Letter re: effectiveness of use of condoms
Donald,
I ran across this column, Black HIV-AIDS awareness urged, at:
http://www.2theadvocate.com/stories/021205/opi_keeping001.shtml
in the course of another search. I thought it was a great column, getting a lot of important information out there about the prevalance of AIDS and organizations working to prevent HIV in the African-American community.
All the way up to the end… I can’t believe that any responsible HIV prevention person or editorial writer (even a religiously motivated one, as you seem to be) would say that condoms are flat out ineffective and imply that abstinence is the only real solution to preventing the spread of HIV. This contradicts decades of research and proven techniques for reducing HIV and other STD infection rates.
Even when they are less than 100% effective condom usage dramatically cuts down the spread of STDs and HIV. The math is simple… using round and large numbers for the sake of simplicity, an individual has sex with 33 people 3 times each, 3 of which are infected. That means 9 chances at infection. A natural transmission chance of 50% per contact (fairly high for HIV, from my understanding) means that, without protection, the person has a greater than 90% chance of being infected (.5 to the 4th power). Multiplied thorugh a population, that results in pandemic levels of infection very rapidly.
However, take that same person, and put a condom on them, with a 95% effectiveness rating, and the numbers tumble precipitously… their chances of NOT being infected AFTER having sex 99 times with 33 different partners hover around 90% (.975 to the 4th power)! Note: these figures are consistent with research findings that condoms are 87% effective at preventing the acquisition of HIV over time (numbers vary, as the study suggests)(1). Another study suggests that condoms are 90-95% effective.(2)
(1) http://www.agi-usa.org/pubs/journals/3127299.html
(2)http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9141163&dopt=Abstract (full text of article is available in Google cache at http://216.239.63.104/search?q=cache:CwY-XhXLRHwJ:www.salud.gob.mx/conasida/preven/condon/pinker01.htm+HIV+condom+effective&hl=en) Note: this article also includes much more sophisticated mathematical models that model rates of transmission under various circumstances.
Multiplied through the entire population, and you have an epidemic with far less impact. When people are knowledgable and consistent about their use of condoms, their real world effectiveness is vastly greater than 87 or even 95%… and the evidence backs this up:
“In a study of 245 heterosexual couples where one partner was HIV-infected and the other wasn’t, none of the 123 male or female partners who consistently used condoms became infected. In contrast, 12 of the 122 partners who either didn’t use condoms or used them inconsistently became infected.(13)”
Source: http://www.caps.ucsf.edu/condtext.html
Source referenced in quote: De Vincenzi I. A longitudinal study of human immunodeficiency virus transmission by heterosexual partners. New England Journal of Medicine 1994;331:341-346.
Other similar studies demonstrate very low rates of transmission.
In the real world, where the vast majority of folks don’t have that many partners, that frequently, the level of risk is even less - when a condom is used, even less than perfectly!
If you have any questions about what I’m saying here, I urge you to read up on this yourself. Lives are at stake here, and tons of epidemological evidence indicates that encouraging the use of condoms along with other modifications in personal behavior, vastly reduces the rate of HIV infection and other STDs.
I noticed you don’t actually quote Rhonda Roberson as saying this, although the structure of the column doesn’t make it clear whether these are your words or hers, and could easily lead people to believe the latter.
Concluding your column this way, without any mention of the fact that both the Red Cross and the Baton Rouge AIDS Society strongly encourage the use of condoms, and without clearly labeling the last paragraph as the columnist’s opinion, is irresponsible and disrespectful to the organizations quoted in the article who clearly disagree. As a clearly religious person, you must realize that a rhetorical strategy of this sort is unethical.
**quote**
Rhonda Roberson, prison and small groups coordinator with Volunteers of America, said she keeps busy educating inmates about HIV-AIDS and prevention.
“I go into the four state prisons, and I collaborate with American Red Cross, with Louis Hicks, the health and safety director there, and we teach the inmates at the prisons how to become certified HIV-AIDS instructors so that they can teach other inmates about HIV and AIDS prevention measures,” Roberson said.
“This year at Angola, on Monday, we will be having an HIV awareness program,” she said.
One problem related to the spread of HIV-AIDS is that many people don’t get tested, Roberson said.
If you engage in premarital sex, or sex outside of marriage, understand that condoms’ success rate (even when condoms are used properly) is too low a success rate on which to gamble your life.
**end quote**
I’ve cc’d Louis Hicks, the Director of Health and Safety Services for the Lousiana Area Capital Chapter of the Red Cross and Monique Marino, Director of Development and Community Resources, who I sincerely hope will confirm my expectation that this is not the message Ms. Robertson or their organizations convey. I’ve also cc’d A.J. Johnson, in the hope that he will author some sort of response clarifying that his organization has a different perspective and request that it be printed, and your publication’s executive and managing editors in the hope that they will print something with an alternative point of view.
Sincerely,
Thomas Leavitt
Note: to write the individuals referenced
Donald Lee: djlee@theadvocate.com,
Louis Hicks: lhicks@louisianacapitalarea.redcross.org,
Advocate Executive Editor: llightfoot@theadvocate.com,
Advocate Managing Editor: credman@theadvocate.com,
Baton Rouge AIDS Society: AIDS102@AOL.COM,
Baton Rough Chapter, Volunteers of America: Monique@voa-br.org
