Everyone knows condoms help to prevent pregnancy and protect
against sexually transmitted diseases. But how well do
they work? That question is at the center of a debate
over whether the labels on condom packages should be
changed. On one side are abstinence advocates, including a
conservative congressman who is blocking appointment of a
new federal drug agency chief until the labels are
changed. On the other side are safer-sex advocates who
fear label changes could undermine confidence in
condoms and increase the spread of HIV and other STDs.
Each side has some truth in its argument: Condoms are very
effective against HIV, but data for their
effectiveness against some other STDs is surprisingly
"They do not provide 100% protection, but for people
who are sexually active, they are the best and the
only method we have for preventing these
diseases," said Heather Boonstra, a public policy
official with the Alan Guttmacher Institute, a
nonprofit group that researches reproductive health
issues. Boonstra said Republican senator Tom Coburn, a
physician from Oklahoma, and the abstinence-promoting
Medical Institute for Sexual Health are
"manipulating this data to drive home their own
anti-condom, anti-contraceptive message."
James Trussell, who serves on the board of the Medical
Institute and is director of Princeton
University's Office of Population Research, said
there is "absolutely incontrovertible
evidence" that condoms reduce transmission of
the most serious sexually transmitted disease, HIV.
"To my mind, everything else is gravy,"
Trussell said this week. "All of this is
ideologically motivated. What they're really
concerned about is people who are not married having
But John Hart, spokesman for Coburn, said the
senator's June 15 hold on Lester
Crawford's nomination as commissioner of the Food and
Drug Administration is an effort to make Crawford obey
a 2000 law Coburn sponsored. It requires the FDA to
change condom labels to give more information on their
"effectiveness or lack of the effectiveness in
Hart said FDA officials recently have said they will have a
draft of the language soon. FDA spokeswoman Julie
Zawisza said she could not discuss policy issues.
Marie Savard, a physician and women's health
specialist in Philadelphia, said she has qualms about
using the word "ineffective" but agreed that
people need reliable information. "The labeling
should be changed to something like, 'Condoms protect
better against some STDs than others,"'
Currently, the FDA requires condom boxes and packets to
state: "If used properly, latex condoms will
help to reduce the risk of transmission of HIV
infection (AIDS) and many other sexually transmitted
diseases." Many brands also state that condoms
are highly effective in preventing pregnancy.
When latex condoms are used every time and put on early
enough, they reduce chances of pregnancy over a
one-year period to 3%, compared with 85% without birth
control. Likewise, condoms cut risk of HIV infection by
about 80%, to less than a 1% chance of infection per year.
According to the National Institutes of Health, condoms are
impervious to the smallest viruses and only break or
slip off 1% to 2% of the time. But surveys show most
people don't use them properly or consistently, and
roughly 12 million Americans each year contract an STD.
The Medical Institute for Sexual Health's board
chairman, Tom Fitch, who has previously pushed FDA
officials for label changes, said some STDs are much
more easily spread than others. In addition, STDs such as
herpes and human papilloma virus, or HPV, can be
transmitted by contact with skin not covered by a
Fitch said he would not discourage condom use, but his group
advocates abstinence or monogamy and trains teachers
how to teach students about abstinence.
That's an "unrealistic explanation" for
young people, said Shari Brasner, an
obstetrician/gynecologist at Mount Sinai Medical Center in
New York who has patients as young as 13 who are
sexually active. "These conservatives are the
same people that are trying to limit access to the
morning-after (birth control) pill. They'll leave us
with nothing." (AP)