SexEdLibrary — Condoms

Condoms | Teen Pregnancy | STDs | Adolescent Sexual Behavior | Program Efficacy

Condoms

	Male Condom
	Condoms and Pregnancy Protection
	Condoms and STD Prevention
	Condoms and HIV Prevention
	Breakage and Slippage
	Factors That Affect Condom Use
	Female Condom

Condoms are a barrier method of contraception that, when used consistently and correctly, can prevent pregnancy by blocking the passage of semen into the vaginal canal. Condoms can also prevent the exchange of blood, semen, and vaginal secretions, which are the primary routes of STD transmission.
In recent years, as a result of misinformation and insufficient research, the efficacy of condoms, especially in terms of STD prevention, has been debated in many forums. Research continues to show that condoms are one of the best methods of preventing unintended pregnancy and are one of the only methods for sexually active individuals to protect themselves against STDs, including HIV.
This page includes information on both the male and female condom; on their effectiveness in protecting against unplanned pregnancies and STDs, including HIV; and on condom breakage and slippage, regulations and tests, and consistent and correct use. It is designed to provide the most recent information about condoms and to clear up confusion and misunderstandings.
Many of the studies on this page apply to more than one of these topic categories. Those studies have been listed under multiple topic headings so that all relevant data can be easily found.

The information on this page is broken down into several topics: male condom, condoms and pregnancy prevention, condoms and STD prevention, condoms and HIV prevention, breakage and slippage, factors that affect condom use, and female condom.

How to Use a Condom: Male Condoms

Source: The American Social Health Association (ASHA)

Description: This is a description of the steps involved in using the male condom, as well as general directions for condom storage and use.

Key Statistics:

Keep condoms out of the sun.
Never use condoms with lotions, baby oil, Vaseline, or cold creams.
Put the condom on before the penis touches the mouth, vagina, or anus.
Use a new condom if you want to have sex again, or in a different place (for example, in the anus and then in the vagina).

To View this Resource click here: www.ashastd.org/condom/condom_male_nopics.cfm

How to Use a Condom: Do’s and Don’ts

Source: The American Social Health Association (ASHA)

Description: This is a description of the do’s and don’t of using male condoms.

Key Statistics:

DON'T regularly use lubricants with spermicide called nonoxynol-9 ("N-9") as they may cause skin irritation or tiny abrasions that make the genital skin more susceptible to STDs.
DON'T use out of date condoms. Check the expiration date carefully. Old condoms can be dry, brittle, or weakened and can break more easily.
DO use only latex or polyurethane condoms.

To View this Resource click here: www.ashastd.org/condom/condom_overview.cfm

Male Condoms

Source: R. A. Hatcher, et al., Contraceptive Technology, 17th revised Edition (New York: Ardent Media, Inc., 1998).

Description: This article contains all of the basic information about male condoms as a method of contraception that health care practitioners, educators, and users will need.

Key Statistics:

Condoms manufactured from lambskin, also known as “natural skin,” or “natural membrane,” are made from the intestinal lining of lambs. While these condoms can prevent pregnancy, they contain small pores that may permit passage of some STDs, including HIV, the Hepatitis B virus, and the herpes simplex virus.
Condoms manufactured from polyurethane are thinner and stronger than latex condoms, provide a less constricting fit, are more resistant to deterioration, and may enhance sensitivity.
Polyurethane condoms have not been studied for their effectiveness in the prevention of STD transmission.
Condoms made of polyurethane are compatible with oil-based lubricants, unlike latex condoms which must be used with water-based lubricants.

To View this Resource: www.amazon.com/Contraceptive-Techonology-Robert-Hatcher/dp/0966490215

l Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention

Source: Department of Health and Human Services, National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases

Description: Published in 2001, this report presents the findings of a workshop to evaluate the effectiveness of latex male condoms. The effort was led by the National Institutes of Health (NIH), in association with the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the United States Agency for International Development (USAID).

Key Statistics:

In a recent well-controlled randomized clinical trial of monogamous couples using latex male condoms for contraception over six months, the pregnancy rate during “typical use” was reported at 6.3%, with a 1.1% pregnancy rate during “consistent use.”
As condom experience and facility in use of condoms increases in couples using condoms as their primary method of birth control, unintended pregnancies decrease.
The combined method failure rate (slippage plus breakage) of condoms is estimated at 1.6%–3.6%.

To View this Resource: http://www3.niaid.nih.gov/research/topics/STI/pdf/condomreport.pdf

l Male Condoms

Source: R. A. Hatcher, et al., Contraceptive Technology, 17th revised Edition (New York: Ardent Media, Inc., 1998).

Description: This article contains all of the basic information about male condoms as a method of contraception that health care practitioners, educators, and users will need

Key Statistics:

To fully understand research on condom effectiveness, one must understand the difference between method failure and user failure. Method failure is failure that results from a defect in the product. User failure refers to failure that results from incorrect or inconsistent use.
The first-year effectiveness rate in preventing pregnancy among typical condom users on average is 86%. This includes pregnancies resulting from errors in condom use.
Method failure of male condoms (failure that is a direct result of a flaw in the condom) is uncommon. In fact, it is estimated to occur among only 3% of couples using condoms consistently and correctly during the first year of use. To help individuals understand this estimate, Contraceptive Technology explains that “only three of 100 couples who use condoms perfectly for one year will experience an unintended pregnancy.”
If each of these 100 couples had intercourse at the average coital frequency of 83 acts per year, then 100 couples would have intercourse a combined 8,300 times a year. Three pregnancies resulting from 8,300 acts of condom use is a remarkably low pregnancy rate (.04 %) when calculated on a per-condom basis.
Among couples using condoms as their primary method of contraception, approximately 14% experience an unintended pregnancy each year. It is important to remember that they may not have been using a condom correctly or at all when they became pregnant.
In comparison, 85% of women using no birth control will become pregnancy in the first year, as will 25% of women using periodic abstinence.

To View this Resource: This book may be obtained online for a fee. For more information:

See the Contraceptive Technology online at: www.amazon.com/Contraceptive-Techonology-Robert-Hatcher/dp/0966490215, or Contact your local librarian.

If you have difficulty finding this book, you may contact SIECUS at www.siecus.org/feedback.html.

l Contraceptive Failure in the United States: An Update

Source: J. Trussel, et al., “Contraceptive Failure in the United States: An Update,” Studies in Family Planning 21.1 (January/February 1990).

Description: Studies in Family Planning is a peer-reviewed journal published on behalf of the Population Council. This article contains the results of research on contraceptive effectiveness.

Key Statistics:

Condoms are 98% effective in preventing pregnancy when used consistently and correctly.

To View this Resource: The full text of this article may be obtained online for a fee. For more information:

See the Studies in Family Planning online at: www.blackwellpublishing.com/subs.asp?ref=0039-3665, or Contact your local librarian.

If you have difficulty finding this article, you may contact SIECUS at www.siecus.org/feedback.html.

l Pregnancy Rates for Birth Control Methods

Source: The Food and Drug Administration (FDA), “Consumer-Friendly Birth Control Information,” Consumer Magazine (April 1997).

Description: This table compares the effectiveness of different birth control methods in preventing pregnancy. The methods studied include male and female sterilization, implants (Norplant), hormone shots (Depo-Provera), oral contraceptives, intrauterine devices (IUDs), male and female condoms, vaginal sponges, cervical caps, diaphragms, spermicides, withdrawal, and natural family planning methods (calendar, temperature, cervical mucus).

Key Statistics:

With consistent and correct use, male condoms have a 3% failure rate, the diaphragm has a 6% failure rate, the pill (estrogen/progestin) has a 0.1% failure rate, and withdrawal has a 4% failure rate.
With “typical use”—which the FDA defines as not always using the method correctly, not using the method during every act of sexual intercourse, sometimes forgetting to take the birth control pill, or using the method correctly but having it fail— the failure rate for condoms is 14%, the failure rate for the diaphragm is 20%, the failure rate for the pill is 5%, and the failure rate for withdrawal is 19%.

To View this Resource:
http://www.fda.gov/fdac/features/1997/conceptbl.html

Fact Sheet for Public Health Personnel: Male Latex Condoms and Sexually Transmitted Diseases

Source: Department of Health and Human Service, Centers for Disease Control and Prevention (CDC)

Description: This fact sheet presents the Centers for Disease Control and Prevention’s key messages on the effectiveness of condoms in preventing STDs.

Key Statistics:

When used consistently and effectively, condoms are highly effective in preventing transmission of HIV, the virus that causes AIDS.
Correct and consistent use of condoms can reduce the risk of discharge diseases including gonorrhea, Chlamydia, and trichomoniasis.
Correct and consistent use of condoms can reduce the risk of genital ulcer diseases including herpes, syphilis, and chancroid.
Condom use is associated with a lower rate of cervical cancer, an HPV-related disease.

To View this Resource click here: www.cdc.gov/nchstp/od/latex.htm

Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention

Source: Department of Health and Human Services, National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases

Description: Published in 2001, this report presents the findings of a workshop to evaluate the effectiveness of latex male condoms in preventing STDs including HIV. The effort was led by the National Institutes of Health (NIH), in association with the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the United States Agency for International Development (USAID).

Key Statistics:

Beyond mutual lifelong monogamy among uninfected couples, condom-use is the only method for reducing the risk of HIV infection and STDs available to sexually active individuals.

To View this Resource click here: www3.niaid.nih.gov/research/topics/STI/pdf/condomreport.pdf

Effect of Condoms on Reducing the Transmission of Herpes Simplex Virus Type 2 from Men to Women

Source: Anna Wald, et al, “Effect of Condoms on Reducing the Transmission of Herpes Simplex Virus Type 2 from Men to Women,” Journal of the American Medical Association 285.4 (June 2001).

Description: This report presents the findings of a study to determine the effectiveness of condoms in reducing Herpes Simplex Virus Type 2.

Key Statistics:

Younger age and more frequent sexual activity were associated with higher risk for Herpes Simplex 2.
Condom use during more than 25% of sex acts was associated with protection against Herpes Simplex 2 for women but not for men.
Condom use offers significant protection against Herpes Simplex 2 among susceptible women.
Changes in sexual behavior, correlated with counseling about avoiding sex when a partner has lesions, were associated with reduction of Herpes Simplex 2 cases over time.

To View this Resource click here: www.jama.ama-assn.org/cgi/content/abstract/285/24/3100 or contact your local librarian.

If you have difficulty finding this article, you may contact SIECUS at www.siecus.org/feedback.html

The Effect of Correct and Consistent Condom Use on Chlamydial and Gonococcal Infection Among Urban Adolescentso Women

Source: Gabriela Paz-Bailey, et al, “The Effect of Correct and Consistent Condom Use on Chlamydial and Gonococcal Infection Among Urban Adolescents,” Archives of Pediatric and Adolescent Medicine 159.6 (June 2005): 536–542.

Description: This report presents the findings of a study to determine the effectiveness of condoms in reducing Chlamydia and gonorrhea.

Key Statistics:

Both correct and consistent condom use was reported by only 80 patients (16%).
Correct and consistent use was associated with a significant reduction in Chlamydia.
Correct and consistent use was associated with a significant reduction in gonorrhea.
No adolescent girls were infected with gonorrhea if they and their partner(s) used condoms consistently and correctly.

To View this Resource click here: www.archpedi.ama-assn.org/cgi/content/abstract/159/6/536

If you have difficulty finding this article, you may contact SIECUS at www.siecus.org/feedback.html

Condom Use and the Risk of Genital Human Papillomavirus Infection in Young Women

Source: Rachel L. Winer, et al, “Condom Use and the Risk of Genital Human Papillomavirus Infection in Young Women,” New England Journal of Medicine 354.25 (June 22, 2006): 2645–2654.

Description: This report presents the findings of a study to determine the effectiveness of condoms in reducing HPV infection.

Key Statistics:

Among newly sexually active women, consistent condom use reduced the risk of HPV infection by 70%.
Women whose partners used condoms more than half of the time had a 50% risk reduction, as compared with those whose partners used condoms less than 5% of the time.

To View this Resource click here: www.content.nejm.org/cgi/content/full/354/25/2645

U.S. Centers for Disease Control and Prevention: Report to Congress: Prevention of Genital Human Papillomavirus Infection

Source: U.S. Centers for Disease Control and Prevention, Report to Congress: Prevention of Genital Human Papillomavirus Infection (Jan. 2004)

Description: This study presents the U.S. Centers for Disease Control and Prevention’s (CDC) findings on effectiveness of condoms in reducing HPV infection. The CDC presented these findings to the U.S. Congress.

Key Statistics:

According to the CDC, available studies suggest that condoms reduce the risk of genital warts and cervical cancer.

To View this Resource click here: www.cdc.gov/std/HPV/2004HPV%20Report.pdf

This section contains information on condoms’ effectiveness at preventing HIV, the virus that causes AIDS.

Fact Sheet for Public Health Personnel: Male Latex Condoms and Sexually Transmitted Diseases

Source: Department of Health and Human Service, Centers for Disease Control and Prevention (CDC)

Description: This fact sheet presents the Centers for Disease Control and Prevention’s key messages on the effectiveness of condoms in preventing STDs.

Key Statistics:

When used consistently and effectively, condoms are highly effective in preventing transmission of HIV, the virus that causes AIDS.

To View this Resource click here: www.cdc.gov/nchstp/od/latex.htm

Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention

Source: Department of Health and Human Services, National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases

Description: Published in 2001, this report presents the findings of a workshop to evaluate the effectiveness of latex male condoms in preventing STDs, including HIV. The effort was led by the National Institutes of Health (NIH), in association with the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the United States Agency for International Development (USAID).

Key Statistics:

Beyond mutual lifelong monogamy among uninfected couples, condom-use is the only method for reducing the risk of HIV infection available to sexually active individuals.

To View this Resource click here: www3.niaid.nih.gov/research/topics/STI/pdf/condomreport.pdf

A Longitudinal Study of Human Immunodeficiency Virus Transmission by Heterosexual Partners

Source: I. De Vincenzi, “A Longitudinal Study of Human Immunodeficiency Virus Transmission by Heterosexual Partners,” The New England Journal of Medicine 331.6 (August 1994).

Description: This article contains the results of study of 20-month study of heterosexual couples in which one partner was HIV-positive and the other was HIV-negative. (These couples are referred to as sero-discordant).

Key Statistics:

No sero-conversion occurred among the 124 couples who used latex condoms consistently and correctly for vaginal or anal intercourse.
10% of the HIV-negative partners (12 of 121) of couples became infected when condoms were used inconsistently for vaginal or anal intercourse.
15% of HIV-negative partners became infected when condoms were not used.

To View this Resource click here: www.content.nejm.org/cgi/content/abstract/331/6/341

This section contains information on condom breakage and slippage. Research in this section covers condom slippage and breakage rates, as well as factors that affect condom breakage and slippage.

Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Preventionual Partners

Source: Department of Health and Human Services, National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases

Key Statistics:

The latex male condom accounts for 97% of all United States condom sales.
Condom shape, thickness, and other specifications, including the latex formulation itself, have been engineered to produce a product that is placed easily (onto the penis), minimizes slippage and breakage during vaginal intercourse, and contains the collected fluids.
The combined method failure (slippage plus breakage) of condoms is estimated at 1.6% –3.6%.
Factors affecting slippage and breakage are related to user familiarity and knowledge, including user experience, selection of condom size (width), and proper use of additional (exogenous) lubricant.
As condom experience and facility in use of condoms increases in couples using condoms as their primary method of birth control, unintended pregnancies decrease.
With increased education and improved experience, one can expect condom slippage and breakage rates to decrease.

To View this Resource click here: www3.niaid.nih.gov/research/topics/STI/pdf/condomreport.pdf

Young Men’s Experience with Condom Breakage

Source: Laura Duberstein Lindberg, et al, “Young Men’s Experience with Condom Breakage,” Family Planning Perspectives 29.3 (May/June 1997).

Description: This article contains the results of a study to determine what factors affect condom breakage in males ages 17–22. Variables in the study include experience with condoms, amount of sexuality education, history of STDs, and household income.

Key Statistics:

Increased experience with condoms reduced the likelihood of experiencing condom breakage.
Recent sexuality education was associated with an almost 80% decrease in the risk of breakage among young men who used condoms infrequently.
Young males who had ever had a sexually transmitted disease (STD), or whose sexual partner had had an STD, were almost three times as likely as other respondents to have experienced condom breakage.
Young males with a household income of less than $60,000 were 2–3 times as likely to have broken a condom as were those with a higher household income.

To View this Resource click here: www.guttmacher.org/pubs/journals/2912897.pdf

Male Condoms

Source: R. A. Hatcher, et al., Contraceptive Technology, 17th revised Edition (New York: Ardent Media, Inc., 1998).

Description: This article contains all of the basic information about male condoms as a method of contraception that health care practitioners, educators, and users will need

Key Statistics:

Although people fear that condoms may break or fall off during use, studies indicate this rarely occurs when condoms are properly used.
Most studies report that condoms break less than 2% of the time during intercourse or withdrawal.
It is also important to note that not all condom breaks are equally risky. As many as 24 to 65% occur before intercourse and pose no biological risk of pregnancy or infection if a new condom is used for intercourse.
Condoms fall off the penis in 0.6% to 5.4% acts of vaginal intercourse and may slip down the penis without falling off in 3.4% to 13.1% of acts of vaginal intercourse.
Breakage rates during anal sex for gay men in four prospective studies ranged from 0.5% to 12%, with rates less than 2% in three of the studies.

To View this Resource click here: www.amazon.com/Contraceptive-Techonology-Robert-Hatcher/dp/0966490215 or contact your local librarian.

This section contains information on factors that affect condom use, including the impact of parental discussions about condoms and a survey to determine unmarried women’s motivations for using condoms.

Patterns of Condom-Use among Adolescents: The Impact of Mother-Adolescent Communication

Source: U.S. Centers for Disease Control and Prevention, “Patterns of Condom-Use among Adolescents: The Impact of Mother-Adolescent Communication,” The American Journal of Public Health (October 1998).

Description: This article presents the findings of a study to determine the impact of mother-adolescent discussions on adolescent sexual behavior. The study was conducted with sexually active adolescents ages 14–17.

Key Statistics:

Frank discussions between mothers and their adolescents about condoms can lead teens to adopt behaviors that will prevent them from becoming infected with HIV and other sexually transmitted diseases.
Timing of discussions is critical; Condom use increased only among teens whose mothers talked to them about condoms before their first sexual encounter.
Teens who used condoms at first intercourse were 20 times more likely to use condoms in subsequent acts.

To View this Resource click here: www.cdc.gov/nchstp/dstd/Condom_Use_Among_Adolescents.htm

Condom Use for Disease Prevention among Unmarried U.S. Women

Source: John E. Anderson, et al, “Condom Use for Disease Prevention among Unmarried U.S. Women,” Family Planning Perspectives 28.1 (January/February 1996).

Description: This report contains the findings of a study to determine why unmarried U.S. women choose to use condoms.

Key Statistics:

41% of women reported using condoms for protection against sexually transmitted diseases, and 30% said they used condoms for this reason every time or most times they had intercourse.
Condom use for disease prevention appeared most common among young women, never-married women, those with the highest incomes, women at an early stage of their reproductive career, women who had not been surgically sterilized and were not using oral contraceptives, those who believed in the effectiveness of condoms, and women who had intercourse infrequently.

To View this Resource click here: www.guttmacher.org/pubs/journals/2802596.html

The female condom is made of polyurethane and provides protection against pregnancy and STDs, including HIV. This section includes information on correct use of the female condom, as well as effectiveness rates for preventing against pregnancy and STDs.

How to Use a Condom: The Female Condom

Source: The American Social Health Association (ASHA)

Description: This website contains information on female condoms.

Key Statistics:

The female condom is a polyurethane (plastic) pouch that fits inside a woman’s vagina. It has a soft ring on each end. The outer ring stays on the outside of the vagina and partly covers the labia (lips). The inner ring fits on the inside of the vagina, somewhat like a diaphragm, to hold the condom in place.
Add lubricant to the inside of the condom.
Remove the condom before standing up.

To View this Resource click here: www.ashastd.org/condom/condom_female_nopics.cfm

Pregnancy Rates for Birth Control Methods

Source: The Food and Drug Administration (FDA), “Consumer-Friendly Birth Control Information,” Consumer Magazine (April 1997).

Key Statistics:

With consistent and correct use, female condoms have a 5% failure rate at preventing pregnancy.
With “typical use,”—defined as not always using the condom correctly, not using the condom with every act of sexual intercourse, or using the condom and having it fail anyway—female condoms have a 21% failure rate at preventing pregnancy.

To View this Resource click here: www.fda.gov/fdac/features/1997/conceptbl.html

The Female Condom

Source: The Female Health Company, developer and manufacturer of the female condom.

Description: This website provides information on the female condom.

Key Statistics:

Available under the brand name Reality®, the female condom provides protection against pregnancy and STDs, including HIV.
The female condom and male condom should not be used together as they can adhere to each other, causing slippage or displacement.
The first-year effectiveness rate of preventing pregnancy among typical condom users averages about 79% for female condoms. This includes pregnancies resulting from errors in condom use.
The female condom is estimated to reduce the risk of HIV infection for each act of intercourse by 97.1% when used consistently and correctly.
Laboratory studies have shown the female condom to be an effective barrier to microorganisms including HIV and including a bacteriophage smaller than hepatitis B, the smallest virus known to cause an STD.

To View this Resource click here: www.femalehealth.com/theproduct.html