July 20, 2001 (Washington) -- Condoms effectively prevent the spread of HIV and gonorrhea, but the jury is still out on whether they stop other sexually transmitted diseases, like chlamydia and syphilis. That's the final word of a new government report released Thursday.
Some are concerned that pro-abstinence groups and even the Bush administration may use the report to show that condoms are ineffective and to support their abstinence message. If they do, however, they will find themselves standing on very shaky ground, according to experts. Available data overwhelmingly suggest that condoms prevent the spread of STDs when used correctly.
A panel of experts representing universities, the National Institutes of Health, the CDC, and the FDA reviewed available condom studies and found that condoms are effective in "reducing sexually transmitted HIV in both men and women" and for reducing "the risk of gonorrhea for men."
But the experts could not conclusively say that condoms prevented the transmission of other STDs, including chlamydia, syphilis, and human papilloma virus, which causes genital warts and cervical cancer.
"It does not mean that condoms are ineffective. It just doesn't mean that," says panel member Timothy W. Shacker, MD, an assistant professor of medicine and infectious diseases at the University of Minnesota.
It only means that the data is not yet available for STDs besides HIV and gonorrhea, Shacker tells WebMD. "Many of us [on the panel] feel that when that data is available, it will show that condoms are effective at preventing all STDs," he says.
That's because HIV is so small -- much smaller than the bacteria and viruses that cause other STDs, says Doug Colvard, PhD, of the Contraceptive Research and Development Program, which works to develop better contraceptives for third world countries. So if data show condoms prevent HIV from spreading, it's reasonable to conclude that they stop other STDs, he tells WebMD.
Ward Cates, MD, president of Family Health International, which focuses on contraceptive research and education, agrees. "The glass is 90% full," Cates tells WebMD, referring to the fact that most studies now show or suggest that condoms are an effective way to prevent STDs.
"Condoms prevent the most dangerous STD, HIV, and the most easily transmitted STD, gonorrhea, [so] condom promotion is an important thing to continue to do," he says.
In addition, a study in the Journal of the American Medical Association that came out too late to be included in the report showed that condoms were effective at preventing the transmission of herpes, a spokesman for the Department of Health and Human Services, Campbell Gardett tells WebMD. This study would have been included in the report, if there had been time.
Tom Coburn, MD, a former member of Congress who requested the panel review condom effectiveness, has publicly questioned their effectiveness in preventing the spread of disease.
Coburn argues that the government has been promoting "an unsubstantiated claim that promiscuity can be safe. ... This report," he says, "finally exposes the 'safe' sex myth for the lie that it is."
Abstinence until marriage and a mutually monogamous relationship are the only ways to prevent the spread of STDs, says Coburn, who is on the board of the pro-abstinence group Family Research Council. The Family Research Council agrees with Coburn, spokeswoman Heather Cirmo tells WebMD.
Panel member Shacker says, "I would have to say that [Coburn] didn't understand the report."
The Bush administration did not return phone calls from WebMD, but the Department of Health and Human Services (HHS) and the CDC appear unlikely to make any radical policy changes as a result of the report.
The CDC will continue to advise that the "surest protection from STDs is sexual abstinence and mutually monogamous relations." But it adds that for those who are sexually active "condoms, when used correctly and consistently, are highly effective in protecting against HIV and can reduce the risk of other sexually transmitted diseases."
"A lot of what's in this report, you sort of know already," a source at HHS tells WebMD. "I don't think it surprises anyone or changes anything."