We Should Have a Better Condom by Now | Hacker News Reader

We Should Have a Better Condom by Now

slate.com

250 pointsdanso133 comments

Orthogonal to the article: condoms are not one size fit all.

A lot of people think they are, and this causes problems. Too small, and condoms break. Too large, and they slip off. Either way feels far less comfortable than with a properly fitting condom. This ultimately leads to less usage.

Condom boxes have something called "nominal width" on the side. To fit properly, you or your partner need to take a precise measure of the penis circumference, then match that to the appropriate width:

http://www.condom-sizes.org/condom-sizes/suggested-condom-wi...

Note that you have to double check the comdoms. For instance, magnums list 58mm, but actually are 54mm at the base, which is the most important place.

Fitted properly, latex condoms will feel significantly better and work better.

Not orthogonal: the article discusses the role of size in breakage and comfort. It also discusses how the FDA forced TheyFit to discontinue their custom-fit condoms due to unreasonable ASTM testing requirements.

Oops, my mistake. I read about halfway through the article, and didn't reach that part. Leaving the comment as is as I expect it may help some people get better condoms.

In spite of their niche popularity [...] the FDA challenged the acceptability of TheyFit condoms [...] having noticed [...] that some of the sizes did not meet ASTM dimensional requirements. The smaller sizes, in particular, didn’t hold the requisite volume of air and water in the air-burst test and the water-leak test, because they were, well, smaller. Glickman [...] was given 30 days to remove his condom from the market, and, after consulting with an attorney, complied.

Wow. So they were forced to take these off the market because they didn't conform to a completely irrelevant FDA standard....

In an alternate universe, adolescent children are being taught to abstain from ingesting more than three liters of water and air.

Very true. In particular a too small condom can be very painful ...

Easy there buddy... ;)

This thread practically demands a NSFW link for classic 4-panel comic strip. If you are at work, think at least twice before clicking the following link:

[NSFW] http://thinhline.tumblr.com/post/5370750268/thl-7-nothing-i-...

The article touches the issue of sensitivity and the need to develop a condom that makes sex more enjoyable. So does the comic at the link above, if in a slightly different way.

In case of markets and products, one can rely on cynicism and economics. In case of sex, we should be able to rely on hedonism.

(Are there any other SL fans?)

Anti sensitivity condoms seem to be fairly popular, to improve "male performance". Any simple condom or device like in that comic would be a massive success. I don't know the stats but I'd be shocked to find many guys don't rate their partner's pleasure over their own.

And yes, SexyLosers is the funniest "adult" comic I've ever read.

I was kind of shocked that the entire article doesn't mention that Japan has basically solved this problem. They have had 0.03 mm (that's .03 MM, not 3 mm) and more recently 0.02mm polyurethane condoms for quite some time. The only negative to them is that they have to be sold in different size ranges (Normal, Large, probably there's an XL) since they are not very stretchable. Also, being so insanely thin, it takes a fair bit of skill to apply one. They are expensive, but not as expensive as a disease.

They feel so close to nothing that someone unwilling to wear one with an unknown partner is shocking to me, yet even in Japan, condom use is extremely low.

On a side note, I'm surprised that so many people take their life in their hands to slightly improve the sensory feel of sex, and yet circumcision, which removes a huge percentage of the nerve endings in the area, remains popular in the US.

As a user of said Japanese condoms, I still have to admit that I can tell that there's something there. There's nothing that will actually solve the problem that you will want something that feels good.

If you ask me, we can get more people to use condoms if we develop a condom that feels even better than not wearing one. If we can combine a sex toy and contraceptive together that works during sex basically, it might be hard to get people to NOT use condoms. Some people swear that fleshlights feel better than actual sex in itself, so who knows if we could develop advanced haptics for condoms or something down the road?

Yeesh what an overwritten article. I plowed through it because this is relevant to my interests but man this could've been 3 paragraphs. I'll try and sum it up:

-People don't use condoms mostly because they are uncomfortable

-Current condoms are highly suboptimal for anal sex in particular

-Materials other than latex are generally difficult to get to pass FDA tests, and it looks like there is some disagreeing science about why. All condoms seem to be good at blocking pregnancy, some, like polyurethane and lambskin condoms, have disagreeing science about how well they stop the transmission of STDs (including HIV).

-New condoms sometimes get blocked because of somewhat antiquated tests (specifically sizing tests)

Overall there was not a lot of information here. It follows someone named Resnic, loosely, who claims to be making a new revolutionary condom, but who ultimately decides to change his condom back to latex because it's so much easier to manufacture in the US. It's not clear what his key innovations are that will make his condom more useful/comfortable to more people.

Overall the point that a better condom would get more people to use it makes sense, but the article doesn't make the case that one is on the way, or explain what one even would be. Yes, a better material might transmit heat better, but there are obvious downsides, especially with regards to Africa, where STD transmission is the primary concern, not pregnancy.

If there is one conclusion I take from this article it's that if you are in a committed relationship where you are not worried about STD transmission and are primarily concerned about pregnancy prevention, and do not like latex condoms, give lamb skin or polyurethane condoms a shot. Otherwise you're probably best sticking to latex.

Or, to sum up even more succinctly:

- Government regulations have stifled innovation, thereby making existing products less safe, less comfortable, and less used than they would be otherwise.

In other words, nothing new.

That doesn't explain why the innovation didn't happen in, say Somalia, where there are no government regulations to speak of.

The situation in Somalia can be readily explained by low incomes and decades of violence.

Which in turn can readily be explained by the lack of a strong government.

Can it? On what do you base that opinion? What particular facts from the modern history of Somalia have you used to support it?

The fact that it's currently in a state of near anarchy and has been for a while.

That's not an explanation, that's restating the fact.

Your comment was ambiguous. I thought you were asking me for the basis of my claim that Somalia lacks a strong government. If you think the civil war doesn't have anything to do with Somalia's current problems, I'm open to being persuaded.

The civil war and the lack of a strong government are not the same. It's the former, and not the latter, which maintains them in poverty.

A civil war happens precisely because there is no strong government. It's completely bizarre to claim that there's no link between the two.

How do you explain the improvements that have occurred since the collapse of Barre's regime? That seems to indicate that anarchy cannot be blamed for the poor conditions in Somalia compared to, say, wealthy Western nations.

I'm not defending the hypothesis that any government is better than no government. So sure, having a really really bad government could be worse for Somalia than having none at all.

That's a pretty facile response. Lots of African countries with "strong" governments still have tons and tons of violence.

Somalia went through a civil war in recent history. That's about the best possible example of violence caused by the lack of a strong government. Of course, violence can occur for other reasons too, so merely having a strong government is no guarantee of its absence.

I presume you know very little about Somalia's recent history. It had a strong government from 1969 to 1991. It was a military dictatorship with a centrally planned economy ("scientific socialism"). After the regime's collapse in 1991, Somalia was essentially stateless, and there was dispersed fighting between various groups for control of various areas of Somalia. Yet, perhaps surprisingly to many people, it's not clear that things were worse under "anarchy" than under Barre's regime. For instance, life expectancy improved dramatically, as did access to health care and technology.

You appear to be confusing strength with brutality. The military dictatorship was not strong. That’s why it collapsed. In general, dictatorships tend to be weak and unstable in comparison to more democratic forms of government.

I'm not confusing the two. The government was brutal, and it was also strong. It censored the media. It nationalized all major industries. It carried out large scale terror campaigns against political dissidents and Somali clans. It suppressed civil liberties on a very wide scale.

Right, because Somalia has never had a government, or the lack thereof today has nothing to do with the previous government.

We really are going down the libertarian rabbit hole when even the absence of government is blamed on government.

I'm not trying to paint all governments with the same brush. I'm just saying that, perhaps, you don't know anything about Somalia and are just using it as a strawman against small government.

edit: it's one, single country that has had a very violent history, not a case study in deregulation of markets.

I didn’t say anything about small government or market deregulation. Small vs large is orthogonal to strong vs. weak.

You don't have to be libertarian to recognize that Barre's military dictatorship was not an example of a good government. From Wikipedia:

> The United Nations Development Programme stated that "the 21-year regime of Siyad Barre had one of the worst human rights records in Africa."

http://en.wikipedia.org/wiki/Siad_Barre#Human_rights_abuse_a...

...And an abundance of strong governments who are willing to fund various factions to kill other various factions to fight a proxy war over natural resources.

That's why they don't have an industry there. But any western manufacturer could go to some lightly-regulated place, start handing out Better Condoms (tm) like candy, and then point to major improvements in user satisfaction, disease transmission rates, and so on in order to create pressure for a more careful evaluation in other markets like the US or EU.

Think back to news you've read about the deployment of improved mosquito netting and the like, which is tried out in Africa because that's where the greatest need exists.

But if there's no government intervention, then why are incomes so low, and why is there so much violence?

After the collapse of the Somali Democratic Republic in 1991, incomes increased and violence decreased.

...which means they will need children and are not focused on prevention technology

> Government regulations have stifled innovation, thereby making existing products less safe, less comfortable, and less used than they would be otherwise.

The article implied this in tone, but in facts reported within did not make a slam dunk case. Latex is probably significantly safer in terms of blocking STD transmission, and it's also heavily understudied whether or not the sizing differences matter. I wouldn't say it's obvious government regulation is really the devil here.

There's some truth to this, but your tone makes it a little hard to spot.

I'm not sure that the article provides much support for the broad claim, implied by your comment, that government regulation is always a bad idea, or that the government should get out of the condom regulation business. I for one think it's a pretty good idea for a regulator to ensure that condoms (like other health-related products) perform up to some minimum standard. The social impact of sub-standard products is too significant to leave to the market and there is good reason to think that the market would not adequately communicate the signals that consumers need in order to make rational condom-purchasing decisions in the absence of regulation.

I agree with your narrower claim that the existing condom regulations seem to be badly in need of reform. But I'm not at all convinced that they are worse than having no regulations at all.

I more or less agree with your reading of this. I found it a little curious that the author didn't mention anything about researchers taking a slightly different tack, like the people who designed the Pronto, a South African-designed condom whose application is much faster than a traditional condom. Obviously condom feel is an issue in usage rates, but I suspect that speed/ease of use is at least as important. It's not like condoms take forever to put on, but the process of locating and using one can definitely interrupt the moment.

The pronto is a brilliant step in advancing product design at least. https://www.youtube.com/watch?v=kMriPq9k278

> Yeesh what an overwritten article.

So often, it seems that's what is meant by "long-form article."

Sadly true. Information that could be conveyed directly in a paragraph or two is dragged out to create a long and often dull narrative, usually without any points of reference. Condom designs don't change every year? Neither do penises. Medical gloves (whose technology derives from condom manufacturing) haven't changed much for decades either. Infection risks are mitigated with antimicrobial coatings and double-gloving. The basic problem is that condoms work well enough for most people and so there isn't that much economic incentive to launch different kinds, even before you consider the regulatory factors.

> Condom designs don't change every year? Neither do penises.

This misses the point by a mile. Particularly for someone complaining about the article having too much unnecessary information, it's bizarre that you missed the ~3 paragraphs following this that describe _why_ it's a problem that they haven't changed: low rates of satisfaction and usage for something that has considerable public health implications (particularly in the developing world).

> Medical gloves (whose technology derives from condom manufacturing) haven't changed much for decades either.

....and if more than 50% of doctors weren't using medical gloves (regulation aside) due to evidently significant issues with comfort and convenience, this would be a cause for complaint too.

> The basic problem is that condoms work well enough for most people and so there isn't that much economic incentive to launch different kinds

This is a particularly ignorant claim, even if you hadn't read the article. Low rates of condom use in situations where they're extremely important is something that any informed person is aware of (again, this is most dramatically true for things like AIDS crises in developing countries like many in Sub-Saharan Africa). As the article establishes, usage isn't great even in the developing world:

"5 percent of men and 63 percent of women who’d most recently had sex with a “new acquaintance” hadn’t used a condom. More alarmingly, 75 percent of women who weren’t using a back-up birth control method reported not using a condom the last time they’d had sex. Adults who’d had anal sex in the past year—the highest-risk sexual act with regard to HIV transmission—said they’d used condoms only 20 percent of the time."

It should go without saying that economic incentives aren't a panacea for reaching global optima: Sometimes you end up in local optima, as in this case where the risk of doing research to potentially tap into the vast market of non-condom users may not be worth it. That's not to mention the systematic under-emphasis that economic incentives have on externalities, as in this case where the public health effects of more universal condom usage wouldn't all be captured by condom manufacturers.

I'm aware of all those things. But you're assuming that people are desperate to adopt something other than existing condoms, eg in Africa. They won't, on past form. Education efforts yield a better return than any putative new condom technology.

I'm not saying they're perfect, by any means. But when you get down to it, they're not hard to use and have a high success rate when used properly. Governments and aid agencies already substantially subsidize the distribution of condoms, which subsidies should easily be enough to offset the non-capture of positive externalities by manufacturers (as if the positive externality of repeat demand due to people living longer healthier lives were not sufficient incentive).

The biggest failure in managing the spread of AIDS in Africa has not been the ongoing deficiency of condoms but the apparently completely wasted expenditure of $1.3 billion in aid monies spent on promoting sexual abstinence instead of harm reduction over the last 15 years: http://www.nytimes.com/2015/02/27/health/american-hiv-battle...

We spent over a dollar on every person in Africa to tell them we don't think they should be having sex, in defiance of all the evidence about the inefficacy of such programs, so as to satisfy a small political faction of religious extremists who also support things like instituting the death penalty for homosexuality (https://www.academia.edu/1053858/Locating_Neocolonialism_Tra... ); meanwhile suspending other kinds of educational programs. And then we look at the low rates for condom use and we conclude that the deficiency is with the condoms? Please.

Could we and should we be working to improve condoms? Of course. Are such improvements subject to the law of diminishing returns? Also, of course. You're just not going to get paradigm shifting results through busywork, any more than you're going to get order-of-magnitude improvements in wheel design. A condom is always going to be basically an elastic tube that's closed on one end, just as a wheel is always going to be a circular structure that rotates around a central axle.

I feel for the guy in the article who got unlucky and contracted HIV, but when he's talking about people iterating on things like salt, pepper, and olive oil every year - no they're not. They market it slightly differently, the basic product has seen very little change in thousands of years - much like condoms. Unless we discover drugs that are cheap and have a broad-spectrum prophylactic effect against STDs and pregnancy, we have to be realistic about the prospect of small incremental improvements rather than great leaps forward in this area.

Thanks for the summary. One of these days I should hire someone to write summaries like this. More than a one-liner, simply all the stuff that is... interesting. I guess your definition of interesting and mine line up pretty well.

There is a company that pretty much does that, give them a try: https://www.blinkist.com/

"never use a long word when a short word will do"

"if it is possible to cut a word out, cut it out."

Highly recommended:

"Female Condoms"

http://www.plannedparenthood.org/learn/birth-control/female-...

Don't want to get into a bunch of inappropriate talk but suffice to say much better for both parties.

> Don't want to get into a bunch of inappropriate talk but suffice to say much better for both parties.

I'd encourage you to talk. The more people know about it, the more they will use effective contraception and the fewer HIV (and other STD) infections there will be. And people who read it from you will tell others. We're all adults here; I don't think it's inappropriate.

We're all adults here

Almost certainly not true.

From my experience there is no comparison to the feeling and sensitivity experienced when using this. Almost feels like nothing is there (or close to it).

Women don't seem to mind using it either (and it is actually marketed or was marketed at one point as women taking control).

All in all to me no comparison to a traditional condom for men. Edit: And after using it it's hard for me to understand why it's not more widely known. [2]

The only drawback is the cost, about $2 each at retail. [1] In theory it can be re-used as well since it's not stretchy but simply a large sheath like protection.

[1] Planned parenthood gives them and and sells them. If you are nice to them they will give you a bunch at no cost for a small donation. (Call it $5).

[2] My guess is that it lacks the marketing budget to take off. The local pharmacy used to carry them but then stopped for lack of demand which mystifies me given my personal experience. Not a new product by the way has been around for quite some time but as I said primarily distributed by PP and to women, not men.

>We're all adults here

And even if we aren't, kids have sex too!

http://www.xojane.com/sex/female-condom-test-review

"the female condom experience was definitely a letdown."

Contraceptive innovation is WAY behind other industries. Condoms are completely outdated, the pill really hasn't changed since the 1960s, the IUD since the '70s, the "new" implants are really just a minor evolution of the pill, etc. You'd think such a basic human need would be more of a priority.

My startup is helping to tackle this problem by trying to inform people that menstrual cycle data, on its own, can help prevent pregnancy with the same efficacy as hormonal contraception (and this isn't the rhythm method, despite the common misconception). While it doesn't prevent the spread of STIs like condoms, tech that replaces "modern" methods for women could change the industry.

We actually just released a marketing campaign for that exact purpose:

https://youtube.com/watch?v=3PzfJ4caalY

I'm really looking forward to the much-needed innovation in this industry.

> My startup is helping to tackle this problem by trying to inform people that menstrual cycle data, on its own, can help prevent pregnancy with the same efficacy as hormonal contraception (and this isn't the rhythm method, despite the common misconception).

I think you should be very careful with making unqualified statements like that. If it isn't the rhythm method then you should explain exactly what it is because the 'common misconception' requiring you to distance yourself from the rhythm method before someone even brings it up is alive and kicking and it is up to you to provide the evidence that it isn't so by explaining how it does work.

Your marketing video certainly does nothing to clarify, and the app description on your website screams 'rhythm method in an app' from every page.

Noted.

If you read our "App" page, you would have seen 'sympto-thermal method of fertility awareness' mentioned at least once. Check out "Learn" for a literal book's worth of information (complete with references) about how this works. We've taken an approach of trying to ease people into this, but maybe that hasn't come across in this instance.

How would you suggest we introduce the topic without scaring people off with such scientifically dense-sounding terms as "sympto-thermal method"? Is anything we can say going to be believable to our target customer off the bat?

> sympto-thermal method of fertility awareness

You're going to run smack into the wall of terminology here.

The 'rhythm method' or 'calender method' was a Rome sanctioned family planning method whose only ingredient was a calendar. The fact that it had a spectacular failure rate as an anti-conceptive method must not have been lost on the promotors.

But since a calendar is part of pretty much any fertility/anti-conception scheme you'd do well to highlight the differences rather than the similarities with the rhythm method.

Using clever marketing words isn't going to work here, just stick to the cold hard facts and assume that the women and men you're trying to address here don't need to be talked down to but are perfectly capable of understanding what you're trying to say if you are un-ambiguous and direct about it.

You're talking about people that are having intercourse, the least you could do is treat them as the adults they think they are.

Historically plenty of couples that used the rhythm method added a thermometer or other symptoms to increase reliability complicating your quest for proper terminology even further.

Arguably, people since Roman times have been bred for calendar-incompetence. Those that have a hard time operating a calendar, had more children.

I work for another startup in the same space. (Hi from Clue!)

> You're talking about people that are having intercourse, the least you could do is treat them as the adults they think they are.

That's pretty much exactly the point here though, no? I think we all agree it's reckless/irresponsible to make any decision without being adequately informed. All these apps can do is tell you "hey, we need more data from you if you want us to be accurate". Scientific terms don't need to be bandied about, but they can be tucked into KB/FAQ pages if people really want to delve. It simply becomes a UX issue at that point - driving people into regularly entering necessary information for accurate insights.

Our product tries to be very matter-of-fact, and treat our users with dignity and respect. Viva adulthood!

> You're talking about people that are having intercourse, the least you could do is treat them as the adults they think they are.

My intention definitely wasn't to imply that you're not an adult, so apologies if what I said offended you. My statement was simply based on hundreds of conversations I've had with individuals who immediately jump to asking "Isn't that the rhythm method?" when I explain our concept using direct, accurate, and scientific terminology.

We are, however, incredibly direct with our users.

Point taken, though.

From a contraception purpose exclusively, there's always RISUG AKA Vasalgel that's under clinical trials now. http://en.wikipedia.org/wiki/Reversible_inhibition_of_sperm_...

I'd probably worry less about this if PrEP were cheap enough to get without insurance (or wealth). The odds of finding a monogomous (or at least polyfidelitous) partner around here is slim, and I'm not too keen on taking my chances with Grindr. A better condom would alleviate a lot of worries.

Doesn't PrEP have serious side-effects?

Currently. I'm sure things will improve as existing drugs are improved and new ones are invented.

About $15,000 a year for someone to pay. Insurance companies resist expensive drugs not used to treat an existing disease.

Seems to be readily available under medicaid. But you have to keep you income under $15K or ($10K in non-Obamacare states) to qualify.

That's actually not true. Insurance companies, such as Kaiser Permanente, see a few years of PrEP during a patients active sexual years favorable to treating HIV for life. I have a few friends that are on Prep and have private insurance and have not had any difficulty acquiring the prescription.

Some yes.

Kidney failure in a small set of patients. Typically urine/blood samples are taken for the first few months to check for this. There's some evidence of bone degradation in long term use (think 10+ years) but its mitigated with regular strength exercises. Beyond that not much else the formula has been altered a few times to make it pretty safe to take regularly.

Some people experience gastrointestinal distress from it but that usually passes after a month. If it doesn't they usually just stop taking it.

All of the side effects stop if you stop taking it.

Because I had no idea what PrEP is. This might help, http://www.cdc.gov/hiv/basics/prep.html

I recommend this company: https://thisisl.com/

You buy one, they give one away model. They also use less toxic ingredients in general.

Thanks for this link. These look great, and I've never heard of them.

I could only imagine the positive impact a noticeable increase in condom usage would bring to the world. I feel like it would be a silent yet very beneficial change if condom usage went up about 10% globally.

Let's start with making them free. Are the medical/abortion costs really lower than providing everyone with unlimited plastic with a little lotion on it?

Some condoms should be free. But since the point of TFA is that innovation is slow, it seems good for better condoms (as judged by consumers) to cost more. That way condom manufacturers have an incentive to make better condoms.

I'm from Québec (Canada) and you can easily find free condoms at your Local Community Services Centre or any anti-aids/healthcare organization. But, I'm not exactly sure that it helped to reduce AIDS transmission or the number of abortions (if we look at the numbers they have increased in past years), but there's a lot more to take into account than condoms usage alone. Still, I completely agree with you that it should be free. I'm curious, are we alone in this world to give free condoms or it's a common practice?

You can get free condoms just about everywhere (including the United States). The problem is that you get them free from your local family-planning clinic, or community centre, etc.

People who are at risk for having unprotected sex probably need the condoms to be easily available (i.e free in high-schools, free in bars/nightclubs, etc.). If they have enough forethought in order to make a trip to one of the places where they are free, they probably have enough forethought to buy them themselves without problems.

In Vancouver they get handed out on the Granville Street strip by some crazy lady with a bucket full of them, as well as being freely available many other places.

Opposition to contraceptive availability by right-wingers doesn't take into account the higher cost of not providing these services because that isn't as important as their moral crusade. Rather, it's about punishing and shaming people who engage in what they view as immoral behavior and controlling women's bodies, which is why you also see laws banning female sex toys alongside anti-sex ed and anti-contraception legislation.

There's tons of places in most major cities that give away condoms for free. When I was in my freshman year of college, the main study room for a program I was in had a big bowl of free condoms by the exit.

There've been many people in this thread suggesting that condoms ARE already free, if you go and seek them out. It is like saying food is free when you go out of your way to select places. You'd have to know where to go and then be comfortable in grabbing a dozen free condoms there. Until you're out two weeks later. So a bi-weekly visit to your favorite free-condom location. Do you know anyone who actually does this? It makes for a great comedy sketch :)

Besides, I don't want to use condoms that came from a bowl at a public place. I remember the first time I bought a bunch of condoms at a young age, not only was it terribly embarrassing and expensive at that time (I wasn't working, try explaining to your parents you need money for sex), it wasn't fun hiding them from my parents either.

I imagine this is a bigger problem for women - imagine a mother finds a dozen condoms in her 15 year old's purse.

I do see your point regarding places that someone would go to explicitly for condoms - but the big bowl was in the study room for a college program. Almost all the people in the program were there everyday condoms or not - so maybe the solution is to put them in places where people already frequent?

School/work/etc.

Because I do agree that not many people are going to make a trip to Planned Parenthood, park, and go in just to get some free condoms.

I don't see a problem with condoms from a public bowl. I used them throughout my freshman year without a problem. As for your embarrassment factor, that's a problem regardless of free or paid. That's just the stigma around sexual activity in general.

Agreed. It seems to me that the problem is that it is easy to get condoms for free/cheap in many places in western countries.

However, my experience living in Chile is that in countries that often need it more, they are much more expensive to get. In Chile, they were roughly twice as expensive as in my home country Belgium. Add in the big difference in wages and we're at approx. 4x difference. The argument that they are available for free is a joke, since it requires people to go to a doctor instead of simply a pharmacy.

I also believe that for many people, the difference between cheap and free is a big one.

If a person cannot find free condoms in the US, there is a serious problem with that person's searching. The government gave out a ton grant money that was to be spent on free condom dispensers (oddly multi-colored from one vendor). States and public health clinics will give them free in various programs.

And let's not forget the machines in a huge number of gas station rest rooms across the country. Most of them are $0.75.

If a person cannot find free or ultra-cheap condoms today, the person really is not trying and probably should be doing other things.

Also, as many of the folks at work discovered, the free contraceptives were accompanied with a larger than cost increase in premiums.

The people who need condoms the most, are the ones least likely to go looking. If a condom is not around, 'ah baby come on I'll just pull out.' And then when there's a baby on the way and they're both 16 or can't afford an abortion etc etc, oops. Now we have a teenage mother and a father who doesn't want to be one.

We can go around hand-waving and saying how irresponsible people are, or we can recognize how people are, were and will be and make sure they don't accidentally reproduce for no good reason.

We know how, we just need to stop expecting people to be other than they already are for a minute and start a world-wide free-condoms campaign. Where's Bill Gates, make it happen! :)

Because you know who's supporting that single mother and all the difficulty that ensues? You and I, with our tax dollars and otherwise.

"The people who need condoms the most, are the ones least likely to go looking."

That is the problem that condom availability will not fix. The only system solutions are pushing girls into sports and other extra curricular activities, and getting more male teachers in elementary schools to provide proper role models. I'm well away from my desk so I don't have the study references, but both help in this regard.

but they are already pretty much free and easy to get. do we have to put them on for everyone too? do you want to just mail a package to every person in the world once a month? I mean, what is your solution to make people actually use them. They are already free!

Japan has had polyurethane condoms as standard for at least 15 years (indeed there is the stereotype of foreigners stocking up on latex ones whenever they go home).

Polyurethane is definitely superior in many regards, but they are less stretchy than latex and if you're not used to them they can be a little frustrating.

What I'd really like to see is research on a a male version of The Pill. The Pill was introduced in the 1960s. What efforts, research, has been done to bring a similar product for males?

Though it wouldn't help on the disease transmission front.

Here it is. Very cool:

http://www.newmalecontraception.org/vasalgel/

I've always wondered why you can't dip a penis into liquid latex or a similar compound. Perfect fit, won't slip off (presumably?), probably harder to break. Getting it off without lots of screaming might be tricky...

I wondered if a temporary glue could fix a thin flexible tube in the urethra, containing a carefully folded sealed bag. Full sensitivity, no cum.

An article on ebola said that the condom provides 95% protection per use. i.e. a 5% chance of infection anyway each time they are used.

That's basically worthless because after 13 uses there is a 50/50 chance of infecting someone.

They are more effective with HIV only because HIV is not as infective, not because the condom is more effective.

So the problem with the condom is not the design, but that they are not as effective as people think. Couples using them consistently every time still have a good lifetime chance of transmitting HIV if their partner is infected.

"That's basically worthless because after 13 uses there is a 50/50 chance of infecting someone."

Well, there's 50/50 chance of not infecting anybody vs infecting at least one person from 13. That's a much better chance than say 50% chance of infecting at least 10 person from 13. When you are thinking about spreading a disease, this matters a lot. Sure, for couples, the chances of infection after N use is high, but that's not the only use case. (E.g. one night stands.)

You are forgetting that people change behavior based on risk.

Telling someone there is a tool to reduce risk, that doesn't actually reduce risk (enough), actually makes things much much worse.

Yes, they do change, you're right. However, if it comes to sex, people do not care that much about risks.

Condom usage decreases the prevalence and spread of STDs. That is a very hard fact. Therefore I guess that in this specific case increased risk taking does not offset the advantages of decreased risk. (Same seems to be true for things like airbags or seat belts in cars. You could not possibly argue that we should remove these from cars because we end up with more fatalities with them as it is simply not the case.)

Many have argued that airbags actually increase auto-related fatalities through the so-called 'Peltzman effect' (also known as 'risk compensation'), and that removing airbags from vehicles would cause automobile fatalities to decrease or remain constant.[1][2][3]

I am no aware of the state of the debate of this effect on condoms or STIs/STDs.

[1] http://en.wikipedia.org/wiki/Risk_compensation

[2] http://www.econtalk.org/archives/2006/11/peltzman_on_reg.htm...

[3] https://news.uns.purdue.edu/html4ever/2006/060927ManneringOf...

The condom reduces HIV infection risk by 80% to 95%, depending on the type of intercourse and the direction of infection (M/F->M,F). Since the rate of infection for unprotected sex is in the order of 0.5 per thousand, a 95% reduction brings the infection rate to 1 per 30 thousand. Your numbers are off.

Reference:http://www.catie.ca/en/pif/summer-2012/putting-number-it-ris...

People aren't infectious with Ebola for very long before either becoming extremely ill (and likely not up to having sex). If you're reducing the number of sex-related Ebola transmissions in a population by encouraging condom use, I think that's a pretty good thing.

At any rate, HIV is a much much larger virus than Ebola, and cannot get through micropores in the condom as easily. This contributes to the high rate of transmission prevention.

Actually people appear to be infective sexually even 90 days after getting (otherwise) better.

So far no upper limit is known.

Many reasons that hinder condom usage can never be fixed, even with free, plentiful, good feeling condoms:

The ability to go from foreplay to sex without stopping

The ability to switch between oral and penetrative sex

A while back (2013?), the Bill & Melinda Gates Foundation offered financing for a "next generation" condom.

I can't find the link on the Gates Foundation site now (dead links on Google) but this is some press around it and mentions the 11 finalists:

http://theweek.com/articles/455793/meet-11-condoms-future-se...

So I guess better condoms are in the works already?

the article follows one of the funded parties

I would also add that the reason that nobody has developed a better condom is that there is no profit in doing so.

At a minimum you are looking at a couple of million in research, more if you want to go crazy with material science. Then you have the cost of testing, approval etc. After that you have marketing. It's a great project that will save many lives but the cost/risk analysis alone would put off any for profit organization.

The fact that the Gates Foundation is having to get involved is a sign that the market simply isn't going to solve this one.

(Government research probably won't deliver it either, at least in the US, due to the politics around contraception)

The "no profit" statement made me curious. First link I found

http://www.companiesandmarkets.com/MarketInsight/Consumer-Go...

claims that "The global condom industry has been forecast to hit a market value of US$5.4 billion by 2018". If you have the material science worked out you're mass producing a few grams of latex, selling to non-price sensitive customers, and can even market it as an "entertainment product" as the article states.

What a ridiculous and false assertion-- all you've demonstrated is that there are costs of entering the market.

That says nothing about the potentially enormous profits to be made if your redesigned condom beats the competition and becomes a new consumer favorite. Condoms are purchased by people in a wide age range, income bracket, geographic location, etc. Even a small percentage of the total market would be an enormous amount of money.

You might as well have said that Tesla Motors was a terrible idea, arguing that there's no money to be made in automobiles because of all the upfront costs of designing cars, building factories, and obtaining regulatory permission.

In fact, the entire point of starting any business is to overcome upfront costs by seeking long-term profits.

This article seems to ignore cost. I think a pretty fundamental benefit of a simple latex condom is how cheap it is.

We do. It's called abstinence. Works every time.

http://quotesjunk.com/wp-content/uploads/2014/07/abstinence-...

It must be a sad life...

Here is a folow-up article that trashes Danny Resnic, the CEO of Origami Condoms.

If you want to try out a similar condom that is the best one out there in my opinion, check out nakedcondoms.com

Just love the pictures.

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