The Much Maligned Condom: Why We Can’t Be Surprised Use Is Down Among Teens
Once hailed as a lifesaver and necessity for everyone thinking about having sex, condoms are now frequently maligned—young people are surrounded by messages suggesting they don’t work, they break, and they take all the fun out of sex.
Recently, I wrote a piece about the Center for Disease Control and Prevention’s biennial survey of high school students’ behavior. Even though teens continue to behave as well if not better than adults, the 2013 findings about safer sex were a bit disappointing. In particular, after years of increasing, condom use among sexually active students has gone down by about 4 percent. When the survey began in 1991, only 46.2 percent of sexually active high school students had used a condom the last time they had sex. This rose to 63 percent in 2003. Since then, however, the numbers have stagnated and this year even fell to 59.1 percent.
The Youth Risk Behavior Surveillance System (YRBSS) has been conducted for over 20 years and as such allows us to spot trends like this, but does not attempt to explain why young people behave the way they do. When it comes to condom use, however, I think the answer is pretty obvious. Once hailed as a lifesaver and necessity for everyone thinking about having sex, condoms are now frequently maligned and young people are surrounded by messages suggesting they don’t work, they break, and they take all the fun out of sex.
When the YRBSS began in the 1990s, the HIV epidemic was still first and foremost on everybody’s mind and most students were learning about HIV and AIDS in school. At its high in 2007, 91.5 percent of students were taught about HIV and AIDS. In 2013, this was down to 85.3 percent. The lack of HIV education undoubtedly affects condom use among students, as many HIV and AIDS programs actually focus on the importance of safer sex. The shrinking number of programs across the country means not just that those students aren’t getting important information but shows a shifting of priorities away from safer sex messages.
At the beginning of the epidemic, when they were suddenly faced with a potentially deadly sexually transmitted infection (STI), schools, parents, and public health experts continually emphasized the importance of condoms. Today, fears have subsided and people in this country have begun to learn that HIV is a chronic but not fatal disease. As such, both HIV and condoms have gotten far less attention in sex education programs.
Even worse, as abstinence-only-until-marriage programs became widespread throughout the early 2000s, students began to hear negative messages about condoms in school. One abstinence-only curriculum, Why kNOw?, says this about condoms:
Sex is like jumping out of a plane. Married couples have parachutes, but for unmarried couples, using a condom is equivalent to grasping the corners of a folded blanket and hoping for the best.
Some just get the facts all wrong. Passions and Principles says, “Nearly 1 in 3 will contract AIDS from infected partner with 100% condom use.” (In truth, consistent condom use among serodiscordant couples reduces the chance of HIV transmission by between 80 and 94 percent. In 13 studies reviewed for one analysis, there were only 11 cases of transmission among 587 serodiscordant couples who were consistent condom users.) To seal the deal against condoms, abstinence-only speaker Pam Stenzel holds them up to unreasonable standards. She says, “There is not a condom in the world that can protect your heart, your reputation, your character and your values.”
It isn’t at all surprising when abstinence-only-until-marriage programs speak ill of condoms. Undermining young people’s faith in condoms is central to their message that premarital sex is inevitably harmful. It is more disheartening, however, when mainstream media outlets do the same.
A few years ago I wrote a letter to the editor of Real Simple Magazine to protest an article that called latex fragile and suggested condoms were difficult to use. In my letter, which never got published, I said it was ironic that a magazine that recommends using a hair-straightening iron to get wrinkles out from between buttons on shirts and argues that it’s just as easy to make your own chicken stock, is suggesting that condoms are hard to use.
Then there was the 2013 op-ed in LA Weekly magazine that ran with the simple headline “Condoms Suck.” The authors began by calling condoms “the medical contemporaries of bloodletting and leeches,” and then went on to say: “Having to put a tight, sensation-stealing plastic trash bag over your johnson during sex sucks. And yes, sexually transmitted infections suck, too, but not badly enough, apparently, even with the threat of serious illness and death, to get everyone to use condoms every time. Admit it: You don’t use a condom every time.”
This idea that condoms ruin sex has become part of our cultural zeitgeist. Take the whole line of products available for purchase on the Internet, from t-shirts to mugs to tote bags, which say “Condoms suck!” Or how about the e-card that reads, “Those condoms made it feels so much better! Said nobody ever.” Recently, there have been countless news stories written about the Next Generation Condom Challenge.
In an attempt to spark innovation, the Bill & Melinda Gates Foundation has offered grants to researchers and inventors who have ideas on how to make a condom that people will like better than the ones already on the market. This is a noble goal, and throwing money at innovation knowing many attempts will fail is a great role for a global nonprofit, because for-profit companies often can’t afford that kind of risk. Unfortunately, the media attention on the challenge seems to have started by accepting full stop the assumption that today’s condoms are no good.
What is most disheartening is when public health programs inadvertently throw condoms under the bus in order to promote other contraceptive methods. Many campaigns designed to promote emergency contraception, for example, start by suggesting that condoms break. “The condom broke” is one of the oldest and most convenient excuses for why someone accidentally got pregnant or needs to take emergency contraception, despite the fact that when used properly condoms rarely break. It is understandable why public health organizations would use this common excuse as a jumping off point for a campaign promoting other methods—no one wants to alienate potential clients by suggesting that they’re at fault. It is easier to blame contraceptive failure, and the much-maligned condom makes an excellent scapegoat. More often than not these campaigns are run by organizations that also strongly advocate for condom use. I don’t believe these groups intend to add to the negative image of condoms, but I do think that by capitalizing on the familiar “the condom broke” excuse, the public health community is partly responsible for the overwhelming belief out there that condoms are not reliable. We need to find a different way to promote other contraceptive methods than to continually suggest that this one might not work.
Condoms really are the method everyone loves to hate. The folks at AmplifyYrVoice recently created a list entitled “The 12 Ways You Know There’s a Huge (Magnum) Conspiracy Against Condoms.” They note that in eight states it’s illegal for schools to give students condoms, that Twitter rejects condoms ads, that network television won’t run condom ads, and that some pharmacies still keep them under lock and key, among other examples. Even when young people are told to use condoms, it’s often done in an almost apologetic way—like telling them to take their medicine or go to the dentist. There’s an implicit understanding that we’re asking them to do something they don’t want to do.
Condoms are not bad. They are, as they were promoted in the ’80s and ’90s, a lifesaving necessity. They have also come a long way since the ’80s. They are thinner, covered in higher quality lubricants, and come in different shapes that can add to sensation. Some also come with ribbing, warming, or tingling lubricants, and even vibrating rings.
Still, all we hear about condoms is the negative, and with such bad messages swirling around it does not surprise me that fewer sexually active students are using them. When I was in high school—in those early days of the AIDS epidemic when everyone was still very worried about a potentially deadly sexually transmitted disease—the message was simple: use a condom every time. I, for one, think high school students should get that simple message again today.
I also have a pretty simple message for all of the forces that are currently undermining young people’s confidence in condoms as a pregnancy or STD prevention method, and are perpetuating the idea that condoms suck: Stop it. Whether you’re doing it intentionally (like the abstinence-only proponents) or unintentionally (like promoters of other contraceptive methods accidentally do), you are partly responsible for the fact that fewer young people are now protecting themselves against sexually transmitted diseases and unintended pregnancy—and you have to stop.
Full disclosure: Martha Kempner is a member of the Trojan Sexual Health Advisory Council.