Thursday, February 23, 2012
We're spending billions to develop an HIV vaccine. Why not also focus on building a better condom?
Imagine you're trying to hook up with a date, and he whips out a circa-1999 cellphone. Date over.
Now imagine the evening is going well — really well — and your companion whips out a circa-1799 condom. Date normal.
Condoms, the medical contemporaries of bloodletting and leeches, have not been significantly improved since the 1800s, when rubber first replaced the then-standard animal intestines, which were an upgrade from leather.
Condoms suck. Having to put a tight, sensation-stealing plastic trash bag over your johnson during sex sucks. And yes, sexually transmitted infections suck, too, but not badly enough, apparently, even with the threat of serious illness and death, to get everyone to use condoms every time. Admit it: You don't use a condom every time.
Even doctors don't use condoms every time. A conversation with a USC professor of medicine provoked a hush-hush confession that at least a dozen fellow physicians suffered from sexually transmitted infections — HIV, genital herpes, the gamut. Such infections may be more common in less educated populations, but they're far from nonexistent in academia. If doctors, who have seen firsthand the ravages of such infections, can't reliably use condoms, what hope is there for the rest of humanity?
It's easy to blame the risk takers among us, to dismiss them as impulsive, impoverished and uneducated, but condoms suck whether or not you've got an advanced degree. It's time to look for another place to put the blame.
And it's not with the manufacturers. Condoms are a high-volume, low-cost product, so the businesses that produce them, understandably, put money into distribution, not innovation. They might tinker with shapes, adding "pleasure ribs" or even minivibrators, but game-changing innovation takes a wad of cash that condom makers just don't have.
Take Carter-Wallace, the New York–based company that owned the premier condom brand Trojan for decades. When Carter-Wallace sold its consumer division in 2001, it was worth just $739 million — and that included not just Trojan but also Arrid deodorant and other brands.
Contrast that with the number of Benjamins we've thrown at developing an HIV prevention vaccine: $682 million in 2004 alone, according to a 2005 study funded in part by the Joint United Nations Programme on HIV/AIDS. A huge chunk of that funding — 88 percent — came from the public sector, with the United States kicking in $2.5 billion from 2000 to 2005. Wealthy donors also have been motivated to help: Bill Gates alone has contributed $4.5 billion to vaccines. None of that money went to condom tech.
Yet, although we've been chasing an HIV-prevention vaccine since 1984, we've still got nothing to show for it. Imagine how far those same hundreds of millions could go toward the development of a better-feeling condom — a condom people would actually wear.
After all, there is one area in which condoms don't suck: They prevent sexually transmitted infections. To date, we haven't even found a vaccine to prevent one of the many strains of HIV. Even if an omnipotent AIDS vaccine were developed, it would still leave untouched syphilis, gonorrhea, chlamydia and every other sexually transmitted infection. Compare that to the simplicity of the one-size-fits-all-diseases barrier method: the simple condom.
Chasing a vaccine has so far been a losing game. But a great-feeling condom could be an epic win.
Here's the dirty little secret of condoms: They actually were meant to suck. In 1877, a medical study of syphilis prevention described condoms as "the least bad system, and so much the better if a condom is more likely to inspire disgust than provoke desire. The number of couplings, and consequently of cases of [infection], will thereby be reduced." In other words, if condoms suck badly enough, maybe people will get so turned off that they won't have sex anymore.
Yeah, that's worked really well.
That mindset still exists today: Abstinence is touted as the best solution to sexually transmitted infections, and condoms are just a stopgap for the weak-willed. Although progressive thinkers don't believe that drivel, they haven't done much to change it.
Think of the problems we've solved in the last half-century alone — problems we didn't even know we had. The problem of not being able to carry your entire record collection in your pocket. The problem of not having a giant inflatable pillow pop out of your steering wheel in a crash. The problem of not having a video camera with you at all times. Why are more people not pissed off about the problem of how much condoms suck?
Go ahead, minimize the importance of that "little bit" of lost sensation all you want, but remember: On a daily basis, millions of people risk their health, and their lives, to bridge the pleasure gap inherent in condoms. Human beings are wired for sexual pleasure. To dismiss the critical nature of that pleasure is to dismiss the circuitry that ensures the survival of the species. Why sacrifice sexual pleasure on the altar of inertia? It's literally a matter of life and death.
There have been enormous benefits from antiretroviral therapy, including pre-exposure protection to HIV. Countless lives depend upon that, and we must continue efforts to develop an HIV-prevention vaccine, to implement widespread male circumcision, and to do everything we can to stop the spread of AIDS. But those efforts also must include putting a new, improved, kick-ass condom on the same biomedical fast track as the other stuff.
Feeling glad that you don't live in the days of leather condoms? Quit feeling smug and start imagining a future in which you feel grateful to have escaped the days of wired phones, compact discs and latex condoms. There's too much complacency around the suckiness of this Stone Age bullshit. Where is our Steve Jobs of condoms? Where is our visionary, who sees a way out of this rubber prison?