The Washington Post reports that Washington DC is going to distribute free condoms in public buildings. This seems to me to be an excellent idea. One of the explicit aims is to fight embarassment about condoms.

Of course the post has to follow the standard of balanced coverage. The HIV virus refused to comment, so the con position was taken by monomaniacal advocates of monogamy. I think the work monomaniacal is fair, since even the advocate did not claim that any marginal effect of condom distribution on promiscuity was relevant. Instead the argument was two false statements combined with a blatant fallacy.

"I'm not aware of any evidence that that sort of activity has a positive effect," said Robert E. Rector, a family-issues researcher at the conservative Heritage Foundation. "The number-one determinant of whether a person will catch a sexually transmitted disease is the number of lifetime sexual partners. We seem to go out of our way as a government and a nation to avoid telling people that, but we hand out a lot of free condoms."

Well I guess that Rector might not be aware of it, but their is strong evidence that AIDS prevention efforts stressing condoms have been succesful in Uganda and among gay men in the USA. I suppose it defendes on how you define "that sort of activity". It is hard to prove that condoms are the key to success because Rector's second claim is absurdly grossly false as he must know. He boldly asserts that the Bush administration goes out of his way to avoid telling people that abstinence or monogamy would reduce HIV transmission. Where do they find people like that ? The man is clearly out of touch with reality. Why didn't he criticize the DC government by contrasting it with the Bush administration which follows a policy closer to the views of people like him ?

The logical fallacy is the claim that the number one determinant of .... This is like saying the number one reason that people catch AIDS is the AIDS virus and it would be better to have no aids virus than to hand out condoms. The issue is what is the best public policy. Not what would be nice if you could magically convince all people (or HIV particles) to do what you think best. Saying number one, then acting as if you said only is a logical error so extreme as to be extremely rare.

Then we hear from the Bush administration

"Tom Coburn, a physician, co-chairman of a presidential AIDS panel and former Oklahoma congressman, called condom distribution misguided because, he said, condoms fail 20% of the time
"We used to think condoms were fairly effective," he said. "If used perfectly, they are probably 94 or 95 percent effective, but we're human, and we don't use them perfectly. . . . The city would be much better off spending its money getting people tested, treated and counseled not to give the virus to others."

Coburn deliberately confounds two issues. One is do condoms fail, the other is do couples who plan to rely on condoms actually use them. It is homicidally misleading to tell people that condoms are no good, because other people didn't put them on.

94 or 95% success seems to me shockingly low. I personally have never experienced a condom failure .In fact, itis indeed the low end of results from studies which show 1 to 5% failure.

Such true condom failure does not correspond, as asserted by Coburn, to using "them perfectly". In fact it is clear that some people have much more trouble with true condom failure than others which implies

"Most condom failure occurs as a result of the behaviors of the user, not due to a faulty device. Some user characteristics are also related to condom failure. Hence, understanding which behaviors and characteristics are most strongly associated with condom failure is critical to improving the effectiveness of condoms through public health messages and counseling."

This is clear because failure rates are significantly different for different couples. To avoid blaming the victims I should notel that this could be due to anatomy not behavior. It seems that a large penis could be a risk factor which might explain my 100% condom success rate reported above.

Indeed.

"Research is less clear about which behaviors lead to condom failure. Behaviors that may be related to failure include opening condom packages with sharp objects, unrolling condoms before putting them on, using oil-based lubricants, having lengthy or intense intercourse, and practicing anal intercourse or vaginal drying"

I think that, to be true to his Hypocratic oath, Dr Coburn should not be reporting misleading statistics on condom failure but rather should explain to people not to open condom packages with sharp objects, unroll them before putting them on or use oil based lubricants. In fact, I think that men who really care about fighting AIDS should be willing to be videotaped while putting on a condom according to proper procedure.

Finally, the true condom failure rate due to breaking or slipping overstates the AIDS blocking failure rate. The reason is that spermacide kills HIV. Thus in an actual experiment (ugh) it was shown that there was no then measurable HIV released from spermacide treated condoms filled with infected semen and pressed with e plunger even though the experimenters had pricked a hole in the condom with a pin. I forget the cite and this was detectable a long time ago before PCR was used.