The present review assesses the protection that
condoms offer against sexually transmissible
infections (
STI) and the impact that social, political and religious opinion in the USA has had in the past 8 years on promoting
condoms for safer sex.
Condoms offer protection against most
STI. However, the degree of protection depends on correct and consistent use, the type of sexual activity and the
biological characteristics of different
infections. Cross-sectional and case-control studies and other observational data provide the majority of evidence for
STI prevention.
Condoms provide a high level of protection against those
infections that are transmitted mainly via infected secretions, including HIV, gonorrhoea, chlamydia and
trichomoniasis. Protection against those
infections transmitted via skin and mucous membrane contact, including
Herpes simplex virus infection and human papilloma virus, appears to be less. The Bush administration, driven by conservative political, social and religious elements in the USA, has mounted a concerted campaign to undermine the role of the
condom in health-promotion activities in the USA and overseas by undervaluing and misrepresenting scientific data, and through a sustained and well-funded promotion of abstinence-only education. However, this has lead to considerable controversy and disillusionment with abstinence-only education, both at home and abroad, and there is now incontrovertible evidence that abstinence-only programs are ineffectual.