Will New Condoms Make a Difference?

The Bill and Melinda Gates foundation has been working on a project to encourage the development of a new type of condom. Their goal is to bring about a condom revolution which would reduce the barriers to using them. The Gates foundation has said that there hasn't been a significant innovation in condom design in more than 50 years and it's time.

I love that the Gates foundation is concerned about this and is willing to put a large amount of money into it. We do need innovations in STI prevention. But while some of the proposals that have received a first round of funding are interesting, I think others of them are going in the wrong direction.

An article on Co.Exist explains some of the front-runners. I like the one that is made from a shape-shifting elastomer. The article says "the concept calls for elastomeric (elastic) materials that shape-shift when exposed to body temperature "thereby improving tactility and enhancing sensitivity." I don't know exactly what this would be made of. My concern there is that it would take a very long time to get this material all the way through testing for safety and effectiveness into design, more testing, and onto the market. But hey, people having been having sex for millenia and will be for millenia more so it's not like we don't have the time. What I like about this idea is that it address both sensation and fit - the two biggest issues for people who actually do use condoms.

There is one that is made of a material designed to tighten gently during use. That confuses me. Most people who complain about condoms say that tightness is not good - that it reduces sensation and can lead to breakage. The claim here is that the tightening will enhance sensation and fit. I'm not sure that would be true.

There is another design that aims to tackle the problem of cumbersome application. The package would be broken open and slipped onto the penis in one motion. I can tell you this right now - this will not work. It simply will not work. If, by some miracle, it did work, it won't get any traction on the market. This has been tried a few times in slightly different ways. In the attempts that I've seen - condoms that were actually on the market for a short time, one of which still is, I believe - the supposed easier application was actually more difficult than the traditional application. When you see their training videos on wooden penises, these things look amazing. But when you try to put it on a real penis, you realize that you are dealing with two completely different things. A real penis is soft and fleshy, it's connected to a body that can be in various positions, it does not hold still, and it's usually girthier than a wooden demo model. Besides just simply not working well, the whole idea is just wrong-headed. People do not forego using condoms because they are difficult to put on. They don't use them because they don't like the way they feel, they don't happen to have one with them, their partner won't agree to using one, they think they don't need one because they think they aren't at risk for STI's,or they can't afford them. True, some condom failure can be attributed to putting them on wrong or having trouble putting them on, but I'm concerned that these new applications would actually increase that problem, not decrease it.

The other problem that will go along with all of these newfangled condoms is the cost. Some of them are great ideas. I cannot imagine, however, with the materials and the new engineering that needs to go into them, that you'll be able to get any of these condoms for less than $3 a piece. At this point in our culture in North America, most people will not pay $3 for a condom, even if they can afford it. You can build the most amazing condom in the world, but if it costs ten times as much as the regular ones, it's not going to be used. This is the way with the 'Female Condom'. This is actually an amazing device and many people who use it quite like it. However, few people try it or continue to use it because it costs anywhere from $3 to $6 per condom.

So yes, I am glad that the Gates foundation is doing this. If nothing else, it brings media attention to an issue that's really important. But I think of all the reasons I listed above, these new condoms address only one of the main issues that cause people not to use condoms - that they don't feel good. In my opinion, this is actually one of the lesser issues. I've spent a lot of time with condoms, talking about condoms, talking to people about when, how, why they do or don't use them. The way they feel comes up a lot. But what comes up most is that most people who are in any sort of long-termish relationship don't think they need to use condoms. In fact, they are actually insulted by the idea. A condom symbolizes trust, or lack thereof. To use condoms with a steady partner is to say 'I am sleeping around' or 'I think you are sleeping around'. We, at least in North America, still believe that condoms are only for people who have lots of sex with lots of people. We believe that you use condoms until you've 'gotten serious' and then you graduate to other types of birth control because you don't need to worry about disease anymore. But condoms are one of the cheapest and most effective forms of birth control around. It is also accessible, easy to use and does not cause the kinds of side effects that hormonal methods can.

If we want to increase the use of condoms, I think we need only three things. First, we need to address that attitude. We need to work on reinforcing the idea that condoms are not a trust issue, they are a health issue. Second, we just need more options for thin condoms in more sizes and more options for non-latex condoms. Many times a week, someone comes into the store looking for bigger condoms or tighter condoms. I show them what we have but I explain that because the current regulations on condoms includes standards for size, even the biggest of the big is only going to be a few millimetres wider or longer. We need condoms like 'They Fit' to be available everywhere in the world, not just Europe. Third, we need all of these options to be affordable and available. Not-for-profits have to be able to get these things for little or no cost and have them available at a wide variety of locations so people can get them when they need them and can get them free if they can't pay for them.