Catholic God Revises Position on Condom Use

In 2009 God told Pope Benedict XVI to tell you that using condoms increases the problem of AIDS. It's now a year later and it looks like God has informed the Pope that it has an update on its position on condom use and HIV:

VATICAN CITY – In a seismic shift on one of the most profound — and profoundly contentious — Roman Catholic teachings, the Vatican said Tuesday that condoms are the lesser of two evils when used to curb the spread of AIDS, even if their use prevents a pregnancy.

...

The Vatican spokesman, the Rev. Federico Lombardi, told reporters Tuesday that he asked the pope whether he intended his comments to apply only to men. Benedict replied that it really didn't matter, the important thing was that the person took into consideration the life of another.

"I personally asked the pope if there was a serious, important problem in the choice of the masculine over the feminine," Lombardi said. "He told me no. The problem is this: ... It's the first step of taking responsibility, of taking into consideration the risk of the life of another with whom you have a relationship."

"This is if you're a man, a woman, or a transsexual. ... The point is it's a first step of taking responsibility, of avoiding passing a grave risk onto another," Lombardi said.

Any guesses on what God's position on condom use will be next year?

City Condoms

In case you just had to know, the new design for the city's condom wrapper is...the electronic power button:



Here's a list of the other top finalists, and this is the current design (I like this one better than the new one):

Sex and Trojans in the City

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When Trojan Brand Condoms comes up with a new condom brand, the Trojan Ecstasy, the company releases a sex survey and you get to compare your sexual frequency and satisfaction to that of your fellow Americans.

First, the Trojan Ecstasy.

Its claim to fame is a groundbreaking new design, a condom shape that's actually bigger at the tip and tappers at the bottom to allow for a more natural fit for him. The condom is also lubricated on both sides for an incredibly natural feel for both partners....

What I want to know is, did the Trojan manufacturer come up with a new design because their researchers read the Male condoms that break in use do so mostly by a "blunt puncture" mechanism Contraception article? [I asked their PR person but he didn't have the info.]

Second, the survey*. Are you having sex on average 101/year (Houston) or more like 60/year (San Francisco)?

Turns out that, on average, Americans have sex 79 84** times a year or roughly one and a half times a week. Nearly two-thirds of Americans (62 percent) wish they were having sex more often, while a small, yet surprising, number of people report having too much sex (4 percent). Men (73 percent) are more likely than women (53 percent) to want more frequent sex.

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When it comes to sexual satisfaction, people in Atlanta (73%) and the city (71%) top the list, with the most active Houstonians falling to third place (70%).

Overall, Americans rate their sexual satisfaction as only just above average (6.5 out of 10).

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Bottom line: 83 percent of Americans believe good sex is an important part of overall health and wellbeing, and 76 percent say they are looking for ways to make their sex lives more exciting. Seventy-five percent believe “sex without an orgasm is like the Fourth of July without fireworks,”....

*Fortunately for us Reuters just reprints the manufacturer's press release so you, too, can have a look at it. [Since you're not special enough to get it in your inbox like Reuters and us, that is.]

**Typo from the PR people.


N.B. Other than the Amazon link, I have no financial interest in/ties with Trojan Brand Condoms.

Condoms: To Use Or Not To Use

Interesting report on condom use:

NEW YORK (Reuters Health) - Many teenagers and young adults fail to use condoms consistently, regardless of whether they have sex with a serious or a "casual" partner, a new study suggests.

Researchers found that among more than 1,300 15- to 21-year-olds, those with casual sex partners had unprotected sex just as often as those in serious relationships -- about 20 times over the previous three months, on average.

Those who had casual sex were more likely to use condoms at least some of the time, the study found. But because they had sex more often, they ended up having unprotected intercourse just as frequently as their peers in steady relationships.

The findings point up two different problems, according to the researchers.

"Unfortunately, this reveals that teens may overestimate the safety of using condoms most of the time with a casual partner and underestimate the risk of unprotected sex with a serious partner," lead study author Dr. Celia Lescano said in a statement.

And, based on my clinical experience, here's a third, quite common, problem: many patients simply do not like using condoms.

Interestingly, I find it's mostly the adults who are adverse to the very concept of condom use. Teens are very receptive to advice on condom use, and the majority report they already use condoms (or so they tell me). But try convincing monogamous adults, in long term relationships, to use condoms. It's not easy, and, I must admit, more often than not, quite unsuccessful.

Condoms Found To, You Know, Prevent Stuff

Okay, that's not quite accurate. More like Condoms Found to Prevent HPV Transmission:

Women whose sexual partners consistently used condoms were 70% less likely to acquire genital human papillomavirus infection than were those whose partners did not, in a prospective study specifically designed to determine whether condoms prevent HPV transmission.

"Even women whose partners used condoms more than half the time had a 50% risk reduction, as compared with those whose partners used condoms less than 5% of the time," reported Dr. Rachel L. Winer and her associates at the University of Washington, Seattle.

Several previous studies have suggested that condom use doesn't reduce the risk of HPV infection in women. Even though these studies were cross-sectional and were not explicitly designed to evaluate condom use....

...

In contrast to those previous studies, the prospective, longitudinal study by Dr. Winer and her associates “"as designed to evaluate more accurately the temporal relationship between condom use and HPV infection," the researchers said (N. Engl. J. Med. 2006;354:2645–54).

They assessed 210 healthy female students aged 18–22 years who had never had vaginal intercourse or who had had first intercourse with a single male partner within the preceding 3 months. The subjects completed a Web-based diary every 2 weeks concerning their sexual behavior and underwent gynecologic examination that included HPV testing every 4 months.

...

During a mean follow-up of 34 months, the subjects' diary data were 91% complete. The 12-month cumulative incidence of a first HPV infection after first intercourse was 37%.

Women whose partners used condoms 100% of the time were 70% less likely to acquire HPV infection than those whose partners used condoms less than 5% of the time, after the data were adjusted to account for the number of new partners the women had and the estimated number of previous partners the men had.

A linear dose-response effect was seen, in which incident HPV infection decreased as the percentage of time a condom was used increased.

A similar inverse association was noted between the frequency of condom use and the incidence of cervical squamous intraepithelial lesions. No incident lesions were detected in women who reported 100% condom use, compared with 14 incident lesions found in women whose partners used condoms less consistently or not at all.

"This trend is consistent with previous data indicating that condom use by their male partners protects some women against high-grade cervical neoplasia and invasive cervical cancer," Dr. Winer and her associates said.

Of note was the finding that among couples with 100% condom use, those who reported having some genital skin-to-skin contact had a similarly low incidence of HPV infection as did those who avoided all genital skin-to-skin contact. This suggests that brief episodes of skin-to-skin genital contact "are not particularly efficient for male-to-female HPV transmission," the researchers added.

The newly sexually active women in this study "reported a yearly median number of instances of intercourse (48) and a yearly median number of new partners (1) that were similar to those reported in a large national survey of a random sample of women of a similar age," indicating that these results are somewhat generalizable. The results may not apply to older women or to those of lower socioeconomic status, however.

OTC Birth Control And The Internet

Yesterday's post about the Internet's role in facilitating Pill approval in Japan got me thinking about the availability of over-the-counter (OTC) birth control methods online. This availability poses an interesting problem for American women and their Ob/Gyns.

Most of the birth control methods which can be had OTC in Europe and online aren't yet available in the U.S. So, what is a savvy Internet shopper to do?

Obviously, if you're considering using any of these methods, first you should familiarize yourself with them. Second, you should consult with your Ob/Gyn.

To get you started, here is a brief (and I do mean brief) guide to some of the most common OTC methods available for sale on-line:

Unisex Condom

The Unisex condom is a modified condom which has a hoop at the base. It's made of a very thin, hypo-allergenic plastic, and it is designed to be used with a lubricant.

Advantages:

-- may be used by either women or men

-- it's thinner than most latex condoms, so sensation is improved

-- possible STIs protection of the external genital area (Because this condom covers part of the external genital area, it might be able to protect against STIs that are usually transmitted via direct, intimate, skin-to-skin contact (genital herpes, warts, etc).)

Disadvantages:

-- more research is needed on its efficacy

FemCap

FemCap is a modified cervical cap shaped like a tiny sailor's hat (a soft dome, surrounded by a brim, with a strap to aid in removal). It's made of silicone, it's reusable, and can be worn for up to 2 days.

FemCap is available in three sizes and requires an initial fitting by medical personnel. It's used in combination with a spermicide. FemCap is available OTC in Europe and on-line, and is FDA-approved, as a prescription-only device, in the U.S.

Advantages:

-- it's designed to last for at least 3 years

Disadvantages:

-- it appears to have a higher failure rate vs. the diaphragm and conventional caps

Ovès Cap

The Ovès cap is a modified cervical cap equipped with a removal loop. It's made of a very thin silicone elastomer, it's disposable, and may be left in place for up to 3 days.

The Ovès cap comes in three sizes--Mini, Midi, and Maxi (an initial fitting by medical personnel is required). It's best to use Ovès in combination with a spermicide; however, you might be able to use it without one. It's available OTC in Europe, and on-line.

Advantages:

-- it's held in place by surface tension (like 'cling film'), rather then suction (Because of this, the shape and size of the cervix is less important, so a larger number of women are able to use it.)

Disadvantages:

-- higher failure rates vs. hormonal methods and IUDs

Lea's Shield

Lea's Shield (Lea contraceptive)is a cross between the diaphragm and the cervical cap. It has a pliable, tea cup-shaped body with a loop for removal, and a one-way valve to allow for the passage of cervical secretions. It's made of silicone, it's reusable, and it can be left in place for up to 2 days.

Lea's Shield comes in only one size (fitting by medical personnel is not required) and may be used with or without a spermicide. It's available OTC in Europe, on-line, and it's FDA-approved, as a prescription-only device, in the U.S.

Advantages:

-- one size fits most women (Precise positioning over the cervix is not necessary. Also, weight fluctuations have less of an effect on its fit.)

-- can be used during menses (It shouldn't be left in place for more than 24 hours (12 for heavy flow days). Note that some physicians recommend against use during menses because of a possible increased risk of TSS.)

Disadvantages:

-- higher failure rates vs. hormonal methods and IUDs

-- needs to be replaced about every 6 months

The Contraceptive Sponge

The Sponge is a small round or cylindrical device, made of soft polyurethane foam. It's disposable, comes pre-treated (impregnated) with spermicide and all brands are designed to be effective for many hours (regardless of the number of acts of sexual intercourse during this period). The Sponge can be inserted hours in advance (helps with spontaneity), but must be left in place for a few hours after last intercourse.

Currently, there are 3 types of sponges, each with its advantages and disadvantages. All are available on-line, and some are available OTC in stores in Canada and the EU.

Pharmatex sponge

Protectaid sponge

Today sponge

Emergency Contraception

In Europe, the UK, and online Plan B is available OTC. The brand names you'll most commonly encounter are NorLevo and Levonelle.