London, Jan 25 : It is common knowledge that using condoms consistently can reduce the spread of HIV, but how useful they are in protecting against other sexually transmitted diseases, still remains a question.
Many researchers have debated the issue in the latest issue of British Medical Journal (BMJ).
According to Markus Steiner and Willard Cates of Family Health International, condoms remain the best solution for sexually active individuals in order to minimise the risk of contracting sexually transmitted infections (if uninfected) or transmitting these infections (if infected).
They wrote that, though there are some discrepancies in the evidence of the same, it has been shown by studies that condoms act as a successful physical barrier to obstruct the passage of the tiniest of sexually transmitted pathogens.
For example, it has been proved recently through a recent review that condoms cut the risk of gonorrhoea and chlamydia both in men and women. Also it wa demonstrated by studies that consistent and correct use of condoms can reduce genital herpes and human papillomavirus infection.
Now, condom promotion still remains controversial in many countries including the United States and even India. Other major concern is that condom promotion may also cause risk compensation.
Though, the authors also indicated a recent review of condom related prevention approaches which gave the conclusion that sexual risk reduction interventions do not increase unsafe sexual behaviour.
However, the authors said that condoms are not 100% effective and thus accurate messages about their use should focus on a wide range of risk avoidance and risk reduction approaches, like the ABC strategy: abstinence, be faithful to one partner, and use condoms.
The authors also proposed that sexually active individuals are reassured by clinicians that condom use reduces the risk of most infections, while emphasising the importance of consistent and correct use for optimal risk reduction.
On the other hand, Stephen Genuis from the University of Alberta counter argued the need for a more comprehensive approach.
He wrote that condoms should not be considered the best answer to sexually transmitted infection, as they provide insufficient protection against many common diseases. He added that intercourse generally involves skin to skin contact in the external genital area which is not covered by a condom.
However, he said that the main problem with condoms, that a majority of people, mainly teenagers and young adults, do not use condoms consistently despite of sound knowledge and education.
He also pointed to many large studies in which strenuous efforts of condom promotion has constantly failed to control rates of sexually transmitted infections, even in countries with advanced sex education programmes like Canada, Sweden, and Switzerland.
The Data indicated that changes in sexual behaviour (fewer partners, less casual sex, and less use of sex workers) is more effective in reducing infections in countries such as Thailand and Cambodia, than widespread condom use.
He argued that, according to the World Health Organisation estimates, two thirds of sexually transmitted infections worldwide occur in teenagers and young adults. Still many adolescents thorough with condom focused sex education, contract sexually transmitted infections.
He concluded by saying that, though factual information should be included in any discussion of sexually transmitted infections, narrow condom focused initiatives should be replaced with comprehensive evidence-based programmes.