What constitutes responsible sex education? What should it look like? It’s an ongoing debate, but one thing all sides at least pay lip service to is the idea that that the information we give to young people in schools should be based on scientific evidence.
So why are some key facts about condom effectiveness being left out of the debate?
Chastity groups like Pure In Heart have recently gotten a lot of grief for suggesting that “condoms have a one-in-six failure rate”. Those in favour of teaching kids about “safe sex” tend to respond that in fact, condoms are 98% effective at preventing pregnancy.
The thing is, both these claims are, to some extent, true, but only one actually describes the world as it is now. Confused? Let’s unpack the statistics.
According to the Federal Centre for Disease Control (CDC) in the US:
(Family planning) effectiveness can be measured during “perfect use,” when the method is used correctly and consistently as directed, or during “typical use,” which is how effective the method is during actual use (including inconsistent and incorrect use).… For each method of birth control, effectiveness with typical use is provided below. We present this as the percent of women who experience an unintended pregnancy within the first year of typical use (also known as the failure rate).
In other words, effectiveness rates with “perfect use” describe what would happen if everyone always used contraceptive methods correctly. Effectiveness rates with “typical use” describe what actually happens. The percentage of women who get pregnant after a year of using a particular contraceptive method is known as the method’s “failure rate.”
Let’s go back to the CDC again and look at the failure rates for condoms [1]. With perfect use, they have a 2% failure rate. With typical use, that figure rises to 18% – yes, more than one in six.
It’s not just the US, either. According to patient.co.uk, a British health website [2] that adheres to the NHS’s certification programme The Information Standard [3]:
‘About 2 women in 100 will become pregnant each year if condoms are used perfectly for contraception. Nearer to 20 women in 100 will become pregnant with normal (not perfect) usage.’
Even Planned Parenthood, one of the biggest advocates for “safe sex” contraceptive education in the world, has the following passage in their interestingly-titled document The Truth About Condoms:
Of 100 women whose partners use condoms inconsistently or imperfectly, 18 will become pregnant in the first year of use. Only two will become pregnant if condoms are used perfectly.
Perhaps unsurprisingly, they forget to mention that the “used inconsistently or imperfectly” rate is in fact the normal rate.
So what does all this mean? It means that any programme of sex education that doesn’t mention typical failure rates for condoms is irresponsibly ignoring the evidence – and it means that if Pure In Heart made the “one in six” claim about contraceptive failure rates, then they were right.
Of course, those who want “safe sex” education will argue that we can simply teach teenagers to use condoms more effectively. I have a very simple question: how?
Considering the link between teenage sex and alcohol, are we to educate students on correctly putting on condoms while drunk or when aroused? And, how, precisisely, would you do that in a classroom setting?
But it is precisely these factors – the influence of alcohol, the fact that most people about to use a condom have other things on their mind – that lead to high “typical use” failure rates. I’m not sure how education programmes short of the absurd kind I’ve suggested could get around these. Just look at Britain, where the contraception-based model of sex education has been much more widespread than in Ireland. Their teenage pregnancy rates are much higher than ours [4].
But let’s assume, for a moment, that the contraceptive-based model could work – that students could be taught to use condoms perfectly. In that case, if we’re trying to change behaviour already, why not educate young people with a view to them delaying having sex [5]? Why not teach them that the best context in which to have it is that of a lifelong, committed relationship?
Because that would look an awful lot like what Pure In Heart already do.