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Laboratory studies and product testing have shown that reputable condoms tested in the laboratory are completely impermeable to micro-organisms as small as viruses.

However, the same studies show that condoms come off the penis altogether 3 to 5% of the time but may slip down (but not off) up to 13% of the time.

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.

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.

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The next problem is deciding what kind of study provides truly reliable evidence.

It would be unethical to mount a randomised trial of condom use because the control group would have to stop using them altogether.

Despite this, the use and promotion of condoms continue to be targets for controversy and criticism, and sexual abstinence and monogamy are often promoted as superior alternatives.

While condoms offer useful and vital protection, they have also become associated with promiscuity and infidelity.

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