From the "They Haven't Got a Clue " file.

Dr. Michael Sidibe praised Pope Benedict for giving new room for dialogue, apparently by saying something new.

The head of the U.N. AIDS agency told a Vatican conference Saturday that the pope had opened the door to greater dialogue with his groundbreaking comments on condoms and HIV prevention – even as Vatican officials stressed abstinence and marital fidelity as the best prevention.


Dr. Michel Sidibe, executive director of UNAIDS, was invited to speak to the conference on preventing HIV and caring for HIV-positive people, a significant event in and of itself, given that the Vatican usually only invites like-minded outsiders to its conferences and UNAIDS has not been like-minded on this issue at all.

UNAIDS holds that condoms are an "integral and essential" part of HIV prevention programs, which it says should also include education about delaying the start of sexual activity, limiting sexual partners and marital fidelity. The Catholic Church opposes condom use as part of its overall opposition to artificial contraception.

The Church does, however, play a crucial role in caring for HIV-positive people, particularly in Africa where some two-thirds of the world's 22 million infected people live. It runs hospitals and hospices, orphanages and clinics and has played a critical role in helping to de-stigmatize those with the virus and stress the need for changes in sexual behavior to stop its spread.

But the Church has long been accused of contributing to the AIDS crisis because of its opposition to condoms.

That was why Pope Benedict XVI made headlines last year when he said in the book "Light of the World" that a male prostitute who intends to use a condom might be taking a first step toward greater responsibility because he is looking out for the welfare of his partner.

"This is very important," Sidibe told the conference. "This has helped me to understand his position better and has opened up a new space for dialogue."

At the same time, however, the Vatican officials speaking at the conference either glossed over or made no reference whatsoever to Benedict's condom remarks – evidence of a certain "one step forward, two steps back" mentality that often characterizes developments in the Catholic Church.

Dr. Sidibe and the author of this column demonstrate that they have spent so much time listening to their "amen corner" that their ability to hear and understand something other than what they want to hear has atrophied.

Benedict did not endorse condom usage.  What he did was say that when a person choose to commit a moral wrong in a way that limits worse evils to other people rather than lesser evils, that person may be making the first steps toward a conversion. 

That's all.

It's nothing new really, and hardly surprising, except to people who can't handle shades of gray in their moral outlook.

Undoubtedly, the anti-condom teachings of the Catholic Church are to blame.

Victor Davis Hanson points out the odd conjunction of society's movers and shakers, infidelity and the absence of condom usage notwithstanding decades of propaganda about "safe sex":

One strange thing about these serial sordid trysts in the news (not to mention the 1990s scandals) is the apparent absence of prophylactics during sexual congress — odd, since a three-decade-old government campaign to insist on them was always predicated on “education” and “awareness.” But in the cases of the Rev. Jesse Jackson, John Edwards, and Arnold Schwarzenegger, their extramarital hook-ups led to pregnancies, and the preliminary and tabloid “physical” evidence surrounding the Strauss-Kahn episode seems to show yet another lack of such concern. Factor in Eliot Spitzer’s use of prostitutes, and I think a new campaign either about safe sex or proper background discretion in the selection of partners should be targeted at politicians, multimillionaires, and those with advanced degrees in law. I mean, if a prominent minister, a former VP candidate, and the governors of the two largest states seem to show little worry for themselves or their spouses, how is the message of safe sex and proper awareness of risk to be taken seriously? And lest we forget, the former “AIDS czar” (and deputy secretary of state) Randall Tobias was caught serially frequenting a Washington, D.C. madam. All this sort of sounds like a sexual version of the Treasury secretary, House Ways and Means chairman, attorney general, labor secretary, and would-be HHS secretary either not paying their full family tax obligations or paying them late.

Speaking of which, I had this interaction recently on "Skeptics Exchange," which I found oddly educational about condom usage.

The questions was:

Some people say that holes in latex are large enough for the AIDS-causing HIV and chlamydia to pass through, so that condoms do not protect against these STDs. Others dispute this statement and consider condoms to be effective in blocking HIV transmission. What is the typical size of holes in latex and how does it compare to the size of viruses? Are viruses like HIV able to get through these holes?

Someone responded with a screed against the Catholic Church, which he edited after my answer.

My response was intrigued by some really stupid things that the former said - such as the proof of the efficacy of condoms is that they don't leak water and water molecules are smaller than HIV viruses.  As I said the original version of the post is gone, and the author has walked-back most of his claims. Vive, intellectual debate!

My response:

Concerning the question of whether the HIV virus can pass through condoms, the answer appears to depends on the type and condition of the condom.


The first question is, what kind of condoms? It seems that the available internet literature readily acknowledges that:

“Condoms manufactured from latex are the most popular, and studies conducted on the ability of condoms to prevent the transmission of STDs and HIV most often involve latex condoms. Condoms manufactured from lambskin, also known as "natural skin," or "natural membrane," are made from the intestinal lining of lambs. While these condoms can prevent pregnancy, they contain small pores that may permit passage of some STDs, including HIV, the hepatitis B virus, and the herpes simplex virus.”

These kinds of condoms were not widely available at one time. Users would be well advised to recognize this point in making their condom selection if the interest is to avoid the transmission of sexually transmitted diseases (“STD”s), including AIDS.

Incidentally, presumably, natural membrane condoms presumably make dandy water balloons. Likewise, rubber gloves are “water tight” but HIV can pass through the pores in rubber gloves, which is why the latex used for condoms is manufactured to more rigorous specifications. According to Straight Dope:

I'll say. Your clip is a 1992 letter to the editor from Mike Roland, editor of Rubber Chemistry and Technology, a publication of the American Chemical Society. Roland argued that "the rubber comprising latex condoms has intrinsic voids [pores] about 5 microns (0.00002 inches) in size. Since this is roughly 10 times smaller than sperm, the latter are effectively blocked.... Contrarily, the AIDS virus is only 0.1 micron (4 millionths of an inch) in size. Since this is a factor of 50 smaller than the voids inherent in rubber, the virus can readily pass through."

This sounds scary, but there are a couple problems with it. First, Roland bases his statement about a 5 micron latex pore size on a study of rubber gloves, not condoms. The U.S. Public Health Service says that condoms are manufactured to higher standards than gloves. Condoms are dipped in the latex twice, gloves only once. If just 4 out of 1,000 condoms fail the leak test, the whole batch is rejected; the standard for gloves is 40 out of 1,000. A study of latex condoms by the National Institutes of Health using an electron microscope found no holes at a magnification of 2000.

This seems to be the an article on the original report on holes in latex gloves.

So, the point that HIV molecules are larger than water is a “red herring” with respect to determining whether condoms are useful to preventing the transmission of HIV.

Second, and a more precise question is, can HIV pass through latex condoms?

As the Straight Dope quote indicates, there was an FDA report indicating that under extreme test conditions – certainly unlikely to replicated in actual performance - HIV viruses were found to have passed through latex condoms.

Internet literature from AIDS information sites - that do not seem to have an "anti-condom" agenda - seem to agree that the “pores” in latex condoms are approximately .5 microns in size, whereas the HIV virus size is .1 microns. See this Arizona health site for corroboration.

There seems to be some dispute as to whether infection can occur through the virus alone. According to Straight Dope:

As for the substantive issue you raise, it's true "the transmission of HIV by genital fluids most probably occurs through virus-infected cells since they can be present in larger numbers than free virus in the body fluids" (Jay Levy, "Pathogenesis of Human Immunodeficiency Virus Infection," Microbiological Reviews, March 1993--an exhaustive treatment of the subject). But it would be wrong to construe this to mean that HIV is transmitted only by cells. When I spoke to Dr. Levy he readily conceded that HIV may be transmitted by free virus as well. He did add that the viscosity of semen may hinder the passage of such virus through the latex barrier.

If this information is outdated it would be nice to know.

A lot of internet sources quote the “factoid” that condoms have “pores” of .5 microns in size. I suspect from my efforts to chase down the source of this information that it may come from the 1992 report based on an examination of latex gloves noted above. This site directly addresses the “pore hypothesis” and concludes that the double layers of latex in condoms prevents the formation of holes or pores that go through the entire condoms. That seems to be the best explanation for the anomaly of HIV not passing through condoms like "bullets through a netting."

So, the answer seems to be that outside of artificially created circumstances and assuming properly manufactured, non-defective, non-deteriorated condoms, the HIV virus will not pass through latex condoms.

Third, an even more precise question, is whether HIV can pass through condoms under ordinary usage?

A caveat to arguments about the effectiveness of condoms is always that they have to be used properly and invariably. Proper usage involves more than mechanics. Health sites often contain warnings that deterioration, and opening up condom practices with teeth or nails, can introduce tears into the condoms. For example, Health Communities.com states:

Condoms should be purchased from a source that can guarantee product reliability and freshness. Heat, pressure, and age can break down latex. Condoms should not be used more than 5 years after the manufacture date. If the condom looks deteriorated or discolored, or feels sticky or brittle, it should be discarded. If the packaging is torn or damaged, the condoms should not be used.

Condoms are easily torn if they are handled roughly or with sharp fingernails, so care should be taken while putting them on and taking them off. Petroleum or oil-based lubricants (e.g., Vaseline, baby oil) can break down latex and should not be used. Water-based lubricants (e.g., KY Jelly) should be used and are usually labeled "For use with latex condoms or diaphragms."

Hence, fresh out of the box condoms provide a level of protection that may not be found in one left in a wallet or the glove compartment.

Fourth, even if all things go right, are condoms always effective?

The answer is clearly “no,” as suggested by the 4 out of 1,000 flaw rate mentioned above.

According to this site:

Generally, the condom's effectiveness at preventing HIV transmission is estimated to be 87%, but it may be as low as 60% or as high as 96%. Conclusions: Consistent use of condoms provides protection from HIV. The level of protection approximates 87%, with a range depending upon the incidence among condom nonusers. Thus, the condom's efficacy at reducing heterosexual transmission may be comparable to or slightly lower than its effectiveness at preventing pregnancy. Family Planning Perspectives, 1999, 31(6):272-279

Condoms are clearly effective in decreasing the odds of being infected, but, clearly they are not absolutely effective. It appears, though, that the risk of infection from an HIV viruses making its way through a non-defective, non-compromised condom is de minimis. One, however, should not be entirely sanguine about the effectiveness of condoms under all circumstances.

I found those statistics to be rather surprising in light of the "safe sex" campaigns I've been hearing for decades.

So, perhaps, Arnie, John and the Rev are just part of the planned 4 out of 1,000 failure rate or the larger inherent defective rate for not using a condom under lab conditions.