Effectiveness of Condoms

I am a specialist in public health and a district health officer in Los Angeles County for a district of more than half a million people, but I am writing as a private citizen.

I think you did the public a great disservice by the sensational slant you gave to your article on condoms (“Condoms and AIDS: How Safe Is ‘Safe’?” by Allan Parachini, Aug. 18). I find it hard to believe that a task force concluded that, “there are no clinical (human trial) data supporting the value of condoms” in preventing sexually transmitted diseases (STDs). That must have been taken out of context or else they did not search very hard. I have many examples of studies. For example in Lancet, Oct. 15, 1977, an article described a study which found that men who used condoms regularly and correctly had only one-tenth the gonorrhea and syphilis of non-users. Many other studies have found a similar protective effect.

You state that condoms were never designed to control sexually transmitted diseases. That may be true but it is misleading. I am sure that the armed forces were not concerned with birth control when they urged their men to use condoms. In one study, none of 55 soldiers who always used condoms contracted a sexually transmitted disease (STD), but 35% of the non-users contracted an STD (British Journal of Venereal Disease, February, 1974).

Unfortunately, many experiences of the protective effect of condoms are not written down in medical journals. For example, in Los Angeles County we are seeing a dramatic drop in gonorrhea cases at the same time that people have decreased their number of sexual partners and lots of men who never used condoms before are now using condoms regularly. However, no one has written an article about it.

Of course no method is foolproof and people need to be aware of that. In view of the above facts, it is very important for people to use condoms even though they may be only 90 to 98% effective.

MARSHA EPSTEIN MD

Los Angeles