Starlight dances off the sparkling water as the waves gently lap the shore. A cool breeze brushes across your face as you stroll hand in hand along the moonlit beach.
The party was getting crowded and the two of you decided to take a walk on the deserted waterfront. You’ve only known each other a short while but things seem so right. You laugh together and sense a longing to know this person in a deeper way.
You pause and tenderly gaze into each other’s eyes, blood rushing throughout your body as your heart beats faster. Soon you are in each other’s arms kissing softly at first, then fervently. You tug at each other’s clothes and both kneel to the sand. The condom comes on. You join in passionate lovemaking, then relax, hearing only the gentle waves and each other’s breathing, grateful that you are comfortable in mutual care and that all is safe.
Or is it?
Was the condom you used enough to keep you safe? Aside from the emotional and psychological implications of your romantic encounter, realize that the condom is not a 100% guarantee of safety against AIDS for the same reason the condom is not a 100% guarantee of safety against pregnancy. There’s always the possibility of human or mechanical error. Condoms can slip and break. They also can leak. Even the experts aren’t certain condoms can guarantee against sexual transmission of the HIV virus.
Theresa Crenshaw, M.D., has been a member of the President’ s Commission on HIV. She is past president of the American Association of Sex Educators, Counselors, and Therapists{1} and once asked this question to 500 marriage and family therapists in Chicago: “How many of you recommend condoms for AIDS protection?”
A majority of the hands went up. Then she asked how many in the room would have sex with an AIDS infected partner using a condom. Not one hand went up.
These were marriage and family therapists, the “experts” who advise others. Dr. Crenshaw admonished them that, “It is irresponsible to give students, clients, patients advice that you would not live by yourself because they may die by it.”{2} What does this tell you about the confidence experts have in condoms to protect persons against AIDS?
Not too long ago herpes caught the public’s attention. Now, of course, the focus is on AIDS. As with herpes, it is very difficult to be absolutely certain that your partner in premarital sex does not have AIDS and there is no known cure. But, of course, there’s a big difference between herpes and AIDS: herpes will make you sick; AIDS will kill you.
Assessing the Risk
After I had made these remarks at a university in California, one young man asked me to explain what I meant when I said that condoms aren’t safe. Consider this:
Condoms have an 85% (annual) success rate in protecting against pregnancy. That’s 15% a failure rate.{3} But remember, a women can get pregnant only about six days per month.{4} HIV can infect a person 31 days per month.
Latex rubber, from which latex gloves and condoms are made, has tiny, naturally occurring voids or capillaries measuring on the order of one micron in diameter. Pores or holes five microns in diameter have been detected in cross sections of latex gloves.{5} ( A micron is one thousandth of a millimeter.) Latex condoms will generally block the human sperm, which is much larger than the HIV virus. (A human sperm is about 60 microns long and three to five microns in diameter at the head.{6} But the HIV virus is only 0.1 micron in diameter.{7} A five- micron hole is 50 times larger than the HIV virus. A one-micron hole is 10 times larger. The virus can easily fit through. It’s kind of like running a football play with no defense on the field to stop you or shooting a soccer ball into an open goal. The hole is huge!
In other words, many of the tiny pores in the latex condom are large enough to pass the HIV virus (that causes AIDS) in its fluid medium.
One study focused on married couples in which one partner was HIV positive. When couples used condoms for protection, after one and one-half years, 17% of the healthy partners had become infected.{8} That’ s about one in six, the same odds as Russian roulette.
One U.S. Food and Drug Administration (FDA) study tested condoms in the laboratory for leakage of HIV-sized particles. Almost 33% leaked.{9} One in three.
One analysis of 11 studies on condom effectiveness found that condoms had a 31% estimated failure rate in protecting against HIV transmission. In other words, as the report stated, “These results indicate that exposed condom users will be about a third as likely to become infected as exposed individuals practicing “unprotected” sex…. The public at large may not understand the difference between “condoms may reduce risk of” and “condoms will prevent” HIV transmission. It is a disservice to encourage the belief that condoms will prevent sexual transmission of HIV. Condoms will not eliminate risk of sexual transmission and, in fact, may only lower risk somewhat.”{10} Burlington County, New Jersey, banned condom distribution at its own county AIDS counseling center. Officials feared the legal liabilities if people contracted AIDS or died after using the condoms the county distributed. They were afraid the county would be held legally responsible for the deaths. {11}
Over Easy Please
Latex condoms are sensitive to heat, cold, light, and pressure. The FDA recommends they be stored in “a cool, dry place, out of direct sunlight, perhaps in a drawer or closet.”{12} Yet they are often shipped in metal truck trailers without climate control. In winter the trailers are like freezers. In summer they’re like ovens. Some have reached 185F (85C) inside. A worker once fried eggs in a skillet next to the condoms, using the heat that had accumulated inside the trailer.{13} Are you thinking of entrusting you life to this little piece of rubber?
Is the condom safe? Is it safer? Safer than what?
Look at it this way: If you decide to drive the wrong way down a divided highway, is it safer if you use a seat belt?{14} You wouldn’t call the process “safe.” To call it “safer” completely misses the point. It’ s still a very riskyand a very foolishthing to do.
Remember that a national study found that condoms have a 15% failure rate with pregnancy. Perhaps you have flown in airplanes. Suppose only 15 crashes occurred for every 100 plane flights. Would you say airline travel was safe? Safer?{15} Would you still fly?
AIDS expert Dr. Redfield of the Walter Reed Hospital put it like this at an AIDS briefing in Washington, DC: If my teenage son realizes it’s foolish to drink a fifth of bourbon before he drives to the party, do I tell him to go ahead and drink a six pack of beer first, instead? {16} According to Dr. Redfield, when you’re considering AIDS, “Condoms aren’t safe; they’re dangerous.”{17}
The Test
You might say, “We’ve both been tested for AIDS. Neither of us has it.”
The time span between HIV infection and detection of HIV antibodies has been found to be anywhere from three to six months, sometimes longer. {18}In rare cases it can even take years for signs of the virus to appear.{19} Dr. Redfield says that after he was exposed to HIV in his work, he waited 14 months before having sex with his wife.{20} Suppose you meet someone who says, “I had an HIV test a year ago; it was negative. I haven’t had sex for a year. I just had another test; it was negative. I’m safe.” You see the test results in writing. Is it safe to sleep with that person?
We all know how hormones can influence honesty. It comes down to this: Are they telling the truth about not being sexually active in the interim? Is there even a chance that person might twist the truth even slightly in order to get into bed with you? Even with the tests, it all boils down to trust. That’s why I say, “It’s very difficult to be absolutely certain that your partner in premarital sex does not have AIDS.”
“Condom sense” is very, very risky. Common sense says, “If you want to be safe, wait.”
The Total You
There are many other benefits to waiting (or to stopping until marriage, if you’re a sexually active single). By “waiting,” I mean reserving sex for marriage.
Sex involves your total personalitybody, mind, and spirit. Besides being physically risky, premarital sex can hurt you emotionally and relationally. While you are single, sex can breed insecurity (“Am I the only one they’ve slept with? Have there been, or will there be, others?”). It can generate performance fears that can dampen sexual response. (If you fear even slightly that your acceptance by your partner hinges on your sexual performance, that fear can hamper your performance.) It can cloud the issue, confusing you into mistaking sexually charged sensations for genuine love.
After you marry, you might wonder, “If they slept with me before we married, how do I know that they won’t sleep with someone else now that we are married?” (Marital faithfulness in the age of AIDS is, of course, important both emotionally and physically.) When disagreements crop up with your mate, will you be tempted to ask yourself, “Did we just marry on a wave of passion?” Don’t forget flashbacks, those mental images of previous sexual encounters that have a nasty way of creeping back into your mind during arousal. Who wants to be thinking of previous sex partners while making love with their spouse? Worse, who wants their spouse to be thinking of previous sex partners?
Waiting until marriage can help you both have the confidence, security, trust, and self respect that a solid, intimate relationship needs. “I really like what you said about waiting,” said a recently married young woman after a lecture at Sydney University in Australia. “My fianc and I had to make the decision and we decided to wait.” (Each had been sexually active in other previous relationships.) “With all the other tensions, decisions, and stress of engagement, sex would have been just another worry. Waiting ’till our marriage before we had sex was the best decision we ever made.”{21}
Why Is It Hard to Wait?
Apart from the obvious physical power of one’s sex drive, there are other equally powerful emotional factors that can make it difficult to wait. A longing to be close to someone or a yearning to express love can generate intense desires for physical intimacy. Many singles today want to wait but lack the inner strength or self-esteem They want to be lovedas we all do and may fear losing love if they postpone sex. They are frustrated when unable to control their sexual drives or when relationships prove unfulfilling.
Often sex brings an emptiness rather than the wholeness people seek through it. As one TV producer told me, “Frankly, I think the sexual revolution has backfired in our faces. It’s degrading to be treated like a piece of meat.” The previous night her lover had justified his decision to sleep around by telling her, “There’s plenty of me for everyone.” What I suspect he meant was, “There’s plenty of everyone for me.” She felt betrayed and alone.
I explained to her and to her TV audience that sexuality also involves the spiritual. One wise spiritual teacher understood our loneliness and longings for love. He recognized human emotional needs for esteem, acceptance, and wholeness and offered a plan to meet them. His plan has helped people to become whole “new creatures,”{22} that is, “brand new person(s) inside.”{23} He taught that we can be accepted just as we are, even with our faults.{24} We can enjoy the self-esteem that comes from knowing who we are and that our lives can count for something significant.{25} He promised unconditional love to all who ask.{26} Once we know we’re loved and accepted, we can have greater security to be vulnerable in relationships and new inner strength to make wise choices for safe living.{27} This teacher said, “You shall know the truth, and the truth shall make you free.”{28} “My peace I give to you,” He explained. “Do not let your hearts be troubled and do not be afraid.”{29} Millions attest to the safety and security He can provide in relationships. His name, of course, is Jesus of Nazareth. I placed my faith in Him personally my freshman year at Duke, Two Lambda Chis influenced me in that direction. Though I was skeptical at first, it “has made all the difference,” as Robert Frost would say.
Sex and spirituality are, of course, quite controversial topics. I realize that our International Fraternity contains a wide spectrum of beliefs on these issues. I offer these perspectives not to preach but to stimulate healthy thinking.
Diversity was one of the things that attracted me to our chapter at Duke. Politically, philosophically, and spiritually we ran the gamut. There were liberals, conservatives, Christians, Jews, atheists, and agnostics. We tried to respect one another and learn from each other even when we differed on issues like these. That is the spirit in which I offer these remarks; may I encourage you to consider them in the same way.
To summarize, the only truly safe sex is the lovemaking that occurs in a faithful monogamous relationship where both partners are HIV negative. Condoms may reduce the risk of HIV transmission somewhat, but they can’t guarantee prevention. Please, don’t entrust your life to something as risky as a condom.
Notes
1. Richard W. Smith, “Parent’s HIV Prevention Information Package:’ n.d., p. 48. (Smith is “a public health professional with more than 20 years of experience in the epidemiology of Sexually Transmitted Diseases and HlV/AIDS prevention and control.” He resides in Trenton, NJ.)
2. Theresa Crenshaw, M.D., “The Psychology of AIDS Prevention: Implementing Effective Strategies, “Transcript: National Conference on HIV, Washington, DC, November 1987, p. 4.l
3. Elise F. Jones and Jacqueline Darroch Forrest, “Contraceptive Failure Rates Based on the 1988 NSFG (National Survey of Family I Growth):’ Family Planning Perspectives 24:1 (January/February 1992), pp. 12, 18. (Jones is senior research associate and Forrest is vice president for research for Planned Parenthood’s Alan Guttmacher Institute.) See also R. Gordon, Journal of Sex and Marital Therapy (1989), 15, pp. 5-30; in David G. Collart is affiliated with the Emory University Department of Biology. His doctorate is from the University of Florida in biochemistry and molecular biology.)
4. Richard W. Smith, “Is the Condom Really Safe Sex?”, n.d., p. I; see also Collart, loc. cit.
5. C.M. Roland, “Barrier Performance of Latex Rubber,” Rubber World: The Technical Service Magazine for Rubber Industry, 208:3, June 1993, pp. 1 518; and personal conversation, September 24, 1993. (Roland, who holds a Ph.D., is editor of Rubber Chemistry and Technology and also head of the Polymer Properties Section, Navel Research Laboratory, Washington, DC.)
6. William R. Hensyl, ed., Stedman’s Medical Dictionary, 25th Ed. (Baltimore: Williams & Wilkins, 1990), p. 1445; Macdonald Critchley, ed., Butterworth’s Medical Dictionary, 2nd Ed. (Boston: Butterworth & Co., 1978), p. 1577; Marcia F. Goldsmith, “Sex in the Age of AIDS Calls for Common Sense and ‘Condom Sense,”‘ JAMA (Journal of the American Medical Association) 257:17, May 1, 1987, p. 2262.
7. James Kettering, Ph.D., “Efficacy of Thermoplastic Elastometers and Latex Condoms as Viral Barriers,” Contraception, vol. 47, June 1993, pp. 563-564; and personal conversation, September 20, 1993. (Kettering is with the Department of Microbiology, Loma Linda University School of Medicine, Loma Linda, CA.)
8. Margaret A. Fischl, et al, “Heterosexual Transmission of Human Immunodeficiency Virus (HIV): Relationship of Sexual Practices to Seroconversion,” III International Conference on AIDS, June 15, 1987, Abstracts Volume, p. 178; in “In Defense of a Little Virginity, Focus on the Family,” USA Today, April 14, 1992, 11A.
9. Ronald F. Carey, Ph.D., et al, “Effectiveness of Latex Condoms as a Barrier to Human Immunodeficiency Virus-sized Particles Under conditions of Simulated Use,” Sexually Transmitted Diseases 19:4 (July-August 1992), pp. 230-234. (Carey works for the US Food and Drug Administration.)
10. Susan C. Weller, “A Meta-Analysis of Condom Effectiveness in Reducing Sexually Transmitted HIV,” Soc Sci Med 36:12 (1993), pp. 1635-1644, emphasis hers. (Weller is with the Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston. TX. Soc Sci Med is published in Great Britain.)
11. Douglas A. Campbell, “Burlco Stops Distribution of Condoms,” The Philadelphia Inquirer, April 11, 1991. IB, 4B.
12. Condoms and Sexually Transmitted Diseases …. Especially AIDS,” HHS Publication FDA (90-4239), in Smith, op. cit., P. 2.
13. William B. Vesey, “Condom Failure,” HLI Reports (the newsletter of Human Life International, Gaithersburg, MD) 9:7 (July 1991); see also Collart, op. cit., p. 3.
14. “Condoms Fail,” Staying Current (the newsletter of AIDS Information Ministries), iv: III (May-June 1992), p. 4.
15. George V. Corwell, “When simple solutions yield deadly results,” Trenton Times (NJ), February 5, 1993. (Corwell is associate director for education, New Jersey Catholic Conference, Trenton, NJ.)
16. Robert Redfield, Jr., M.D., “Why Wait? Capital Briefing; AIDS: What You’re Not Hearing Could Kill Your Youth,” oral presentation), Washington, DC, May 8, 1992. (Dr. Redfield is chief of the Department of Retroviral Research at Walter Reed Army Institute of Research.)
17. Ibid.
18. Ibid.
19. Ibid. Redfield says that some people with hypogammaglobulinemia do not make antibodies, hence it takes years for them to show signs of HIV infection. (Current HIV tests detect not the virus itself, but rather the antibodies that the human body manufactures to attempt to fight the virus.)
20. Ibid.
21. Space limits extensive development here of the practical, psychological, and emotional advantages of waiting. These have been more adequately discussed in Rusty Wright and Linda Raney Wright, How to Unlock the Secrets of Love, Sex, and Marriage, Barbour Books, 1981; Rusty Wright, “Dynamic Sex: Beyond Technique and Experience,” Campus Crusade for Christ, 1977.
22. 2 Corinthians 5:17, New American Standard Bible.
23. 2 Corinthians, 5:17, Living Bible.
24. Luke 15:10-32.
25. John 1:12; II Corinthians 5:20.
26. John 3:16; 13:34-35; 17:20, 23, 26; I John 4:7-21.
27. Acts I :8; Ephesians 5: 18; Galatians 5: 16-24; I Corinthians 6:18-20.
28. John 8:32.
29. John 14:27, NIV.
Reprinted with permission of Cross and Crescent of Lambda Chi Alpha International Fraternity, of which the author is a member. He offers special thanks to Richard Smith, John Harris, and Josh McDowell for valuable research provided for this project.
This article appeared in Connecticut Medicine 59:5, May 1995.
©1994 Rusty Wright. All rights reserved. Printed by permission.