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Consistently used condoms provide significant protection against HIV, pregnancy and sexually transmitted infections (STIs).The degree of protection they offer against HIV and STIs is significantly better than any other single prevention method, taken in isolation, other than sexual abstinence or complete mutual monogamy between two people who have tested negative for HIV.In one of the most highly publicised statements, in October 2003, the President of the Vatican's Pontifical Council for the Family, Cardinal Alfonso Lopez Trujillo, said: "The AIDS virus is roughly 450 times smaller than the spermatozoon.The spermatozoon can easily pass through the 'net' that is formed by the condom.For these reasons, HIV transmission within long-term serodiscordant relationships, especially heterosexual ones, may be rarer than it is between casual sex partners.For all these reasons, large studies may be needed to establish differences in HIV (and HSV and HPV) incidence between condom users and non-users.
One disadvantage is that condom use in long-term relationships, even in serodiscordant couples, is relatively rare.
Research early on in the epidemic showed that 40 to 70% of men who claimed they use condoms 100% of the time in fact did not use them for every act of intercourse.
Twenty years later, 51 to 66% of women taking part in a microbicide study reported 100% condom usage at different time points during the trial, but the researchers calculated from inconsistency in their answers that the actual proportion who maintained 100% condom use was 25%.
The efficacy of an intervention is how well it works in a scientific trial or when people use it as indicated, i.e.
consistently; its effectiveness is how well it actually works to prevent disease or infection in a given population, given actual levels of use.