Abstinence, Condoms, and Safe Sex--Sorting Out the Confusion

The recent launch of CDC s Prevention Marketing Initiative (PMI) and, especially, the airing of its new public service announcements have generated a flurry of public comments, most revolving around the abstinence versus condoms issue. Both messages are incorporated in the PMI repertoire because both are critically important strategies for preventing HIV infection.

But what IS abstinence?

CDC s prevention messages encourage abstinence, but studies have shown that the term means different things to different people. For some people, abstinence means voluntarily refraining from all sexual acts, and is often grounded in moral or religious beliefs. For HIV prevention and other public health purposes, abstinence may be defined as refraining from practicing sexual activities that involve vaginal, anal, or oral intercourse.

Delaying the initiation of sexual activity, or practicing abstinence during adolescence, is a valuable health behavior for young people. It also prevents unintended pregnancy and the transmission of other sexually transmitted diseases (STDs), many of which can have severe or permanent side effects. (Many people are not aware of the extent and number of STDs in the United States--in addition to gonorrhea, syphilis, and herpes, other serious infections are widespread in the general population, such as chlamydia, human papillomavirus [genital warts], trichomonas, and hepatitis B.)

Abstaining from sexual activity is a 100 percent effective method of avoiding sexually transmitted infections. For most people, however, abstinence is not a lifelong goal, but a temporary, reasonable, and healthy strategy to adopt during certain periods of one's lifetime, e.g., during the emotionally vulnerable adolescent period or between marriages.

Having sexual intercourse with only one uninfected (and faithful) partner is equally as effective as abstinence, but is effective only if it is practiced consistently by both partners in the relationship. (Having a series of monogamous relationships is not a safe prevention strategy.)

To be sure that a person is not infected with HIV, two separate HIV-antibody test results, 6 months apart, should be obtained after any behavior that might have resulted in HIV infection. If the second test is negative 6 months after engaging in the risky behavior, that person can be reasonably certain that HIV infection is not present.

What exactly is risky sexual behavior?

Any activity that would allow the exchange of body fluids (semen, vaginal secretions, or blood) could result in the transmission of HIV if one of the partners is infected. This means that all penetrative sexual intercourse (vaginal, oral, or anal) is risky if latex condoms are not used, or are not used correctly. Having anal intercourse presents an increased risk for both homosexual men and heterosexual women. Most heterosexual transmission occurs through vaginal intercourse, and oral intercourse has also been reported to transmit HIV.

Kissing generally does not present a risk, but because of the theoretical risk of HIV transmission through blood that might be present in the mouth, CDC does not recommend engaging in deep (French) kissing with an infected person, or a person whose infection status is unknown.

What about Safe Sex?

Using a latex condom correctly and consistently (i.e., for each and every act of intercourse) provides a very high degree of protection. To request a free brochure on the correct way to use a condom, call the CDC National AIDS Hotline at 1-800-342-AIDS 2437).

Making Responsible Choices

Sexually transmitted diseases, including HIV infection, are preventable. Individuals have several responsible prevention strategies to choose from, but the effectiveness of each one depends largely on using it consistently (every time). Those who practice abstinence will find it effective only if they consistently abstain. Similarly, those who choose any of the other recommended prevention strategies, including using condoms, will find them highly effective only if used correctly and practiced consistently.

(CDC HIV/AIDS Prevention. Summer 1994. DISTRIBUTED BY GENA/aegis (714.248.2836 * 8N1/Full Duplex). SOURCE: Department of Health and Human Services.)