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  • Bell, Elizabeth
    NIH Condom Report Draws Fire Bay Area Reporter (San Francisco) (07.26.01) Vol 31; No 30: P 1::David Fraser A National Institutes of Health (NIH) report
    Message 1 of 1 , Aug 3, 2001
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      "NIH Condom Report Draws Fire"
      Bay Area Reporter (San Francisco) (07.26.01) Vol 31; No 30: P
      1::David Fraser
      A National Institutes of Health (NIH) report released amid
      controversy recently has a number of health care professionals
      and HIV/AIDS organizations worried. The uncertainty the report
      reflects about research on the use of condoms, many fear, will
      end up making individuals uncertain about condom use -a
      devastating thought for public health workers.
      Conservative physician and former US Rep. Tom Coburn (R-
      Okla.) commissioned the report -"Scientific Evidence on Condom
      Effectiveness for Sexually Transmitted Disease (STD)
      Prevention." Conducted by several key agencies, including NIH,
      CDC and the Food and Drug Administration, the study was released
      July 20. It analyzed more than 138 peer-reviewed published
      studies on the properties and user patterns of male latex condoms
      in penile-vaginal intercourse. No gay approaches to sex were
      included in the analyses.
      The report concluded that condoms work well in HIV in male-
      to-female intercourse and in male gonorrhea, but found evidence
      inconclusive on several other STDs. Although the CDC participated
      in the NIH study, the CDC has since reiterated that condoms are
      effective against STDs.
      Coburn's response to the release of the study was a letter
      to Health and Human Services Secretary Tommy Thompson saying,
      "This report means that when condom use is discussed, it is no
      longer medically accurate -or legal for the CDC -to refer to
      sex as 'safe' or 'protected.'"
      Response among AIDS activists and service organizations was
      scathing. Maureen O'Leary, executive director of the national Gay
      and Lesbian Medical Association, said, "The danger is taking
      what Coburn is suggesting so that people might stop using
      condoms, thinking they're not going to have any effect
      whatsoever. Our stand is that used properly, they reduce AIDS
      [risk] and other STDs...."
      In a counter-report drafted on July 19 by the San Francisco
      AIDS Foundation (SFAF), activist researchers argued: "The bottom
      line is that abstinence fails more often than condoms. And
      abstinence, like a condom, is only effective when it is
      consistently used as a means of STD and HIV prevention." Point
      for point, the SFAF refuted the NIH study. Included in its
      analysis: the NIH omits important studies, and its study, by the
      report's admission, was not designed to see how well condoms
      worked. "The government groups looked at the quality of
      published research studies. The group did not look at the
      effectiveness of condoms. We know that when condoms are used
      consistently and correctly they reduce the transmission of HIV
      and other STDs, including gonorrhea, chlamydia, syphilis and
      herpes," said Dr. Jeff Klausner, director of the STD Prevention
      and Control Services at the San Francisco Department of Public
      Health. "Condoms are adequate. Condoms do work. This report is
      similar to one evaluating whether speed limits reduce car
      accidents and death. There may be a few large published research
      studies but we all know that driving slower is safer and an
      effective way to protect ourselves, protect others, and protect
      loved ones, " Klausner added.
      The issue for most public health workers is how to make
      condom use the norm. In populations where condom use is the norm,
      STD transmission is infrequent. In Thailand, according to health
      experts, 100 percent condom use has led to great reductions in
      new STDs and HIV transmission. "A core strategy for Asian and
      Pacific Islander Wellness Center's (APIWC) prevention efforts is
      promoting condom use combined with regular voluntary HIV
      testing," said John Manzon-Santos, APIWC's executive director.
      "Even if condoms only prevented the transmission of HIV and not
      all STDs, then using a condom has tremendous value and saves
      lives."
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