Are condoms as safe as filtered cigarettes?

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From Dr. Frank’s Blog

During my training, I remember dreading those patient visits where I was expected to provide “safe sex” counseling to my patients. It wasn’t necessarily the awkwardness of speaking about such matters to a complete stranger so much as it was the difficult position of trying to meet the expectations of my evaluators without personally contributing to this irrational and flawed set of beliefs held by the “secular” medical establishment. Ironically, the ones promoting biased, false, and misleading information are not the abstinence-based programs, but the condom devotees who arrogantly discredit such abstinence-based programs as failing to provide medically accurate material. In other words, the most scientifically accurate answer to the problem of sexually transmitted diseases and so-called “unwanted” pregnancies is not a wider distribution of condoms and more promulgation of condom awareness. Undeterred by objective data to the contrary, we are still taught “if only we have enough faith in condoms, we will be saved; don’t get bogged down and encumbered by scientific data, just believe and you will see…” What is the fruit of the worldwide conversion of hearts to a sincere faith in latex? Are we still cursed with HIV and AIDS because there remain a few infidels who obstinately insist on that dreary scientific evidence showing that self-mastery and marital fidelity is the real answer?

Consider the following epidemiologic data. In 1987 (shortly after the discovery of HIV), two Asian nations of similar population had approximately the same number of HIV patients. In Thailand there were 112 cases and in the Philippines there were slightly more—135 cases. Over the next 16 years, these two countries approached the problem with very different tactics. The government of Thailand embraced the theology of condoms and successfully implemented a “100% condom use” campaign wherein every man, woman, and child had ready access to a superabundance of condoms and where thoroughly indoctrinated on the apparent benefits of latex barriers. In the Philippines, however, something very unusual happened when their government rejected the internationally popular condom movement and decided instead to promote sexual abstinence and marital fidelity. How did these two radically different tactics fair? By 2003, Thailand had 570,000 people with HIV, whereas the Philippines had 9,000 people with HIV. In other words, the rate of HIV was 80 times higher in Thailand! Fortunately, this remarkable contrast didn’t go unnoticed by all of the mainstream media. A 2003 New York Times article in 2003 reported on this unexpected data in the Philippines. However, the author was clearly perplexed and unable to see the logic and reason behind it. In pitiful desperation, he suggests a theory that prostitutes in the Philippines must be less promiscuous! Would he further conclude that we should encourage prostitutes to be more chaste, all the while standing by the belief that teaching the same to school children is irresponsible and dangerous? Absurdity upon absurdity. Could anyone really believe that the HIV rate in a country saturated with condoms is 80 times higher simply because it’s prostitutes are more promiscuous than the prostitutes in a neighboring country where condoms are far more sparse? Even this far-fetched idea supports the concept that behavior is a far more influential factor than material barriers in the spread of this deadly disease.

The medical community has had to reform itself in a similar way over the past century with another issue. I speak now of a behavior that is even more habit-forming than the various sexual behaviors so vigorously promoted by the more influential members of modern society—cigarette smoking. When physicians first recognized an association between smoking and lung disease, an early approach that gained widespread popularity was adding filters to the cigarettes. Since people were going to smoke anyway (so it seemed), what better solution could there be than “safe smoking.” What foolish and religious nonsense to think that you could ever convince people to stop smoking, especially since so many youth were beginning to smoke. I wonder if anyone ever thought of passing out filtered cigarettes in schools to protect the children of the close-minded parents who didn’t accept this new progressive wisdom. Surely someone must have come up with a plan to teach the more sheltered school children about all the different varieties of tobacco products and the various ways in which they could be ingested. Imagine how much danger these children would face if not given such life-saving “health” information?

Hindsight is 20/20. We have since learned that “safe smoking” with filtered cigarettes wasn’t so safe after all. It simply forced people to suck harder while drawing the smaller carcinogenic smoke particles to deeper parts of the lungs. We then saw a shift from cancer in the large airways (like the trachea and bronchi), to the smaller airways (like the alveoli). Guess which cancer was more deadly. Yes, the ones involving the smaller airways. Fortunately, the medical community recognized this and made a radical shift in policy. We decided that as challenging as this may be, we had to encourage people to fundamentally change their behavior and abstain from cigarettes altogether. It’s not an easy answer, but we unanimously agree that it is the only one we can with integrity endorse. In fact, a physician would be thoroughly condemned if he or she failed to counsel a smoking patient to quit such harmful behavior. The attention given to smoking cessation is now unrivaled among health advocacy topics; unrivaled except perhaps by the current “safe sex with condoms” campaigns. Let us hope that sound reason and logic can soon correct the false religion of salvation by latex.

Dr. Frank (Ob/ Gyn)

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