- The male latex condom, as a proven effective, simple and low-cost device, is the single most efficient, available method to reduce the sexual transmission of HIV and other sexually transmitted infections and offer dual protection for the prevention of unintended pregnancy1. For maximum effect for contraception or infection prevention, condoms have to be used correctly and consistently.
- Laboratory (in-vitro) testing shows that intact latex condoms are highly effective barriers to sexually transmitted pathogens, including HIV. Condoms therefore protect against many STIs, although the level of protection has not been quantified for each specific STI. Male latex condoms may be less effective in protecting against STIs that are transmitted by skin-to-skin contact than those transmitted in fluids, since the condom may not cover all of the infected skin areas.
- With consistent and correct use of quality condoms, there is a near-zero risk of HIV. Studies on couples where one partner is infected show that with consistent condom use, HIV infection rates for the uninfected partner are below 1% per year.
- Condoms are an essential part of HIV prevention, particularly for key populations who are at higher risk, such as sex workers and their clients, men who have sex with men (MSM), transgender people, sexually active young people, people who inject drugs (PWID) and people who are living with HIV and their partners.
- Condoms are also effective barriers against other diseases such as herpes simplex, hepatitis B, chlamydia and gonorrhea.
- After condom use rates rose among Thai sex workers from 14% in 1989 to 94% five years later, STIs dropped from 400,000 to 30,000 per year.
- The success of 100% condom use programme (CUP) in Thailand has made the country the first in Asia able to combat the HIV epidemic.
- Condom use in Cambodia has also resulted in drops of HIV rates of more than 80% since the peak of the epidemics, and comprehensive condom programmes have kept HIV prevalence very low among sex workers in China.
More efforts needed
- Nearly everywhere in Asia, more efforts are needed to promote condoms. They may be unavailable or costly, and there may be limited public knowledge about their benefits.
- In many areas, the majority of sex workers, people who inject drugs, men who have sex with men and transgender persons are not using condoms consistently.
- Even countries that have heavily promoted condoms still need to do more. In Thailand, for example, where condom accessibility and knowledge is good, the use of condoms is still not as high during casual sex encounters or among men who have sex with men and transgender persons.
- Meaningful involvement and empowerment of sex workers is essential for sustaining consistent use of condoms for HIV prevention.
- Particular efforts should be made to increase condoms use in street based, low-class-sex workers and their old male clients. More strategic efforts to target clients of male, female and transgender sex workers, MSM, PWID as well as their sexual partners.
- In partnership with UNAIDS, United Nations Population Fund (UNFPA) and Family Health International (FHI), WHO has recently revised and published its global condom manual "Male Latex Condom: Specification, Prequalification and Guidelines for Procurement, 2010."2 This manual aims to help policy-makers, procurement officers, logistics and programme managers, national regulatory authorities and testing laboratories make the right decisions to procure, receive, distribute, test and promote a quality product.
- The purchase of poor-quality condoms will adversely affect every aspect of condom promotion and programming. Not only is it a waste of limited budgetary resources, but also it damages the credibility of the one inexpensive device that has been proven to help prevent the transmission of HIV/STIs and unintended pregnancy.
- It is important for policy-makers, programme managers, bulk procurement agencies, social marketing programmes, logistic/procurement officers and national regulatory authorities to know how to apply the essential elements of condom quality assurance to guarantee that a quality product is purchased, promoted and distributed to the end user. The condom is an important medical device and needs to be regulated and controlled as such.
- Condoms can be promoted by governments through a variety of ways:
- Subsidize the cost, or lower the price by reducing taxes on them.
- Make condoms more convenient to acquire, by making them available in vending machines, stores, pharmacies, truck stops, bars and hotels.
- Make condoms more socially acceptable so people feel less embarrassed to buy them.
- Improve public knowledge about the benefits of condoms and how to use them.
How to use a condom correctly
- Make sure the condom is of good quality, of the right size and not past its shelf-life.
- Open the packet carefully so the condom does not tear.
- Squeeze the tip of the condom before unrolling it on to the erect penis.
- After ejaculation, hold the rim of the condom and pull the penis out when still hard.
- Do not use oil-based lubricants (stick to water-based products such as KY Jelly).
1WHO/UNFPA/UNAIDS position statement—condoms and HIV prevention. 2004, updated 2009.
2WHO/UNAIDS/UNFPA/FHI: Male Latex Condom: Specification, Prequalification and Guidelines for Procurement, 2010