People commonly say that using a condom makes sex safe, but is this really true? What are the risks still involved with 'protected' sex? Can you still get pregnant? Can you still get an STI (sexually transmitted infection)? The unexpected answer: Yes, definitely.
The truth is, even if you use a condom every time you have sex, you're still at risk of becoming pregnant or getting a STI. It is alarming to consider that, especially given the widespread distribution of condoms and education regarding condom use in the U.S., there are still over 70 million people suffering the destructive consequences of STIs today (with 20 million more added to that number each year, almost half of whom are teenagers).
What we are not typically told is that condoms have the highest pregnancy rate among the most common methods of birth control. But they do. Typical use results in 15 out of 100 users getting pregnant each year. And teens have a higher failure rate than adults.
About three out of every 20 couples using condoms to avoid pregnancy end up pregnant anyway within the first year of use.
Sexually transmitted infections (all STDs are STIs) are a serious matter. STIs are spread through vaginal, anal, and oral sex. You can have an STI and never know, and pass it on to others too.
The Centers for Disease Control and Prevention (CDC) has reported that now 85 percent of the most prevalent infectious diseases in the United States are sexually transmitted. The rate of STIs in this country is 50 to 100 times higher than that of any other industrialized nation. One in four sexually active Americans (possibly more) will be affected by an STI at some time in his or her life.
Thirty years ago, people only worried about two STDs—syphilis and gonorrhea. Today, there are at least 25, and many of them have no symptoms and no cure.
In addition, about 20 million new STI cases occur in the U.S. each year. Almost half of those occur in someone between the ages of 15 and 24.
STIs can have very painful long-term consequences as well as immediate health problems. They can cause:
Infertility and other abnormalities of the reproductive system
The Centers for Disease Control and Prevention (CDC) gathered the information from many different, rigorous scientific studies performed to determine the effectiveness of condoms in preventing STIs and unplanned pregnancies. Here is what they found:
There is no clinical proof that condoms are effective in reducing the risk of infection from chlamydia, genital herpes, HPV, syphilis, chancroid or trichomoniasis. Some protection was found for men against gonorrhea infection, but not for women. Condoms were found to reduce the risk of HIV/AIDS transmission during vaginal sex by 85% when used consistently (every time a person has sex, without exception) and "correctly" (following a specific 6 step procedure).1
What this means is that even using condoms correctly 100 percent of the time still leaves a 15 percent risk of HIV infection, the virus that causes AIDS, a routinely fatal disease.
Yes, thankfully STIs can be prevented. Practice abstinence by avoiding sexual activity if you are single. Save sex until marriage. Be faithful to one uninfected partner for the rest of your life. This is truly the only way to avoid the risk of an infection.
There are also a number of ways to reduce the risk of infection. Wait to have sex until you are in a faithful lifelong relationship. The fewer people you have sex with, the lower your risk of getting STIs. Correct and consistent condom use can also reduce (but not eliminate) your risk of getting most STIs.
Even with "consistent condom" use you are still at risk of catching most STIs about half the time and every 15 out of a 100 people having sex with a condom still get HIV. (Very few studies have been done to see whether condoms reduce the risk of STIs, including HIV, during oral or anal sex.)
What is meant by "consistent" condom use? Consistent condom use means using a condom 100 percent of the time during every sex act. Few individuals actually manage to use condoms consistently and correctly for any length of time. Typical condom use is inconsistent. Studies have shown that even in couples in which one partner is known to be infected with HIV, consistent use was attained by only 45 percent of the participants.
How do teens fare? A study conducted over a period of six months found that "always" condom use was reported by adolescent females only 13 percent of the time. In another study, just 50 percent of females reported consistent condom use. Generally, adolescent males report slightly more condom use than females.
Unfortunately, inconsistent use provides little to no risk reduction for most STIs. According to a National Institutes of Health panel on condom effectiveness, even if 100 percent consistent condom use could be attained, it would not totally eliminate the risk of acquiring any sexually transmitted infection, including HIV.
Almost no studies actually measure correct condom use. In theory, condom effectiveness against STI transmission is further diminished if a condom is used incorrectly. In a study of college males, more than a third reported major errors in condom use over a three-month time period, despite having received instructions on correct use.
What about condom breakage and slippage? Condom breakage and slippage is estimated to occur one to four percent of the time. This is known as method failure.
By far the most extensive research on condom effectiveness has been done for HIV. A number of authors have performed meta-analyses (summaries) of other studies. These meta-analyses show that with 100 percent consistent condom use, condoms reduce the risk of HIV transmission by about 85 percent. Condom effectiveness against transmission of bacterial diseases like gonorrhea, chlamydia and syphilis is significantly lower than for HIV. Conclusive evidence is lacking for condom effectiveness against transmission of several other specific STIs, such as HPV and T. vaginalis, which each affect over seven million people annually. Finally, effectiveness is seriously limited for the many STIs which are transmitted through skin-to-skin contact, since condoms do not cover all the areas of the body which may be the source of transmission.
The major factor affecting "condom effectiveness" is not method failure, over which the user has no control, but user failure—the incorrect and inconsistent use of condoms during sexual acts.
Try this: check out the inside of the condom box. This is where the FDA covers their bases and reports all of the details they require manufacturers to have. Get past the marketing of "safe" sex and read the real truth about condoms.
Let's be honest. Most people don't use condoms every single time they have sex. Studies by the National Survey of Family Growth and the Youth Risk Behavior Survey showed that rarely do even half of those surveyed show consistent condom use. In fact, the older and more sexually experienced a person gets the less likely he is to use a condom. The other problem is that many who do use condoms use them incorrectly. Additionally, condoms can tear or slip off, putting each partner at risk.
The only truly "safe sex" out there is sex between married couples that are faithful to each other for life. If you're single, then the only safe sex is no sex. Abstinence is not engaging in sexual contact (vaginal, anal, oral, or any other genital contact whatsoever) with another person. If you are not practicing abstinence while single then you are making yourself vulnerable to potentially deadly diseases and pregnancy.
Condoms simply cannot provide complete protection against STIs or unplanned pregnancies. Having anything other than married, monogamous sex—even with a condom—is like playing Russian roulette with your life. You are choosing to put a bullet in the gun and hold it up to your head. All you can hope for is that it doesn't fire, this time. But there are no guarantees.
Choosing to save sex for the special person you will end up spending the rest of your life with is the only way to truly enjoy the gift of sex without the risk of getting a life-threatening STI or causing an unplanned pregnancy. This will also increase your likelihood of having a healthy relationship. This is your life we are talking about here. We want you to make it a good one.
If you don't take control of and responsibility for your sexual life, who will?
1 Centers for Disease Control and Prevention, Sexually Transmitted Disease Surveillance, 2004 (Atlanta, GA: U.S. Department of Health and Human Services, September 2005). Available at http://www.cdc.gov./std/stats/trends2004.htm, accessed on January 22, 2007.