Condom effectiveness


Condoms always have and always will pose a great use-effectiveness problem. In fact, the FDA requires the manufacturer to list the ideal use-effectiveness rates of approved contraceptives in the package inserts for oral contraceptives, which are even more easily controlled in use. Combining the ideal and the use-effectiveness rates, condoms are listed at 90-70 percent, which translates to a failure rate of 10-30 percent. These rates are based on birth prevention, not disease prevention.

This distinction is critical when safety and protection are honestly considered and evaluated. For example, a woman's window of fertility is 7 days out of an average 28-day cycle. Infections such as AIDS, however, can occur every day at any given minute, depending on the immune system. This means that there are at least four times as many days during which disease can be transmitted as opposed to the occurrence of fertilization - the simple transmission of a sperm into an egg.(1, 2, 3)

Some claim that condoms will cut down on the spread of many sexually transmitted diseases, including AIDS. However, a study published in Sexually Transmitted Diseases fails to show any reduction in newly acquired STDs among those who are described as "always users" of condoms. (4) S. duBose Ravenel, M.D., comments that "the obvious possibility that condoms do not provide significant protection was not even discussed by the authors." (5)

According to Joe S. McIlhaney, Jr., M.D., there is clinical evidence to show that "the same rate of chlamydial infection occurs in those who use condoms and those who do not." We can conclude that the condom also fails to protect women from chlamydia trachomatis, "the most common bacterial sexually transmitted disease in the United States." (6)

Doctors Zelig Friedman and Liliana Trivelli of the HIV/AIDS Advisory Council of New York City's Board of Education express grave concerns about condom effectiveness and write: Although no one would argue that condoms may help reduce the risk of pregancy and of some diseases if used perfectly, a closer look at the circumstances of failure renders this option unacceptable. Condoms have a poor track record as contraceptives (15% failure for youngsters in the first year of use), offer no protection for chlamydia or HPV [human papiloma virus] and have a 2Ü4% rate of tearing, breakage and slippage. With regard to HIV they are not impermeable. (7)

THE SPERM VS. THE AIDS VIRUS

A paper in the February 1992 issue of Applied and Environmental Microbiology reports that filtration techniques show the HIV-1 virus to be 0.1 micron (4 millionths of an inch) in diameter. It is three times smaller than the herpes virus, 60 times smaller than the syphilis spirochete, and 50 to 450 times smaller than sperm. (8)

THE FLAWED CONDOM

Naval Research Laboratory (NRL) researchers, using powerful electron microscopes, have found that new latex, from which condoms are fabricated, contains "maximum inherent flaw[s]" (that is, holes) 70 microns in diameter. (9) These holes are 700 times larger than the HIV-1 virus. There are pores in latex, and some of the pores are large enough to pass sperm-sized particles. Carey, et al., observed leakage of HIV-sized particles through 33%+ of the latex condoms tested. In addition, as Gordon points out in his review, the testing procedures for condoms are less than desirable. United States condom manufacturers are allowed 0.4% leaky condoms (AQL). Gordon states, "The fluctuations in sampling permits many batches not meeting AQL to be sold." In the United States, 12% of domestic and 21% of imported batches of condoms have failed to meet the 0.4% AQL. (10)

CONDOMS FAIL TESTING

In a 1988 study sponsored by the National Institutes of Health, Bruce Voeller of the Mariposa Foundation in Topanga, California, a non-profit organization dedicated to preventing the spread of sexually transmitted diseases, ranked 31 brands of latex condoms according to how well they met the U.S. and international quality assurance standards designed to ensure that condoms provide an effective barrier against human sperm. "Many of the condoms now on the market would not get FDA approval if they were required to meet today's standards," says Voeller. Although all condoms sold in the U.S.are supposed to pass quality assurance tests, those marketed before 1976 need not meet the more stringent requirements necessary to win FDA marketing approval. (11)

Dr. Collart reports that "Gotszche and Hording in their study of in vivo [real life] condom failure rates concluded 'Condoms to prevent HIV transmission do not imply truly safe sex.' In addition Steiner, et al., observed newer lots of condoms had actual breakage rates of 3.5-8.8%, while actual breakage rates for older lots ranged from 9.8-18.6%. In a study conducted by Ahmed, et al., 29%-42% of those who had used condoms experienced at least one breakage. In a survey conducted by the University of Manchester, 52% of those who had obtained condoms from their family planning clinic had one or more either burst or slip off in the 3 months before the survey. In studies by Albert, et al., and by Wright, et al., 36% and 38% of their respondents reported condom failures respectively." (12)

CONDOM + SPERMICIDE

Some have advocated the use of spermicide containing nonoxynol-9 in the prevention of HIV infection. However, the protective effects of nonoxynol-9 have not been established in vivo for any of the viral STDs. Some reports suggest that spermicides (including nonoxynol-9) may be associated with irritation and ulceration of genital and rectal epithelia, side-effects that may actually facilitate HIV infection. In a study with Nairobi prostitutes, a higher rate of new HIV infections was found among women using nonoxynol-9 than among those not using it. Additionally, in a study of rhesus monkeys who were exposed to a high dose of simian immunodeficiency virus following vaginally inserted nonoxynol-9 foam, half the monkeys developed an infection. (13, 14, 15, 16)

CONDOM CLIMATE CONTROL

Condoms are sensitive to heat and cold, yet they are not normally transported in climate-controlled vehicles. Vesey, in his study of condoms,checked 72,000 trucks and has actual photographs of eggs frying in the backs of trucks used for condom distribution. Partly due to Vesy's study, Burlington County, NJ, banned the distribution of condoms at the county's AIDS counselling center, because they concluded that the risk of liability for condom failures was too great. (17)

DEADLY DELUSIONS

In a 1990 review article by April and Schreiner, the authors summarize recent studies on HIV infection and conclude, "Recent studies on HIV prevention show the assumption that condoms provide reliable protection against HIV to be a dangerous illusion." The studies reviewed by the authors showed that the rate of seroconversion (HIV infection) associated with condom use ranged from 13% to 27% and more. (18) Frosner concludes that "Available data now indicate that efficacy of condoms has been largely overestimated." (19) In a study in Florida, where heterosexual couples used condoms, 17% of partners of AIDS patients became infected within 18 months, (20) despite the frequency of sexual relations being lower if one partner is HIV-positive.(21) Detels, et al., (22) observed a risk reduction of only 3.3:1 for those who used condoms with all of their partners, and a 1.8:1 increase in risk for those who used condoms for some of their partners as opposed to using condoms for none of their partners. This would indicate that condoms are ineffective for prolonged or lifelong protection from AIDS. (23) In addition, since 100% condom use is difficult if not impossible to obtain, the realistic number to look at would be the risk while using condoms some of the time. It is more realistic to expect teens to be abstinent (which is 100% effective in preventing sexual transmission of HIV) than it is to expect them to use condoms 100% of the time (which has an HIV failure rate approaching 100% with life-long use.) Joffe, et al., (24) state: "The association between categories of condom use and history of an STD were not statistically significant at conventional levels after adjustment for number of partners." Cohen, et al., (25) conducted a study in which patients who had contracted an STD were given a condom education course. Within nine months "19.9% of the men and 12.6% of the women returned with new STD," some multiple times. The STD reinfection rate actually increased for women. Frosner states the U.S. government has withdrawn a $2.6 million grant to study condoms because "An unacceptably high number of condom users probably would have been infected in such a study."

PANACEA OR PLACEBO?

In conclusion, Herbert Ratner, M.D., offers the best summary of all when he says, Actually, the major accomplishment of the condom campaign to prevent AIDS is to impress the promoters, politicians and the public at large that something is being done; and although well-intentioned, it offers more of a placebo than a panacea. Publicizing the condom to the four winds is, for the most part, the bravura of a puritan who is trying to prove to the world that he is not a puritan. To concentrate on the mechanical aspects of the sex act to the exclusion of the emotional and psychological aspects (which the condom campaign ignores) is the essence of Puritanism. The only difference between the new and the old is that whereas the traditional puritans were alleged to believe that sex was something to be isolated and repressed, neo-puritans accept sex as something to be isolated and exercised. (28) Reviewed by Joel McIlhaney, M.D., of the Medical Institute for Sexual Health

NOTES

1.Weller, Susan C., "A Meta-Analysis of Condom Effectiveness in Reducing Sexually Transmitted HIV," Social Science and Medicine, Vol. 36, #12, June 1993, pp. 1635-1644. 2.Smith, Richard W., The Condom: Is It Really Safe Sex? (unpublished, October 1990) pp. 8-9. 3.Collart, David G., M.D., Condom Failure for Protection From Sexual Transmission of the HIV: A Review of the Medical Literature, Feb. 16 1993. 4.Zenilman, Jonathan, et al., "Condom Use to Prevent Incident STDs: The Validity of Self-Reported Condom Use," Sexually Transmitted Diseases, Jan.-Feb. 1995, pp.15-21; 5.Ravenel S. duBose, M.D., "Comments and Observations," Aug. 5, 1995. 6.Joel McIlhaney, Jr., M.D., "Chlamydia Trachomatis; The Most Common Bacterial Sexually Transmitted Disease in the United States," Medical Institute for Sexual Health Sexual Health Update, Vol. 3, #3, Fall, 1995. 7.Friedman and Trivelli, "Condom Availability for Youth: A High Risk Alternative," Pediatrics, 2/97, p. 285. 8.Lytle, C. D., et al., "Filtration Sizes of Human Immunodeficiency Virus Type 1 and Surrogate Viruses Used to Test Barrier Materials," Applied and Environmental Microbiology, Vol. 58, #2, Feb. 1992. 9."Anomalous Fatigue Behavior in Polysoprene," Rubber Chemistry and Technology, Vol. 62, #4, Sep.-Oct. 1989. 10.Collart, David G., M.D., loc. cit. 11.Nowak, Rachel, "Research Reveals Condom Conundrums," The Journal of NIH Research, Vol. 5, Jan. 1993, pp. 32, 33. 12.Collart, David G., M.D., op. cit. 13.Bird, K.D., AIDS, Vol. 5, pp. 791-796, 1991. 14.Voeller, B., AIDS, Vol. 6, pp. 341-342, 1992. 15.Kreiss, J.; Ruminjo, I.; Ngugi, E.; Roberts, P.; Ndinya-Achola, J.; and Plummer, F., 1989 V International Conference on AIDS, Montreal. 16.Miller, C.J.; Alexander, N.J.; Sutjipto, S.; et al., J. Med. Primatol, Vol. 19, pp. 401-409, 1990. 17.Vesey, W.B., HLI Reports, Vol. 9, pp. 1-4, 1991. 18.April, K., and Schreiner, W., Schweiz. med. Wschr., Vol. 120, pp. 972-978, 1990. 19.Frosner, G.G., 1989, Infection, Vol. 17, pp. 1-3. 20.Fischl, M.A.; Dickinson, G.M.; Segsl, A.; Flanagan, S.; and Rodriguez, M.; Presentation THP. 92, III International Conference on AIDS in Washington D.C., 1-5 June, p. 178, 1987. 21.Klimes, I., et al., AIDS Care, Vol. 4, p. 151, 1992. 22.Detels, R.; English, P.; Visscher, B.R.; Jacobson, L.; Kingsley, L.A.; Chmiel, J.S.; Dudley, J.P.; Eldred, L.J.; and Ginzburg, H.M.;Journal of Acquired Immune Deficiency Syndromes, Vol. 2, pp. 77-83, 1989. 23.Gordon, R., loc. cit. 24.Joffe, G.P.; Foxman, B.; Schmidt, A.J.; Farris, K.B.; Carter, R.J.; Neumann, S.; Tolo, K.-A.; and Walters, A.M.; 1992, Sexually Transmitted Diseases, Vol. 19, pp. 272-278. 25.Cohen, D.A.; Dent, C.; MacKinnon, D.; and Hahn, G.; Sexually Transmitted Diseases, Vol. 19, pp. 245-251, 1992. 26.Frssner, G.G., loc. cit. 27.Byer, C.O., and Shainberg, L.W., Dimensions of Human Sexuality, Wm. C. Brown Publishers, 1991. 28.Ratner, Herbert, M.D., "Condoms and AIDS," ALL About Issues, Feb. 1989, p. 36.


Condoms afford no real protection

One or more of the following characteristics puts you at above average risk of ovarian cancer:

Family history of ovarian cancer, breast cancer, colon cancer. Personal history of breast cancer, endometrial cancer, colon cancer. No pregnancies or no birth control use and infertility (uninterrupted ovulation). Exposure to talc or asbestos (industrial contamination, frequently used douches, CONDOMS, dusting powder containing talc, used in the genital area. Increasing age. Breast-Ovarian Cancer Syndrome(s) Ashkenazi Jewish population. Fertility drugs taken for more than three cycles has been linked to an increased risk.
http://www.families-first.com/features/ovariancancer.htm

Why Don't Condoms Stop HPV?

Human papillomavirus differs from other sexual disease in its method of transmission; it is not spread from one person to another through the exchange of bodily fluids. Rather, it spreads through skin-to-skin contact. Since HPV is a regional, multicentric disease, it infects the entire genital area: the penis, scrotum, vulva and surrounding areas. Condoms do not cover the scrotum, nor most of the other areas that can be infected with the virus. There also tends to be contact between the anogenital skin of the partners before a condom can be correctly placed on the penis. "No known effective barrier exists that will protect the vulva or prevent vulvar transfer of the virus," according to Barbara S. M.D., M.S., clinical associate professor of family practice, University of Michigan Medical School. Adds Mary E. Verdon, M.D., of the American Academy of Family Physicians, "In the 1970s, it was demonstrated that a single sexual contact with a person infected with external genital warts carries about a 60 percent chance of transmission." However, there are several different strains of HPV that do not cause genital warts; therefore, transmission can occur without the presence of any visible symptoms. These strains are more likely to be cancerous.

Are condoms safe?

Dr. Patrick Dixon A spokesman from the London Rubber Company (Durex) admitted that if incorrectly used, the failure rate of condoms could be anything from 25% up to 100%, and there are real problems with teaching people how to use them---not least because of illiteracy. Problems of illiteracy are so bad in the United States (one in five adults) that the army printed manuals in cartoon form for the Gulf War. In the United Kingdom, Durex instructions now contain illustrations for the one in ten who cannot read. The condom is the least reliable contraceptive in wide use---it's as bad as the diaphragm or cap with spermicide. The only thing less reliable is the sponge (up to 25% pregnant each year). Many violently disagree. They say it is a superb contraceptive, it is people who are unreliable: they put it on too late or inside out, tear it, forget it, let it fall off. They say people are unreliable but the condom is reliable, if properly used. Condoms may be too small for one in five men. Recently there was an outcry about how dangerous three-wheeled invalid vehicles were. `Unsafe,' people said. No one went on TV to say that the vehicles were perfectly safe, it's just that people need to be careful when driving them when going round corners. On the contrary, I think most people saw that average drivers could very easily have accidents through no fault of their own. It is easy to have an accident with a condom. Condoms are unreliable compared to, for example, the pill. That is why the pill is so popular---not just because it is a more convenient method. Things are worse than they appear from the pregnancy rates. Out of 100 couples, ten will have great difficulty in conceiving anyway. Five will probably never be able to conceive for various reasons, including previous infections with sexually-transmitted diseases. After four months of trying to conceive, only about half of an average group of women will succeed in becoming pregnant. If they used a perfectly safe method two out of three times that they had intercourse, it would take a year for half to become pregnant. If they used the method for ten out of twelve months of the year, then twenty-five out of a hundred could be expected to get pregnant in a year. If they had unprotected sex for one month a year and used the method for eleven months, then it could be expected that over twelve would become pregnant in a year. What this means is that if condoms produce a failure rate of around twelve in a hundred per year, then they must be leaking often. It is about the same thing as having intercourse for a whole month without any protection at all but taking the pill the rest of the year. Somehow or other secretions from a man and a woman are very frequently meeting each other. This conclusion is confirmed by a study of 2,000 acts of intercourse by eighty heterosexual and seven homosexual couples, with fourteen types of condoms. The overall failure rate from slippage or rupture was 11.3%, even higher than the one in twelve (8.3%) theoretical rate predicted above.

Are Condoms Really Safe?

Fact: Latex condoms have tiny intrinsic holes called "voids." The AIDS virus is 50 times smaller than these tiny holes which makes it easy for the virus to pass through them (5), about as easy as a dime passing through a basketball hoop.

References (1) "Contraceptive Failure Rate in the U.S.: Estimates from the 1982 National Survey of Family Growth, " M.D. Hayward and J. Yogi, Family Planning Perspectives, Sept/Oct. 1986, p. 204. (2) "Contraceptive Failure Rate in the U.S.: Revised Estimates From the 1982 Natl. Survey of Family Growth," E.F. Jones and J.D. Forrest, Family Planning Perspectives, May/June 1989, p. 103. (3) "Condom 'Cure' Questioned by top AIDS researcher," Russell Shaw, Our Sunday Visitor, 1/23/94. (4) "Condoms: Experts Fear False Sense of Security," The New York Times, 8/18/87. (5) Dr. C.M. Roland, Editor of Rubber Chemistry and Technology, Letter to the Editor, The Washington Times, 4/22/92. (6) Sources for STD statistics: The Alan Guttmacher Institute, New York and the Centers for Disease Control, Atlanta.

Condoms have an annual contraceptive failure rate of 18.4 percent for girls under age 18..... (1). And among young, unmarried, minority women the annual failure rate is 36.3 percent; among unmarried Hispanic women it is as high as 44.5 percent (2). (2) "Contraceptive Failure Rate in the U.S.: Revised Estimates From the 1982 Natl. Survey of Family Growth," E.F. Jones and J.D. Forrest, Family Planning Perspectives, May/June 1989, p. 103.

Condoms and syphilis

Because syphilis can be spread through direct contact with infected material, condoms may NOT be completely effective in preventing the spread of syphilis. From: - AIDS Project Los Angeles Web Site http://www.apla.org/apla/ed/syphilis.html


Are condoms the cause of the epidemic of anal,
penile, testicular and ovarian cancers?

Lt. Hal Henderson died of latex induced anaphylaxis. One of the hundreds of victims of Latex Allergies and LIDS.

According to FDA Medwatch data as far back as June 1996, there were 28 reported deaths and 225 anaphylactic events associated with latex products in all settings. Recent reports in the literature indicate that from about 1 percent to 6 percent of the general population and about 8 percent to 12 percent of regularly exposed health care workers are sensitized to latex. An estimated 17 million Americans are now sensitive to latex ( up from not one recorded case twenty years ago). (Kelley et al. 1996; Katelaris et al. 1996; Liss et al. 1997; Ownby et al. 1996; Sussman and Beezhold 1995).

FACT: CONDOMS CONTAIN KNOWN CARCINOGENS IS SUBSTANTIAL QUANTITIES

The one fact we do know is condoms contain chemicals KNOWN to cause cancer and others suspected as carcinogens. Seven carcinogens or suspected carcinogens are used in condom manufacture. PLEASE TAKE THE TIME TO CHECK THE LINKS YOURSELF.

LATEX PROCESSING CHEMICALS

http://www.itcilo.it/english/actrav/telearn/osh/ic/106490.htm
By John G. Downing, M..D. First Published in the New England Journal of Medicine, * Highly Toxic or Irritant * Aniline * Hexamethyline-tetramine * Ortho-toluidine * * Slightly Toxic or Irritant * Alpha-naphthylamine * Beta Methyline aniline * Para-Phenylinediamine FROM :- http://193.51.164.11/htdocs/monographs/Suppl7/Toluidine-ortho.html Overall evaluation: - Ortho-Toluidine is possibly carcinogenic to humans (Group 2B). Para-toluidine Inhalation Blue lips or finger nails. Blue skin. Confusion. Dizziness. Headache. Laboured breathing. Nausea. Shortness of breath. Unconsciousness. Weakness. Ingestion Blue lips or fingernails. Blue skin. Dizziness. Headache. Laboured breathing (further see Inhalation).

ROUTES OF EXPOSURE:

The substance can be absorbed into the body by inhalation and through the skin and by ingestion. INHALATION RISK: Evaporation at 20¡C is negligible; a harmful concentration of airborne particles can, however, be reached quickly on spraying or when dispersed, especially if powdered.

EFFECTS OF SHORT-TERM EXPOSURE:

The substance irritates the eyes and the skin. The substance may cause effects on the blood, bladder and kidneys , resulting in tissue lesions and formation of methaemoglobin. Exposure to high concentrations may result in damage to kidneys and bladder. The effects may be delayed. Medical observation is indicated. See Notes.

EFFECTS OF LONG-TERM OR REPEATED EXPOSURE:

Repeated or prolonged contact may cause skin sensitization. The substance may have effects on the blood , resulting in formation of methaemoglobin (see Notes). The following chemicals are known or suspected carcinogens. This list has been compiled from a number of sources, but it is not (and cannot be) comprehensive. Therefore, the absence of a chemical from this list does not mean that it cannot have carcinogenic properties. Neither does the presence of a chemical in the list indicate that it is a proven carcinogen. However, users should treat the materials listed with the caution due to suspected carcinogens, and gather as much safety data as possible before starting work. Restrictions apply to the use of some of these chemicals in the U.K. We have done our best to ensure the data below is as accurate as possible, but cannot accept responsibility for its use or mis-use. Aniline 4,4'-Methylenedianiline Trichlormethine (Trimustine hydrochloride)

List Of Chemicals Known to Cause Cancer Or Reproductive Toxicity.

(a) On or before March 1, 1987. State of California The Governor shall cause to be published a list of those chemicals known to the state to cause cancer or reproductive toxicity within the meaning of this chapter, and he shall cause such list to be revised and republished in light of additional knowledge at least once per year thereafter. Such list shall include at a minimum those substances identified by reference in Labor Code Section 6382

(b)(1) and those substances identified additionally by reference in Labor Code Section 6382(d). * Aniline 62533 January 1, 1990 * Benzene 71432 February 27, 1987 * Trichlormethine (Trimustine hydrochloride) 817094 January 1, 1992 * 4,4'-Methylenedianiline 101779 January 1, 1988 * 4,4'-Methylenedianiline dihydrochloride 13552448 January 1, 1988 FROM CANCER DATABASE benzene, aromatic amines ‹ Rubber processing chemicals Carcinogen :- lymphatic & haemato-poietic system (leukemia) (bone marrow) bladder http://www.bccancer.bc.ca/cid/25-3.html

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