San Francisco: Condom Conundrum

This month the Stop AIDS Project handed out its 4 millionth condom for the year. Other San Francisco AIDS agencies also distribute thousands of condoms every month.

According to the CDC, it is commonly believed that "prior to the [AIDS] epidemic, virtually no American gay men used condoms. By 1992, 70 percent of at-risk gay men reported consistent condom use." Even ten years later, the percentage of men who say they use condoms remains high. The Black Coalition on AIDS has found that 80 percent of the people interviewed during its risk reduction counseling say they use condoms. And of the 2,525 men surveyed last fiscal year by the Stop AIDS Project, 81 percent said they intended to use condoms in the next six months. The Asian and Pacific Islander Wellness Center reports similar findings.

Yet, if so many condoms are being handed out why do rates of STDs and HIV continue to rise among the city's gay men? It is a question health officials are trying to answer. "There's always that discrepancy between what people say they do and what they actually do," said Andre Robertson, director of prevention at the Black Coalition on AIDS. "In my activities on the streets, I find very few -- maybe 10 or 20 percent -- of the people don't use condoms. But those folks tend to engage in the most risky behavior."

"With AIDS deaths down dramatically -- and along with that, visible reminders of the deadly consequences of AIDS -- just handing out condoms or discussing safer sex is not going to do the job," maintains Susan M. Kegeles, University of California-San Francisco professor of medicine and associate director of the Center for AIDS Prevention Services. "You need to establish places that are not gay bars or cruising areas where young gay men can create community that supports them in all aspects of their lives."

Promoting condom use remains the best strategy in stopping the spread of HIV, but prevention officials are finding more complex methods are needed to get the message across. In the meantime, they will continue to pass out condoms. "We go on the assumption people aren't going to use condoms all the time. We just try to get them to use them at the riskiest times," Robertson said.

Back to other CDC news for August 28, 2002

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