"The infected spouse who wears a condom, and then goes about a "normal" sex life might as well take a shotgun to their "beloved's" head. <[> "Condoms have efficacy rates of about 95% in preventing pregnancy, but much lower in preventing HIV. And studies suggest only 50% of those who use condoms do so faithfully and correctly. Still, suppose the efficacy rate for preventing HIV transmission was 99%, including 100% "success rate" in properly wearing the condom. What would that mean?
"Well, for someone having several one-night stands and very-short-term relationships, that'd probably work. The condom would allow a person to have 100 times more sex partners with the same chance of catching AIDS as someone who didn't. Again, of course, condoms are not nearly this effective, but we're just being hypothetical.
"Now, suppose someone has a perfectly monogamous relationship with an HIV-infected spouse. Maybe they have intercourse maybe four times a month... hardly an excessive sex life! But here's the problem: Every instance of intercourse is another chance to become infected. So in just one year, there is a FORTY PERCENT CHANCE (.99^100) that the HIV+ person will expose their spouse to AIDS. And that's with 99% effectiveness for the condom, there is a 99.99% chance that the spouse will become exposed to AIDS. (Mrs. Don-o added emphasis/)
"And it's really worse than that. Not only are condoms WAAAAAAYYYYY less than 99% effective, but, believe it or not, monogamous sex with an HIV+ person is WORSE than promiscuous sex with many HIV+ people:
"The truth is that exposure does not mean that a person contracts the AIDS virus. But repeated sex with the same person means that the same regions experience repeated wear and tear. OK, it's an ugly choice of words, but it's the truth. And, well, it's the places that experience wear and tear that are where AIDS transmissions are most likely to occur."
Well stated, dangus. Return volley, retMD?
Sure.
So in just one year, there is a FORTY PERCENT CHANCE (.99^100) that the HIV+ person will expose their spouse to AIDS. And that's with 99% effectiveness for the condom, there is a 99.99% chance that the spouse will become exposed to AIDS.
First is the difference between being exposed and being infected. HIV (fortunately for the spouses involved) is not as infective as some viruses, such as hepatitis B. Exposure doesn't always result in transmission even with Hep B, and transmission is much less with AIDS. On a quick search, I found this abstract from the well-regarded Cochrane database comparing those who said they "always used condoms" and those who "never used condoms":
"There were 13 cohorts of "always" users that yielded an homogeneous HIV incidence estimate of 1.14 [95% C.I.:.56, 2.04] per 100 person-years. There were 10 cohorts of "never" users that appeared to be heterogeneous. The studies with the longest follow-up time, consisting mainly of studies of partners of hemophiliac and transfusion patients, yielded an HIV incidence estimate of 5.75 [95% C.I.: 3.16, 9.66] per 100 person-years." (emphasis added).
Aside from statistics and the "lesser of two evils" theologians may be contemplating, what sensible person would risk having sex with a spouse who has AIDS or is HIV positive? For me, it is just that simple.