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i have also seen no sign of the total dismissal of condom-efficacy the author refers to...but hey, if a bit of hype enables a reiteration of condom virtues, i don't mind. as Reeders notes, condoms don't always protect against HPV or syphilis or herpes...tho they often greatly reduce risk.
If taking Prep means more STI screening then that is also to the benefit of the wider community.
I worry that people will forgo condoms before starting Truvada. In addition, Truvada is very expensive. If a person using Truvada as a prevention method finds herself or himself in a position of doing without for financial reasons, it is imperative that she or he knows a partner's viral load or uses a condom in the interim. Lastly, we should consider all these methods of prevention as tools in our prevention toolkits. Each individual, and each situation, may call for a unique set of tools.
It is an excellent article. But I would like you to check about the difference of acquiring HPV in the outer anus (in foreplay) and in the inner anus/rectum (penetration). My proctologist said it is different, since HPV in outer anus causes only warts, and HPV in the transition tissue between anal mucosa and rectum can cause also cancer. So avoiding condomless penetration, even when allowing foreplay, means harm reduction for HPV.
The only thing wrong with this excellent piece is the title. I've never heard anyone seriously say that condoms don't prevent STIs. I have heard a defensive statement about relative harm i.e. "Well condoms don't prevent SOME STIs anyway, so I'm gonna use that to make myself feel less anxious not using them." I wonder if we should follow the advice of the authors of Freakonomics who found that most condom efficacy is concentrated into the first three dates and make than another 'rule of three'.
The author is unaware of the difference between STI that spread through skin contact vs intermucosal contact. Condoms don't protect against ulcerating STI like herpes and syphilis, which spread through skin contact and contribute to significantly increased HIV transmission risk. That's not 'reactionary philosophy', that's established fact.
Frank R Car
Sure condoms reduce other STI's, but why do we not hear the straight community debating this issue? They obviously are not using condoms either since we're still having pregnancies. Why is it just the gay community constantly gnashing their teeth?
October 2, 2014 • Shreveport LA