Condoms do protect against HIV

Dear Dr. Roach: I read that condoms have tiny holes in them, and that they don’t provide protection against HIV/AIDS. Is this true? — G.D.M.

Condoms do have tiny holes in them if magnified enough; however, latex condoms are effective at preventing HIV transmission, both measured in a laboratory as well as in clinical studies. In couples who use condoms 100 percent of the time, HIV transmission is reduced by at least 90 to 95 percent.

Another way of reducing transmission is by pre-exposure prophylaxis. This involves taking a medication in order to prevent infection. In people who took the medication as directed, there was a 96 percent reduction in HIV transmission. The combination of pre-exposure prophylaxis and condoms provides an even greater reduction in risk. Condoms also provide protection against other possible sexually transmitted infections. Post-exposure prophylaxis is appropriate for someone who had condomless sexual intercourse with a person potentially infected with HIV or who had a needlestick from a person known or suspected to have HIV.

Another way of reducing HIV transmission is to treat the person who is infected. With effective treatment, most people with HIV can achieve no detectable virus in the blood. With no detectable virus in the blood, the risk for infection becomes very, very low, with more than 99 percent effectiveness at preventing transmission. This is partly why it’s so important to identify and treat everyone with HIV as early as possible. The Centers for Disease Control and Prevention recommends routine testing for everyone, and I agree.

Finally, people can reduce HIV transmission by abstinence — that is, not having sex and not sharing needles or other devices that can transmit blood.