Condoms' efficacy questioned

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TRENTON, N.J. -- Birth-control advocates and detractors want to find out the effectiveness of condoms to determine whether labels on the contraceptive packaging should be changed.

On one side are abstinence proponents, including a senator who is blocking the appointment of a new federal drug agency chief until the labels are changed. On the other side are "safe sex" advocates who fear label changes could undermine confidence in condoms and increase the spread of AIDS and other sexually transmitted diseases.

Condoms are effective against the AIDS virus, but data for their effectiveness against some other STDs is surprisingly sparse.

"They do not provide 100 percent protection, but for people who are sexually active, they are the best and the only method we have for preventing these diseases," said Heather Boonstra, a public-policy official with the Alan Guttmacher Institute, a nonprofit group affiliated with Planned Parenthood that researches reproductive health issues.

Miss Boonstra said that Sen. Tom Coburn, Oklahoma Republican, who is a doctor, and the abstinence-promoting Medical Institute for Sexual Health are "manipulating this data to drive home their own anti-condom, anti-contraceptive message."

James Trussell, who serves on the board of the Guttmacher Institute and is director of Princeton University's Office of Population Research, said there is "absolutely incontrovertible evidence" that condoms reduce transmission of the most serious sexually transmitted disease, AIDS.

"To my mind, everything else is gravy," Mr. Trussell said. "All of this is ideologically motivated. What they're really concerned about is people who are not married having sex."

Coburn spokesman John Hart said the senator's June 15 hold on Lester Crawford's nomination as commissioner of the Food and Drug Administration is an attempt to encourage Mr. Crawford obey a 2000 law Mr. Coburn sponsored when he was a congressman. It requires the FDA to change condom labels to give more information on their "effectiveness or lack of the effectiveness in preventing STDs."

Mr. Hart said FDA officials recently have said they will have a draft of the language soon. FDA spokeswoman Julie Zawisza said she could not discuss policy issues.

Currently the FDA requires condom packages to state: "If used properly, latex condoms will help to reduce the risk of transmission of HIV infection (AIDS) and many other sexually transmitted diseases." Many brands state condoms are highly effective in preventing pregnancy.

When latex condoms are used every time they reduce chances of pregnancy over a one-year period to 3 percent, compared with 85 percent without birth control. Condoms cut risk of HIV infection by about 80 percent, to less than a 1 percent chance of infection per year.

A 2001 NIH expert panel, convened at Mr. Coburn's request, examined dozens of published studies. It reported that for STDs besides AIDS and gonorrhea, for which condoms cut transmission by 50 percent to 100 percent, the evidence on protection is unclear because of weak and contradictory studies.