Spat Over Condom Wrapper Wording

Condoms do a great job of stopping the spread of AIDS and preventing pregnancy. But the evidence they protect against other sexually transmitted diseases is spotty, according to some conservative groups in the United States that want to make condom labels "medically correct."

A conservative senator and groups promoting abstinence from sex are even blocking appointment of a new U.S. drug agency chief until the labels are changed, while others warn that undermining confidence in condoms could lead to decline in their use and, consequently, to more unwanted pregnancies and the spread of AIDS.

"They do not provide 100 percent protection, but for people who are sexually active they are the best and the only method we have for preventing these diseases," said Heather Boonstra, an official with the Alan Guttmacher Institute, a nonprofit group that researches reproductive health issues.

Boonstra said Republican Sen. Tom Coburn, a physician from Oklahoma, and the abstinence-promoting Medical Institute for Sexual Health are "manipulating this data to drive home their own anti-condom, anti-contraceptive message."

James Trussell, a director of Princeton University's Office of Population Research, said there is "absolutely incontrovertible evidence" that condoms reduce transmission of AIDS.

"To my mind, everything else is gravy," Trussell said this week. "All of this is ideologically motivated. What they're really concerned about is people who are not married having sex."

John Hart, spokesman for Coburn, said that's not true. Hart said the senator's June 15 hold on Lester Crawford's nomination as commissioner of the Food and Drug Administration is an effort to make FDA change the condom labels to state their "effectiveness or lack of the effectiveness in preventing STDs."

Currently, the condom packets say: "If used properly, latex condoms will help to reduce the risk of transmission of HIV infection (AIDS) and many other sexually transmitted diseases." Many brands also state condoms are highly effective in preventing pregnancy.

When latex condoms are used every time and put on early enough, they reduce chances of pregnancy over a one-year period to 3 percent, compared with 85 percent without birth control. Likewise, condoms cut risk of HIV infection by about 80 percent, to less than a 1 percent chance of infection per year.

According to the National Institutes of Health, condoms are impermeable to the smallest viruses and only break or slip off 1 percent to 2 percent of the time.

But surveys show most people don't use them properly or consistently, and roughly 12 million Americans each year contract an STD.

In 2001, an expert panel convened at Coburn's request, examined dozens of studies and reported condoms cut transmission of AIDS and gonorrhea by 50 to 100 percent but that that for other STD's evidence on protection is unclear. Individual studies cited in the report show prevention rates range from 18 percent to 92 percent, depending on the disease.

The Medical Institute for Sexual Health's board chairman, Dr. Tom Fitch, said some STDs are much more easily spread than others - herpes and human papilloma virus, or HPV, can be transmitted by contact with skin not covered by a condom.

Fitch said he would not discourage condom use, but his group advocates abstinence or monogamy.

That's an "unrealistic explanation" for young people, said Dr. Shari Brasner, an obstetrician/gynecologist at Mount Sinai Medical Center in New York who has patients as young as 13 who are sexually active.

Meanwhile, Lori Heise of the Global Campaign for Microbicides, said her group is trying to correct the false belief that nonoxynol-9, the spermicide used in contraceptive creams, some lubricated condoms and some personal lubricants, protects against spread of STDs.

Recent evidence shows it does not. The detergent-like spermicide can irritate the vagina or rectum, making it easier to become infected with an STD. The campaign is working to have nonoxynol-9 removed from lubricants and condoms.