HIV/AIDS Prevention

Condoms and Their Use in Preventing HIV Infection and Other STDs

With more than 1 million Americans infected with HIV, most of them through sexual transmission, and an estimated 12 million other sexually transmitted diseases occurring each year in the United States, effective strategies for preventing these diseases are critical.

The proper and consistent use of latex condoms when engaging in sexual intercourse--vaginal, anal, or oral--can greatly reduce a person's risk of acquiring or transmitting STDs, including HIV infection. In fact, recent studies provide compelling evidence that latex condoms are highly effective in protecting against HIV infection when used properly for every act of intercourse.

Latex condoms are highly effective when used consistently and correctly-- new studies provide additional evidence that condoms work.

The protection that proper use of latex condoms provides against HIV transmission is most evident from studies of couples in which one member is infected with HIV and the other is not, i.e., "discordant couples." In a study of discordant couples in Europe, among 123 couples who reported consistent condom use, none of the uninfected partners became infected. In contrast, among the 122 couples who used condoms inconsistently, 12 of the uninfected partners became infected.

As these studies indicate, condoms must be used consistently and correctly to provide maximum protection. Consistent use means using a condom from start to finish with each act of intercourse. Correct condom use should include the following steps:

Use a new condom for each act of intercourse.
Put on the condom as soon as erection occurs and before any sexual contact (vaginal, anal, or oral).
Hold the tip of the condom and unroll it onto the erect penis, leaving space at the tip of the condom, yet ensuring that no air is trapped in the condom's tip.
Adequate lubrication is important, but use only water-based lubricants, such as glycerine or lubricating jellies (which can be purchased at any pharmacy). Oil-based lubricants, such as petroleum jelly, cold cream, hand lotion, or baby oil, can weaken the condom.
Withdraw from the partner immediately after ejaculation, holding the condom firmly to keep it from slipping off.
MYTHS ABOUT CONDOMS

There continues to be misinformation and misunderstanding about condom effectiveness. The Centers for Disease Control and Prevention (CDC) provides the following updated information to address some common myths about condoms. This information is based on findings from recent epidemiologic, laboratory, and clinical studies.

Myth #1: Condoms don't work

Some persons have expressed concern about studies that report failure rates among couples using condoms for pregnancy prevention. Analysis of these studies indicates that the large range of efficacy rates is related to incorrect or inconsistent use. The fact is: latex condoms are highly effective for pregnancy prevention, but only when they are used properly. Research indicates that only 30 to 60 percent of men who claim to use condoms for contraception actually use them for every act of intercourse. Further, even people who use condoms every time may not use them correctly. Incorrect use contributes to the possibility that the condom could leak from the base or break.

Myth #2: HIV can pass through condoms

A commonly held misperception is that latex condoms contain "holes" that allow passage of HIV. Although this may be true for natural membrane condoms, laboratory studies show that intact latex condoms provide a continuous barrier to microorganisms, including HIV, as well as sperm.

Myth #3: Condoms frequently break

Another area of concern expressed by some is about the quality of latex condoms. Condoms are classified as medical devices and are regulated by the FDA. Every latex condom manufactured in the United States is tested for defects before it is packaged. During the manufacturing process, condoms are double-dipped in latex and undergo stringent quality control procedures. Several studies clearly show that condom breakage rates in this country are less than 2 percent. Most of the breakage is due to incorrect usage rather than poor condom quality. Using oil-based lubricants can weaken latex, causing the condom to break. In addition, condoms can be weakened by exposure to heat or sunlight or by age, or they can be torn by teeth or fingernails.

PREVENTING HIV INFECTION AND OTHER STDS

Recommended Prevention Strategies

Abstaining from sexual activity is the most effective HIV prevention strategy. However, for individuals who choose to be sexually active, the following are highly effective:

Engaging in sexual activities that do not involve vaginal, anal, or oral intercourse
Having intercourse only with one uninfected partner
Using latex condoms correctly from start to finish with each act of intercourse

Other HIV Prevention Strategies

Condoms for Women: The FDA recently approved a female condom, which will soon be available in the United States. A limited study of this condom as a contraceptive indicates a failure rate of about 26 percent in 1 year. Although laboratory studies indicate that the device serves as a mechanical barrier to viruses, further clinical research is necessary to determine its effectiveness in preventing transmission of HIV.

Spermicides: The role of spermicides in preventing HIV infection is uncertain. Condoms lubricated with spermicides are not likely to be more effective than condoms used with other water-based lubricants. Spermicides added to the tip of the condom are also not likely to add protection against HIV.

Making Responsible Choices: In summary, sexually transmitted diseases, including HIV infection, are preventable, and individuals have several responsible prevention strategies to choose from. But the effectiveness of each one depends largely on the individual. Those who practice abstinence as a prevention strategy will find it effective only if they always abstain. Similarly, those who choose any of the other recommended prevention strategies, including condoms, will find them highly effective if used correctly and consistently.

For further information contact:

CDC National AIDS Hotline: 1-800-342-AIDS
Spanish: 1-800-342-SIDA
Deaf: 1-800-324-7889

CDC National AIDS Clearinghouse
P.O. Box 6003
Rockville, MD 20849-6003