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by Paul King
Sunday, Oct. 12, 2003 at 1:32 AM
"The National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, released the report compiled by the panel of 28 experts, who analyzed about 138 published studies on the use of condoms during penile-vaginal intercourse.
"There was a lack of evidence to help us make a definitive conclusion about the effectiveness of condoms," said panel member Dr. Timothy Schacker, an infectious disease expert at the University of Minnesota"
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 ofcondoms,checked 72,000 trucks and has actual photographs of eggs frying in the backs of trucks used for condom distribution.
Partly due to Vesey’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)
The United States Public Health Service states that sexual relations, even with a condom, with a person who is
HIV-positive is so risky that alternative methods of expressing physical intimacy should be considered. Additionally, Public Health Services warns that the rate of HIV transmission in anal intercourse is so high that the practice should be avoided. (27)
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
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,
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
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.Frösner, 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.
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