preventing HIV Infection.
- Sexual transmission of HIV occurs when infected semen, vaginal, or other body fluids contact mucosal surfaces, such as the male urethra, the vagina, or cervix. According to the Centers for Disease Control & Prevention (CDC), a number of carefully conducted studies, employing rigorous methods and measures, have demonstrated that consistent condom use is highly effective in preventing HIV transmission.[1,2]
- In a two-year study of sero-discordant couples (in which one partner was HIV-positive and one was HIV-negative), no uninfected partner became infected among couples using condoms correctly and consistently at every act of vaginal or anal sex versus 10 percent of those using condoms inconsistently.[1,6]
- In a similar two-year study, two percent of uninfected partners who used condoms consistently became HIV-infected versus 12 percent among those who used condoms inconsistently or not at all.
- A recent study of declining HIV prevalence in Uganda found no evidence that abstinence or monogamy had contributed to the decline. Findings identified the increased use of condoms in casual relationships as important in Uganda's declining HIV infection rates.
"Latex condoms, when used consistently and correctly, are highly effective in preventing the sexual transmission of HIV, the virus that causes AIDS."
—CDC. Male Latex Condoms and Sexually Transmitted Diseases. Atlanta, GA: CDC, 2002.
Condoms Are Effective in Preventing Some STI's.
- Gonorrhea, chlamydia, and trichomoniasis are transmitted when infected semen or vaginal fluids contact mucosal surfaces. Because condoms block the discharge of semen or protect the male urethra against exposure to vaginal secretions, condoms provide a greater level of protection against these STI's.
- Condoms also provide some protection against genital ulcer STI's—such as genital herpes, syphilis, and chancroid—which are transmitted through contact with mucosal surfaces or infected skin.[2,4] Because these STI's may be transmitted across surfaces not covered or protected by the condom, condoms provide a lesser degree of protection against them.
"Latex condoms, when used consistently and correctly, can reduce the risk of transmission of gonorrhea, chlamydia, and trichomoniasis."
"Genital ulcer diseases and HPV infections can occur in both male or female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. Correct and consistent use of latex condoms can reduce the risk of genital herpes, syphilis, and chancroid only when the infected area or site of potential exposure is protected. While the effect of condoms in preventing human papillomavirus infection is unknown, condom use has been associated with a lower rate of cervical cancer, an HPV-associated disease."
—CDC. Male Latex Condoms and Sexually Transmitted Diseases. Atlanta, GA: CDC, 2002.
Condoms Are Effective in Reducing Risk for HPV and Cervical Cancer.
- Almost all cases of cervical cancer are caused by HPV. While at least 3.1 million women in the United States are newly infected each year with HPV, perhaps as many as 40,000 develop non-invasive cervical cancer and less than 11,000 develop invasive cervical cancer.
- Regular Pap smears can detect precancerous conditions long before cervical cancer develops or becomes invasive, permitting women and their doctors to prevent cervical cancer.
- In a 28-month study of 123 college women, researchers found that sexually active women who used condoms consistently were significantly less likely to contract HPV than were women who had not used condoms.
- In a study among 148 women already diagnosed with a pre-cancerous cervical condition and their male partners, 53 percent of women who used condoms had normal cervical findings at two consecutive follow-ups, versus 35 percent of women who did not use condoms. In the same study, 23 percent of women who used condoms cleared HPV from their system (as shown by HPV testing) compared to four percent of women who did not use condoms.
- In one study, men who used condoms consistently and correctly had reduced risk for penile infection with HPV. Another study showed that men who consistently used condoms had a lower incidence of anal HPV infection than did inconsistent or non-users. In one study, men who consistently used condoms showed a faster regression in penile HPV lesions than did men who did not use condoms.
Condoms Are Effective in Preventing Unintended or Unwanted Pregnancy.
- In one year, only two of every 100 couples who use condoms consistently and correctly will experience an unintended pregnancy—two pregnancies arising from an estimated 8,300 acts of sexual intercourse, for a 0.02 percent per-condom pregnancy rate.
- In one year with perfect use (meaning couples use condoms consistently and correctly at every act of sex), 98 percent of women relying on male condoms will remain pregnancy free. With typical use, 85 percent relying on male condoms will remain pregnancy free.
- In one year with perfect use, 95 percent of women relying on the female condom will remain pregnancy free. With typical use, 79 percent relying on female condoms will remain pregnancy free.
- By comparison, only 15 percent of women using no method of contraception in a year will remain pregnancy free.
Condoms Are Effective Barriers.
- The condom—latex or polyurethane, male or female—is the only technology available to prevent the sexual transmission of HIV.
- Laboratory studies show that latex condoms provide an essentially impermeable barrier to particles the size of HIV and other STI pathogens. Studies show that polyurethane condoms also provide effective barriers against sperm, bacteria, and viruses such as HIV.
- Several studies clearly show that condom breakage rates in this country are less than two percent. Most of the breakage and slippage is likely due to incorrect use rather than to the condoms' quality.
Condom Availability Programs Increase Condom Use among Sexually Active Teens.
- Condom availability programs reduce the barriers—financial, logistical, and social—that deter sexually active teens from using condoms. They operate in locations (such as schools and teen clinics) where adolescents congregate; make condoms available at low or no cost to teens; and provide condoms in ways that minimize teens' discomfort about obtaining condoms.
- Studies show that condom availability programs encourage sexually active teens to use condoms more often and more consistently than do their sexually active peers who are without condom availability programs.[17,18,19,20]
- Studies show that condom availability programs do not encourage teens to initiate sex and do not cause sexually active teens to have sex more often or with more partners.[17,18,19,20]
- The American Academy of Pediatrics, American College of Obstetricians & Gynecologists, American Medical Association, and Institute of Medicine all support communities' making condoms available to teens. In addition, CDC has included condom availability among an array of effective approaches to reducing HIV and other STI's.
- CDC. Condoms and Their Use in Preventing HIV Infection and Other STD's. Atlanta, GA: CDC, 1999.
- CDC. Male Latex Condoms and Sexually Transmitted Diseases. Atlanta, GA: CDC, 2002.
- Hatcher RA et al. Contraceptive Technology, 18th rev. ed. New York: Ardent Media, 2004.
- Holmes KK et al. Effectiveness of condoms in preventing sexually transmitted infections. Bulletin of the World Health Organization 2004; 82:454-461+.
- Hogewoning CJA et al. Condom use promotes regression of cervical intraepithelial neoplasia and clearance of human papillomavirus: a randomized clinical trial. International Journal of Cancer 2003; 107:811-816.
- de Vincenzi I. A longitudinal study of human immunodeficiency virus transmission by heterosexual partners. New England Journal of Medicine 1994; 331:341-346.
- Wawer MJ et al. Declines in HIV Prevalence in Uganda: Not as Simple as ABC. Presentation at the 12th Conference on Retroviruses and Opportunistic Infections, February 22-25, 2005, Boston, Massachusetts; http://www.retroconference.org/2005/CD/Abstracts/25775.htm; accessed 3/2/2005.
- Walboomers JMM et al. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. Journal of Pathology 1999; 189:12-19.
- Weinstock H et al. Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000. Perspectives on Sexual and Reproductive Health 2004; 36:6-10.
- American Cancer Society. What Are the Key Statistics about Cervical Cancer? Washington, DC: The Society, 2004.
- Winer RL et al. The Effect of Consistent Condom Use on the Risk of Genital HPV Infection among Newly Sexually Active Young Women, presented at the 16th Biennial Meeting of the International Society for Sexually Transmitted Diseases Research, July 10-13, 2005, Amsterdam, The Netherlands.
- Baldwin SB et al. Condom use and other factors affecting penile human papillomavirus detection in men attending a sexually transmitted disease clinic. Sexually Transmitted Diseases 2004;31:601-607.
- Chin-Hong PV et al. Condoms Prevent Incident Anal Human Papillomavirus (HPV) Infection in Men: the Explore Study, presented at the 16th Biennial Meeting of the International Society for Sexually Transmitted Diseases Research, July 10-13, 2005, Amsterdam, The Netherlands.
- Bleeker MC et al. Condom use promotes regression of human papillomavirus-associated penile lesions in male sexual partners of women with cervical intraepithelial neoplasia. International Journal of Cancer 2003; 107:804-810.
- Chaya N, Amen KA. Condoms Count: Meeting the Need in the Era of HIV/AIDS. Washington, DC: Population Action International, 2002.
- American College of Obstetricians and Gynecologists. Condom availability for adolescents. Journal of Adolescent Health 1996; 18:380-383.
- Guttmacher S et al. Condom availability in New York City public high schools: relationships to condom use and sexual behavior. American Journal of Public Health 1997; 87:1427-1433.
- Blake SM et al. Condom availability programs in Massachusetts high schools: relationships with condom use and sexual behavior. American Journal of Public Health 2003; 93:955-962.
- Furstenberg FF et al. Does condom availability make a difference? An evaluation of Philadelphia's health resource centers. Family Planning Perspectives 1997; 29:123-127.
- CDC. Condom availability as a prevention strategy. CDC Update 1997 (February):[1-2].
- American Academy of Pediatrics. Condom availability for youth. Pediatrics 1995; 95:281-285.
- American Medical Association. Update on AMA Policies on human sexuality and family life education [H-170.974] HOD Policy 1997. Chicago, IL: AMA, 1997.
- Committee on Prevention and Control of Sexually Transmitted Diseases. The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Washington, DC: National Academy Press, 1997.
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