Studies of condom efficacy have therefore largely contrasted HIV and STI incidence or prevalence in people who claim 100% consistent use against people who use them inconsistently or not at all.
Because these studies involve private behaviours that investigators cannot observe directly, it is difficult to determine accurately whether an individual is a condom user and whether condoms are used consistently and correctly.
One widely quoted remark of this nature came from Ugandan President Yoweri Museveni who, at the Fifteenth International AIDS Conference in Bangkok in 2004, advocated for HIV prevention based on “optimal relationships based on love and trust instead of institutionalised mistrust, which is what the condom is all about…I think of condoms as an improvisation, not a solution”.
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These can be done in individuals whose characteristics are known and can be controlled for, and if the relationship truly is monogamous then infections by acute STIs and from outsiders can be ruled out.
One disadvantage is that condom use in long-term relationships, even in serodiscordant couples, is relatively rare.
However, because they are not always used correctly even if they are used consistently, studies have found efficacy rates of 85 to 87% when young women use condoms as their sole form of contraception.
Condoms are, however, the only method on that list that has been shown to protect against STIs as well as pregnancy.
Consistently used condoms provide significant protection against HIV, pregnancy and sexually transmitted infections (STIs).