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Want your unbiased opinion on biased opinions
Jan 12, 2006

Dr. Bob,

I've been following your responses from 4 years now. By your responses, if we use condoms every time, we will be fine. But my friend (Dr. doing residency) treats HIV patients regularly and thinks you can never be sure. Either the condom may not work properly (tears, slips) or there are other ways of tranmission such as oral, bleeding gums etc.

He thinks your stand on condoms could be "biased" (with all due respect) may be because of your individualized scenario. He also thinks the fact that Steve is still -ve cannot be used to generalize the hypothesis.

I know you very well -- you are great, pure and perfect but still human. You can subconciously have a biased opinion, may be because you simply want it to be true.

So, what do you think? I want your unbiased opinion -- Dont you think condoms are better than nothing but not so perfect that you can wear it every time for a thousand times and still be fine?

Happy new year, Ricky

Response from Dr. Frascino

Hello Ricky,

If you've been reading my responses for four years, you certainly haven't been paying attention to what you've been reading!

Go back and have another look at the archives. I'll repost an example below.

Stay safe. Stay well.

Dr. Bob

I hope you won't be annoyed May 14, 2005

Dr Bob,

You seem to imply that the catholic church's position re: rubbers is wrong. And I agree with you a 100%. However, what I disagree with is your counter-implication that condoms provide almost perfect protection. Fact is, in studies with discordant couples, there were always one or two that got infected with condoms (as opposed to 10 out of a 100 odd couples) implying that the risk is still significant. I want to know if I am misunderstanding you, or what your opinion is on this otherwise.

Thank you for educating us on these issues. You are the best!

Response from Dr. Frascino

Hi,

No, of course I'm not annoyed but I do think you are misinterpreting my "counter-implication." If you go back to the archives, what you will find is that my statements are very consistent and reflect what we know about how well condoms work for preventing HIV and other sexually transmitted diseases. Perhaps the easiest way to explain this is to make a distinction between efficacy and effectiveness. Efficacy can be defined as the protection the user would have under "ideal" conditions. Efficacy, therefore, is dependent on the properties of the device, in this case the condom, tested in controlled situations.

Effectiveness can be defined as the protection the user would have under "actual" or "real life" conditions. Effectiveness, therefore, is dependent on both the properties of the device (condom) and the behaviors of the user.

Laboratory studies, including those conducted by the FDA, have shown the latex condom to be essentially impermeable to particles the size of STD germs, including HIV. However, in large-scale, "real life" epidemiological studies, condoms are 80-95% effective in reducing HIV infection.

The bottom line is that condoms provide a highly effective barrier method when used correctly.

The Catholic Church is shamefully wrong in their condemnation of condoms. For example, in El Salvador the Church helped push through a law requiring condom packages to carry a warning label stating that condoms do not protect against AIDS. Studies now show fewer than four percent of Salvadoran couples use condoms the first time they have sex. The result will be more funerals. The Church must choose between obeying tradition and saving lives. Somehow the answer to the often quoted question "What would Jesus do?" seems painfully obvious.

Stay safe. Stay well.

Dr. Bob



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