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
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
"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."