No glove, no love: The condom dilemma

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. GRAPHIC| MICHAEL MOSOTA

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

DON’T store condoms in your wallet as heat and friction can damage them. PHOTO| FILE| NATION MEDIA GROUP

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)

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. PHOTO| FILE| NATION MEDIA GROUP

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

 DO use a condom every time you have sex. PHOTO| FILE| NATION MEDIA GROUP

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:

  1. Condoms ‘‘deny’’ pleasure

  2. They want it to feel more natural

  3. ‘‘It is like having sex with yourself’’

  4. Using a condom means ‘‘losing twice’’

  5. No sexual satisfaction for the woman

  6. Women suffer friction from the condom

  7. It takes too long to reach sexual climax

  8. Condoms have unsafe micro-organisms

  9. The HIV virus can still penetrate the sheath

  10. Vaginal fluids are twice as acidic as sperm

  11. Condoms are developed for Westerm environments

  12. The sheaths can be too tight and uncomfortable

  13. Some men are too endowed for the standard offer

  14. They are not helpful clinically for disease prevention

  15. They come off during sex so no need to use them

  16. A peer educator was dying and said condoms

  17. White people introduced condoms laced with HIV/Aids 

  18. Women who preach condom use have a higher mortality rate

  19. Condoms collect sperm that infiltrate back

  20. They cause wounds in women’s private parts

  21. Condoms can cause penile injuries

  22. They also cause allergies

  23. They can come off and remain in the woman

  24. A man must get rid of his sperm

  25. Insisting on their use makes one feel untrusted

  26. Throwing away sperm in infanticide

  27. Condoms cause cancer

  28. They promote promiscuity

  29. Some men insist they can know who is and isn’t safe

  30. Others say rural or young partners are safe

  31. One can avoid infection by taking medicine before sex and urinating soon after

  32. HIV/Aids does not exist

  33. If infected you have sex with many others to get rid of the virus

  34. Men are too shy to buy them in public

  35. Men don’t remember to buy them

  36. Men have a ‘‘weak sexual nature’’

  37. Men should not have to worry about carrying condoms

  38. Men don’t have anywhere to carry condoms

  39. Those who are already infected want to infect others so they do not die alone

  40. One cannot put on a condom without getting aroused, but once aroused, one cannot think protection

  41. Alcohol abuse makes people forget protection

  42. Sometimes it happens so quickly there is no time

  43. HIV/Aids is a calamity long prophesied by the Bible, so humans have no control over it

  44. Condoms are against God’s command... to go out and fill the world

  45. God intended sex to be pleasurable

  46. Dying of HIV/Aids  is like dying from an automobile accident. You cannot control it

  47. We are all going to die anyway, so we might as well die happy

  48. Those who use condoms have ‘‘lost hope’’

  49. For some ethnic groups, sex is used for certain transactions, and condoms interfere with this

  50. Using condoms in a relationship means you do not trust your partner