No glove, no love: The condom dilemma
The International Condom Day falls conveniently just a day before Valentine’s Day, which is marked on the February 14. Whether by design or accident, there is a strong associative message in the choice of these two days, as love and care go side by side. So why is it so hard for Kenyans to use condoms correctly and consistently?
The Healthy Nation team unearthed some pertinent information about condom history, myths, right usage, the science of protection and human errors that can impact its effectiveness:
A SHEATHED HISTORY
The first condom dates back to Roman times, when animal bladders were used to prevent the spread of STDs
In 1564, Italian anatomist Gabriel Fallopio recommended a linen sheath moistened with lotion to protect against syphilis.
It was only in the 18th Century that male condoms entered the fray and were adopted in family planning programmes.
In the 1960s, ’70s and ’80s, condom use was promoted with other methods of preventing unwanted pregnancies.
In the 1980s the threat of AIDS put condoms back in the spotlight for protection against HIV.
COMMON MYTHS ABOUT CONDOM USE
Condoms have holes big enough to allow HIV through
Men have a hard time finding condoms that fit properly
Condoms break and slip easily
Using condoms for contraception is like playing Russian Roulette
The latex in condoms can degrade during storage
Condoms provide no protection against HPV or herpes
Making condoms available to youth encourages them to have sex
Condoms do not feel good
Teaching youth about condoms entices sex
Condoms are celebrated for the dual role of being both a contraceptive device and a barrier against sexually transmitted infections, but their success is tied to correct and consistent use
THE RIGHT WAY TO USE A MALE CONDOM
THE DO'S
DO use a condom every time you have sex
DO put on a condom before having sex
DO read the package and check the expiry date
DO make sure there are no tears or defects
DO store condoms in a cool, dry place and not in your wallet
DO use water-based or silicone-based lubricants to prevent breakage
THE DON'TS
DON’T store condoms in your wallet as heat and friction can damage them
DON’T use oil-based products like baby oil, lotion, petroleum jelly, or cooking oil because they will cause the condom to break
DON’T use more than one condom at a time.
DON’T reuse a condom
THE SCIENCE OF PROTECTION
Are the pores in latex condoms large enough to allow passage of HIV? The HIV virus is about 0.1 microns in diameter — in comparison, the diameter of the head of a human sperm is about 3 microns.
Because of the huge public interest in the matter, condoms have been examined microscopically for evidence of porosity, including by the US National Institutes of Health, who found no pores at x2000 magnification.
Another study, by Consumers Union, used a scanning electron microscope at x30,000 power so as to observe the HIV-sized particles. It reported a somewhat bumpy condom surface but no pores, even when the condoms were stretched.
Further laboratory studies that simulated the stresses of intercourse on condoms so as to assess leakage of a variety of microorganisms, including HIV, demonstrated that the latex membrane has the ability to prevent the passing of HIV, herpes and hepatitis B viruses, as well as cytomegalovirus and chlamydia trachomatis, even after mechanical stimulation.
Latex rubber is not naturally porous, but microscopic holes can occur as a result of manufacturing defects or subsequent damage.
Most studies showed even the worst case of leakage under radical conditions allowed less than 0.03 per cent of the volume to leak (it is generally believed that the risk of HIV infection decreases significantly with decreasing exposure to the virus).
This study was conducted using viralsize microspheres in a concentration up to 100 million times the concentration of HIV in semen. In addition, the microspheres were subjected to conditions equivalent to 10 minutes of coital thrusting after ejaculation.
Failure of condoms from holes is a function of “the size and location of the holes, viscosity of semen, size and critical number of disease organisms required for infection, and extent of coital activity following ejaculation.”
In addition, the HIV virus is nonmotile (incapable of moving) and suspended in a viscous medium (semen), and is in most cases attached to cells that are considerably larger than individual viruses, meaning it is hard for it to breach the condom. (PATH)
HUMAN ERRORS THAT CAN IMPACT CONDOM EFFECTIVENESS IN PREVENTING STDS
Wearing the sheath inside-out and then turning it over
Removing the condom even before coitus
Putting it on in the middle of a sexual encounter
Condom contacting a sharp object before/during sex
Using an oil-based lubricant
50 REASONS MEN DON'T USE CONDOMS WITH SEX WORKERS
A 2004 study titled Fifty Ways to Leave Your Rubber: How Men in Mombasa Rationalise Unsafe Sex outlined reasons men who have sex with sex workers give for not using protection:
Condoms ‘‘deny’’ pleasure
They want it to feel more natural
‘‘It is like having sex with yourself’’
Using a condom means ‘‘losing twice’’
No sexual satisfaction for the woman
Women suffer friction from the condom
It takes too long to reach sexual climax
Condoms have unsafe micro-organisms
The HIV virus can still penetrate the sheath
Vaginal fluids are twice as acidic as sperm
Condoms are developed for Westerm environments
The sheaths can be too tight and uncomfortable
Some men are too endowed for the standard offer
They are not helpful clinically for disease prevention
They come off during sex so no need to use them
A peer educator was dying and said condoms
White people introduced condoms laced with HIV/Aids
Women who preach condom use have a higher mortality rate
Condoms collect sperm that infiltrate back
They cause wounds in women’s private parts
Condoms can cause penile injuries
They also cause allergies
They can come off and remain in the woman
A man must get rid of his sperm
Insisting on their use makes one feel untrusted
Throwing away sperm in infanticide
Condoms cause cancer
They promote promiscuity
Some men insist they can know who is and isn’t safe
Others say rural or young partners are safe
One can avoid infection by taking medicine before sex and urinating soon after
HIV/Aids does not exist
If infected you have sex with many others to get rid of the virus
Men are too shy to buy them in public
Men don’t remember to buy them
Men have a ‘‘weak sexual nature’’
Men should not have to worry about carrying condoms
Men don’t have anywhere to carry condoms
Those who are already infected want to infect others so they do not die alone
One cannot put on a condom without getting aroused, but once aroused, one cannot think protection
Alcohol abuse makes people forget protection
Sometimes it happens so quickly there is no time
HIV/Aids is a calamity long prophesied by the Bible, so humans have no control over it
Condoms are against God’s command... to go out and fill the world
God intended sex to be pleasurable
Dying of HIV/Aids is like dying from an automobile accident. You cannot control it
We are all going to die anyway, so we might as well die happy
Those who use condoms have ‘‘lost hope’’
For some ethnic groups, sex is used for certain transactions, and condoms interfere with this
Using condoms in a relationship means you do not trust your partner