FLASHBACK FRIDAY: Condom effectiveness: What’s brand name got to do with it?

This blog was originally posted on April 25, 2012 and was written by Diana Sanchez.

Condoms are one of the most commonly used contraceptive/STD prevention products used worldwide. The United Nations Population Fund estimated that over 10 billion condoms were used in 2005.  Here on campus, Campus Health Services provides thousands of condoms to students each year.

As a sexual health counselor, I have noticed that many people’s preferences for certain condom brands are based (almost entirely) on their perception of that condom brand’s effectiveness. We offer a variety of condom brands for free to students through Campus Health Services. Occasionally, when people check out the condoms we have available, they’ll ask: “are those safe to use?”, and “don’t those break more than [other condom brand]?”.

So, do some condoms in fact perform better than others in terms of STD/pregnancy prevention?

The answer is no, not really. Condoms are regarded by the United States Food and Drug Administration (FDA) as “Class II medical devices”, a designation that includes pregnancy tests and powered wheelchairs.  Products in this category have to meet special labeling requirements and performance standards. For condoms, the FDA standards include systematic “water leak” tests to ensure that no fluid can leak out of the condoms. To meet standards, all condoms must have at least 996 out of 1,000 condoms, on average, pass this test. This means that FDA-approved condoms must be at least 99.6% effective in laboratory tests to be available to consumers.

In a 2004 publication, Walsh and colleagues used condom use data from trials of three bands of condoms, including Trojan, LifeStyles and Ramses – all of which are FDA-approved condom brands. Out of 3,677 condom-protected sex acts analyzed in the study, the authors found that 55 condom acts failed, either due to breaking (16 condoms broke; break rate = 0.04%) or slipping (39 condoms slipped; slip rate = 1%). The likelihood of condoms breaking during sex was not statistically associated with condom brand.

FDA-approved condoms are all quite effective at preventing pregnancy and STD, and performance is probably not related to brand type. You might be wondering if the condoms you’re using are FDA-approved. With the exception of novelty condoms (which are pretty uncommon), just about all of the condoms you’ll come across in the United States are approved by the FDA.  All the condoms we provide through Campus Health Services are FDA-approved, and same goes for places like Planned Parenthood and local STD/HIV clinics. If you’d like to be certain, you can check the condom packet to look for wording about STD and pregnancy prevention. If it’s on the packet, those condoms meet federal regulations for quality and safety.

Check out the following pictures to see how we’ve looked for this language on some condoms we provide at Campus Health Services:

If you can’t find language about STD/HIV prevention on condom packaging, then it’s not FDA approved.
If you can’t find language about STD/HIV prevention on condom packaging, then it’s not FDA approved for STD/HIV and pregnancy prevention.

All of this said, although condoms must be at least 99.6% effective in safety trials, testing conditions do not necessarily mean 99.6% real-life effectiveness for any condom brand. But here’s the good news:  there’s a lot you can do to increase the effectiveness of condoms. One of the biggest challenges to condom effectiveness is correct use.  Some of the most common errors with condom use are: using the wrong lubricant (water-based, NOT oil-based, lubricants should be used with condoms); incorrect storage (ie, storing a condom in a hot place, like a glove compartment, or in a place with lots of friction, like a wallet or pocket); and not checking the expiration date.

FLASHBACK FRIDAY: Barriers to using barrier methods?

This blog is a guest blog from Ruth Abebe, a UNC graduate interested in HIV and sexual health, and was originally published on April 1, 2013.

College is a time when many students are discovering and exploring ourselves and the condomsworld around us. This world may include sexuality.

Many college students choose to be sexually active, and college-aged students are particularly likely to engage in risky sexual behaviors and are disproportionately affected by negative sexual health outcomes such as STI or unintended pregnancy.  According to national surveys, many college students are engaging in sexual activity without protection. In a 2011 survey of undergraduate students across the US, approximately 70% of sexually active students reported using condoms inconsistently or not at all during sex in the last 30 days. With all the information out there regarding sexually transmitted infections (STI), unintended pregnancy and ways to prevent them, why do college students still put themselves at risk?

As a college student myself, I have heard several of my peers talk about why they don’t use condoms.  But, there are ways to go beyond these barriers and make sure sexual experiences are safe and pleasurable.

1. Cost — Most of us are on a budget, and the cost of safer sex supplies like condoms is still an obstacle for students when deciding to use protection. However, this is a problem that can be easily remedied. Here at UNC, we have access to free safer sex supplies. Condoms, both male and female, and dental dams, as well as lube, are available to us through UNC Student Wellness and at several residence halls around campus. Furthermore, with the introduction of Wellness’s free condom dispensers, cost will be even less of an issue (update: These condom dispensers are now in service! They are located around campus, including in the Union and the Rams Head Recreation Center, and are refilled frequently). Click here for more information on where you can currently access safer sex supplies throughout Campus Health Services.

2. Many consider only pregnancy risk—Some students only consider pregnancy as a possible consequence of unprotected sex. For this reason, many believe they will be able to protect themselves using prescription contraceptives (examples: the pill, patch, ring, IUD, etc.). However, STI risk and protection should be considered in every sexual partnership.  Aside from abstinence, condoms are the only method which can protect against both pregnancy and STIs, including HIV/AIDS. They can also be converted to a dental dam.

3. “Oral sex isn’t sex.” – Many are under the false impression that oral sex is “safe sex.” Oral sex, just like anal and vaginal sex, carries a risk for STI transmission.  Condoms and dental dams can protect against the risk of STI transmission during oral sex.

4. Pleasure Factor— Some college students don’t use condoms during sexual activity because they believe “it doesn’t feel the same.”  But you can do things to make sex with condoms feel just as good. Plus, knowing that you have the protection of a condom can help you to relax and enjoy the moment.  There are several kinds of condoms out there, including “ultra-sensitive” condoms that enhance the feeling of both parties during sex. Using lube can also make sex more pleasurable for both partners. In addition, there are condoms and other safer sex supplies geared toward making sex more pleasurable. Explore different condom styles and protect yourself!

5. “It’ll ruin the moment.” – Some college students are not protecting themselves for fear of ruining the mood of the moment. There are ways around this too. If you are having sex with someone, you can talk about condom use beforehand. Of course, I realize that not all sexual activity will be between two people in either a romantic or ongoing sexual relationship. In these cases, it’s important to place your sexual health above any potential awkwardness. Cases of STIs are on the rise, and aside from the dangers to your health, having an STI can make your sex life more difficult in the future. So, why not protect and enjoy yourself?

Despite these barriers, there are several ways to allay your fears and hesitations about using protection. As college students, preventing against STIs and pregnancy by using condoms is essential to protecting our sexual health.