Cum hastis sic clypeatis: the turbulent history of the condom.

Abstract

The recommendation of the surgeon general of the US Public Health Service that individuals use the condom to prevent the risks of human immunodeficiency virus (HIV) infection and transmission has been poorly received. Many oppose it on the basis of the perception that condoms would promote continued sexual activity when the solution to Acquired Immune Deficiency Syndrome (AIDS) is to discourage such activity. Others raise questions about the efficacy of condoms in preventing HIV infection. Further, many advertisers are unwilling to promote a product about which they perceive disapproval on the part of large segments of the public. On the basis of the dire consequences of HIV infection and the absence of any effective treatment, it is difficult to rationalize this resistance. A historical analysis of condom use as a means of preventing sexually transmitted infections offers some insights into this apparent paradox. The 1st published description of the condom as an aid to the prevention of venereal infection appeared in "De Morbo Gallico," published in 1564. The use of "a small linen cloth made to fit the glans" was advised as a protection against syphilis. Condoms were advertised during the 18th century, usually by handbill. The medical community's reluctance to promote condoms as prophylactics was due to the fact that 18th century condoms were far inferior to modern varieties. Yet, beyond the issue of efficacy, other factors shaped medical thinking about condom use to prevent sexually transmitted infections. Most significant was the prominent association between condoms and sexual encounters outside marriage. Most 18th century references to condoms describe their utilization in the context of prostitution. The association of condoms with sexual intemperance, along with concerns about their efficacy, helped to support the idea that abstinence was the only acceptable prophylaxis for sexually transmitted disease. It was the exigencies of World War II that brought about the 1st, largescale systematic promotion of condoms to prevent venereal disease. Condom quality was much improved, yet the promotion was not without criticism. On the basis of historical precedent, one can expect negative reactions to accompany the recommendation that condoms be used to prevent transmission of HIV infection, yet it is important to recognize the contribution condoms can make and to separate their ability to prevent disease from their often turbulent past.

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