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 A condom is a device most commonly used during sexual intercourse. It is put on a man's erect penis and physically blocks ejaculated semen from entering the body of a sexual partner. Condoms are used to prevent pregnancy and transmission of sexually transmitted diseases (STDs—such as gonorrhea, syphilis, and HIV). Because condoms are waterproof, elastic, and durable, they are also used in a variety of secondary applications. These range from creating waterproof microphones to protecting rifle barrels from clogging.

In the modern age, condoms are most often made from latex, but some are made from other materials such as polyurethane, or lamb intestine. A female condom is also available, most often made of polyurethane. As a method of contraception, male condoms have the advantage of being inexpensive, easy to use, having few side-effects, and of offering protection against sexually transmitted diseases. With proper knowledge and application technique—and use at every act of intercourse—users of male condoms experience a 2% per-year pregnancy rate.

Condoms have been used for at least 400 years. Since the nineteenth century, they have been one of the most popular methods of contraception in the world. While widely accepted in modern times, condoms have generated some controversy. Improper disposal of condoms contributes to litter problems, and the Roman Catholic Church generally opposes condom use

Before the 19th century

Whether condoms were used in ancient civilizations is debated by archaeologists and historians. In ancient Egypt, Greece, and Rome, pregnancy prevention was generally seen as a woman's responsibility, and the only well documented contraception methods were female-controlled devices. In Asia before the fifteenth century, some use of glans condoms (devices covering only the head of the penis) is recorded. Condoms seem to have been used for contraception, and to have been known only by members of the upper classes. In China, glans condoms may have been made of oiled silk paper, or of lamb intestines. In Japan, they were made of tortoise shell or animal horn.

In 16th century Italy, Gabriele Falloppio wrote a treatise on syphilis. The earliest documented strain of syphilis, first appearing in a 1490s outbreak, caused severe symptoms and often death within a few months of contracting the disease. Fallopio's treatise is the earliest uncontested description of condom use: it describes linen sheaths soaked in a chemical solution and allowed to dry before use. The cloths he described were sized to cover the glans of the penis, and were held on with a ribbon. Fallopio claimed that an experimental trial of the linen sheath demonstrated protection against syphilis.

After this, the use of penis coverings to protect from disease is described in a wide variety of literature throughout Europe. The first indication that these devices were used for birth control, rather than disease prevention, is the 1605 theological publication De iustitia et iure (On justice and law) by Catholic theologian Leonardus Lessius, who condemned them as immoral. In 1666, the English Birth Rate Commission attributed a recent downward fertility rate to use of "condons", the first documented use of that word (or any similar spelling).

Rubber and manufacturing advances

The rubber vulcanization process was patented by Charles Goodyear in 1844. The first rubber condom was produced in 1855. For many decades, rubber condoms were manufactured by wrapping strips of raw rubber around penis-shaped molds, then dipping the wrapped molds in a chemical solution to cure the rubber. In 1912, a German named Julius Fromm developed a new, improved manufacturing technique for condoms: dipping glass molds into a raw rubber solution. Called cement dipping, this method required adding gasoline or benzene to the rubber to make it liquid.Latex, rubber suspended in water, was invented in 1920. Latex condoms required less labor to produce than cement-dipped rubber condoms, which had to be smoothed by rubbing and trimming. Because it used water to suspend the rubber instead of gasoline and benzene, it eliminated the fire hazard previously associated with all condom manufacturers. Latex condoms also performed better for the consumer: they were stronger and thinner than rubber condoms, and had a shelf life of five years (compared to three months for rubber).

Until the twenties, all condoms were individually hand-dipped by semiskilled workers. Throughout the decade of the 1920s, advances in automation of condom assembly line were made. The first fully automated line was patented in 1930. Major condom manufacturers bought or leased conveyor systems, and small manufacturers were driven out of business. The skin condom, now significantly more expensive than the latex variety, became restricted to a niche high-end market

Rubber and manufacturing advances

The rubber vulcanization process was patented by Charles Goodyear in 1844. The first rubber condom was produced in 1855. For many decades, rubber condoms were manufactured by wrapping strips of raw rubber around penis-shaped molds, then dipping the wrapped molds in a chemical solution to cure the rubber. In 1912, a German named Julius Fromm developed a new, improved manufacturing technique for condoms: dipping glass molds into a raw rubber solution. Called cement dipping, this method required adding gasoline or benzene to the rubber to make it liquid.

 Latex, rubber suspended in water, was invented in 1920. Latex condoms required less labor to produce than cement-dipped rubber condoms, which had to be smoothed by rubbing and trimming. Because it used water to suspend the rubber instead of gasoline and benzene, it eliminated the fire hazard previously associated with all condom manufacturers. Latex condoms also performed better for the consumer: they were stronger and thinner than rubber condoms, and had a shelf life of five years (compared to three months for rubber).

Until the twenties, all condoms were individually hand-dipped by semiskilled workers. Throughout the decade of the 1920s, advances in automation of condom assembly line were made. The first fully automated line was patented in 1930. Major condom manufacturers bought or leased conveyor systems, and small manufacturers were driven out of business. The skin condom, now significantly more expensive than the latex variety, became restricted to a niche high-end market

In preventing pregnancy

See also: Comparison of birth control methods#Effectiveness of various methods

The effectiveness of condoms, as of most forms of contraception, can be assessed two ways. Perfect use or method effectiveness rates only include people who use condoms properly and consistently. Actual use, or typical use effectiveness rates are of all condom users, including those who use condoms improperly, inconsistently, or both. Rates are generally presented for the first year of use. Most commonly the Pearl Index is used to calculate effectiveness rates, but some studies use decrement tables.

The typical use pregnancy rate among condom users varies depending on the population being studied, ranging from 10–18% per year. The perfect use pregnancy rate of condoms is 2% per year. Condoms may be combined with other forms of contraception (such as spermicide) for greater protection.

Several factors account for typical use effectiveness being lower than perfect use effectiveness:

• mistakes on the part of those providing instructions on how to use the method
• mistakes on the part of the user
• conscious user non-compliance with instructions.

For instance, someone might be given incorrect information on what lubricants are safe to use with condoms, mistakenly put the condom on improperly, or simply not bother to use a condom.

In preventing STDs

A giant "condom" on the Obelisk of Buenos Aires, Argentina, part of an awareness campaign for the 2005 World AIDS Day

See also: Safe sex

Condoms are widely recommended for the prevention of sexually transmitted diseases (STDs). They have been shown to be effective in reducing infection rates in both men and women. While not perfect, the condom is effective at reducing the transmission of HIV, genital herpes, genital warts, syphilis, chlamydia, gonorrhea, and other diseases.

According to a 2000 report by the National Institutes of Health, correct and consistent use of latex condoms reduces the risk of HIV/AIDS transmission by approximately 85% relative to risk when unprotected, putting the seroconversion rate (infection rate) at 0.9 per 100 person-years with condom, down from 6.7 per 100 person-years. The same review also found condom use significantly reduces the risk of gonorrhea for men.

A 2006 study reports that proper condom use decreases the risk of transmission for human papillomavirus by approximately 70%. Another study in the same year found consistent condom use was effective at reducing transmission of herpes simplex virus-2 also known as genital herpes, in both men and women.

Although a condom is effective in limiting exposure, some disease transmission may occur even with a condom. Infectious areas of the genitals, especially when symptoms are present, may not be covered by a condom, and as a result, some diseases can be transmitted by direct contact. The primary effectiveness issue with using condoms to prevent STDs, however, is inconsistent use.

Condoms may also be useful in treating potentially precancerous cervical changes. Exposure to human papillomavirus, even in individuals already infected with the virus, appears to increase the risk of precancerous changes. The use of condoms helps promote regression of these changes. In addition, researchers in the UK suggest that a hormone in semen can aggravate existing cervical cancer, condom use during sex can prevent exposure to the hormone

Human immunodeficiency virus (HIV) is a lentivirus (a member of the retrovirus family) that can lead to acquired immunodeficiency syndrome (AIDS), a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections. Previous names for the virus include human T-lymphotropic virus-III (HTLV-III), lymphadenopathy-associated virus (LAV), and AIDS-associated retrovirus (ARV).

Infection with HIV occurs by the transfer of blood, semen, vaginal fluid, pre-ejaculate, or breast milk. Within these bodily fluids, HIV is present as both free virus particles and virus within infected immune cells. The four major routes of transmission are unprotected sexual intercourse, contaminated needles, breast milk, and transmission from an infected mother to her baby at birth (Vertical transmission). Screening of blood products for HIV has largely eliminated transmission through blood transfusions or infected blood products in the developed world.

HIV infection in humans is now pandemic. As of January 2006, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) estimate that AIDS has killed more than 25 million people since it was first recognized on December 1, 1981. It is estimated that about 0.6 percent of the world's population is infected with HIV. In 2005 alone, AIDS claimed an estimated 2.4–3.3 million lives, of which more than 570,000 were children. A third of these deaths are occurring in sub-Saharan Africa, retarding economic growth and increasing poverty. According to current estimates, HIV is set to infect 90 million people in Africa, resulting in a minimum estimate of 18 million orphans. Antiretroviral treatment reduces both the mortality and the morbidity of HIV infection, but routine access to antiretroviral medication is not available in all countries.

HIV primarily infects vital cells in the human immune system such as helper T cells (specifically CD4⁺ T cells), macrophages, and dendritic cells. HIV infection leads to low levels of CD4⁺ T cells through three main mechanisms: firstly, direct viral killing of infected cells; secondly, increased rates of apoptosis in infected cells; and thirdly, killing of infected CD4⁺ T cells by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4⁺ T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections.

Eventually most HIV-infected individuals develop AIDS. These individuals mostly die from opportunistic infections or malignancies associated with the progressive failure of the immune system. Without treatment, about 9 out of every 10 persons with HIV will progress to AIDS after 10-15 years. Many progress much sooner. Treatment with anti-retrovirals increases the life expectancy of people infected with HIV. Even after HIV has progressed to diagnosable AIDS, the average survival time with antiretroviral therapy (as of 2005) is estimated to be more than 5 years. Without antiretroviral therapy, death normally occurs within a year. It is hoped that current and future treatments may allow HIV-infected individuals to achieve a life expectancy approaching that of the general public.