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Some say condoms make sex "safe." But how well
do condoms work? Can you still get a sexually transmitted
infection (STI)? Can you still get pregnant? You bet!
If you are worried about STIs, condoms just reduce your risk;
they don't eliminate it. And about 1 of every 5 teen couples
using condoms for birth control get pregnant within a year.[1] So
even if you use a condom every time you have sex, you're still at
risk for STIs and pregnancy.
The STI
Epidemic
Every year, 1 in 4 young people under 25 gets an STI.[2] There
are at least 25 different STIs. Many of these have no cure.
Untreated STIs can cause long-term pain, some cancers and even
death. Consider the facts:
If you use condoms every time you have vaginal sex, you can cut your chance of getting chlamydia or gonorrhea in half.[3,4] Chlamydia and gonorrhea infections are common in teens. But you probably won't know if you're infected because most people with these infections have no symptoms. Even if you have no symptoms, you can still spread these infections. If left untreated, both chlamydia and gonorrhea can cause long-term pain and problems getting pregnant when you want to.[5]
If you use condoms every time you have vaginal sex, you can cut your chance of getting genital herpes in half.[6,7] Genital herpes infects 1 in 6 teens and adults.[8] Once you're infected, you have it for life. If you don't stay on medication, sores can keep coming back. Even if you have no symptoms, you can still spread the infection to others.
If you use condoms every time you have vaginal sex, you may be able to cut your chance of getting HPV in half.[9-12] HPV is a very common STI in the US. About half of all sexually active college-age females get HPV.[13] Most people with HPV have no symptoms. HPV can cause genital warts or cancer of the cervix, penis or anus.[14]
If you use condoms every time you have vaginal sex, you can cut your chance of getting HIV by 85%.[10,15] That might sound pretty good, but that still leaves you at risk for infection. HIV/AIDS has killed nearly half a million Americans—and the number is growing.[16]
Condoms for Oral or Anal
Sex
Although using condoms for oral sex might reduce your risk for
gonorrhea,[17] no one knows for sure whether using condoms all
the time during oral sex reduces your chance of getting HIV or
other infections. Always using condoms for anal sex may cut your
chance of getting HIV by up to half.[18]
The Real World
Most people don't use condoms every time they have sex. In fact,
people use condoms less often as they get older.[19] Even when
people do use condoms, they don't always use them correctly. And,
even if you use them correctly every time you have vaginal sex,
they can still break or slip off.[20]
The Bottom
Line
Condoms don't make sex safe, just less risky. You can still get
an STI or get pregnant.
To completely reduce your risk of getting STIs, you should avoid
sexual activity (oral, vaginal or anal sex) or be faithful to one
uninfected partner for life. If you've already had sex, see a
doctor about getting checked for STIs.
Waiting to have sex until you are in a faithful, lifelong
relationship (such as marriage) is the only certain way to avoid
being infected sexually.
-------------------------
References:
1. Grady WR, Hayward MD, Yagi J. Contraceptive failure in the
United States: estimates from the 1982 National Survey of Family
Growth. Fam Plann
Perspect. 1986;18(5):200-209.
2. Weinstock H, Berman S, Cates W Jr. Sexually transmitted
diseases among American youth: incidence and prevalence
estimates, 2000. Perspect Sex
Reprod Health; 2004;36(1):6-10.
3. Ahmed S, Lutalo T, Wawer M, et al. HIV incidence and sexually
transmitted disease prevalence associated with condom use: a
population study in Rakai, Uganda. AIDS. 2001;15(16):2171-2179.
Available from:http://www.aidsonline.com/pt
jsessionid=Df45SnM7gkk38EFpMUFX
U4cX3Cl7zEEENny13OaW!1389088241
4. Baeten JM, Nyange PM, Richardson BA, et al. Hormonal
contraception and risk of sexually transmitted disease
acquisition: results from a prospective study. Am J Obstet Gynecol.
2001;185(2):380-385.
5. Westrom L, Eschenbach D. Pelvic inflammatory disease. In:
Holmes KK, et al, eds. Sexually Transmitted Diseases. 3rd
ed. New York: McGraw-Hill; 1999:783-809.
6. Shlay JC, McClung MW, Patnaik JL, Douglas JM Jr. Comparison of
sexually transmitted disease prevalence by reported level of
condom use among patients attending an urban sexually transmitted
disease clinic. Sex Transm
Dis. 2004;31(3):154-160.
7. Wald A, Langenberg AG, Krantz E, et al. The relationship
between condom use and herpes simplex virus acquisition.
Ann Intern Med.
2005;143(10):707-713.
8. Xu F, Sternberg MR, Kottiri BJ, et al. Trends in herpes
simplex virus type 1 and type 2 seroprevalence in the United
States. JAMA.
2006;296(8):964-73.
9. Vaccarella S, Franceschi S, Herrero R, et al. Sexual behavior,
condom use, and human papillomavirus: pooled analysis of the IARC
human papillomavirus prevalence surveys. Cancer Epidemiol Biomarkers Prev.
2006;15(2):326-33.
10. National Institute of Allergy and Infectious Diseases,
National Institutes of Health. Workshop Summary: Scientific
Evidence on Condom Effectiveness for Sexually Transmitted Disease
(STD) Prevention. 2001. Available from http://www.niaid.nih.gov/dmid
11. Manhart LE, Koutsky LA. Do condoms prevent genital HPV
infection, external genital warts, or cervical neoplasia? A
meta-analysis. Sex Transm
Dis. 2002;29(11):725-735.
12. Winer RL, Hughes JP, Feng Q, et al. Condom use and the risk
of genital human papillomavirus infection in young women.
N Engl J Med.
2006;354(25):2645-2654.
13. Peyton CL, Gravitt PE, Hunt WC, et al. Determinants of
genital human papillomavirus detection in a US population. J
Infect Dis. 2001;183(11):1554-1564. Available from: http://www.journals.uchicago
14. Koutsky LA, Kiviat NB. Genital human papillomavirus. In:
Holmes KK, Mardh PA, Sparling PF, et al, eds. Sexually Transmitted Diseases. 3rd
ed. New York, NY: McGraw Hill, Co; 1999:347-359.
15. Weller S, Davis K. Condom effectiveness in reducing
heterosexual HIV transmission. Cochrane Database Syst Rev.
2002;(1):CD003255.
16. Centers for Disease Control and Prevention. HIV/AIDS
Surveillance Report, 2005. Vol. 17. Atlanta: U.S. Department of
Health and Human Services, Centers for Disease Control and
Prevention; 2006. Available from: http://www.cdc.gov/hiv/topics
17. Wong ML, Chan RK. A prospective study of pharyngeal
gonorrhoea and inconsistent condom use for oral sex among female
brothel-based sex workers in Singapore. Int J STD AIDS.
1999;10(9):595-599.
18. Saracco A, Musicco M, Nicolosi A, et al. Man-to-woman sexual
transmission of HIV: longitudinal study of 343 steady partners of
infected men. J Acquir Immune
Defic Syndr 1993;6(5):497-502.
19. Centers for Disease Control and Prevention. National Center
for Health Statistics. 2005. Mosher WD, Chandra A, Jones J.
Sexual behavior and selected health measures: Men and women
15–44 years of age, United States, 2002 . Advance data from
vital and health statistics; no 362. Hyattsville, MD. Available
from: http://www.cdc.gov/nchs/data
20. Crosby RA, Diclemente RJ, Wingood GM, et al. Correlates of
condom failure among adolescent males: an exploratory study.
Prev Med. 2005;
41(5-6):873-6. Epub 2005 Oct 27.
Authored by:Sheetal
Malhotra, MBBS, MS
Reviewed by: Kate
Hendricks, MD, MPH&TM
Date: February
2007