Condoms

Posted on | January 28, 2009 | Comments Off on Condoms

Time for straight talk

This week we’ve seen opposition to the Obama Administration Stimulus Package with a lead sound bite from the opposition about "Millions for Condoms." In the past, the battle over condoms has often engaged around what approach to birth control and disease prevention is most successful. Back in 1986, Surgeon General C. Everett Koop spoke the truth when he said "…the best protection against [HIV] infection right now – barring abstinence – is use of a condom. A condom should be used during sexual relations, from start to finish, with anyone who you know or suspect is infected." Now more then 20 years later, let’s examine this unique piece of human engineering and lay out the truth.

Condoms go way, way back. The ancient Egyptians in and around 1000 B.C. fashioned the first-known prototypes out of linen sheaths. The Chinese did the same with silk paper. Other cultures adapted various materials over the centuries that followed, directed at a dual purpose — preventing pregnancy and preventing disease. Not until 1844 were they mass-produced.

As a piece of contraceptive technology, all agree that when used correctly, the condom is remarkably effective. Between 1990 and 2002, nearly $700 million worth of condoms were purchased for donations to nations struggling with population growth and/or sexually transmitted diseases.

What about condoms and STDs? Well, everyone agrees with Dr. Koop when it comes to the prevention of HIV. By everyone I mean the World Health Organization, the CDC, the AMA, the American Academy of Pediatrics, the NIH, the RAND Corporation, and Institute of Medicine. As to other infections, all agree, as well, that condoms decrease risk, but do not eliminate it.

So what’s the problem? The problem is that some believe that offering condoms to adolescents increases the likelihood of early sexual activity. Multiple studies have proven this to be false. The second problem is that some believe that abstinence, as the only absolutely foolproof way to avoid unwanted pregnancy and STDs, has been a poorly supported effort that deserves better funding. Maybe so. But studies are having some difficulty proving that abstinence-only programs do deter sexual activity. Finally, talking about condoms can be embarrassing and perceived by some to be undignified.

So what’s the truth about condoms? First, the bad: They are not perfect, or at least not as perfect as not having sex at all. Now, the good: They are an affordable, well-made, accessible, simple, useful, cross-cultural piece of proven technology that can prevent unwanted pregnancies and unwanted diseases. Making them available has not proven to increase promiscuity or sexual activity in adolescents. And, finally, it is possible to encourage the appropriate use of condoms while remaining true to the values of commitment to care in partner selection, mutual faithfulness, and avoidance of sexual activity until mature and fully developed as a human being.

To learn more about the history and development of condoms, watch this week’s video, embedded with this blog post, or read the full transcript. Then let me know how you feel about the issue of condoms. What should our public policy be?