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Controversy and need for study on condoms




 

WASHINGTON, July 27 (UPI) - A report that shows mixed findings on the effectiveness of condoms in preventing the spread of sexually transmitted diseases has renewed debate over what the Centers for Disease Control should be telling the public on the subject and what additional research is needed.

The report, issued last week by the National Institute for Allergy and Infectious Diseases, included a review of the scientific literature on the use of latex male condoms to prevent the spread of STDs during intercourse. It found while condoms are effective against the transmission of HIV and gonorrhea in men, the same was not true in women, and for other STDs, such as syphilis, genital herpes or chlamydia, it said there was not enough information to make a determination one way or another.

The report prompted the Physicians Consortium, a nationwide group of some 2,000 physicians committed to providing accurate medical information about sexually transmitted diseases, to accuse the CDC in Atlanta of overstating the effectiveness of condoms in protecting against STD transmission.

"If the government doesn't do something about adjusting the information being circulated, I am considering organizing a class-action suit because so many people are being hurt," said Dr. Thomas Coburn, a family practitioner from Oklahoma and former congressman. "Sixty-five million people in this country have sexually transmitted diseases."

At a press conference on Capitol Hill Tuesday held by the Physicians Consortium with the Catholic Medical and Christian Medical Associations, Coburn called for the resignation of Dr. Jeffrey Koplan, head of the CDC. He said the agency's failure to acknowledge the limitations of the effectiveness of condoms was illegal.

Coburn said while in Congress he authored a bill, which became law last year, which requires any agency receiving federal funding to provide medically accurate information about condoms.

"The CDC has known about these studies for years, but has failed to stress the limitations of condoms," Coburn said. "Instead, the agency stresses safe sex when there is no evidence for such a thing."

Representatives from the CDC were at the press conference, but the agency has declined to comment on Coburn's accusations.

The agency issued a statement that said the new report "doesn't say condoms are ineffective -- it says the evidence is fully sufficient only for HIV and gonorrhea and for other STDs more research is needed."

The CDC said it continues to advise "male latex condoms, when used correctly and consistently, are highly effective in protecting against HIV and can reduce the risk of other sexually transmitted diseases." That was not enough for Coburn, who said the problem with the agency's statements is they leaves the public making assumptions without the whole story.

"Sure, the CDC may tell the public that condoms aren't always effective, but many people assume that that means they are 95 percent effective instead of 100 percent," he said. "But for some of these diseases, they may be effective closer to 30 percent of the time. The public isn't getting that message, and it is the CDC's responsibility that they do. Would the public rely on seat belts or airbags that were effective only 30 percent of the time?"

Planned Parenthood said the issue of condoms and STDs needs more and better research.

"Many laboratory studies show evidence that condoms protect against organisms that cause various sexually transmitted diseases," said Dr. Vannessa Cullins, vice president for medical affairs for the Planned Parenthood Federation of America. "Epidemiological studies of transmission may not reflect the level of protection that one would predict from these lab studies, but that may just be a problem with methodology. Epidemiological studies are notoriously flawed that way. We need better studies.

Referring to the studies that form the basis of the government report, Cullins said the findings are all over the board, some showing good protection, some moderate and still others poor protection against STDs.

"The studies are inconsistent and, except for the HIV studies, many are more than 10 years old," she said. "Because so much funding has been directed toward AIDS research, transmission studies of these other infections, with or without condoms, have received short shrift."

Many in health care, including Cullins, agree condoms appear to provide poor or no protection against the transmission of human papillomavirus, which is associated with cervical cancer. Dr. Robert Klausner, former director of the National Cancer Institute, has written the evidence that condoms are ineffective against HPV is clear enough so "that additional research efforts by NCI on effectiveness of condoms in preventing HPV transmission are not warranted."

The Physicians Consortium was joined by the Catholic Medical Association, the Christian Medical Association and Rep. Dave Weldon, R-Fla., a practicing physician who serves on the Government Reform Committee, which has oversight of the CDC and the Department of Health and Human Services.

"The role of the CDC is to provide medical information. If they have any information that suggests condoms are not as effective as most people think, they have an obligation to provide it," said Dr. John Diggs, an internist from South Hadley, Mass., who serves on the Executive Committee of the Physicians Consortium. "I am not telling the CDC to support an 'abstinence-only before marriage' policy, even though that is my own position. We are just saying, 'Tell the truth.' We cannot, as physicians, go on telling patients that condoms protect against syphilis, herpes, or chlamydia when the evidence isn't there."



 


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Information in this article was accurate in July 27, 2001. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.