Playing Russian Roulette with Sexual Health

Too much faith is placed in condoms as a means of improving the nation’s sexual health, according to the Family Education Trust. In a new factsheet, which is being mailed to all secondary schools in the UK this week, Trevor Stammers warns that reliance on condoms could actually increase the number of unwanted pregnancies and sexually transmitted infections (STIs) to which sexually active people – especially young people – are exposed.

Dr Stammers, a GP with over 20 years of experience, describes reliance on condoms as a form of sexual Russian Roulette. The user failure rate of the condom as a means of preventing pregnancy is estimated at 14%, which means that one woman in seven relying on it will become pregnant in a year, but this failure rate is not evenly spread across ages and types of relationships. Older monogamous couples can use it with a failure rate of only 1%, but amongst teenagers the risk is much higher. There is also the phenomenon of risk displacement: confidence in the condom may persuade people to be more sexually active with multiple partners, thus exposing themselves to higher risks.

The protection provided by condoms is even more problematic in relation to sexually transmitted infections, which are reaching epidemic proportions amongst young people. Pregnancy can only occur during a few days of each menstrual cycle, but STIs can be transmitted at any time. Most evidence of condom effectiveness in preventing STIs is in relation to HIV, which has a low level of infectivity. HIV/AIDS affects only small numbers of people in the UK, and the Family Education Trust has already called for funds to be transferred from HIV/AIDS to other conditions more likely to present a risk to the general population.

Human Pappiloma Virus (HPV) is the most common viral STI in the UK, and can be a cause of both cervical and anal cancers, but there is no evidence that condoms are effective in preventing its transmission. Chlamydia, which affects up to 10% of sexually active women, and which can be a cause of infertility, also might not be prevented by condoms.

Dr Stammers suggests replacing campaigns for ‘safer sex’ with an awareness of the benefits of ‘saved sex’, by means of which ‘sex is saved for a time when the relationship between the partners is at such a level of intimacy and commitment that they are able to make a reasoned decision that, once having made love, they will go on making love together exclusively with each other for the rest of their lives’.