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| Coordinates | 40°37′29″N73°57′8″N |
|---|---|
| Width | 200 |
| Caption | A rolled-up condom |
| Bc type | Barrier |
| Date first use | AncientRubber: 1855Latex: 1920Polyurethane: 1994Polyisoprene: 2008 |
| Rate type | Pregnancy |
| Failure measure | first year, latex |
| Perfect failure% | 2 |
| Typical failure% | 10–18 |
| User reminders | Latex condoms damaged by oil-based lubricants |
| Std protection yesno | Yes |
| Benefits | No medications or clinic visits required |
In the modern age, condoms are most often made from latex, but some are made from other materials such as polyurethane, polyisoprene, or lamb intestine. A female condom is also available, most often made of nitrile. As a method of birth control, male condoms have the advantage of being inexpensive, easy to use, having few side effects, and of offering protection against sexually transmitted diseases.
However, according to a study in the Sexually Transmitted Diseases Journal of the American Sexually Transmitted Diseases Association condoms have a breakage rate of 2.3% and a slippage rate of 1.3% which "may translate into a high risk for individuals who are very sexually active." With proper knowledge and application technique—and use at every act of intercourse—women whose partners use male condoms experience a 2% per-year pregnancy rate with perfect use and a 15% per-year pregnancy rate with typical use.
Condoms have been used for at least 400 years. Since the 19th century, they have been one of the most popular methods of contraception in the world. While widely accepted in modern times, condoms have generated some controversy, primarily over what role they should play in sex education classes. They are considered unacceptable in almost all situations by certain religions, notably the Catholic church.
Condoms interfere with the process of paternal tolerance, by which exposure of a woman's immune system to semen during unprotected sex may decrease the risk of pregnancy complications in subsequent pregnancies.
After this, the use of penis coverings to protect from disease is described in a wide variety of literature throughout Europe. The first indication that these devices were used for birth control, rather than disease prevention, is the 1605 theological publication De iustitia et iure (On justice and law) by Catholic theologian Leonardus Lessius, who condemned them as immoral.
From at least the 18th century, condom use was opposed in some legal, religious, and medical circles for essentially the same reasons that are given today: condoms reduce the likelihood of pregnancy, which some thought immoral or undesirable for the nation; they do not provide full protection against sexually transmitted infections, while belief in their protective powers was thought to encourage sexual promiscuity; and they are not used consistently due to inconvenience, expense, or loss of sensation. The first rubber condom was produced in 1855. The earliest rubber condoms had a seam and were as thick as a bicycle inner tube. Besides this type, small rubber condoms covering only the glans were often used in England and the United States. There was more risk of losing them and if the rubber ring was too tight, it would constrict the penis. This type of condom was the original "capote" (French for condom), perhaps because of its resemblance to a woman's bonnet worn at that time, also called a capote.
For many decades, rubber condoms were manufactured by wrapping strips of raw rubber around penis-shaped molds, then dipping the wrapped molds in a chemical solution to cure the rubber. But during this period Fascist Italy and Nazi Germany increased restrictions on condoms (limited sales as disease preventatives were still allowed).
In the 20th century the invention of plastic and other man-made materials did not lead to an improvement in the quality of condoms. However the deterioration of the rubber became less rapid. Condoms became not only thinner but also more reliable. In 1995, plastic condoms went on the market in the USA.
In the 1960s and 1970s quality regulations tightened, and more legal barriers to condom use were removed. the use of condoms was encouraged to prevent transmission of HIV. Despite opposition by some political, religious, and other figures, national condom promotion campaigns occurred in the U.S. and Europe. As one response, manufacturers have changed the tone of their advertisements from scary to humorous. Worldwide condom use is expected to continue to grow: one study predicted that developing nations would need 18.6 billion condoms by 2015.
Other terms are also commonly used to describe condoms. In North America condoms are also commonly known as prophylactics, or rubbers. In Britain they may be called French letters. Additionally, condoms may be referred to using the manufacturer's name.
Latex has outstanding elastic properties: Its tensile strength exceeds 30 MPa, and latex condoms may be stretched in excess of 800% before breaking. In 1990 the ISO set standards for condom production (ISO 4074, Natural latex rubber condoms), and the EU followed suit with its CEN standard (Directive 93/42/EEC concerning medical devices). Every latex condom is tested for holes with an electrical current. If the condom passes, it is rolled and packaged. In addition, a portion of each batch of condoms is subject to water leak and air burst testing.
While the advantages of latex have made it the most popular condom material, it does have some drawbacks. Latex condoms are damaged when used with oil-based substances as lubricants, such as petroleum jelly, cooking oil, baby oil, mineral oil, skin lotions, suntan lotions, cold creams, butter or margarine. Contact with oil makes latex condoms more likely to break or slip off due to loss of elasticity caused by the oils. Additionally, latex allergy precludes use of latex condoms and is one of the principal reasons for the use of other materials. In May 2009 the U.S. Food and Drug Administration granted approval for the production of condoms composed of Vytex, latex that has been treated to remove 90% of the proteins responsible for allergic reactions. An allergen-free condom made of synthetic latex (polyisoprene) is also available.Polyurethane condoms tend to be the same width and thickness as latex condoms, with most polyurethane condoms between 0.04 mm and 0.07 mm thick.
Polyurethane can be considered better than latex in several ways: it conducts heat better than latex, is not as sensitive to temperature and ultraviolet light (and so has less rigid storage requirements and a longer shelf life), can be used with oil-based lubricants, is less allergenic than latex, and does not have an odor. Polyurethane condoms have gained FDA approval for sale in the United States as an effective method of contraception and HIV prevention, and under laboratory conditions have been shown to be just as effective as latex for these purposes.
However, polyurethane condoms are less elastic than latex ones, and may be more likely to slip or break than latex, and are more expensive.
Polyisoprene is a synthetic version of natural rubber latex. While significantly more expensive, it has the advantages of latex (such as being softer and more elastic than polyurethane condoms) Lambskin provides more sensation and are less allergenic than latex, but because of their comparatively less-safe nature, other hypoallergenic materials such as polyurethane are recommended for latex-allergic users and/or partners. Lambskin condoms are also significantly more expensive than other types, similar to polyurethane's comparative expense to latex.
A collection condom is used to collect semen for fertility treatments or sperm analysis. These condoms are designed to maximize sperm life.
Some condom-like devices are intended for entertainment only, such novelty condoms may not provide protection against pregnancy and STDs.
The typical use pregnancy rate among condom users varies depending on the population being studied, ranging from 10–18% per year. The perfect use pregnancy rate of condoms is 2% per year.
According to a 2000 report by the National Institutes of Health (NIH), correct and consistent use of latex condoms reduces the risk of HIV/AIDS transmission by approximately 85% relative to risk when unprotected, putting the seroconversion rate (infection rate) at 0.9 per 100 person-years with condom, down from 6.7 per 100 person-years. Analysis published in 2007 from the University of Texas Medical Branch and the World Health Organization found similar risk reductions of 80–95%.
The 2000 NIH review concluded that condom use significantly reduces the risk of gonorrhea for men. Another study in the same year found consistent condom use was effective at reducing transmission of herpes simplex virus-2 also known as genital herpes, in both men and women.
Although a condom is effective in limiting exposure, some disease transmission may occur even with a condom. Infectious areas of the genitals, especially when symptoms are present, may not be covered by a condom, and as a result, some diseases can be transmitted by direct contact. The primary effectiveness issue with using condoms to prevent STDs, however, is inconsistent use. In addition, researchers in the UK suggest that a hormone in semen can aggravate existing cervical cancer, condom use during sex can prevent exposure to the hormone.
Different modes of condom failure result in different levels of semen exposure. If a failure occurs during application, the damaged condom may be disposed of and a new condom applied before intercourse begins – such failures generally pose no risk to the user. One study found that semen exposure from a broken condom was about half that of unprotected intercourse; semen exposure from a slipped condom was about one-fifth that of unprotected intercourse.
Standard condoms will fit almost any penis, although many condom manufacturers offer "snug" or "magnum" sizes. Some manufacturers also offer custom sized-to-fit condoms, with claims that they are more reliable and offer improved sensation/comfort. Some studies have associated larger penises and smaller condoms with increased breakage and decreased slippage rates (and vice versa), but other studies have been inconclusive. Nevertheless, it is recommended for condoms manufactures to avoid very thick, or very thin condoms, because they are both considered less effective. Some authors even encourage users to choose thinner condoms "for greater durability, sensation, and comfort", but others warn that "the thinner the condom, the smaller the force required to break it".
Experienced condom users are significantly less likely to have a condom slip or break compared to first-time users, although users who experience one slippage or breakage are more likely to suffer a second such failure. An article in Population Reports suggests that education on condom use reduces behaviors that increase the risk of breakage and slippage. A Family Health International publication also offers the view that education can reduce the risk of breakage and slippage, but emphasizes that more research needs to be done to determine all of the causes of breakage and slippage.
Another possible cause of condom failure is sabotage. One motive is to have a child against a partner's wishes or consent. Some commercial sex workers from Nigeria reported clients sabotaging condoms in retaliation for being coerced into condom use. Using a fine needle to make several pinholes at the tip of the condom is believed to significantly impact their effectiveness.
Condom use for disease prevention also varies. Among gay men in the United States, one survey found that 35% had used two condoms at the same time, a practice called "double bagging". While intended to provide extra protection, double bagging actually increases the risk of condom failure.
In the United States, teaching about condoms in public schools is opposed by some religious organizations. Planned Parenthood, which advocates family planning and sex education, argues that no studies have shown abstinence-only programs to result in delayed intercourse, and cites surveys showing that 76% of American parents want their children to receive comprehensive sexuality education including condom use.
Collection condoms are made from silicone or polyurethane, as latex is somewhat harmful to sperm. Many men prefer collection condoms to masturbation, and some religions prohibit masturbation entirely. Also, compared with samples obtained from masturbation, semen samples from collection condoms have higher total sperm counts, sperm motility, and percentage of sperm with normal morphology. For this reason, they are believed to give more accurate results when used for semen analysis, and to improve the chances of pregnancy when used in procedures such as intracervical or intrauterine insemination. Adherents of religions that prohibit contraception, such as Catholicism, may use collection condoms with holes pricked in them.
Other uses of condoms include: Covers for endovaginal ultrasound probes. Covering the probe with a condom reduces the amount of blood and vaginal fluids that the technician must clean off between patients. Condoms can be used to hold water in emergency survival situations. Condoms have also been used to smuggle cocaine, heroin, and other drugs across borders and into prisons by filling the condom with drugs, tying it in a knot and then either swallowing it or inserting it into the rectum. These methods are very dangerous and potentially lethal; if the condom breaks, the drugs inside become absorbed into the bloodstream and can cause an overdose. In Soviet gulags, condoms were used to smuggle alcohol into the camps by prisoners who worked outside during daylight. While outside, the prisoner would ingest an empty condom attached to a thin piece of rubber tubing, the end of which was wedged between his teeth. The smuggler would then use a syringe to fill the tubing and condom with up to three liters of raw alcohol, which the prisoner would then smuggle back into the camp. When back in the barracks, the other prisoners would suspend him upside down until all the spirit had been drained out. Aleksandr Solzhenitsyn records that the three liters of raw fluid would be diluted to make seven liters of crude vodka, and that although such prisoners risked an extremely painful and unpleasant death if the condom burst inside them, the rewards granted them by other prisoners encouraged them to run the risk. In his book entitled Last Chance to See, Douglas Adams reported having used a condom to protect a microphone he used to make an underwater recording. According to one of his traveling companions, this is standard BBC practice when a waterproof microphone is needed but cannot be procured. Condoms are used by engineers to keep soil samples dry during soil tests. Condoms are used in the field by engineers to initially protect sensors embedded in the steel or aluminum nose-cones of Cone Penetration Test (CPT) probes when entering the surface to conduct soil resistance tests to determine the bearing strength of soil. Condoms are used as a one-way valve by paramedics when performing a chest decompression in the field. The decompression needle is inserted through the condom, and inserted into the chest. The condom folds over the hub allowing air to exit the chest, but preventing it from entering.
The use of condoms to prevent STD transmission is not specifically addressed by Catholic doctrine, and is currently a topic of debate among theologians and high-ranking Catholic authorities. A few, such as Belgian Cardinal Godfried Danneels, believe the Catholic Church should actively support condoms used to prevent disease, especially serious diseases such as AIDS. However, the majority view—including all statements from the Vatican—is that condom-promotion programs encourage promiscuity, thereby actually increasing STD transmission. This view was most recently reiterated in 2009 by Pope Benedict XVI.
The Roman Catholic Church is the largest organized body of any world religion. The church has hundreds of programs dedicated to fighting the AIDS epidemic in Africa, but its opposition to condom use in these programs has been highly controversial.
In a recent interview, the pope discussed for the first time the use of condoms to prevent STD transmission. He said that the use of a condom can be justified in a few individual cases if the purpose is to reduce the risk of an HIV infection. He gave as an example male prostitutes. There was some confusion at first whether the statement applied only to homosexual prostitutes and thus not to heterosexual intercourse at all. However, Federico Lombardi, spokesman of the vatican, clarified that it applied to heterosexual and transsexual prostitutes, whether male or female, as well. He did, however, also clarify that the vatican's principles on sexuality and preservatives had not been changed.
In addition, the large-scale use of disposable condoms has resulted in concerns over their environmental impact, like via littering and in landfills, where they can eventually wind up in wildlife environments if not incinerated or otherwise permanently disposed of first. Polyurethane condoms in particular, given they are a form of plastic, are not biodegradable, and latex condoms take a very long time to break down. Experts, such as AVERT, recommend condoms be disposed of in a garbage receptacle, as flushing them down the toilet (which some people do) may cause plumbing blockages and other problems. The plastic and foil wrappers condoms are packaged in are also not biodegradable. However, the benefits condoms offer are widely considered to offset their small landfill mass.
While biodegradable,
Perhaps even more troubling is the apparent fact of a telephone survey conducted by Rand Corporation and Oregon State University and published in the Journal of Acquired Immune Deficiency Syndromes that showed that belief in AIDS conspiracy theories among United States black men is linked to rates of condom use. As conspiracy beliefs about AIDS grow in a given sector of these black men, consistent condom use drops in that same sector. Female use of condoms, interestingly, was not similarly affected.
In the African continent, condom promotion in some areas has been impeded by anti-condom campaigns by some Muslim Some women in Africa believe that condoms are "for prostitutes" and that respectable women should not use them. A few clerics even promote the idea that condoms are deliberately laced with HIV.
The Invisible Condom, developed at Université Laval in Québec, Canada, is a gel that hardens upon increased temperature after insertion into the vagina or rectum. In the lab, it has been shown to effectively block HIV and herpes simplex virus. The barrier breaks down and liquefies after several hours. As of 2005, the invisible condom is in the clinical trial phase, and has not yet been approved for use.
Also developed in 2005 is a condom treated with an erectogenic compound. The drug-treated condom is intended to help the wearer maintain his erection, which should also help reduce slippage. If approved, the condom would be marketed under the Durex brand. As of 2007, it was still in clinical trials.
Category:Penis Category:Sexual health Category:HIV/AIDS Category:Medical technology Category:HIV prevention tools
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