Condoms II

[The following information on this webpage is an excerpt from the booklet Condom Expose'. "This document is a compendium and summary of the latest scientific information about the most widely-used contraceptive device in the world today — the male condom. This summary draws from many sources, but focuses primarily on medical journals. This summary is intended to be a resource for those who need straightforward, simple and concise facts about condoms."
The entire report can be found at http://www.hli.org/condom_expose_complete.html.]

The basic problem is as follows. No matter how much `safe(r) sex’ education is taught, no matter how many bowls of free condoms are left in plain view, and no matter how much contraceptive marketing is propagated, there are a number of mechanical and human factors that simply cannot be controlled [3];

* Condoms break and slip off

* They age. One study found that the breakage rate for condoms increased from 3.6% for new condoms to as high as 18.6% for condoms several years old.[4]

* They deteriorate in even the best of conditions, but even more rapidly in extremely cold or hot situations. Condom wrappers recommend storing the product at temperatures between 59 and 88 degrees Fahrenheit. One researcher found that, at major condom distribution points in New Jersey and New York, boxes of condoms were left outdoors in the ice and snow during the dead of winter. During the summer months, the researcher took photographs of eggs frying on the floors of dozens of trucks and containers where condoms were stored in temperatures exceeding 180 degrees.[5] High temperatures cause oxidation and freezing temperatures cause crystallization in some of the chemical compounds that make up condoms, leading to cracking, drying, shrinking and drastic loss of flexibility and strength. Keep in mind that condoms exported from the United States sit in uninsulated shipping containers in extreme weather conditions for even longer periods of time.

* If taken out of the package and left unused for a long period of time, they are liable to ozone deterioration, which causes damage invisible to the eye.

* Improper use of oil-based lubricants can degrade them.

* They get broken in their packages.

* They have allowed rates of manufacturing defects. The present acceptable quality limit (AQL) for North American condom manufacturers is 99.6% of condoms free of leaks. The British AQL is 97%, and the Dutch AQL is 96.5%.

* The users are caught up in passion and do not properly follow the ten- to sixteen-step process for safe usage [6];

* The users are compromised by the use of alcohol, marijuana, illegal drugs, prescription and over-the-counter drugs, or exhaustion; and

* Bodily secretions can get around and over a condom even if it performs perfectly.

The Primary Danger — Not Pores, But Catastrophic Failure.

“Counting on condoms is flirting with death.”

— Dr. Helen Singer‑Kaplan, founder of the Human Sexuality Program at the New York Weill Cornell Medical Center, Cornell University.[7]

Overview. Although latex condoms appear to occasionally be permeable to the AIDS virus, by far the greatest danger of infection lies in their propensity to burst, tear and slip off.

Even if only a few HIV viruses did pass through a porous condom, the risk of infection would still be extremely small; but in those cases where condoms fail catastrophically, massive exposure to the HIV virus is inevitable. In cases of failure during intercourse with an HIV‑infected person, there is the distinct possibility of a protracted and extremely unpleasant death.

The Studies. The frequency of condom breakage depends upon many factors, including the type of lubricant used and the brand of condom. Contraceptive Technology tallied the results of fifteen studies involving a total of 25,184 condoms used during heterosexual intercourse and found that 4.64 percent of all of the condoms broke and 3.44 percent of them partially or completely slipped off, for a total of 8.08 percent, or about one in twelve.[8]

Figure 1 is a summary of these studies.

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Figure 1

A Summary of Major Studies
on Condom Breakage and Slippage Rates

Total Breakage Slippage
Condoms Rate Rate Total Total

Study Used (percent) (percent) Breaks Slips

1. Nevada 353 0.0% 3.9% 0 14

2. United States #1 4,632 0.4% 0.6% 19 28

3. United States #2 147 0.7% 7.4% 1 11

4. Sydney, Australia 605 0.5% ‑‑‑ 3 ‑‑‑

5. Atlanta, Georgia #1 478 3.7% 13.1% 18 63

6. Atlanta, Georgia #2 405 2.4% 13.1% 10 53

7. California #1 3,717 3.0% 2.9% 112 108

8. California #2 2,059 4.3% 2.2% 89 45

9. North Carolina #1 1,072 3.3% 5.4% 35 58

10. North Carolina #2 4,589 11.1% ‑‑‑ 509 ‑‑‑

11. North Carolina #3 1,947 5.3% 3.5% 103 68

12. North Carolina #4 752 4.1% ‑‑‑ 31 ‑‑‑

13. North Carolina #5 358 6.7% — 24 —

14. Denmark 385 5.0% ‑‑‑ 19 ‑‑‑

15. New Zealand 3,685 5.3% 5.1% 195 188

────── ───── ───

Totals 25,184 1,168 636

Summary of Studies

Average breakage rate of all condoms: 1,168/25,184 = 4.64%

Average slippage rate of all condoms: 636/18,495 = 3.44%

Total failure rate of all condoms: 8.08%

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According to Contraceptive Technology, the condom’s user effectiveness rate is 85 percent [9]. This means that, under real-world conditions, a woman whose sexual partners use condoms for every act of sexual intercourse has a 15 percent chance of becoming pregnant in a year.

Figure 2 shows the chances of pregnancy for a woman whose sexual partners faithfully use condoms for 83 average annual instances of sexual intercourse.[10]

Keep in mind that these are the lowest rates that can generally be expected, since they assume 100% condom usage.

——————————————————————

Figure 2

Probability of Pregnancy Over Time for Women
Whose Sexual Partners Always Use Condoms

Time Probability
Span of Pregnancy

1 year 15 percent

2 years 28 percent

3 years 39 percent

4 years 48 percent

5 years 56 percent

10 years 80 percent

——————————————————————

According to United States Census Bureau sources, about 6.8 million couples use condoms as their primary means of contraception in the USA.[11] 15 percent of this number means that about one million unwanted pregnancies occur every year due to condoms breaking ‑‑ a number equivalent to half of the unintended pregnancies in the United States annually!

This experience is mirrored in many other surveys of people who use condoms under real-world conditions;

* 1,609 of 4,666 women (34.5 percent) obtaining abortions at the Leeds Marie Stopes International abortion clinic were using condoms that failed [12].

* 27% of the abortions performed at Paris’ Hospital St. Louis are done because of condom failure.[13]

* A 1996 study of students requesting “emergency contraception” at the Rusholme Health Center in Manchester claimed condom failure.[14]

* In Botswana, HIV prevalence among pregnant urban women rose from 27 percent to a staggering 45 percent from 1993 to 2001 as condoms sales tripled. In Cameroon, adult HIV prevalence rose from 3 percent to 9 percent as condom sales rose from six million to 15 million during the same period [15].

* Cambodia instituted a “100% Condom Program” early on in its fight against AIDS. Condom use rocketed from 99,000 in 1994 to 16 million in 2001. Reported HIV infections more than kept pace, soaring from 14 in 1994 to more than 16,000 in 2001 [16].

* When United States Surgeon General Joycelyn Elders was Arkansas Health Director from 1987 to 1992, she pushed condoms by every means possible, including in 24 high schools. The results were predictable. The teen pregnancy rate in Arkansas rose 17 percent between 1989 to 1992, the syphilis rate among teenagers rose 130 percent, and the HIV rate rose 150 percent [17].

Figure 3 includes many quotes from leading experts who have shown in studies that condoms are dismal failures at preventing pregnancies.

Understandably, for practical and ethical reasons, few studies have actually used live couples to test HIV transmission rates. A University of Miami Medical School study showed that three out of 10 women whose HIV‑infected husbands faithfully used condoms contracted AIDS‑Related Complex (ARC) in an 18‑month period.[18]

This translates into an infection rate of 21 percent per year, 38 percent in two years, 51 percent in three years, 70 percent in five years, and 91 percent in 10 years. One article in The Lancet concluded that

The possible consequences of condom failure when one partner is HIV infected are serious enough and the likelihood of failure sufficiently high that condom use by risk groups should not be described as `safe sex.’… Condoms have a substantial failure rate: 13‑15% of women whose male partners use condoms as the sole method of contraception become pregnant within one year.[19]

Figure 4 consists of quotes from leading experts who believe that condoms are ineffective at preventing AIDS and other sexually transmitted diseases.

——————————————————————

Figure 3

Experts Speak on the Ineffectiveness
of the Condom at Preventing Pregnancy

“After reviewing the extensive literature on contraception, some variation in results is found. Reported failure rates for condom use vary from about 2 to 35 unplanned pregnancies per year, but a conservative consensus reveals a rate in the range of 8 failures per 100 users each year in the general population. Simple mathematics would conclude that after five years, the number pregnant with this method would be f

ive times the yearly rate. Thus, after five years of condom use, there would be about forty pregnancies in this group of 100 real people …”

‑‑ Stephen Genuis, M.D. “What About the Condom?” Risky Sex (2nd Edition) [Edmonton, Alberta: KEG Publishing, 1991].

“Of 100 women whose partner uses a condom for one year, 3 to 36 will become pregnant.”

-‑ United States Department of Health, Education and Welfare. “Contraception: Comparing the Options.”

“In the Oxford/Family Planning Association contraceptive study, 4% of highly motivated couples relying on condoms experienced an unplanned pregnancy within one year, while more generally representative data from the National Survey of Family Growth in the United States show that between 6% and 22% of couples relying on condoms experienced an unplanned pregnancy within a year, the rate depending on the woman’s age and whether the couples wished to delay pregnancy or to prevent it. Much of the health education material about HIV infection has failed to stress the limitations of the condom.”

‑‑ M.P. Vessy and L. Villard Mackintosh. “Condoms and AIDS Prevention.” The Lancet, March 7, 1987, page 568.

“Use of a barrier method backed up by abortion in case of failure confers over a woman’s reproductive life complete protection against unplanned childbearing with a minimal risk of mortality. For some women, however, such a course is morally unacceptable, since it involves a high likelihood of having at least one abortion.”

‑‑ K. Ory, et.al. Making Choices: Evaluating the Health Risks and Benefits of Birth Control Methods [Alan Guttmacher Institute, 1983], page 60.

“In a survey of family planning clients who used condoms as their only or primary birth control method, only 1.3% of the 388 women followed all five steps for proper use.”

‑‑ Marilyn Elias. “Correct Use of Condoms is Rare.” USA Today, December 13, 1991.

“Dr. Richard Gordon, International AIDS Conference presenter and University of Manitoba professor, concluded after live studies that red dye testing demonstrated that seminal fluid leaks out of even properly‑fitted condoms both prior to and after orgasm.”

‑‑ Beverly Sottile‑Malona. “Condoms and AIDS.” America, November 2, 1991.

One test showed that 14.6 percent of condoms used in a clinical trial either broke or slipped off the penis during intercourse or withdrawal. A survey at a Manchester, England family planning clinic revealed that 52% of the respondents had experienced condom breakage or slippage during the past three months alone.

‑‑ Alan Guttmacher Institute. Family Planning Perspectives, January/February 1992, pages 20 to 23. Also see R.J.E. Kirkman, J. Morris, and A.M.C. Webb. “User Experience: Mates v. Nuforms.” British Journal of Family Planning, 1990;15:107‑111.

A Federally‑funded UCLA study of the effectiveness of 29 major condom brands showed that reliability ranged from a high of 98.9% to an incredible low of 21.3%.

‑‑ “Condom Reliability.” Los Angeles Times, June 29, 1988.

——————————————————————

Figure 4

Experts Speak on the Ineffectiveness of the Condom
at Preventing AIDS and Other Sexually Transmitted Diseases

“I think these results certainly tell us right off that one condom is not the same as the next. Koop and AIDS groups and others promoting condoms have been very careless about that point … The Lifestyles Conture, Trojan Ribbed Natural, Trojan Ribbed and Contracept Plus all showed evidence of virus leakage. One in 10 condoms tested leaked in each brand, except for the Contracept Plus, which leaked [HIV] virus 10 of the 25 times it was tested.”

‑‑ Dr. Cecil Fox, quoted in Allan Parachini. “Condom Study Finding Wide Differences Among Brands.” Los Angeles Times, June 29, 1988.

“The possible consequences of condom failure when one partner is HIV infected are serious enough and the likelihood of failure sufficiently high that condom use by risk groups should not be described as `safe sex’… Condoms have a substantial failure rate: 13‑15% of women whose male partners use condoms as the sole method of contraception become pregnant within one year.”

‑‑ Jeffrey A. Kelly and Janet S. St. Lawrence. “Cautions About Condoms in Prevention of AIDS.” The Lancet (Journal of the British Medical Association). February 7, 1987, page 323.

“Professionals and the public alike have been misled into believing that sex with a condom is safe … considering the 10% pregnancy rate with the use of condoms, this creates a dangerous false sense of security. We consider it irresponsible to suggest to anyone that condoms are entirely safe … advising persons that it is safe to have sex with condoms is false, provides an erroneous sense of security, and can kill partners.”

‑‑ Journal of Sex and Marital Therapy, Fall 1986, page 164.

“As has been discussed, condoms do not offer protection for diseases that are transmitted by skin to skin contact such as human papilloma virus and herpes simplex virus, frequently found throughout the genital area in infected individuals. No degree of condom education will curb the transmission of these organisms.”

‑‑ Stephen Genuis, M.D. “What About the Condom?” Risky Sex (2nd Edition). Edmonton, Alberta: KEG Publishing, 1991.

“The officials note that condoms have been widely rejected as a method of birth control because they frequently fail, and say the devices may be no better ‑‑ in fact, may be worse ‑‑ at curtailing AIDS. They warn that sexually active men and women should not assume that they are protected simply because they use prophylactics … The safe‑sex message just isn’t true. You’re still playing a kind of Russian roulette. Instead of having six bullets in the chamber, you have one.”

‑‑ Bruce Voeller, M.D., researcher with the Mariposa Research Foundation, quoted in Lindsey Gruson. “Condoms: Experts Fear False Sense of Security.” The New York Times, August 18, 1987.

“Condoms failed to prevent HIV transmission in three of 18 couples, suggesting that the rate of condom failure with HIV may be as high as 17%.”

‑‑ James J. Goedert, M.D. “What is Safe Sex?” New England Journal of Medicine, October 21, 1987, page 1,340.

“The condom was useless as a prophylactic against gonorrhea and even under ideal conditions against syphilis.”

‑‑ Nicholas J. Fiumara, M.D., Massachusetts Department of Public Health. “Effectiveness of Condoms in Preventing V.D.” New England Journal of Medicine, October 21, 1971, page 972.

——————————————————————

The effectiveness of condoms at preventing AIDS is obviously much lower than their effectiveness at preventing pregnancy, for two primary reasons;

* A couple can conceive during only a fraction of the menstrual cycle (the “fertility window”), about five to seven days per cycle. It is possible, however, to be infected with HIV at any time during the menstrual cycle.

* A sperm cell is massively larger than an HIV virus. The head of a sperm cell is about 3,000 to 5,000 nanometers in diameter, and an HIV virus is about 100 to 120 nanometers in diameter (1 nanometer = one billionth of a meter).[20]

Condoms and Leakage.

The Primary Point to Remember. There is a lot of debate in the pro-life community today over whether or not latex condoms have pores large enough to leak the HIV virus.

As this booklet will describe, the latex condom does indeed occasionally leak the HIV virus. However, the following point cannot be stressed enough:

The risk of HIV leakage by latex condoms is trivial when compared to the risk of massive exposure to the HIV virus caused by the condom’s propensity to frequently break, tear or slip off…

The Family Planners `Speak.’ Perhaps family planners were at their most eloquent and revealing when they were not saying anything at all. In 1987, 800 sexologists gathered for a conference in Heidelberg, Germany. Dr. Theresa Crenshaw, past President of the American Association of Sex Educators, Counselors and Therapists (AASECT), asked the assembly how many of them would have intercourse with the HIV-infected partner of their dreams using a latex condom. Not a single one raised their hand. Dr. Crenshaw concluded that “Putting a mere balloon between a healthy body and a deadly disease is not safe.”[61]

The United States government pamphlet entitled “Condoms and Sexually Transmitted Diseases” says “Condoms are not 100 percent safe, but if used properly will reduce the risk of sexually transmitted diseases, including AIDS.”

Read this quote again. What the United States government is telling us is that condoms reduce the risk of a disease that is 100 percent fatal!

This has led to a phenomenon that one expert delicately terms a “disservice.” Susan Weller says that

A negative effect has been the misinterpretation and misinformation regarding condom effectiveness. The public at-large may not understand the difference between `condoms may reduce risk of’ and `condoms will prevent’ HIV infection. It is a disservice to encourage the belief that condoms will prevent sexual transmission of HIV.[62]

There are hundreds of sources that claim that condoms reduce HIV transmission from 80 to 90 percent. This is absolutely true — but only if we compare (1) people using condoms to (2) people not using condoms at all.

But this is a false choice. The condom promoters simply assume that people are going to have extra-marital sex because they can’t help themselves. Such thinking is called “risk reduction,” and is ultimately fatalistic. It assumes that people are largely powerless to change their risky behaviors, and assumes that people who are generally acting irrationally (by engaging in high-risk sexual behavior) will suddenly begin acting rationally when handed a condom.

The real decision is (1) to abstain or (2) to use condoms during extramarital sex. Abstinence is obviously safer.

The condom promoters are offering people a choice that is similar to this: If a person is going to run into burning buildings just for thrills, it is much better for him to wear a fireproof suit than not to wear a fireproof suit.

What we are saying is simply this: It is far better not to run into that burning building at all.

Endnotes.

[1] Lee Warner, Ph.D., M.P.H., Robert A. Hatcher, M.D., M.P.H., and Markus J. Steiner, Ph.D. “Male Condoms.” Chapter 16 in Robert A. Hatcher, M.D., M.P.H., et. al. Contraceptive Technology (18th Revised Edition). New York: Ardent Media, Inc., 2004.

[2] Ibid., page 334.

[3] Richard Gordon. “A Critical Review of the Physics and Statistics of Condoms and Their Role in Individual Versus Societal Survival of the AIDS Epidemic.” Journal of Sex & Marital Therapy, Spring 1989 [Volume 15, number 1], pages 5 to 30.

[4] M. Steiner, R. Flodesy, D. Cole and E. Carter. Contraception 46, 279 [1992]; C.M. Roland. “The Barrier Performance of Latex Rubber.” RubberWorld [“The Technical Service Magazine for the Rubber Industry”], June 1993 [Volume 208, Number 3].

[5] William B. Vesey. “Condom Failure.” Human Life International Reports, July 1991, pages 1 to 3.

[6] Condom usage guides list anywhere from ten to sixteen steps involved in using condoms. One article in the American Journal of Public Health says primly; “Condoms are not 100% efficacious and a high degree of individual compliance is required for condoms to be effective in use” [William L. Roper, M.D., M.P.H., Herbert B. Peterson, M.D., and James W. Curran, M.D., M.P.H. “Commentary: Condoms and HIV/STD Prevention — Clarifying the Message.” American Journal of Public Health, April 1993 [Volume 83, Number 4], pages 501 to 503].

[7] Helen Singer‑Kaplan. The Real Truth about Women and AIDS. Simon & Schuster, 1987.

[8] All of these studies are listed in Robert A. Hatcher, et. al. Contraceptive Technology (17th Revised Edition) [New York: Ardent Media, Inc., 1998]. Table 16‑3, “Prospective Studies of Condom Breakage and Slippage,” pages 330 to 332. The Table refers to the following studies, as listed above. All studies refer to vaginal intercourse only.

(1) Nevada — Study of Nevada Brothel Prostitutes. A.E. Albert, D.L. Warner, R.A Hatcher, J. Trussell, and C. Bennett. “Condom Use Among Female Commercial Sex Workers in Nevada’s Legal Brothels.” American Journal of Public Health, 1995;85:1,514‑1,520.

(2) United States #1 — Study of Monogamous American Couples. M.J. Rosenberg and M.S Waugh. “Latex Condom Breakage and Slippage in a Controlled Clinical Trial.” Contraception, 1997;56:17.21 (events of breakage and slippage were unambiguously not double counted).

(3) United States #2 — U.S. Clinical Research Participants. M.A. Leeper and M. Conrardy. “Preliminary Evaluation of REALITY, a Condom for Women to Wear.” Advances in Contraception 1989;5:229‑235.

(4) Sydney, Australia — Study of Sydney Female Prostitutes. J. Richters, B. Donovan, J. Gerofi and L. Watson. “Low Condom Breakage Rate in Commercial Sex” [letter]. Lancet 1988;2:1,487‑1,488. Correction by John Gerofi in personal communication to Philip Kestelman, July 1989.

(5) Atlanta, Georgia #1 — Study of Atlanta Family Planning Recruits. J. Trussel, D.L. Warner and R.A. Hatcher. “Condom Performance During Vaginal Intercourse: Comparison of Trojan‑Enz and Tactylon Condoms.” Contraception 1992;45:11‑19.

(6) Atlanta, Georgia #2 — Study of Atlanta Family Planning Recruits. J. Trussel, D.L. Warner and R.A. Hatcher. “Condom Slippage and Breakage Rates.” Family Planning Perspectives 1992;24:20‑23 (events of breakage and slippage were unambiguously not double counted; slippage rate recalculated from original article and reflects condoms that fell off or slipped down during intercourse or withdrawal).

(7) California #1 — Study of Southern California Monogamous Couples. A. Nelson, G.S. Bernstein, R. Frezieres, T. Walsh, V. Clark and A. Coulson. “A Study of the Efficacy, Acceptability and Safety of a Non‑Latex (Polyurethane) Male Condom; Revised Final Report (N01‑HD‑1‑3109). Bethesda, Maryland: National Institute of Child Health and Human Development, September 15, 1997 (events of breakage and slippage were unambiguously not double counted).

(8) California #2 — Study of Southern California Monogamous Couples. A. Nelson, R. Frezieres, T. Walsh, V. Clark and A. Coulson. “A Controlled Randomized Evaluation of a Commercially Available Polyurethane and Latex Condom (Avanti Versus Ramses Sensitol): Final Report (N01‑ HD‑1‑3109). Bethesda, Maryland: National Institute of Child Health and Human Development, November 6, 1996 (events of breakage and slippage were unambiguously not double counted).

(9) North Carolina #1 — Study of North Carolina Monogamous Couples (events of breakage and slippage were unambiguously not double counted; among new condoms used with either no additional lubricant or water‑based lubricant, rates recalculated from the original article).

(10) North Carolina #2 — Study of Nort

h Carolina Monogamous Couples (breakage rates ranged from 3.5% for a new lot to 18.6% for an 81‑month old lot).

(11) North Carolina #3 — Study of North Carolina Monogamous Couples (events of breakage and slippage were unambiguously not double counted).

(12) North Carolina #4 — Study of North Carolina Couples Recruited by Mail.

(13) North Carolina #5 — Study of North Carolina Local Recruits.

(14) Denmark — Study of Denmark Female Prostitutes and Male and Female Hospital Staff.

(15) New Zealand — Study of New Zealand Male and Female Family Planning Clinic Clients (events of breakage and slippage were unambiguously not double counted).

In another major study, the nation’s most trusted consumer’s advocacy group, the Consumer’s Union (CU), interviewed 3,300 of its readers in order to determine the effectiveness of condoms at preventing conception and disease. CU also mechanically tested 16,000 condoms of 37 different varieties and brands. It published the results of its studies in the March 1989 issue of Consumer Reports. About one‑fourth of the Consumer Union’s readers reported at least one instance of condom breakage in a one‑year period, and about one in eight experienced two or more incidents of breakage in one year. Using these and other data, CU estimated that an average of one condom in 165 broke during heterosexual intercourse, and about one in 105 broke during anal intercourse. This failure rate was much lower than that produced by most other studies. The results of this study were not included in this Chapter because CU relied heavily on self‑reporting, which is inherently unreliable [“Can You Rely on Condoms?” Consumer Reports, March 1989, pages 135 to 141].

Other studies do not reply on self-reporting, but rigorously document all procedures. One such study found that 15.1% of 405 condoms broke or slipped off [James Trussell, David Lee Warner and Robert A. Hatcher. “Condom Slippage and Breakage Rates.” Family Planning Perspectives [Alan Guttmacher Institute], January/February 1992 [Volume 24, Number 1], pages 20 to 23].

[9] Lee Warner, Ph.D., M.P.H., Robert A. Hatcher, M.D., M.P.H., and Markus J. Steiner, Ph.D. “Male Condoms.” Chapter 16 in Robert A. Hatcher, M.D., M.P.H., et. al. Contraceptive Technology (18th Revised Edition). New York: Ardent Media, Inc., 2004.

[10] Accumulated condom failure rates can be calculated with the formula 1‑(1‑f)**n, where f equals the failure rate (0.14) and n equals the number of years.

[11] United States Department of Commerce, Bureau of the Census. Reference Data Book and Guide to Sources, Statistical Abstract of the United States 2006 (126th Edition) [Washington, D.C.: United States Government Printing Office]. Table 92, “Contraceptive Use by Women, 15 to 44 Years of Age: 1995 and 2002.”

[12] Judy Murty and Sue Firth of the Marie Stopes Centre. “Use of Contraception By Women Seeking Termination of Pregnancy.” The British Journal of Family Planning, April 27, 1996, pages 6 to 9.

[13] Le Monde, May 28, 1996.

[14] M. Gabbay and A. Gibbs. “Does Additional Lubrication Reduce Condom Failure?” Contraception, March 1996, pages 155 to 158.

[15] ”Condom Promotion for AIDS Prevention in the Developing World: Is it Working?” Studies in Family Planning, March 2004.

[16] ”Condom Promotion for AIDS Prevention in the Developing World: Is it Working?” Studies in Family Planning, March 2004; UNAIDS, UNICEF and WHO. “Epidemiological Fact Sheet on HIV/AIDS and STIs: Cambodia.” 2004 Update.

[17] Don Feder. “CDC Opts to Wage Its Own Trojan War.” The Boston Herald, August 19, 1993; Kentucky Citizen’s Digest, January/February 1993, pages 4 and 5.

[18] ”Evaluation of Heterosexual Partners, Children and Household Contacts of Adults With AIDS.” Journal of the American Medical Association (JAMA), February 6, 1987.

[19] Jeffrey A. Kelly and Janet S. St. Lawrence. “Cautions about Condoms in Prevention of AIDS.” The Lancet (Journal of the British Medical Association). February 7, 1987, page 323.

[20] By comparision, neisseria gonorrhoeae (the largest STD infectious agent) is about 1,000 nanometers in diameter; a hepatitis B surface antigen (the smallest STD infectious agent) is about 22 nanometers in diamater, and the herpes virus is about 400 nanometers in diameter. Marsha F. Goldsmith. “Sex in the Age of AIDS Calls for Common Sense and `Condom Sense.’ JAMA, May 1, 1987, pages 2,261 to 2,263 and 2,266.

[21] Lauran Neergaard. “CDC: Condoms Can Block AIDS.” The Philadelphia Enquirer, August 6, 1993, page E10.

[22] C.M. Roland. “The Barrier Performance of Latex Rubber.” RubberWorld [“The Technical Service Magazine for the Rubber Industry”], June 1993 [Volume 208, Number 3].

[23] C.M. Roland, Ph.D., Editor, Rubber Chemistry and Technology and Head of the Polymer Properties Section, Naval Research Laboratory. Letter entitled “Do You Want to Stake Your Life on a Condom?” Washington Times, April 22, 1992.

[24] G.B. Davis and L.W. Shroeder. Journal of Testing and Evaluation, 18, 352 (1990); C.M. Roland. “The Barrier Performance of Latex Rubber.” RubberWorld [“The Technical Service Magazine for the Rubber Industry”], June 1993 [Volume 208, Number 3]. Sometimes, condom advocates say that HIV is always attached to or associated with a cell. This is not a factual allegation.

HIV is definitely present in free virus form, that is, it is not associated with or attached to sperm cells or white blood cells [J.H. Mermin, M. Holodniy, D.A. Katzenstein and T.C. Merigan. “Detection of Human Immunodeficiency Virus DNA and RNA in Semen by the Polymerase Chain Reaction.” Journal of Infectious Diseases, October 1991, pages 769 to 772].

[25] R. Schmukler and R.B. Beard, unpublished study. Described in C.M. Roland. “The Barrier Performance of Latex Rubber.” RubberWorld [“The Technical Service Magazine for the Rubber Industry”], June 1993 [Volume 208, Number 3].

[26] ”From the Surgeon General, US Public Health Service.” Journal of the American Medical Association, June 9, 1993, page 2,840.

[27] Ronald F. Carey, William A. Herman, Stephen M. Retta, Jean E. Rinaldi, Bruce A. Herman, and T. Whit Athey. “Effectiveness of Latex Condoms As a Barrier to Human Immunodeficiency Virus‑Sized Particles under Conditions of Simulated Use.” Sexually Transmitted Diseases, July‑August 1992, pages 230 to 233. The article stated that “Leakage of HIV-sized particles through latex condoms was detectable (P<0.03) for as many as 29 of the 89 condoms tested.” This study used fluorescence-labeled, 110-nanometer polystyrene microspheres to model free HIV particles.

[28] C.M. Roland, Ph.D., Editor, Rubber Chemistry and Technology and Head of the Polymer Properties Section, Naval Research Laboratory. Letter entitled “Do You Want to Stake Your Life on a Condom?” Washington Times, April 22, 1992.

[29] Quoted in John Kelly, M.D. “Condom Failure and Transmission of HIV Infection.” CMAC Bulletin, October 1992, pages 19 and 19.

[30] Robert A. Hatcher, et. al. Contraceptive Technology (17th Revised Edition). New York: Ardent Media, Inc., 1998. See the Index to find discussions of the various sexually transmitted diseases.

[31] United States Department of Commerce, Bureau of the Census. Reference Data Book and Guide to Sources, Statistical Abstract of the United States 1999 (119th Edition) [Washington, D.C.: United States Government Printing Office]. Table 226, “Specified Reportable Diseases ‑‑ Cases Reported: 1980 to 1997.”

[32] Ibid.

[33] Ibid.

[34] Lynda Richardson. “Condoms in School Said Not to Affect Teen‑Age Sex Rate.” The New York Times, September 30, 1997, pages A1 and A14.

[35] W.R. Grady, M.D. Hayward, and J. Yagi. “Contraceptive Failure in the United States: Estimates From the 1982 National Survey of Family Growth.” Alan Guttmacher Institute’s Family Planning Perspectives, September/October 1986, page 204.

[36] Jana Mazanee. “Birth Rate Soars At Colorado School.” USA Today, May 19, 1992, page 3A.

[37] Joint United Nations Program on HIV/AIDS (UNAIDS). “Uganda: Epidemiological Fact Sheet on HIV/AIDS and Sexually Transmitted Diseases,” 2000.

[38] President Yoweri Museveni of Uganda. What is Africa’s Problem? [Minneapolis: University of Minnesota Press], 2000.

[39] Tom Carter. “Uganda Leads by Example on AIDS.” The Washington Times, March 13, 2003.

[40] Joint United Nations Program on HIV/AIDS (UNAIDS). “AIDS Epidemic Update, December 2005.” You can see this PDF report online http://www.unaids.org/epi/2005/doc/EPIupdate2005_pdf_en/epi‑update2005_en.pdf.

[41] Joseph Loconte. “The White House Initiative to Combat AIDS: Learning from Uganda.” The Heritage Foundation’s Executive Summary Backgrounder #1692, September 29, 2003. 18 pages, PDF document. http://www.heritage.org/research/africa/bg1692.cfm for the article.

[42] E.C. Green, V. Nantulya, R. Stoneburner, and J. Stover. “What Happened in Uganda? Declining HIV Prevalence, Behavior Change and the National Response.” United States Agency for International Development (USAID), September 2002. To see this report, http://www.usaid.gov/pop_health/aids/Countries/africa/uganda_report.pdf.

[43] Ibid.

[44] Global HIV Prevention Working Group. Mobilization for HIV Prevention: A Blueprint for Action, July 2002. http://www.glf.org/nr/downloads/globalhealth/aids/HIVprevreport_final.pdf to access this report.

[45] Norman Hearst and Sanny Chen. “Condom Promotion for AIDS Prevention in the Developing World: Is It Working?” Studies in Family Planning, March 2004.

[46] Joint United Nations Program on HIV/AIDS (UNAIDS). Country-by-country HIV/AIDS statistics can be accessed http://www.unaids.org/en/Regions_Countries/Countries/default.asp.

[47] Joint United Nations Program on HIV/AIDS (UNAIDS). “United States of America: Epidemiological Fact Sheet on HIV/AIDS and Sexually Transmitted Diseases,” 2004 Update.

[48] C. Hermann, E.C. Green, J. Chin, M. Taguiwalo, and C. Cortez. “Evaluation of the Philippines AIDS Surveillance and Education Project.” USAID/Philippines, May 8, 2001.

[49] Poster by `Catholics’ for a Free Choice (CFFC) entitled “Abstinence Has a High Failure Rate: Good Catholics Use Condoms.” Downloaded from the Web site of CFFC at http://www.condoms4life.org/images/image2.htm.

[50] Some examples of this thinking from the past;

* ”Chastity cannot be a virtue because it is not a natural state” [Dr. Harry Benjamin, endocrinologist and Kinsey advocate, in the Introduction to pedophile Rene Guyon’s book Sexual Ethics, 1948].

* ”Our alternative solution is to be ready as educators and parents to help young people obtain sex satisfaction before marriage. By sanctioning sex before marriage, we will prevent fear and guilt. We must also relieve those who have them of their fears and guilt feelings, and we must be ready to provide young boys and girls with the best contraception measures available so they will have the necessary means to achieve sexual satisfaction without having to risk possible pregnancy. We owe this to them” [Dr. Lena Levine. “Psychosexual Development.” Planned Parenthood News, Summer 1953, page 10.

* ”The adolescent years are, among other things, for learning how to integrate sex usefully and creatively into daily living. Therefore, we must accept that adolescent sexual experimentation is not just inevitable, but actually necessary for normal development. … The adolescent years are, among other things, for learning how to integrate sex usefully and creatively into daily living. Sexual experimentation is a moral and appropriate decision for adolescents … I advocate discussion of it [sex], so young people know they have choices beginning with masturbation, of course, and petting to climax and mutual orgasm before moving on to intercourse. … An extramarital affair that’s really solid might have a very good result” [Mary Steichen Calderone, M.D., founder of the Sexuality Information and Education Council of the United States (SIECUS) and its President from 1964 to 1982, Medical Director of Planned Parenthood/World Population (PP/WP) from 1982 to 1993, and President of Physicians for Social Responsibility (PSR). Quoted in “Woman Favors Sex Testing by Adolescents.” Minneapolis Tribune, October 13, 1965, and “An Interview With Mary Calderone.” Playboy Magazine, April 1970].

* ”No religious views, no moral standards, are to deflect the child from the overriding purposes of self‑discovery, self‑assertion, and self‑gratification” [Planned Parenthood Sex Education and Mental Health Report, 1979].

* ”FIRST PRIZE: A Solid Gold Condom: “From using a condom you will learn/No deposit means no return.” SECOND PRIZE: A Bronzed Wallet with Circular [Condom] Indentation: “Rubberizing copulation/Puts a cap on population.” THIRD PRIZE: A Gross of Condoms (144) for the Night of Your Life: “When you rise … Condomize.” FINALISTS. “Twins are bad, triplets worse/Use a condom, safety first!” “Rubbers are jolly, rubbers are fun/Better to use one than end up a mum”“ [Winners of the Population Institute’s “Condom Couplet Contest,” announced on “Condom Day,” February 20, 1978. Described in the National Alliance for Optional Parenthood’s “Searching for Alternatives to Teenage Pregnancy,” 1980].

* ”We are not going to be an organization promoting celibacy or chastity” [Faye Wattleton, former President of the Planned Parenthood Federation of America (PPFA), quoted in the Los Angeles Times, October 17, 1986, page V-1.

* ”God knew when he made us that he has given us a built‑in sex drive to go out and sow our seeds. He has given us promiscuous genes. I think it would be wrong for the church to condemn people who have followed their instincts” [Richard Holloway, the Anglican Bishop of Edinburgh, quoted in “The Edge: The Quotebag,” The Oregonian, June 26, 1995, page C1.

* ”The big lie is that it’s easy to be monogamous, and that everybody is. If you believe that, you’d better choose well. We can’t go back to the values we had because they don’t exist anymore. For the most part, women are not virgins anymore, so to teach virginity doesn’t work” [Carol Cassell, former Director of Education for the Planned Parenthood Federation of America (PPFA) and Past President of the American Association of Sex Educators, Counselors and Therapists (AASECT). Family Life Educator, Fall 1987, page 19, also quoted in Focus on the Family Citizen, December 1989].

[51] Allan Parachini. “Condom Industry Seeking Limits on U.S. Study.” Los Angeles Times, August 28, 1987. The article also states that “Among other things, the association [the Health Industry Manufacturers Association, which is the condom industry’s trade group] has insisted to federal funding officials that the research rely solely on testing standards established by condom makers, that condom companies be allowed to supply all prophylactics to be tested, and that only products currently sold in the United States be studied … The documents indicate that the attempt to force major modifications in the condom study was apparently motivated by industry concerns that the research might conclude that no American‑made condom is currently able to consistently prevent the spread of HIV.”

[52] Lothrop Stoddard, Ph.D. The Rising Tide of Color Against White World‑Supremacy. New York: Charles Scribner’s Sons, 1921. Repr

inted in 1971 by Negro Universities Press, Westport, Connecticut. Pages i, 8, 9, 90, 231, 298, 301, 302, 308, and 309 in the reprinted version.

[53] ”Abstinence, Condom Controversy Erupts at AIDS Meet.” Reuters, July 12, 2004.

[54] D. Kristof. “The Secret War on Condoms,” available http://www.valleyskeptic.com/bush_condoms.html.

[55] ”Abstinence Row Overshadows AIDS Day.” Daily Dispatch (South Africa), November 30, 2004.

[56] ”World AIDS Day: Condom Restrictions Cost Lives.” Human Rights Watch.

[57] ”Ugandan Anti‑AIDS Activist Demands UN Fire Lewis For Pushing Condoms.” LifeSite Daily News at http://www.lifesite.net, September 7, 2005.

[58] ”Mandela, Clinton Close Barcelona Conference, Urging More Action.” UNWire, July 12, 2002, available http://www.unwire.org/unwire/20020712/27624_story.asp.

[59] Edward C. Green, quoted in The Boston Globe and in “United Nations Report Says Condoms Fail to Protect Against AIDS 10% of the Time.” http://www.lifesite.net/ldn/2003/jun/030623.html LifeSite Daily News, June 23, 2003.

[60] Letter entitled “Sound Medical Advice,” by William V. Fitzsimmons, M.D. Fidelity Magazine, April 1987, pages 11 and 12.

[61] Don Feder. “CDC Opts to Wage Its Own Trojan War.” The Boston Herald, August 19, 1993; Kentucky Citizen’s Digest, January/February 1993, pages 4 and 5.

[62] Susan Weller, associate professor of Preventive Medicine and Community Health at the University of Texas Medical Branch at Galvestion, quoted in Jo Ann Zuniga. “Study: Condoms Don’t Eliminate Spread of HIV.” The San Juan Star, June 18, 1993.l

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