Condoms Fail To Protect Against HIV 10% of Time Due to Human Error, UNAIDS Draft Report Says

Even when people use condoms consistently, they fail to protect against HIV approximately 10% of the time, due in large part to incorrect usage and human error, according to a UNAIDS draft report, the Boston Globe reports. According to the report, which examined 20 years of scientific literature on condoms, the failure rate is not due to defective condoms but to human error when using condoms. The most frequent errors when using condoms include: failure to leave room at the tip of the condom to collect semen; failure to use lubrication, which can reduce the risk of breakage; and failure to put on a condom before any genital contact. Catherine Hankins, UNAIDS chief scientific adviser, said that Norman Hearst, lead author of the UNAIDS report, "makes a cogent argument that we should be talking about safer sex, not safe sex, with condoms." She added that condom use should be taught in conjunction with prevention efforts, including programs encouraging people to postpone sexual activity and limit their number of sexual partners. The report said that condoms' failure rate in preventing pregnancy was also likely to be 10%. UNAIDS said that it hopes the report "clears up confusion" over condom effectiveness and helps people in the United States and other countries learn how to use condoms correctly, according to the Globe.

Report Findings At Odds With Other Reports
The report indicates that condoms may not be as effective in protecting against HIV as many advocate groups have said, the Globe reports. Previous reports have estimated that condoms' effectiveness in protecting against HIV is anywhere between 46% and 100%. Population Action International in its September 2002 "Condoms Count" report said that public health experts worldwide "agree that condoms block contact with bodily fluids that can carry the HIV virus and have a nearly 100% effectiveness when used correctly and consistently." Nada Chaya, a PAI senior research associate and the lead author of the "Condoms Count" report, said that the report is "technically ... right, if condoms are used correctly and consistently." However, Chaya said that PAI and other condom advocates should make sure that people know that sex with a condom is "[s]afer sex" and not "safe sex." Terri Bartlett, PAI vice president for public policy, expressed concern that abstinence advocates use condoms' failure rate as a reason to limit condom availability in developing nations, saying that limited condom availability would lead to more HIV infections. Bartlett added, "We are in the midst of a battle in which the opposition seeks to exclude condoms from the mix of HIV prevention. It's an old saying, but vows of abstinence break more often than condoms."

'Not Good Enough'
Edward Green, senior research scientist at the Harvard School of Public Health, said that a 10% failure rate is "not good enough for a fatal disease." He added that people in developing nations should be made aware of UNAIDS' findings and the report's data on condom effectiveness should be used to help set policy. Green and many public health specialists support a comprehensive approach to HIV prevention that includes abstinence, condom use and faithfulness to sexual partners, with the latter likely being the most important, according to Green. Shepherd Smith, president of the Institute for Youth Development, a group that promotes abstinence, said that the report suggests that other HIV prevention strategies should also be evaluated to determine their effectiveness. The draft report is currently under review by UNAIDS and is expected to be released later this month (Donnelly, Boston Globe, 6/22).