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condom reliability - need some solid facts!!


I have a question that I can't seem to get a definative answer from anyone, so I am really hoping you can help.

The question is why are condoms not 100% effective. I understand that condoms need to be used according to instruction and that they can break. Is there anything else that would make a condom not 100% reliable???

So what I am trying to ask is if I use a condom according to instructions, and then after the 'act' test the condom by putting water in it to ensure that there were no breaks(which would also eliminate manufacturer defect as a possible cause of getting an HIV), is it then 100% reliable in not getting HIV (I understand that there are other skin related STD's, but specifically asking about HIV here),.....and if not,.........why not????

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239123 tn?1267651214
For some STDs, male condoms are nowhere near 100% effective.  These are the STDs transmitted by skin to skin contact, especially herpes and human papillomaviru (HPV) infection.  The male condom permits plenty of skin contact above the condom.  On average, condoms probably are aounnd 90% effective in preventing herpes and HPV.  (Syphilis in theory is the same, since it is transmitted skin-to-skin.  But syphilis lesions generally are near the tip of the penis, so condom protection is a lot better than for HPV or herpes.)  

For the STDs transmitted primarily though genital secretions -- semen and cervical, vaginal or anal fluids -- condoms are 100% effective, if the condom is properly used (in place for the entire exposure) and does not rupture.  These STDs include gonorrhea, chlamydia, HIV, and hepatitis B.  in other words, the "biological" effectiveness of condoms is 100% against these STDs.

However, for all STDs, the "use effectiveness" of condoms is lower than the biological effectiiveness.  Use effectiveness account for human failures in proper condom use.  For example, among couples who use condoms as their primary means of contraception, the rate of pregnancy is reduced 90% compared to non-users.  The 10% "failure" rate results mostl from not using condoms correctly, breakage, etc.

Finally, there is no such thing as microscopic leaks in condoms that prevent STD transmission.  That's an urban myth.  If the condom doesn't obviously break, there is no need to test it for leaks with water etc.  If it didn't rupture, STD protection (for the secretion-transmitted infections) was 100%.

I hope this helps.  But I note that this is your second question on the fourm in 2 months.  Please note the MedHelp policy, which allows no more than 2 questions on the moderated forums every 6 months (see Terms and Conditions).

Best wishes--  HHH, MD
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