Nonlatex Condoms Have Higher Breakage Rates
While nonlatex polyurethane condoms have higher breakage rates than latex condoms, they provide an "acceptable alternative" for persons who cannot or will not use latex condoms, researchers conclude in a review of clinical studies.
"Even though the eZ.on condom did not perform as well as its comparison latex condom in terms of preventing pregnancy, the Avanti and the Standard Tactylon had pregnancy rates similar to their latex comparisons (and) substantial proportions of study participants reported preferences for the nonlatex condoms," said Maria F. Gallo, Ph.D., lead study author.
However, a health behavior expert not involved with the review said that pregnancy prevention and safety from sexually transmitted infections should be the primary concern of most condom users.
"It is unclear why (nonlatex condoms) would be endorsed for use with anyone other than those individuals with allergies or sensitivities to latex who are in a committed relationship," said Diane Grimley, Ph.D., chair of the Department of Health Behavior at the University of Alabama in Birmingham.
The review appears in the most recent issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.
The investigators analyzed 11 trials that recruited 3,957 sexually active, adult couples (age 18 or older) who were in monogamous, heterosexual relationships and not at risk for sexually transmitted diseases. Nine trials were conducted in the United States, one in the United Kingdom and one in France.
The review compares nonlatex condoms to latex condoms in terms of contraceptive efficacy, breakage and slippage, safety, and user preferences.
The reviewers report that nonlatex condoms showed statistically significantly higher rates of breakage than latex condoms during intercourse or withdrawal. However, significant proportions of trial subjects preferred nonlatex condoms and indicated that they would recommend them to others.
Lead researcher Gallo was previously employed by Family Health International, a nonprofit international health organization. Family Health International developed the eZ.on condom and sold the manufacturing and distribution rights to Mayer Laboratories. The three other review authors are employed as scientists at Family Health International.
The Avanti condom is manufactured by Schmidt Laboratories and the Standard Tactylon condom is manufactured by Sensicon Corporation. The three nonlatex condoms are made of polyurethane, a thin, strong material that is an effective conductor of body heat, preserving pleasure in sexual contact.
The breakage rate for nonlatex condoms was up to five times higher than for latex condoms. Still, the reviewers conclude that condoms made of the new materials provide an acceptable alternative for individuals with allergies, sensitivities or personal preferences that might prevent the consistent use of latex condoms.
Latex allergies affect about 1 percent of the population.
In the three studies that looked at pregnancy outcomes, the Avanti had a 4.1 percent pregnancy rate compared with 6.2 percent for the latex Ramses Sensitol; the Standard Tactylon had a 10.8 percent rate compared with 7.9 percent for LifeStyles/Trojan-Enz; and the eZ.on had a 9 percent rate compared with 5.4 percent for the Kimono Select.
Disease control was not evaluated, and the authors emphasize that the trials under review were limited to those studying the use of nonlatex condoms during vaginal intercourse to prevent pregnancies. "The ability of the nonlatex condoms to protect against the transmission of HIV or other sexually transmitted infections (STIs) has not been established," they say.
"Given that the nonlatex male condom has a higher frequency of breakage and slippage, this suggests that this type of condom offers less protection from sexually transmitted infections than does the latex condom," Grimley said.
"There are a number of concerns raised by the sample included in the study and with the authors' overall conclusions," Grimley said. "Moreover, I am extremely troubled by the message that is being sent out, which has the potential to be misconstrued among sexually active individuals, particularly adolescents."
Young people ages 15 to 19 are at highest risk for both unintended pregnancies and STIs, according to Grimley.
"There is great concern that nonlatex condoms be marketed to any one based on their 'personal preferences,'" Grimley said. "Yes, sex feels better with a nonlatex condom. However, for sexually active individuals who are not in the ideal, heterosexual situation (as the participants in the studies reviewed), their personal preferences should be to use latex condoms to protect themselves from unintended pregnancy and STIs."