This article is about the contraceptive device. For the town in France, see Condom, France.

A condom is a device, usually made of latex, or more recently polyurethane, that is used during sexual intercourse. It is put on the male partner's penis, for the purpose of preventing pregnancy and/or transmission of sexually transmitted diseases (STDs) such as gonorrhea, syphilis and HIV. It is thought to have been invented in Europe by an unknown inventor.

Condoms are also known as prophylactics, as well as a number of colloquial or slang terms, such as "rubbers", "jimmy hats", "rain coats" and "love gloves". They are also sometimes used to increase pleasure by those who prefer the sensation of sex with condoms.

Etymology

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Folk etymology claims, without historical support, that the word "condom" is derived from a purported "Dr. Condom" or "Quondam", who made the devices for King Charles II of England. Other than through unverifiable folk stories, there is no evidence that any such "Dr. Condom" existed. Other stories tell the word "condom" has its root in the 16th century: in particular, when Catherine de Medici married Henry II of France, she brought to France her minister Gondi and the architect Bernardo Buontalenti. Gondi and Buontalenti started producing special waxed protections to be used as condoms. The French soon called them "gondon"; "gondone" is today still used as a synonym of "condom" in Genova, Italy; "goldoni", another variation, is still used in Milan, Italy. It may be that the word "condom" is a variation of "gondon".

It is also hypothesized that a British army officer named Cundum popularized the device between 1680 and 1717. Bernstein EL, Who was condom?, Hum Fertil. 1940 Dec;5(6):172-5.

Overview and history

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Prior to the early to mid-1980s, condoms were low profile, undervalued articles. Their primary use revolved around the avoidance of pregnancy. Their function in helping to prevent sexually transmitted diseases (STDs), although recognized since Roman times, was not a major consideration among the general public.

The advent of Acquired Immunodeficiency Syndrome (AIDS), coupled with increased incidence of STDs in general and the need to publicise effective means of avoiding infection, led to a much more open discussion of sexual matters. Condoms are now classified medical devices and their production and sale are highly regulated activities.

The first efforts at making condoms involved the use of woven fabrics. These were not effective, as both disease-carrying viruses as well as sperm could fit between the woven fibers. The earliest effective condoms were made of sheep gut or other animal membrane. These are still available today because of their greater ability to transmit body warmth and tactile sensation, when compared to synthetic condoms, but they are not as effective in preventing pregnancy and disease. Mass production of condoms started in the mid-19th century, shortly after the invention of the rubber vulcanization process. Until the 1930s, condoms were made from rubber; they were still quite uncomfortable and expensive (though reusable) and thus only available to a small part of the population. When latex condoms became available in late 1930s, it was a leap forward in effectiveness and affordability. However, before the middle of the 20th century, many places outlawed the sale of condoms, and many subsequently allowed their sale "only for the prevention of disease". During this ban, they were illegally sold under many aliases such as "latex sponges". One of the early condom brands was called "Merry Widows".

Latex condoms are packaged in a rolled-up form, and are designed to be applied to the tip of the penis and then rolled over the erect penis. They have a "right side" and a "wrong side" when rolled up, and the first thing the user must do is to determine which side is which before attempting to apply them. Any touching of the penis to the wrong side of the rolled-up condom before application potentially contaminates the outside with bodily fluid, defeating the condom's purpose.

Early latex condoms were very similar, but later some came to have reservoir tips to contain ejaculated semen. One relatively early innovation, the "short cap", only covered the head of the penis. These were not useful condoms, as there was still contact between the partners' genitals, and bodily fluids could easily spill out of the cap.

In recent decades, condom makers have diversified in colors, sizes and shapes, and thicknesses. Flavors or designs thought to have stimulating properties are sometimes added. Such stimulating properties include enlarged tips or pouches to fit the glans penis better and textured surfaces such as ribbing or studs (small bumps). Many condoms have spermicidal lubricant added, but it is not an effective substitute for separate spermicide use.

Condoms made from natural materials (such as those labeled "lambskin", made from lamb intestines) are not as effective at preventing disease. A few companies today also make condoms from polyethylene and polyurethane, expected to be as effective as, but less tested than, latex. These condoms have the advantage of being compatible with oil-based lubricants. They can also be used by people who have a latex allergy.

As a method of contraception, condoms have the advantage of being easy to use, having few side-effects, and of offering protection against sexually transmitted diseases. With typical use, condoms have an 85% success rate per year in regard to preventing pregnancy – but with proper knowledge and application technique, the success rate climbs to over 98%, with near-total success when combined with a vaginal spermicide or oral contraception."Of 100 women whose partners use condoms, about 15 will become pregnant during the first year of typical use.* Only two women will become pregnant with perfect use.** More protection against pregnancy is possible if condoms are used with a spermicide foam, cream, jelly, suppository, or film. *Typical use refers to failure rates when use is not consistent or always correct. **Perfect use refers to failure rates for those whose use is consistent and always correct. Using the spermicide nonoxynol-9 many times a day, by people at risk for HIV, or for anal sex, may irritate tissue and increase the risk of HIV and other sexually transmitted infections. They also protect both partners during vaginal and anal sex from sexually transmitted infection. Latex condoms offer very good protection against HIV." "Condoms have no side effects except for people who are allergic to latex."Planned Parenthood: The Condom Accessed: March 26, 2006.

Disadvantages

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• Many complain that putting them on can interrupt foreplay and lovemaking, although some people have integrated wearing a condom as part of the entire process for sexual activity.^* (This doesn't apply to female condoms, which can be put on 8 hours prior to sex.)
• Because of an obvious barrier of the skins, sensory stimulation is sacrificed, especially with older style thicker condoms, causing some people to dismiss condoms as limiting their pleasure (though this effect can be largely overcome by properly applying lubricants internally and externally). However, a woman can partially solve this problem by training her vaginal muscles, specifically the pubococcygeus.

Physical properties of latex condoms

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The type of synthetic rubber or latex used in the manufacture of condoms has outstanding elastic properties. Tensile strength exceeds 30 MNm^-2. Condoms may be stretched in excess of 800% before breaking."Condoms produced by Western industrial standards exceed by a wide margin the minimum strength required for effective use" PMID 12264044 "Relationship of condom strength to failure during use." Condoms may be freely colored, and their surfaces textured. Condoms can be made to custom shapes, such as an enlarged "head" or in novelties have tentacles, or other features for clitoral stimulation. Condoms come in many sizes to accommodate all different sizes of penis. ^*

Natural latex can be cured to be 0.046 mm in thickness, while polyurethane can be set at 0.02 mm thickness. In 1990 the ISO set standards for production (ISO 4074, Natural latex rubber condoms) and the EU followed suit with its CEN standard (Directive 93/42/EEC concerning medical devices).
Condoms are tested with an electrical current for holes. If the condom passes, it is rolled and packaged. Batches of condoms are tested for breakage with air inflation tests (Nordenberg T. (1998) 'Condoms: barriers to bad news', FDA Consumer Magazine, March-April). Condoms are evaluated for their ability to form barriers against the pathogens that can cause various sexually transmitted infections which can be vastly smaller than sperm. The average dimensions of a condom are: Length: 190 mm, circumference: 52 mm, thickness: 0.07 mm. Thickness for a condom is a tricky issue, as the condom is thicker at the head than on the shaft in many cases.

Duron/Polyurethane versus latex

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Advantages:

Polyurethane can be considered better than latex in several ways:

• It conducts heat better than latex
• It lasts longer in storage
• It does not degrade in oil-based lubricants, also it does not degrade as readily as latex
• It is suitable for those with latex allergies. Polyurethane is widely used in internal medicine such as artificial hearts, pumps, and blood vessel catheters.
• Polyurethane condoms have no smell, unlike latex condoms
• Polyurethane condoms are smoother than latex ones
• Unlike latex condoms, which must be stored at a reduced temperature range to avoid degradation, polyurethane condoms have no such requirements

Disadvantages:

• Clinical failure (breaks and slippage, together) of polyurethane show significantly higher rates over latex use.Frezieres RG, et al.: Fam Plann Perspect 1998, 30:73-78
• It is more expensive than standard latex condoms.
• It may not be as effective in protecting against STDs. This uncertainty comes from lack of testing."The polyurethane condom Disadvantages vs. latex condoms [.. May not be as effective in protecting against sexually transmitted diseases." Contraception online

Proper use and condom failure

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Condom failure rates can vary depending on usage. People who use condoms "perfectly" have a failure rate of 3%. Typical usage of condoms (mistakes in application, failure to use them every time, and other failures to follow the directions) can bring the failure rate up to 15%.

Most condom failures are due to misuse. This has led some researchers to suggest age-appropriate sex education that includes how to use a condom properly.

The packaging often contains instructions for use, and often suggests lubricants. For more specific information, advice on condom use, and a visual guide to use, please see Use of male condoms.

Another possible cause of condom failure is sabotage. One motive is to have a child against a partner's wishes^*, known to be done by men and women alike. Saboteurs usually pierce the condom's tip multiple times before intercourse. As this can result in pregnancies unwanted by one of the participants, it is generally seen as a deceitful and unethical act. Aside from misuse and sabotage, an improperly fitting condom is a cited risk for slippage, bursting, and leakage.

Effectiveness of preventing STDs

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According to a 2001 report by the National Institutes of Health,"Recently, a number of Federal agencies sponsored a workshop to answer the following question: "What is the scientific evidence on the effectiveness of latex male condom-use to prevent STD transmission during vaginal intercourse?" This workshop was attended by 180 persons, and the data from numerous peer-reviewed published studies were discussed. Following the workshop, a panel of 28 experts worked to develop this report." Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention correct and consistent use of latex condoms:

• reduces the risk of HIV/AIDS transmission by approximately 85% relative to risk when unprotected. See overall HIV transmission rates.
• reduces the risk of gonorrhea for men by approximately 71% relative to risk when unprotected.

A University of Washington study published in the New England Journal of Medicine in June 2006 reports that proper condom use decreases the risk of transmission for human papilloma virus by approximately 70%.The incidence of genital HPV infection was 37.8 per 100 patient-years at risk among women whose partners used condoms for all instances of intercourse during the eight months before testing, as compared with 89.3 per 100 patient-years at risk in women whose partners used condoms less than 5 percent of the time. Among newly sexually active women, consistent condom use by their partners appears to reduce the risk of cervical and vulvovaginal HPV infection. Condom Use and the Risk of Genital Human Papillomavirus Infection in Young Women

Contraceptive Technology concluded that condom failure due to breakage and leakage amounted to 8.08 percent per sexual encounter.

Other studies have shown that the proper and consistent use of condoms prevented HIV from spreading from an infected partner to a non-infected partner in every case.

While different studies show a wide range of results, every scientific study verifies that engaging in sex with a STD positive partner without a condom increases the chances of transmitting an STD when compared to sex with a condom.

Other sexually-transmitted infections may be affected as well, but they could not draw definite conclusions from the research they were working with. In particular, these include STIs associated with ulcerative lesions that may be present on body surfaces where the condom doesn't cover, such as genital herpes simplex (HSV), chancroid, and syphilis. If contact is made with uncovered lesions, transmission of these STIs may still occur despite appropriate condom use. Additionally, the absence of visible lesions or symptoms cannot be used to decide whether caution is needed.

An article in The American Journal of Gynecologic Health"In a study, all women who correctly and consistently used Reality were protected from Trichomonas vaginalis, while sporadic users were not protected." The female condom: STD protection in the hands of women. showed that "all women who correctly and consistently used Reality® were protected from Trichomonas vaginalis" (referring to a particular brand of female condom).

Health issues

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Carcinogenic nitrosamines have been discovered in 29 out of 32 condom brands tested by the Chemical and Veterinary Investigation Institute in Stuttgart."The Chemical and Veterinary Investigation Institute in Stuttgart said on Friday it had found the carcinogen N-Nitrosamine in 29 of 32 types of condoms it tested in simulated conditions." German Study Says Condoms Contain Cancer-causing Chemical However, there have been no studies linking the use of condoms to an increased risk of cancer and a 2001 study from the University of Kiel concluded that humans regularly receive 1,000 to 10,000 times greater nitrosamine exposure from food and tobacco than from condom use and concluded that the risk of cancer from condom use is very low."In addition, humans are regularly exposed to nitrosamines from food and tobacco smoke at a dose which is 1,000 to 10,000 fold higher than expected from condom use. In summary, the risk for the induction of tumors from nitrosamines in condoms is very low." Toxicological evaluation of nitrosamines in condoms.

Some lubricated condoms are produced with dusting powders, such as talc, which aren't recommended by the University of Virginia School of Medicine for surgery because of "acute & chronic problems" that may arise if the powders find their way into the abdominal cavity (i.e. via the vagina)."These dusting powders can gain access to the abdominal cavity through the vagina or through surgical intervention. The toxicity of these dusting powders in the abdominal cavity can be divided into acute and chronic complications that may be life-threatening. The use of medical and surgical products without dusting powders is strongly recommended." Potential toxicity of retrograde uterine passage of particulate matter.

Condoms lubricated with the spermicide Nonoxynol-9 may increase the user's risk of contracting the HIV virus and other sexually transmitted diseases. For this reason, Planned Parenthood has discontinued the distribution of condoms so lubricated, and the Food and Drug Administration has proposed a warning regarding this issue."Nonoxynol 9 works as a vaginal contraceptive by damaging the cell membrane of sperm. It has been shown in laboratory studies to damage the cell walls of certain organisms that cause STDs and to be active against some STD-causing bacteria and viruses. On the basis of data that are described in the labeling proposal, FDA believes that this same membrane-damaging effect can harm the cell lining of the vagina and cervix, thereby increasing the risk of STD transmission." FDA proposes new warning for over-the-counter contraceptive drugs containing Nonoxynol-9
"The Centers for Disease Control states: 'N-9 can damage the cells lining the rectum, thus providing a portal of entry for HIV and other sexually transmissible agents. Therefore, N-9 should not be used as a microbicide or lubricant during anal sex.'" Nonoxynol-9 Dangers: Health Experts Warn Against Rectal Use

Latex condoms used with oil-based lubricants (e.g. vaseline) are likely to break due to rapid deterioration caused by the oils.

Prevalence of condoms

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Condoms are more accessible in developed countries. In various cultures, a number of social or economic factors make access to condoms prohibitive. In some cases, cultural beliefs may cause some persons to shun condoms deliberately even when they are available."Two thirds of teenagers in the central African country of Cameroon have sex by the age of 16 and more than half of them shun condoms, according to a study by German aid agency GTZ." Sexually Active Cameroon Youths Shun Condoms

Furthermore, regardless of culture and availability, many men shun condoms simply because they dislike using them. This dislike may be due to reduced sexual pleasure or to practical problems, e.g. difficulty in sustaining an erection hard enough for effective condom use.

Because they are generally available without a prescription, and because they have some effectiveness in reducing the spread of sexually transmitted disease, condoms tend to be especially popular among younger men, those who are not in exclusive partnerships, and newly-formed monogamous couples. Often, once a steady relationship has deepened, the woman will begin to use the Pill or some other type of highly effective contraceptive, at which time condom use typically (though not always) comes to an end. Ideally, however, this should not occur until blood tests have shown both partners to be free of infection.

Female condoms

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Recently "female condoms" or "femidoms" (not to be confused with femdoms) have become available. They are larger and wider than male condoms but equivalent in length. Female condoms have a flexible ring-shaped opening, and are designed to be inserted into the vagina. The female condom also contains an inner ring which aids insertion and helps keep the condom in place inside the vagina. Inserting the female condom requires squeezing this ring. Sales of female condoms have been disappointing in developed countries, though developing countries are increasingly using them to complement already existing family planning and HIV/AIDS programming.Probable causes for poor sales are that inserting the female condom is a skill that has to be learned and that female condoms can be significantly more expensive than male condoms (upwards of 2 or 3 times the cost). Also, reported "rustling" sounds during intercourse turn off some potential users, as does the visibility of the outer ring which remains outside the vagina. The rustling noise can be mitigated by the application of lubricant. [http://www.path.org/projects/womans_condom_gcfc2005.php This type of condom is made from polyurethane, though newer iterations are made from nitrile.

In September 2005, the primary global manufacturer of female condoms — the Female Health Company of Chicago, Illinois — announced the introduction of a second-generation FC2 Female Condom made from nitrile."Changes in the material for FC2 permits use of a manufacturing process that results in reduced cost as volume increases. This offers the Female Health Company the opportunity to dramatically lower the price of FC2" Female Health Company Announces International Availability of Second - Generation Female Condom at Significantly Lower Price The Female Health Company noted that the second-generation nitrile female condom performs statistically the same as its polyurethane precursor in preventing the transmission of HIV, sexually transmitted infections, and unintended pregnancy. The nitrile female condom has also been designed to mitigate the "rustling" noise that some consumers have attributed to the polyurethane female condom. The nitrile material of the second-generation female condom will also allow for significant reductions in female condom pricing because it can be produced with a new manufacturing process that allows for efficient economies of scale when made in mass quantities.[http://www.femalehealth.com/InvestorRelations/investor_pressreleases/press_2005_09_21_2ndGenerationFC_Announcement.pdf

On November 22, 2005, the World YWCA issued an international Call to Action for the Female Condom that called on national health ministries and international donors to commit to purchasing 180 million female condoms for global distribution in 2006."The World YWCA is issuing a direct appeal to national health ministries, foreign aid agencies and international NGOs. We call on these entities to sign agreements in 2006 that will commit them to purchasing a minimum of 180 million of the second-generation female condom for annual global distribution. We also call on governments to ensure that the female condom is marketed to women in local communities and promoted as an effective method to prevent HIV/AIDS and sexually transmitted infections." Statement of Dr. Musimbi Kanyoro, General Secretary, World YWCA The World YWCA statement, which was signed by General Secretary Musimbi Kanyoro and World YWCA affiliates in six African nations, claimed that "Female condoms remain the only tool for HIV prevention that women can initiate and control," but that they remain virtually inaccessible to women in the developing world due to their high unit cost of 72 cents per female condom. The World YWCA claimed that if the global public health sector will commit to buying at least 180 million female condoms in bulk, the price of the female condom will immediately decline by more than two-thirds — to 22 cents per female condom. Currently, only 14 million female condoms are distributed to women in the developing world on an annual basis. By comparison, between 6 and 9 billion male condoms are distributed per annum.

Female condoms have the advantage of being compatible with oil-based lubricants as they are not made of latex. ^* The external genitals of the wearer and the base of the penis of the inserting partner are more protected than when the male condom is used. Inserting a female condom does not require male erection. (Boston Women's Healthbook Collective, 2005: 336-337)

The instructions for use of female condoms are of necessity different from those of male condoms, since they are inserted rather than worn, and designed to drape around the penis, rather than to fit tightly over it. They are as follows:

• The condom should be removed carefully from the packaging;
• The small inner ring should be squeezed closed;
• The inner ring should be pushed into the vagina, the outer ring remaining outside;
• The penis should be guided through the outer ring to ensure that it is not pushed aside.
• Before removing the condom, the outer ring should be squeezed and twisted (while the wearer is still lying down, if applicable) to ensure that semen does not leak out of the pouch. Pull to remove the condom.
• Any "rustling" can be counteracted by applying extra lubricant to the inside of the condom; this is also the course of action to take if the outer ring is pulled into the vagina during intercourse. (Boston Women's Health Book Collective, 2005: 337-338)

A new, updated female condom is being developed by PATH, a medical technologies NGO, that is claimed to be easier to put in as well as less awkward to use."But the result was a female condom that is easy to insert and remove, is very stable during sex, and feels good for both partners." PATH's Woman's Condom A second iteration of the original female condom is also in development by the Female Health Company that would be cheaper and easier to use."We anticipate that by offering the second generation product at significantly reduced cost, the availability of FC Female Condom will experience considerable growth." The Female Health Company 2004 Annual Report

"French letter"

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There are alternative etymologies for the condom:

1. Condom is sometimes considered a clinical expression, it is in fact intimately linked to the history of this fascinating item. In Britain a condom is also known as a French letter, much like the colloquial German word for a condom, "Pariser". English seventeenth century tourists, travelling through France on their pilgrimage to the center of ancient culture that was Rome, came across the town of Condom on the East coast of France. It is said that there they made contact with ingenious French shepherds who were making prophylactics from sheep gut. A trade then ensued, whereby the English gentry would eagerly await their letters from France - French Letters - with a fresh supply of condoms. The French aristocracy then learned of these useful items from their English friends and called them "Capote Anglaise" - English Raincoats. Thus the condom came full circle, being made in France, being used in London, latterly in Paris, and finally being adopted by the Germans as a Pariser.

2. The English phrase "French letter" expresses the old image (or prejudice) that anything coming from France is decadent and has to do with sex. According to British military history, a Britain's Royal Guards Colonel named Condum, in seventeenth century (when Anglo-French enmity was at its mutual height) devised the French letter to protect his troops from the French by using it.

Religious attitudes concerning the use of condoms

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Main article: Religious and cultural attitudes toward birth control

Condoms and other mechanisms of contraception, along with abortion, are condemned by the Roman Catholic Church, some Protestant denominations, and many Hindus for moral reasons relating to their beliefs regarding the purpose of the sexual faculty. Opinions of Orthodox Christian bishops, Jewish authorities, Muslims, Buddhists, and other Protestant denominations vary on the matter.

Religious condemnation of contraception is usually based on the belief that sex has both a procreative and a unitative aspect, and that an attempt to restrict the number of children a couple has is in opposition to God's divine plan. Natural family planning (NFP) methods such as the Billings or sympto-thermal methods are often accepted by religious groups that condemn artificial methods.

Religious approval is often based on the belief that the choice of contraceptive use lies with individual conscience, or is not significantly different from natural family planning to warrant condemnation; while other religious authorities view contraception from the angle of stewardship of the Earth, viewing overpopulation abatement as part of good stewardship and contraception (including limiting sexual activity) as serving this purpose.

Groups such as Planned Parenthood, which advocate family planning and sexual education, argue that religious opposition interferes with attempts to teach about condoms, which they see as a necessity to help prevent unwanted pregnancies and the spread of STDs. At the same time, religious opponents of condoms often oppose publicly funded contraceptive education or the availability of contraceptives at schools. Their reasons include a belief that education in sexuality should be taught at home and that sexual education programs should exclusively teach abstinence, though a recent study critical of abstinence-only education found that the rate of STD in virginity pledgers was comparable to the rate found in non-pledgers.Hannah Brückner Ph.D.a, and Peter Bearman Ph.D. After the promise: The STD consequences of adolescent virginity pledges. Journal of Adolescent Health. Volume 36, Issue 4 , April 2005, Pages 271-278 Other religious groups do not oppose contraceptive education outright but want abstinence to be the primary content of such programs.

Factors influencing condom use

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Most research has revealed, through survey, four factors which establish the minimal use of condoms: various encumbering beliefs, reduced sexual pleasure, adverse experiences, and fears related to gender and tensions. New technology and beneficial studies have come forth that combat these various factors, however only a small proportion of individuals world-wide actually practice safe sex. This noticeable gap has lead several investigators to analyze whether social factors might be involved such as a residual social stigma attached to condoms.

In broad detail, social factors range from geographical location to race, and become as specified as methamphetamine versus non-drug users, so correlations within this research are not always strong and accurate, but it does establish that correlations do exist.

Geographic location

Several regions provide examples of social factors influencing the use of condoms within their populace. Two examples which contrast the effects of similar problems are South Africa and rural Lebanon.

Unfortunately, South Africa has some of the highest HIV rates in the world, so there the statistics on condom use are being studied heavily. As of 2001, the 21-25 year age group has the peak rate of infection at 43.1% (Campbell & MacPhail 2001). These studies became more specified and it was discovered that despite all the information known today about HIV and the spread of infection, many young people of the study did not feel that they were in danger of contracting this disease. In fact, only 30% of people, males and females, felt they had any risk of contracting HIV at all. Of those that said they felt there was any chance of contracting HIV, only 12.9% thought there was a moderate chance, and 17.6% thought they had a good chance of infection. It seems that even though the youth of South Africa do have a relatively high level of knowledge concerning the risk factors of getting HIV, many feel that it simply won't happen to them. Many of the factors found in South Africa apply to well developed countries of the world and these new findings hopefully will help shape future campaigns against decreased condom use in the future.

Another end of the spectrum are the rural areas of Lebanon in the Middle East. Generally, the use of condoms and other forms of contraceptives in the Middle East is low even though there is a growing awareness of sexually transmitted diseases and HIV/AIDS (Kulczycki, 2004). A study revealed that only twenty-four percent of the women in the regions ever used a condom. A household survey was also done on condom use which found that ninety-eight percent of women had indeed heard of contraceptive methods, but only eighty-five percent of the women had heard of condoms. Some things to keep in mind also are that women in this culture are not expected to have knowledge or express openly knowledge of contraceptives or even sexuality. Also some background that is needed on the group surveyed is that the marital fertility rate of the surveyed women were about five children per woman, and each of the women had a different level of education. About sixty-one percent had intermediate-level education, twenty percent had a primary education, and eighteen percent had trouble reading or could not read at all. This provides evidence that condom use varies dependant on social factors like the area’s cultural background and education.

It should be noted that largely the variances in geographical location are highly affected by culture and cultural beliefs, as well as class and race, but also have dynamic influences resounding from economic yield for the area, use and expansion of communication, and other criteria. These social factors can again be examined in South Africa and rural Lebanon:

An example is that in South Africa, it was discovered (Campbell & MacPhail 2001) that condom availability is a problem for young adults. Although condoms are given away by local clinics, many participants stated that there are instances when they found themselves without condoms because they never know when they are going to need one. Thus, this higher economic region has properly developed health services; they are just not being properly utilized by the public.

Opposing in the lower economic region of rural Lebanon, another reason for the lack of condom use is that public health services and family planning services are very inadequately developed. A health service that is trying to help is the Lebanese Family Planning Association but their funding is very limited and recently they have not been able to increase its budget to promote more complete reproductive health service.

Despite these specific social factors contributing to the differences between these regions and others, most research has identified issues such as trust and gender power in relationships and others as socially relevant to almost all countries worldwide.

Drug use

The use of methamphetamines is shown to dramatically increase one’s desire to have sex, which can lead to pregnancy and/or the transmission of sexually transmitted diseases. Some injection drug users allege to have changed their sexual behavior since the AIDS pandemic, but still a relatively small percentage (6%–44%) of injectors use condoms while averaging twelve partners per year.

Amphetamine use has been associated with stronger sexual excitement, longer duration of intercourse, and intensified orgasms among male injectors. A study showed that methamphetamine users entering treatment had three times the prevalence of HIV than other drug users.

Only 99 of 699 male Out-of-Treatment Injection Drug Users (OTIDUs) that took part in the study reported to have always used a condom. Of the 232 women OTIDUs, 22 claimed their male partner always used a condom. However, when the study was restricted to methamphetamine users only, these numbers dropped to a mere one third and one fourth of the above statistics, respectively.

From this research (Grant, Patterson, Semple, 2004), correlations can be drawn through profiling methamphetamine users against non-users as specific relationships can be drawn. While not always, drug abuse will often identify a lower economic status as well as certain minority groups which could add other specific social factors that need further research to make better correlations.

Anti-condom trends

Studies have shown baby boomers are increasingly contracting sexually transmitted infections because they choose not to wear condoms. Many have been married, and separated, and now have random sexual partners (Watt, 2005). Several reasons for this choice are given. Since the women are no longer capable of conceiving children, they do not see the large risk in not protecting themselves, and thus the importance of a condom becomes minimal. Also, since many of them have just come out of a long term relationship, they are starting over and they are too uncomfortable with their new partner to ask them to use a condom.

The practice of barebacking in Western gay culture is another example of a trend away from condoms. Barebacking partners often know that they could reduce their risk of sexually-transmitted infection by using a condom, but choose not to.

Laws and policies restricting condoms

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Ireland

In Ireland, condoms (and other contraceptives) were originally available only to those with a doctors prescription in Ireland, which was later lifted to being available only to those over the age of 18 in pharmacies in 1985. Sale outside of pharmacies was only legalised in 1993, although stores such as the Virgin Megastore had in fact been selling them openly since 1988. The age limitations were also removed in 1993.

Philippines

Some years ago, former Manila mayor Lito Atienza banned the sale of condoms in the city's convenience stores The Philippines, being a dominantly Roman Catholic nation, has its religious leaders taking the same stand that the Church does – against their use (see above). Since then, the ban has been lifted, and condoms are sold in other convenience stores in other parts of the country and an estimated 73% of its citizens use them. A condom company even has family planning services advertised on local television."A ban on using national funds to distribute condoms could result in an explosion of HIV/AIDS cases in this predominantly Roman-Catholic nation, an international human rights watchdog warned yesterday.... The report, Unprotected: Sex, Condoms, and the Human Right to Health in the Philippines, noted that some local officials, like the Manila mayor, prohibit distribution of condoms in government health facilities. Educators are often not allowed to discuss condoms, it added."Ban on Philippine condom funds blasted

Somalia

In 2003, it became illegal under Islamic Sharia law to sell or use condoms in Somalia. The punishments for violating this law may include flogging."Islamic leaders say they have outlawed condoms in Somalia, where the vast majority of the population is Muslim." Somali Muslim group bans condoms

Environmental impact

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While biodegradable, latex condoms have been known to have a negative impact on the environment if improperly disposed of. It is estimated that 61 million to 100 million condoms are improperly disposed of in Britain alone, often ending up in rivers, or the ocean. According to the Ocean Conservancy these condoms cover the coral reefs, and smothers sea grass and other bottom dwellers. The EPA also has expressed concerns that many animals might mistake this litter as food and eat it."The British Environment Agency estimates Brits discard 61 to 100 million condoms per year, many of which end up in rivers, the sea and on beaches." "Many animals confuse trash for food and try to eat it." Ask E - The environmental magazine

Polyethylene condoms aren't biodegradable, and there have been no studies to determine if lubricated condoms take longer to biodegrade than non-lubricated ones, but it is believed that that their landfill mass is negligible."Unfortunately, condoms made of polyurethane, a plastic material, do not break down at all." Go ask Alice - Environmentally-friendly condom disposal

Other uses for condoms

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• Condoms have been used to waterproof boxes of matches and kindling, often by hikers and campers.
• In WWII, the Vietnam War, the Gulf War, and most recently in Iraq the U.S. military instructed its soldiers to place a non-lubricated condom around the muzzle of the rifle barrel in order to prevent moisture, sand, rain, etc. from fouling the weapon without hindering a bullet in case of firing.
• Another WWII use was by the crews of long-distance bombers. Because the planes often didn't have toilet facilities condoms could be used to hold urine. It was common practice to throw the filled condoms from the plane whilst at altitude over enemy territory.
• During WWII, the OSS used condoms for a plethora of applications, from storing corrosive fuel additives and wire garrotes (with the T-handles removed) to holding the acid component of a self-destructing film canister, to finding use in improvised explosives.OSS Product Catalog, 1944 Condoms excel as multipurpose containers because they are waterproof, elastic, durable, and will not arouse suspicion if found.
• Condoms can be used to hold water in emergency survival situations. http://photo.net/bboard/q-and-a-fetch-msg?msg_id=00542b&tag= The British SAS carry condoms as a method for carrying water in these emergencies.
• Condoms have also been used in many cases to smuggle cocaine and other drugs across borders and into prisons either by filling the condom with drugs, tying it in a knot and then either swallowing it or inserting it into the rectum. These methods are very dangerous as if the condom breaks the drugs inside can cause an overdose."A 41-year-old man has been remanded in custody after being stopped on Saturday by customs officials at the Norwegian border at Svinesund. He had a kilo of cocaine in his stomach." Smuggler hospitalised as cocaine condom bursts
• In his book entitled Last Chance to See, Douglas Adams reported having used a condom to protect a microphone he used to make an underwater recording. According to one of his travelling companions, this is standard BBC practice for when a waterproof microphone is needed but cannot be procured.
• Foot travelers in South America wear condoms when wading through water to prevent a small catfish known as candirú from swimming into the urethra. The fish is attracted to the scent of blood and urine. http://www.goofball.com/news/200402031001
• In movies like The Incredible Shrinking Man, condoms filled with water are a cheap way to simulate giant raindrops.
• In the motion picture American Psycho 2, the protagonist murders her date via strangulation with a condom.
• A condom is often used as a consolation prize in many Trading card game tournaments.

See also

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• Safe sex
• Durex
• LifeStyles
• Trojan Condoms

• Condomi
• State of Louisiana v. Frisard
• Male oral contraceptive
• Something for the weekend

External links

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• Information on condoms and condom use — from Planned Parenthood of America
• Fact sheet on condoms and sexually transmitted diseases — from the US Center for Disease Control.
• Condom use — in French, but with many pictures. (Contains, perhaps obviously, male nudity.)
• How to Use Condom- Movie guide On how to put on a condom correctly.
• Condoms – An Overview — History and production.

References

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Barrier contraception | Penis | Birth control Sexual health Sexually-transmitted diseases HIV/AIDS

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