It has been known for decades that condoms, when consistently and correctly used, help to prevent the transmission of many STIs (Reece et al., 2010b). The condom, one of the great underrated aids to sexual interaction, is the only current contraceptive method (other than abstinence) that protects against pregnancy and most STIs (Reece et al., 2010b). Male latex condoms, when used correctly and consistently, are effective in preventing the sexual transmission of HIV, and they reduce the risk of transmission of other STIs, such as chlamydia, gonorrhea, NGU, bacterial vaginosis, and tricho­moniasis, that are also transmitted by fluids from mucosal surfaces. Condoms are less effective in preventing infections that are transmitted by skin-to-skin contact, such as syphilis, HSV, and HPV, and they have no value in combating pubic lice and scabies. Condoms made from sheep’s membrane (also known as "natural skin" or "natural mem­brane") contain small pores that may permit passage of some STIs, including HIV, HSV, and hepatitis viruses.

The NSSHB reported that adults who used condoms during intercourse were just as likely to rate the sexual experience as positive in terms of pleasure as those who engaged in condomless intercourse (Reece et al., 2010b).

Unfortunately, the proven value of condoms in reducing the spread of HIV/AIDS in Africa was undermined by a change in U. S. policy during George W. Bush’s admin­istration. This change is discussed in the Sex and Politics box, "U. S. Policy During the Bush Administration Reduced Condom Promotion in Africa."

In March 2009, Pope Benedict XVI stated publicly during a visit to Africa that condoms have added to the problem of HIV/AIDS and that this pandemic should be tackled via abstinence rather than condom use. Lancet, a leading medical journal, called on the Pope to retract these inaccurate remarks that undermine HIV/AIDS prevention efforts in Africa (Staines, 2009). Fortunately, in November 2010 the Pope appeared to reverse his position on condoms by stating that "condoms are the lesser of two evils when used to curb the spread of AIDS, even if their use prevents pregnancy" (Simpson & Winfield, 2010, p. 1). This revision in the pontiff’s position on condoms appears to reflect the Catholic Church’s belief that staunch opposition to condoms as a birth con­trol device cannot be justified when it puts lives at risk.

Laboratory studies indicate that the female condom (see Chapter 10) is an effective barrier to viruses, including HIV. If used correctly and consistently, the female condom can substantially reduce the risk of transmission of some STIs, and when the use of male condoms is not an option, we strongly encourage our readers to consider using a female condom. The female condom can be especially valuable to sexually active women who are at substantial risk for acquiring STIs from male partners who are unwilling to use male condoms consistently or at all.

Evidence indicates that vaginal spermicides containing nonoxynol-9 (N-9) are not effective in preventing transmission of chlamydia, gonorrhea, or HIV (Workowski et al., 2010). In fact, frequent use of N-9 has been associated with genital lesions in the