American Foundation for AIDS Research, October 2004
Gunjan Sinha

“Condoms and condom users have been demonized,” over the past several years, said Planned Parenthood’s Susanne Martinez. This is old news to people who have followed the political dogfight playing out in Washington and the media. For example, the Bush administration has proposed doubling the budget for federally supported abstinence-only education programs next year.

Even more alarming, prompted by Congress, the Centers for Disease Control and Prevention (CDC) revamped information on their websites to emphasize condoms’ lack of effectiveness. The site was revised following a review conducted by the National Institutes of Health (NIH) in 2000 that concluded that male condoms are highly effective in preventing HIV transmission, but there was not enough evidence from studies to show that condoms protected against other sexually transmitted diseases such as chlamydia, herpes, and syphilis.

The NIH report clearly stated that a lack of evidence — missing simply because rigorous studies have yet to occur — does not mean ineffectiveness. But these details were lost on the CDC, which chose to minimize condom efficacy and maximize abstinence. “Abstinence and sexual intercourse with one mutually faithful uninfected partner,” the site says, “are the only totally effective prevention strategies.” While no one argues against the veracity of such a statement, groups like Planned Parenthood assert that condoms are unfairly getting a bad rap.

So as government and advocacy groups duke it out, condom manufacturers are hedging their bets on a different strategy to salvage the rubber’s reputation. Selling condoms as defenders against disease was never a completely fruitful tactic anyway, they argue. Manufacturers such as Durex and Trojan are pushing their product with a new mantra: condoms are fun, and psst...they offer protection to boot.

Sales were flat during the 1990s when disease prevention was the marketing mantra, said Richard Kline, vice president of marketing at Trojan. Manufacturers have since decided to focus on enjoyment, introducing a long line of new condom types that promise more pleasure (see below). “Condom usage over the last 10 years has gone up about 25 percent and Trojan volumes have gone up about 60 percent,” said Kline. “So we know that the strategies are producing good trends.”

If trends are any indication, then marketing campaigns may be more helpful in convincing people to use condoms than any information available on government websites or in brochures. While their relatively small sizes and consequent small advertising budgets limit condom companies, both Trojan and Durex do conduct extensive marketing campaigns, often collaborating with other groups that promote sexual health education. They also sponsor events such as National Condom Week. In addition to paid public service announcements on cable television stations such as MTV, Trojan hands out samples of their wares at major party events such as Mardi Gras and Spring Break, where their target audience — 18- to 24-year-olds — gathers.

This crowd of rambunctious and typically irreverent college kids does not pay a lot of attention to the political debates raging in the background. “A lot of people don’t,” said Mark Critchley, group marketing controller at Durex, the largest condom manufacturer in the world. “People don’t like to be preached to.”

That sentiment may extend to the public at large. “We haven’t looked yet at the negative ramifications of government documents that disparage condom use,” said Richard Crosby of the School of Public Health at the University of Kentucky. Crosby provided preliminary data from one state suggesting that residents are highly supportive of condoms and their use, reflecting a disconnect between public opinion and government policy. “Somehow I think all our debate in academic and government circles may be useless,” he remarked. “We don’t know whether or not the American public even looks at these documents. It’s an important question for study.”

The message reaching high schoolers is of greatest concern. There are questions about how to protect the public health of teenagers when sexual education programs are increasingly turning away from teaching about condom use in favor of abstinence only. “Condom manufacturers will not commercially market to young teenagers. But these kids are having unprotected sex,” said Adam Glickman, chief executive officer of Condomania. “Even public service announcements are not going to reach young kids nearly as effectively as education.”

Meanwhile, new research is restoring the condom’s reputation as a valuable tool in preventing the spread of most sexually transmitted diseases. Based on a review of literature published since the 2000 NIH report, King Holmes printed an analysis in Public Health Reviews in June concluding that “condom use is associated with statistically significant protection of men and women against several types of sexually transmitted infections including chlamydial infection, gonorrhea, herpes simplex virus type II, and syphilis.”

Whether or not government information will be updated to reflect this new information is unknown. Ronald Valdiserri, deputy director of the CDC’s National Center for HIV, STD, and TB Prevention, has said that the “CDC routinely reviews, revises, and improves efforts to protect the public health based on scientific updates and information from the field.”

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