HIV and Condoms

From time to time, people like to state as fact, assertions that are completely false. On 7 October, 2004, caller Barbara to Gainesville Florida's WSKY Drive Time Happy Hour program stated that HIV is small enough to penetrate latex condoms, and that unless one uses a condom with spermicidal lubricant containing Nonoxynol-9, one is not protected against contracting the AIDS virus. In fact, she couldn't have gotten the truth more wrong. Studies cited by the CDC make it clear that latex condoms can provide significant protection against HIV when used properly, and that spermicidal lubricant does not add to that effectiveness.

Her call was followed by a man who agreed with her, and went on to say that one of the best things people can do to help the country is to avoid being influenced by those liberal college professors. Some of those college professors work hard to find out the truth of matters of scientific fact. Their politics doesn't have any influence on the truth of such matters.

A third caller, when questioned by Chip Morris about whether it is a fact or opinion that AIDS penetrates latex condoms, said that this is a fact that she teaches. The audience of these teachings was not specified, however, they are being ill served by such false claims.

It is only by knowing and acknowledging the truth of matters of fact that we can take effective action in our lives. Ill-informed belief, no matter how comforting it may be, leads to unexpected outcomes and disappointment. Knowledge is power.

And to Barbara: Next time, just the facts, ma'am. And if you don't know 'em, don't fake 'em.

Here are references:

CDC Report Fact Sheet for Public Health Personnel: Male Latex Condoms and Sexually Transmitted Diseases

For persons whose sexual behaviors place them at risk for STDs, correct and consistent use of the male latex condom can reduce the risk of STD transmission. However, no protective method is 100 percent effective, and condom use cannot guarantee absolute protection against any STD. Furthermore, condoms lubricated with spermicides are no more effective than other lubricated condoms in protecting against the transmission of HIV and other STDs.

...
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.

Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD)Prevention, June 12-13,2000 Hyatt Dulles Airport Herndon,Virginia

FDA researchers have also developed an assay for condom leakage using high concentrations of a laboratory virus (78).The laboratory virus penetration assay is not used routinely as a quality control test,but its sensitivity and relevance are arguably greater than the conventional water leakage test.Using this virus assay,FDA scientists tested many different types of male condoms and showed that condoms are highly effective barriers to virus passage with a very small chance of leakage (76,77).Intact condoms (i.e.,pass the water leak test)are essentially impermeable to particles the size of STD pathogens (including the smallest sexually transmitted virus,hepatitis B).Moreover,these studies show that fluid flow,not virus size,is the most important determinant of viral passage through a hole.Even holes many times larger than the virus impeded fluid flow such that few of the test particles passed through (78).
...
HIV infection is the only STD for which formal meta-analyses have been published (28,166).The most recent analysis by Davis and Weller (28)was evaluated.
...
Longitudinal studies of HIV-sexual partners of HIV+infected cases allow for the estimation of HIV/AIDS incidence among condom users and condom non-users.From the two incidence estimates,consistent condom use decreased the risk of HIV/AIDS transmission by approximately 85%.These data provide strong evidence for the effectiveness of condoms for reducing sexually transmitted HIV.
...
In Thailand,an HIV/AIDS control program that consisted of multiple interventions including sanctions against sex workers if they did not use condoms,mass distribution of condoms,mass media campaigns and establishment of 140 new STD clinics,resulted in increased condom use among sex workers and was associated with a 23%/year decrease in chancroid cases over 4 years (53).From 1989 to 1993,there was a reduction in reported chancroid cases from 29,675 to 1,990.

28. Davis KR and Weller SC. The Effectiveness of Condoms in Reducing Heterosexual Transmission of HIV. Fam Plann Perspect. 1999; 31(6):272-279.
53. Haneberg RS, et al. Impact of Thailand's HIV-control programme as indicated by the decline of sexually transmitted diseases. Lancet. 1994;344:243-245.
76. Lytle CD, et al. Lack of Latex Porosity: A Review of Virus Barrier Tests. J Rubb Res. 1999; 2(1):29-39.
77. Lytle CD, et al. An in vitro evaluation of condoms as barriers to a small virus. Sex Transm Dis. 1997 March; 24(3):161-164.
78. Lytle CD, et al. A sensitive method for evaluating condoms as virus barriers. J AOAC Int. 1997; 80(2):319-324.

	CDC Report Fact Sheet for Public Health Personnel: Male Latex Condoms and Sexually Transmitted Diseases For persons whose sexual behaviors place them at risk for STDs, correct and consistent use of the male latex condom can reduce the risk of STD transmission. However, no protective method is 100 percent effective, and condom use cannot guarantee absolute protection against any STD. Furthermore, condoms lubricated with spermicides are no more effective than other lubricated condoms in protecting against the transmission of HIV and other STDs. ... 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.

	Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD)Prevention, June 12-13,2000 Hyatt Dulles Airport Herndon,Virginia FDA researchers have also developed an assay for condom leakage using high concentrations of a laboratory virus (78).The laboratory virus penetration assay is not used routinely as a quality control test,but its sensitivity and relevance are arguably greater than the conventional water leakage test.Using this virus assay,FDA scientists tested many different types of male condoms and showed that condoms are highly effective barriers to virus passage with a very small chance of leakage (76,77).Intact condoms (i.e.,pass the water leak test)are essentially impermeable to particles the size of STD pathogens (including the smallest sexually transmitted virus,hepatitis B).Moreover,these studies show that fluid flow,not virus size,is the most important determinant of viral passage through a hole.Even holes many times larger than the virus impeded fluid flow such that few of the test particles passed through (78). ... HIV infection is the only STD for which formal meta-analyses have been published (28,166).The most recent analysis by Davis and Weller (28)was evaluated. ... Longitudinal studies of HIV-sexual partners of HIV+infected cases allow for the estimation of HIV/AIDS incidence among condom users and condom non-users.From the two incidence estimates,consistent condom use decreased the risk of HIV/AIDS transmission by approximately 85%.These data provide strong evidence for the effectiveness of condoms for reducing sexually transmitted HIV. ... In Thailand,an HIV/AIDS control program that consisted of multiple interventions including sanctions against sex workers if they did not use condoms,mass distribution of condoms,mass media campaigns and establishment of 140 new STD clinics,resulted in increased condom use among sex workers and was associated with a 23%/year decrease in chancroid cases over 4 years (53).From 1989 to 1993,there was a reduction in reported chancroid cases from 29,675 to 1,990. 28. Davis KR and Weller SC. The Effectiveness of Condoms in Reducing Heterosexual Transmission of HIV. Fam Plann Perspect. 1999; 31(6):272-279. 53. Haneberg RS, et al. Impact of Thailand's HIV-control programme as indicated by the decline of sexually transmitted diseases. Lancet. 1994;344:243-245. 76. Lytle CD, et al. Lack of Latex Porosity: A Review of Virus Barrier Tests. J Rubb Res. 1999; 2(1):29-39. 77. Lytle CD, et al. An in vitro evaluation of condoms as barriers to a small virus. Sex Transm Dis. 1997 March; 24(3):161-164. 78. Lytle CD, et al. A sensitive method for evaluating condoms as virus barriers. J AOAC Int. 1997; 80(2):319-324.