Saturday, March 26, 2005

What CDC Says About Condoms

The people who oppose the new curriculum are foot-stompin' serious about one thing: condoms do not prevent sexually transmitted infection (STI). If you went to last weekend's revival meetin' you would've heard several bona fide self-proclaimed experts stand up and say that condoms do not prevent STI's. Why, I believe that the hosts of that revival meetin' even posted some recordings of those comments on the Internet, even though they forgot to post the ... more interesting ... comments of their featured speakers.

So, y'know, you do start to wonder. Maybe they know something I don't know. Well, what do you do, where do you turn? I thought it would be safe enough to go to the Bush adminstration's Centers for Disease Control web site, wouldn'tcha figure?

And sure enough, I found a site called Male Latex Condoms and Sexually Transmitted Diseases. Bingo.

For each disease type, the document is broken into three sections:
  • Laboratory studies -- this section says whether the latex condom is permeable to particles the size of STD pathogens
  • Theoretical basis for protection -- says why a condom might help, theoretically speaking
  • Epidemiologic studies -- tells what the research says about statistical associations between condom use and the infection in question

For instance, under HIV/AIDS, we read this:
  • Laboratory studies have demonstrated that latex condoms provide an essentially impermeable barrier to particles the size of STD pathogens.
  • Theoretical basis for protection. Latex condoms cover the penis and provide an effective barrier to exposure to secretions such as semen and vaginal fluids, blocking the pathway of sexual transmission of HIV infection.
  • Epidemiologic studies that are conducted in real-life settings, where one partner is infected with HIV and the other partner is not, demonstrate conclusively that the consistent use of latex condoms provides a high degree of protection.

See how that works?

Hey, just a second ... That wasn't the US government saying that "the consistent use of latex condoms provides a high degree of protection," was it?

Each section has a little box with the results summarized. Under Discharge Diseases, Including Gonorrhea, Chlamydia, and Trichomoniasis, we read:
Latex condoms, when used consistently and correctly, can reduce the risk of transmission of gonorrhea, chlamydia, and trichomoniasis.

Mmm, that's not what those experts in the audience were saying last week.

Under Genital Ulcer Diseases and Human Papillomavirus, we see:
Genital ulcer diseases and HPV infections can occur in both male or female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. Correct and consistent use of latex condoms can reduce the risk of genital herpes, syphilis, and chancroid only when the infected area or site of potential exposure is protected. While the effect of condoms in preventing human papillomavirus infection is unknown, condom use has been associated with a lower rate of cervical cancer, an HPV-associated disease.

OK, so I think the conclusion here is, the research is ongoing. You still have to be careful.

The people at CDC know what's being said. They're ready for it:
... Most epidemiologic studies of STDs, other than HIV, are characterized by ... methodological limitations, and thus, the results across them vary widely--ranging from demonstrating no protection to demonstrating substantial protection associated with condom use. This inconclusiveness of epidemiologic data about condom effectiveness indicates that more research is needed--not that latex condoms do not work. For HIV infection, unlike other STDs, a number of carefully conducted studies, employing more rigorous methods and measures, have demonstrated that consistent condom use is a highly effective means of preventing HIV transmission.

OK, I understand these people's reasoning, and so do you. It goes like this: if teenagers found out that condoms work, they would use them, rather than practice chastity.

I have kids, and I don't like that thought, either. But then, I don't think my kids are so dumb they'll try everything they hear about ... but that's a different story.

We know that fifty percent of teens do have sexual intercourse, and almost everybody in American society has sex before they are married (some "abstinence" advocates use a very narrow definition of sex to refute that, but most of us would consider anal and oral sex as "sex," wouldn't we?). So if something is said by the CDC to be "highly effective," mmm, we're for that, right?

We have seen studies, which are undisputed, that show the success rate for condoms for preventing pregnancy is 85 percent when you don't know how to use them, and 98 percent -- say it again, ninety eight percent -- when they are used correctly. (Where the percent means the chance that you won't get pregnant in a year if you use a condom every time you have sex.) Well, figure that "incorrectly" means that semen gets past the barrier, that probably means that germs get around it, too.

So the reasonable conclusion is that condoms will be more effective in preventing infection if people are taught how to use them correctly.

Let's make sure the "Protect Yourself" video stays in the MCPS health education classes, to protect our teens from both pregnancy and sexually transmitted infection. There really should be no argument about it, they need to learn this stuff.


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