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The main findings of studies we look at in more detail below are as follows: These degrees of protection may be lower than some readers expect, and rates of 98% reliability are still sometimes quoted for condoms.
The spermatozoon can easily pass through the 'net' that is formed by the condom.These margins of uncertainty...should represent an obligation on the part of the health ministries and all these campaigns to act in the same way as they do with regard to cigarettes, which they state to be a danger." Finding out the degree to which condoms protect against HIV is important both for HIV-negative people who want to protect themselves against HIV, and HIV-positive people who want to avoid transmitting it.Knowing how well they protect against other STIs is important for sexual health in general and may be particularly important for people with HIV, who may be more vulnerable to the effects of certain STIs.The evidence we have is based on three types of trials, and each has potential weaknesses.For efficacy against HIV and other chronic STIs, studies of the incidence of HIV (or HSV or HPV) in monogamous serodiscordant couples provides the best evidence.Laboratory studies and product testing have shown that reputable condoms tested in the laboratory are completely impermeable to micro-organisms as small as viruses.
However, the same studies show that condoms come off the penis altogether 3 to 5% of the time but may slip down (but not off) up to 13% of the time.These can be done in individuals whose characteristics are known and can be controlled for, and if the relationship truly is monogamous then infections by acute STIs and from outsiders can be ruled out.One disadvantage is that condom use in long-term relationships, even in serodiscordant couples, is relatively rare.Women were much less likely to report inconsistent use of condoms than never using them: over the course of the study, 46% of women said they used condoms ‘always’, 48% ’never’ and only 6% ’sometimes’.For the reasons described above, there is a convention to use two different words when describing the effect of prevention interventions.One widely quoted remark of this nature came from Ugandan President Yoweri Museveni who, at the Fifteenth International AIDS Conference in Bangkok in 2004, advocated for HIV prevention based on “optimal relationships based on love and trust instead of institutionalised mistrust, which is what the condom is all about…I think of condoms as an improvisation, not a solution”.