0.6 Condoms and controversy

Research on condom use

Condom use is often seen as a tipping point in the success of HIV-AIDS education and prevention. This section describes theliterature on the effectiveness of condoms in the prevention of HIV and AIDS.

Here are the facts, to date:

Consistent condom use is the most effective way to reduce exposure to HIV and other sexually transmitted diseases amongsexually-active individuals. Two major, international health agencies (World Health Organization and UNAIDS) are standing by recommendationsfor condom use as a means to prevent transmission of HIV/AIDS and other sexually transmitted disease (STDs).

There are no marketed microbicides or vaccines (with the exception of the Hepatitis B vaccine) for the prevention ofsexually-transmitted diseases.

Latex condoms have demonstrated significant protection against diseases transmitted via penile-vaginalintercourse. STDs studied are: HIV infection, gonorrhea,chlamydial infection, [including gonococcal and chlamydial pelvic inflammatorydisease (PID)], syphilis, chancroid, trichomoniasis, genital herpescaused by herpes simplex viruses (HSV)1 and 2, and genital human papillomavirus (HPV) infection and HPV diseases.

Resistence to condom use

One of the most controversial issues in prevention education is the varying responses towards use of condoms. The body ofliterature on the subject points to cultural and religious taboos; psychological implications (such as illusions of safety); views aboutcondom effectiveness; increased risk behaviors correlating to promising research on treatment; and issues of male aversion. We shall address theseresponses below.

Condom Use

In the United States, where condom availability is pervasive, only 58% of sexually active youth use condoms.

Young people give the following reasons why they do not use condoms: a) embarrassment; b) a belief that it may affect sexualperformance; c) concerns that a partner may be suspicious if a young man puts on a condom; d) an unrealistic optimism in one's personal risk ofcontracting HIV and other STDs.

The reason for unrealistic optimism may be due to several factors, not the least of which is a sense that by understimatingone's risk, a young man or woman can reduce the anxiety. It may seem to be counter-intuitive at first, but the greater the anxiety the young peoplefeel, some studies show, the less chance there is that they will use a condom, for they fight fear by building up a psychological wall of protection. Suchdenial of vulnerability is not uncommon; many populations avoid uncomfortable emotions associated with health problems, an issue that issurely exacerbated in settings where health care options and treatment facilities are limited.

In developed countries, the introduction of more sophisticated drug therapies in HIV Positive treatment may becontributing to a rise of infections and risk-taking behaviors. Young people may rationalize that AIDS is treatable.