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The evidence we have is based on three types of trials, and each has potential weaknesses.For efficacy against HIV and other chronic STIs, studies of the incidence of HIV (or HSV or HPV) in monogamous serodiscordant couples provides the best evidence.Laboratory studies and product testing have shown that reputable condoms tested in the laboratory are completely impermeable to micro-organisms as small as viruses.However, the same studies show that condoms come off the penis altogether 3 to 5% of the time but may slip down (but not off) up to 13% of the time.Moral questions about condom use are not within the remit of this resource, but questions of fact are, and condoms’ ability to stop HIV is periodically questioned by people opposed to their use on religious or moral grounds.

It would be unethical to mount a randomised trial of condom use because the control group would have to stop using them altogether.However, because they are not always used correctly even if they are used consistently, studies have found efficacy rates of 85 to 87% when young women use condoms as their sole form of contraception.Condoms are, however, the only method on that list that has been shown to protect against STIs as well as pregnancy.In one of the most highly publicised statements, in October 2003, the President of the Vatican's Pontifical Council for the Family, Cardinal Alfonso Lopez Trujillo, said: "The AIDS virus is roughly 450 times smaller than the spermatozoon.The spermatozoon can easily pass through the 'net' that is formed by the condom.

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Despite this, the use and promotion of condoms continue to be targets for controversy and criticism, and sexual abstinence and monogamy are often promoted as superior alternatives.