The proper and consistent use of latex or polyurethane condoms when engaging in sexual intercourse--vaginal, anal, or oral--can greatly reduce a person's risk of acquiring or transmitting sexually transmitted diseases, including HIV infection.

A latex condom wall is approximately .05 mm thick and has no pores. HIV is approximately .001 mm in size and thus would have to move through a barrier 500 times thicker than the virus itself. More-over, laboratory studies show that intact latex condoms do not allow air, water, viruses (e.g. Human Immunodeficiency Virus, Herpes Simplex Virus, Hepatitis B Virus), or other organisms such as bacteria to pass through. "Natural" condoms, made from animal intestinal tissue, do have pores, some of which are large enough that HIV and other viruses might pass through and thus are not recommended for HIV or other STD prevention.

Following these basic rules will further reduce the small chance of condom failure. 1. Use latex (rubber) or polyurethane condoms. These are preferable to "natural skin" condoms, which may have tiny holes through which HIV may pass. 2. Choose a condom that fits. Condoms come in different sizes, shapes, and styles. Experiment with different condoms and practice putting them on before intercourse. Also practice talking with a close friend about your desire and intention to use condoms. 3. Open and handle condoms carefully. Never use a condom in a damaged package or one that is past its expiration date. Do not store condoms in hot or sunny places (for example, in a wallet or by a window). 4. Use plenty of water-based lubricant to reduce the friction that can cause breakage. Never use oil-based lubricants like Vaseline, hand cream, Crisco, or mineral oil which can rapidly break down latex and allow the virus to pass through. Water-based lubricants include K-Y Jelly, Slippery stuff, ForPlay, and most contraceptive jellies. 5. Put the condom on after erection but before insertion. Leave some room at the tip for the discharged semen (some condoms have a reservoir tip for this). It is important to pinch the tip as you roll it down onto the penis to be sure that there are no air bubbles that could pop under pressure. If the penis is uncircumcised, pull back the foreskin before unrolling the condom all the way down to the base of the penis. 6. After intercourse, withdraw the penis while still erect, holding the base of the Condom to prevent it from slipping off or spilling semen. 7. Remove the condom and wash the penis with soap and water. 8. Use a condom only once and dispose of it in the garbage; do not flush condoms down the toilet. Never reuse a condom. 9. Use a condom EVERY TIME during sex when transmission or acquisition of HIV is possible.

No method of contraception or disease prevention is effective when practiced incorrectly or inconsistently. Condoms, like other risk-reduction and contraceptive methods, work very, very well when used by committed individuals and couples.

Most condom failures can be blamed on the user, not the condom. In order for condoms to provide maximum protection, they must be used consistently (every time) and correctly. Incorrect use contributes to the possibility that the condom could leak or break. When condoms are used reliably, they have been shown to prevent pregnancy up to 98 percent of the time among couples using them as their only method of contraception.

Similarly, numerous studies among sexually active people have demonstrated that a properly used latex condom provides a high degree of protection against a variety of sexually transmitted diseases, including HIV infection. In a two-year study in Europe, among couples in which one partner was infected with HIV and the other uninfected (HIV sero-discordant couples), researchers demonstrated that consistent use of condoms significantly reduced the chance of passing HIV from the infected partner to the one not infected. Among 124 discordant couples who used condoms consistently over the study period, none of the uninfected partners became infected with HIV. In contrast, among 121 discordant couples who did not use condoms consistently, 12 (10%) of the uninfected partners became infected during the study period. Other researchers concluded that the per contact probability of transmission of HIV was reduced 90-95% by the use of condoms.

Condoms do not need to be 100% effective to be strongly promoted for two reasons: 1) at least 90% efficacy is significant protection; and 2) 100% efficacy is not now and has never been a criterion for promoting any safety device, (e.g. seatbelts, smoke alarms, helmets, or even vaccination).

Condoms are classified as medical devices and are regulated by the Food and Drug Administration. Condom manufacturers in the United States test each latex condom for defects, including holes, before it is packaged. Several studies of correct and consistent condom use clearly show that condom breakage rates in this country are less than 2 percent. Even when condoms do break, one study showed that more than half of such breaks occurred prior to ejaculation.

Condoms help prevent STDs and unwanted pregnancies and studies show that increasing availability of condoms through community campaigns and school availability programs does not increase sexual activity in targeted populations. Latex condoms are highly effective in preventing pregnancy and most sexually transmitted diseases, including HIV infection, but only if they are used consistently and correctly.