The truth is, even if you use a condom every single time you have sex, you’re still at risk for both pregnancy and a significant number of STDs. How serious is your risk? Keep reading.

The STD Epidemic

America is in the midst of an STD epidemic. Each year, more than 15 million Americans become infected with an STD. A quarter of these infections occur in teens, and two-thirds occur in people under 25 years of age.

The numbers have risen at alarming rates. Up through the 1960s, there were only two STDs of major concern—syphilis and gonorrhea—both which could easily be cured with penicillin. The times have changed, however, and today there are more than 25 STDs, many for which there is no cure.1

STDs aren’t just humiliating or painful. They can cause infertility, cervical cancer—even death. So how effective are condoms at protecting you from infection? It depends on the disease.

HPV (Human Papilloma Virus)
There is virtually no evidence that condoms reduce the risk of HPV infection at all, though they may slightly decrease the number of people who go on to get warts or cervical cancer. Despite the fact that most people know little about it, HPV is the single most common STD in America. In one recent study half of the sexually active 18- to 22-year-old women were infected with HPV.2 HPV infections cause many health problems. In addition to genital warts, HPV causes nearly all cervical cancer. In 1999, more women died of cervical cancer (4,800) than AIDS (4,100).3, 4

Chlamydia and Gonorrhea
If used 100 percent of the time (which is uncommon), condoms only reduce the risk of chlamydia and gonorrhea infection by about half. Chlamydia infections are extremely common, particularly in young women. Approximately 700,000 new chlamydia and 360,000 new gonorrhea cases are reported yearly in the U.S.5 Because the majority of chlamydia cases cause no symptoms, even more people are infected but don’t know about it. Left untreated, chlamydia and gonorrhea infections can damage a woman’s fallopian tubes, causing ectopic pregnancies and infertility.6 About a third of in vitro fertilization is necessary due to infertility caused by an STD (usually chlamydia or gonorrhea).

Genital Herpes
Based on the limited studies, it appears condoms only reduce the risk of herpes by half at best. Genital herpes infects nearly a quarter of Americans 12 and older and almost half of all African Americans. Because there is no cure, once you’re infected with genital herpes, you have it for life. The ulcers associated with the infection can recur over and over. You can give it to another person even when you have no symptoms. People with herpes are also more at risk for becoming infected with HIV from an HIV-positive sexual partner.7,8

HIV/AIDS
If used 100 percent of the time, condoms reduce the risk of HIV transmission by 85 percent. It’s important to note that the rate is significantly lower when condoms are used inconsistently (which is common). Since the epidemic began, HIV/AIDS has killed nearly half a million Americans (and the number is growing).

Do Most People Use Condoms Consistently?
In a nutshell, “no.” Less than half of 15- to 19-year-old males report using a condom consistently over the past year. And as they get older and more sexually experienced, fewer males use condoms consistently.9,10 Even under extreme circumstances, such as a study of monogamous couples in which one partner was HIV+ and one was HIV- only about half used condoms consistently for a significant period of time.

How Common Is Correct Usage?
According to the Centers for Disease Control and Prevention (CDC), condoms need to be used both consistently AND correctly.11 Consistent condom use is uncommon, and consistent AND correct use is even more rare. That’s not surprising, given that correct use requires a meticulous 6-step procedure that begins after erection occurs.

Do Condoms Ever Slip or Break?
Yes. According to research, even if used consistently and correctly, condoms slip off or break from 1.5 percent to 3.5 percent of the time.12,13,14

Condom Conclusion
STDs are a real and present danger. Due to the risk, many have turned to condoms for protection under the assumption that condoms make sex safe.

Research shows that condoms reduce risk for some (not all) STDs, but they don’t eliminate the risk. That’s a critical distinction. Condoms do not make sex safe enough for individuals who truly wish to avoid getting STDs and suffering possible long-term effects.

If you’ve already been sexually active outside a lifelong mutually faithful relationship (as in marriage), talk to your healthcare provider about getting you and your partner tested for STDs. Abstinence from sexual activity—including oral sex—or lifetime faithfulness to one uninfected partner is the only certain way to avoid being infected.

References

1. Eng TR, Butler WT, eds. The Hidden Epidemic: Confronting Sexually Transmitted Disease. Institute of Medicine. Washington, DC: National Academy Press; 1997.

2. Peyton CL, Gravitt PE, Hunt WC, et al. Determinants of genital human papillomavirus detection in a US Population. J Infect Dis. 2001;83:1554-1564.

3. American Cancer Society. Cancer Facts and Figures 1999. Surveillance Research. 1999. Available at: www.cancer.org

4. Centers for Disease Control and Prevention, National Center for HIV, STD and TB Prevention. Surveillance Report. 2002;13. Accessed at: www.cdc.gov/hiv/stats/hasr1301/table30.htm

5. Centers for Disease Control and Prevention, National Center for HIV, STD and TB Prevention. Sexually Transmitted Disease Surveillance 2000. 2001.

6. Eng TR, Butler WT, eds. The Hidden Epidemic: Confronting Sexually Transmitted Disease. Institute of Medicine. Washington, DC: National Academy Press; 1997.

7. Eng TR, Butler WT, eds. The Hidden Epidemic: Confronting Sexually Transmitted Disease. Institute of Medicine. Washington, DC: National Academy Press; 1997.

8. Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention. July 20, 2001. National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services. Available at: http://www.niaid.nih.gov/dmid/stds/condomreport.pdf

9. Sonenstein FL, Stryker J. Why some men don’t use condoms: Male attitudes about condoms and other contraceptives. Henry J. Kaiser Family Foundation. 1997:4.

10. Sonenstein FL, Ku L, Lindberg LD, Turner CF, Pleck JH. Changes in sexual behavior and condom use among teenaged males: 1988 to 1995. Am J Public Health. 1998;88:956-959.

11. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2002. MMWR. 2002;51:1-80.

12. Frezieres RG, Walsh TL, Nelson AL, Clark VA, Coulson AH. Breakage and acceptability of a polyurethane condom: A randomized, controlled study. Fam Plann Perspect. 1998;30:73-78.

13. Frezieres RG, Walsh TL, Nelson AL, Clark VA, Coulson AH. Evaluation of the efficacy of a polyurethane condom: Results from a randomized, controlled, clinical trial. Fam Plann Perspect. 1999;31:81-87.

14. Macaluso M, Kelaghan J, Artz L, et al. Mechanical failure of the latex condom in a cohort of women at high STD risk. Sex Transm Dis. 1999;26:450-458.

The above report is from the Medical Institute for Sexual Health.

For more information about STD's:
visit the Medical Institute.