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UN Report Adds to a Condom Debate HIV; Failure Rate Found to Be 10 Percent

June 23, 2003

A draft report for the UN's AIDS agency has found that even when people use condoms consistently, the failure rate for protection against HIV is an estimated 10 percent, making them a larger risk than portrayed by many advocate groups. The report, which looked at two decades of scientific literature on condoms, is likely to fuel the debate that pits proponents of abstinence, who say that the Bush administration should abandon or sharply reduce condom promotion, against health specialists, who say that condoms play an integral part in preventing the spread of AIDS.

In previous reports, condom effectiveness against HIV has been widely estimated at between 46 percent and 100 percent. Many advocates of condoms have said they provide nearly 100 percent protection when used correctly. UNAIDS has voiced hope that the report not only clears up confusion over condom effectiveness but also helps educate people worldwide about how to use condoms properly.

The conclusions do not mean that every tenth condom is defective, but rather that something has gone wrong in about 10 percent of their use. In many cases, specialists said, human error is the source of the failure, resulting in condoms slipping off, breaking, or not being put on early enough. The report also said that the failure rate to protect against HIV was probably the same in preventing pregnancies. Edward C. Green, a senior research scientist at the Harvard School of Public Health, said that the data on condom effectiveness should help set policy and that people in developing countries should know about that risk. One chance in 10 of condom failure is "not good enough for a fatal disease," Green said.

The leading author on the report, Norman Hearst, a professor at the University of California-San Francisco, "makes a cogent argument that we should be talking about safer sex, not safe sex, with condoms," said Catherine A. Hankins, a chief scientific adviser to UNAIDS. "We need a combination of prevention, postponing sexual activities, reducing partners, and using condoms," Hankins said. The report is under review by UNAIDS, and a final version will not be released until the end of the month.

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Excerpted from:
Boston Globe
06.22.03; John Donnelly

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