A report that shows mixed findings on the effectiveness of condoms in preventing
the spread of sexually transmitted diseases has renewed debate over what
the Centers for Disease Control should be telling the public on the subject
and what additional research is needed.
issued last week by the National Institute for Allergy and Infectious Diseases,
included a review of the scientific literature on the use of latex male
condoms to prevent the spread of STDs during intercourse. It found while
condoms are effective against the transmission of HIV and gonorrhea in
men, the same was not true in women, and for other STDs, such as syphilis,
genital herpes or chlamydia, it said there was not enough information to
make a determination one way or another.
The report prompted
the Physicians Consortium, a nationwide group of some 2,000 physicians
committed to providing accurate medical information about sexually transmitted
diseases, to accuse the CDC in Atlanta of overstating the effectiveness
of condoms in protecting against STD transmission.
"If the government
doesn't do something about adjusting the information being circulated,
I am considering organizing a class-action suit because so many people
are being hurt," said Dr. Thomas Coburn, a family practitioner from Oklahoma
and former congressman. "Sixty-five million people in this country have
sexually transmitted diseases."
At a press conference
on Capitol Hill Tuesday held by the Physicians Consortium with the Catholic
Medical and Christian Medical Associations, Coburn called for the resignation
of Dr. Jeffrey Koplan, head of the CDC. He said the agency's failure to
acknowledge the limitations of the effectiveness of condoms was illegal.
while in Congress he authored a bill, which became law last year, which
requires any agency receiving federal funding to provide medically accurate
information about condoms.
"The CDC has
known about these studies for years, but has failed to stress the limitations
of condoms," Coburn said. "Instead, the agency stresses safe sex when there
is no evidence for such a thing."
from the CDC were at the press conference, but the agency has declined
to comment on Coburn's accusations.
The agency issued
a statement that said the new report "doesn't say condoms are ineffective
-- it says the evidence is fully sufficient only for HIV and gonorrhea
and for other STDs more research is needed."
The CDC said
it continues to advise "male latex condoms, when used correctly and consistently,
are highly effective in protecting against HIV and can reduce the risk
of other sexually transmitted diseases." That was not enough for Coburn,
who said the problem with the agency's statements is they leaves the public
making assumptions without the whole story.
"Sure, the CDC
may tell the public that condoms aren't always effective, but many people
assume that that means they are 95 percent effective instead of 100 percent,"
he said. "But for some of these diseases, they may be effective closer
to 30 percent of the time. The public isn't getting that message, and it
is the CDC's responsibility that they do. Would the public rely on seat
belts or airbags that were effective only 30 percent of the time?"
said the issue of condoms and STDs needs more and better research.
studies show evidence that condoms protect against organisms that cause
various sexually transmitted diseases," said Dr. Vannessa Cullins, vice
president for medical affairs for the Planned Parenthood Federation of
studies of transmission may not reflect the level of protection that one
would predict from these lab studies, but that may just be a problem with
studies are notoriously flawed that way. We need better studies.
the studies that form the basis of the government report, Cullins said
the findings are all over the board, some showing good protection, some
moderate and still others poor protection against STDs.
are inconsistent and, except for the HIV studies, many are more than 10
years old," she said. "Because so much funding has been directed toward
AIDS research, transmission studies of these other infections, with or
without condoms, have received short shrift."
Many in health
care, including Cullins, agree condoms appear to provide poor or no protection
against the transmission of human papillomavirus, which is associated with
cervical cancer. Dr. Robert Klausner, former director of the National Cancer
Institute, has written the evidence that condoms are ineffective against
HPV is clear enough so "that additional research efforts by NCI on effectiveness
of condoms in preventing HPV transmission are not warranted."
Consortium was joined by the Catholic Medical Association, the Christian
Medical Association and Rep. Dave Weldon, R-Fla., a practicing physician
who serves on the Government Reform Committee, which has oversight of the
CDC and the Department of Health and Human Services.
"The role of
the CDC is to provide medical information. If they have any information
that suggests condoms are not as effective as most people think, they have
an obligation to provide it," said Dr. John Diggs, an internist from South
Hadley, Mass., who serves on the Executive Committee of the Physicians
Consortium. "I am not telling the CDC to support an 'abstinence-only before
marriage' policy, even though that is my own position. We are just saying,
'Tell the truth.' We cannot, as physicians, go on telling patients that
condoms protect against syphilis, herpes, or chlamydia when the evidence
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