The Facts About HIV and STD Prevention

For people who are sexually active, latex condom use is the most effective method of preventing HIV and many other sexually transmitted diseases (STDs).

Latex Condoms Stop the Spread of HIV
Overwhelming scientific evidence indicates that latex condoms stop the spread of HIV and therefore save lives.

Latex condoms, used consistently and correctly, are 98-99% effective in preventing HIV
transmission. Two rigorous studies of couples in which one person is infected with HIV and the other is not (known as “discordant couples”) indicate that HIV is very rarely transmitted when condoms are always used.

• In one study of 123 discordant couples who used condoms every time they had sex, none of the uninfected partners became infected. But among 122 couples who used condoms inconsistently, 12 uninfected partners became infected.
  
  
• In a separate study of discordant couples, three of 171 (two percent) uninfected female partners became infected when their HIV-infected partners reportedly always used condoms. However, eight of 55 (15 percent) inconsistent condom users became infected.

Studies cited by some to question the effectiveness of condoms in HIV prevention generally have significant design flaws. For example:

• Certain studies do not distinguish between consistent and inconsistent condom use – which is similar to studying the effectiveness of seat belts but including people who do not
  always use them.
  
  
• Some studies do not always assess HIV status before enrolling participants; therefore, it is
  likely that some “uninfected” partners were actually infected before entering the trial.

Condoms Reduce the Risk of Contracting Other STDs
Condoms are effective in reducing transmission of many STDs, including chlamydia, gonorrhea, and syphilis.

A 1997 IOM report prepared by an independent body of experts stated that condoms “decrease the probability of STD transmission during sexual intercourse.”

Given their effectiveness in protecting against HIV, condoms can be expected to provide similar levels of protection against other STDs transmitted via genital secretions, including chlamydia, gonorrhea, and trichomoniasis.

For STDs transmitted through sores or ulcers – genital herpes, syphilis, and chancroid – the level of protection provided by condoms depends on the site of the sore or infection and whether the condom fully covers the lesion. Because they cover and protect a significant portion of the genitals during sexual contact, condoms can be expected to reduce, but not eliminate, the risk of transmitting these STDs.

Unlike other STDs, Human Papillomavirus (HPV) is transmitted from skin cell to skin cell. Although condoms should provide a degree of protection if they cover the infected genital skin and are used properly, less is known about how much condoms protect against the virus. Most people who have HPV are asymptomatic, and in 90 percent of cases, the immune system clears the body of the virus over time. In rare cases, HPV leads to cervical cancer, which can be prevented or treated highly successfully when detected early through regular Pap smears.

Latex Condoms are Highly Effective Devices

• Every condom made in the United States is tested for defects and must meet strict quality controlguidelines enforced by the federal Food and Drug Administration (FDA).
  For condoms to be sold, 99.6 percent of condoms subjected to quality control tests must pass
  a “water test” – that is, they must not leak when filled with 800 milliliters of water.
  
  Condoms are a highly effective barrier against even the smallest sexually transmitted virus
  (hepatitis B).
  
  
• Studies have shown that condoms are not likely to slip off or break if used properly.
  The rate of condom breakage or slippage during sex is low – only 0.4 to two percent. Even in
  these rate situations, condoms would reduce the risk of infection, compared to unprotected
  sex.

Informing People About Condoms is Important
A comprehensive approach to HIV and STD prevention is critical -- including disseminating information about condoms.

While the best protection against STDs, including HIV, is to abstain from sex or remain monogamous with an uninfected partner, it is also critical to ensure that sexually active individuals have information about condoms. There are a number of reasons to ensure that people also are properly informed about the importance of condoms:

• Many unmarried people and people in non-monogamous relationships are sexually
  active. For example, studies show that approximately two-thirds of high school
  students have engaged in sexual intercourse by the time they graduate.
  
  
• Those committed to monogamy cannot be sure that their partner is uninfected or that he or she is always monogamous.
  
  
• Individuals aspiring to abstinence sometimes fail. One study found that more than a fourth of women who say that abstinence is their contraception method become pregnant every year.
  
  
• There are more than 15 million new cases of STDs in the United States ever year – an indication of the serious consequences of unprotected sex.

Comprehensive school health education -- including encouraging teens to delay sexual activity and providing them with appropriate, scientifically accurate information on the effectiveness of condoms – is critical.

Teens are among those most likely to have multiple sex partners and engage in unprotected sex, and therefore are at highest behavioral risk for acquiring most STDs.

Extensive research indicates that comprehensive school health education programs that include information on condom use do not encourage teens to initiate sex at an earlier age or engage in more frequent sex if they are already sexually active.

• In a recent Swiss study of 16- to 19-year-olds, a sex education program did not increase either the level of sexual activity or the number of sex partners. Importantly, though, among those who were sexually active, condom use did increase.
  
  
• A World Health Organization review of 19 studies of sex education programs found there was no evidence that sex education leads to earlier or increased sexual activity in young people. In fact, six studies showed that sex education programs actually led to a delay or decrease in sexual activity. Ten of the studies showed that educationprograms increased safer sex practices among young people who were already
  sexually active.