Experts Defend Condoms Despite US Gov't Report

By Will Dunham
Reuters 20 July 2001

Washington -- Condoms effectively prevent HIV transmission but data is lacking on whether they work to block most sexually transmitted diseases, according to a report released on Friday by federal health officials.

The report, a review of existing medical studies, concluded there is insufficient evidence to judge whether or not male latex condoms effectively prevent the spread of syphilis, genital herpes, genital human papillomavirus (HPV) infection, chlamydial infection, chancroid and trichomoniasis.

Some conservatives touted the report as evidence condoms offer no assurance of protection against a variety of sexually transmitted diseases (STDs), and argued for abstaining from sex outside of marriage. But many public health officials said the report found only that studies regarding condoms were inadequate or absent, not that condoms were ineffective, and said condoms were vitally important as a barrier to disease.

The U.S. Centers for Disease Control and Prevention issued a statement saying that "male latex condoms, when used correctly and consistently, are highly effective in protecting against HIV and can reduce the risk of other sexually transmitted diseases."

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. "So it isn't that they are ineffective. In fact, I know they're not ineffective. I know they're quite effective."

Another member of the panel, Dr. J. Thomas Fitch, a pediatrician in private practice in San Antonio who argues for abstinence, countered: "We need to tell the public we don't have data to say they are effective. The other side says, 'Yes, that doesn't mean that they aren't.' That's true. On the other hand, in medicine we don't usually tell a person something is effective unless we have data to say they are effective."

Concern About Misinterpretation

Dr. Jonathan Jacobs, medical director for the AIDS program at New York Presbyterian Hospital and not a panel member, said he was concerned the study's results might be misinterpreted.

"We have a very difficult time getting people to accept condoms in the first place. And if there is the perception that they don't work, it's going to be even more difficult to get people to use condoms, which are effective in preventing the transmission of the deadliest sexually transmitted disease (AIDS)," Jacobs said.

The report said studies found an 85 percent drop in risk of transmitting HIV, the virus that causes AIDS, among consistent condom users versus nonusers. Experts say condoms have been vital in combating the AIDS epidemic.

The report cited evidence of a big drop in gonorrhea risk among men using condoms compared with nonusers. It also found condoms to be effective at preventing unintended pregnancy.

Sexually transmitted diseases, including HIV infection, affect more than 65 million Americans. AIDS is incurable. Many other of the diseases cause infertility and problems with pregnancy. Long-term infection with HPV can cause cervical cancer in women. And most STDs increase the likelihood of transmitting HIV infection.

The study said "the absence of definitive conclusions reflected inadequacies of the evidence available and should not be interpreted as proof of the adequacy or inadequacy of the condom to reduce the risk of STDs other than HIV transmission in men and women and gonorrhea in women."

The report called for "well-designed and ethically sound clinical studies" to test the effectiveness of condoms in fighting the spread of STDs.