Sexually involved individuals owe it to themselves to get accurate, unbiased information about condoms and the part they play in preventing unwanted pregnancies and sexually transmitted diseases.
SIECUS has updated this Fact Sheet—The Truth About Latex Condoms—for this purpose. It includes information on both their reliability and their effective use.
It also includes resources used in compiling the Fact Sheet so that people will know where to look for more information.
(Published in the SIECUS Report, Volume 27, Number 1 - October/November 1998)
Effectiveness
Condoms are only effective when used consistently and correctly.1
Using a condom during intercourse is more than 10,000 times safer than not using a condom.2
Condoms are 98 percent effective in preventing pregnancy when used correctly3—and up to 99.9 percent effective in reducing the risk of STD transmission when combined with spermicide.4
The first-year pregnancy failure rate among typical condom users averages about 12 percent and includes pregnancies resulting from errors in condom use.5
Studies of hundreds of couples show that consistent condom use is possible when sexual partners have the skills and motivation.6
Regulations and Tests
In the United States, manufacturers follow the voluntary performance standards for condoms established by the American Society for Testing and Materials and recommended by the Food and Drug Administration (FDA).7
Before packaging, every condom is tested electronically for defects. In addition, the FDA tests samples from every batch using water-leak and air burst tests.8
The average batch of condoms tests better than 99.7 percent defect free.9
During the water-leak test, if there is a leak in more than four per 1,000 condoms, the entire lot is discarded.10
Laboratory studies show that sperm and disease-causing organisms (including HIV) cannot pass through intact latex condoms.11
HIV Transmission
Condom use substantially reduces the risk of HIV transmission.12
A study published in The New England Journal of Medicine observed heterosexual couples where one was HIV-positive and the other was HIV-negative (sero-discordant couples), for an average of 20 months. Findings included13:
No seroconversion occurred among the 124 couples who used condoms consistently and correctly for vaginal or anal intercourse.14
10 percent of the HIV-negative partners (12 of 121) couples became infected when condoms were used inconsistently for vaginal or anal intercourse.15
Of the 121 couples who used condoms inconsistently, 61 used condoms for at least half of their sexual contacts ad 60 rarely or never used condoms. The rate of seroconversion was 10.3 percent for the couples using condoms inconsistently and 15 percent for couples not using condoms.16
A study published in The Journal of Acquired Immune Deficiency Syndromes observed sero-discordant heterosexual couples and showed that only three out of 171 who consistently and correctly used condoms became HIV infected; eight out of 55 who used condoms inconsistently became HIV infected; and eight out of 79 who never used condoms became HIV infected.17
CONSISTENT AND CORRECT CONDOM USE
Individuals who use condoms to prevent unwanted pregnancies and STDs must understand the meaning of consistent and correct condom use.
CONSISTENT USE:
Use a condom with every act of sexual intercourse, from start to finish, including penile-vaginal intercourse, oral and anal intercourse.
CORRECT USE:
Store condoms in a cool place out of direct sunlight (not in wallets or glove compartments). Latex will become brittle from changes in temperature, rough handling or age. Don’t use damaged, discolored, brittle or sticky condoms.
Check the expiration date.
Carefully open the condom package—teeth or fingernails can tear the condom.
Use a new condom every time a person has sexual intercourse.
Put on the condom after the penis is erect and before it touches any part of a partner’s body. If a penis is uncircumcised, the person must pull back the foreskin before putting on the condom.
Put on the condom by pinching the reservoir tip and unrolling it all the way down the shaft of the penis from head to base. If the condom does not have a reservoir tip, pinch it to leave a half-inch space at the head of the penis for semen to collect after ejaculation.
Withdraw the penis immediately if the condom breaks during sexual intercourse and put on a new condom before resuming intercourse. When a condom breaks, use spermicidal foam or jelly and speak to a health-care provider about emergency contraception.
Use only water-based lubrication. Do not use oil-based lubricants such as cooking/vegetable oil, baby oil, hand lotion or petroleum jelly—these will cause the condom to deteriorate and break.
Withdraw the penis immediately after ejaculation, while the penis is still erect, grasp the rim of the condom between the fingers and slowly withdraw the penis (with the condom still on) so that no semen is spilled.