We are all familiar with the liberal rule of thumb “Never waste a crisis.” The AIDS epidemic in Africa and the prevalence of teen pregnancy in the United States have given the “family planners” ideal excuses to spread the condom far and wide, not only in the United States but all over the world.
Of course, this is allegedly done for only the purest motives: To fight teen pregnancy and AIDS. But, as happens so frequently, these “solutions” don’t work, and the response of the Culture of Death to criticism is always that we simply haven’t distributed enough condoms yet.
It is important for us to know the basics of the debate over the condom. Not only are our children secretly being given condoms in many high schools, but our tax dollars are being used to distribute billions of them all over the world every year. And this is only leading to the original problems becoming worse and worse.
The Underlying Problem with Condoms
Health care professionals know that sexually transmitted diseases (STDs), some of which are incurable and/or fatal, have found fertile ground to proliferate in societies that permit and even celebrate all forms of permissive sex. Unfortunately, most people, for fear of appearing “backwards” or “repressive,” treat this glaringly obvious fact like a basilisk — they dare not look at it or even speak about it.
The response of most “developed” world governments at every level, and the reaction of various social service agencies to this explosion of STDs, was as predictable as it was ineffective: They took the inherently secularist position that people are mere animals with little or no impulse control. So the condom pushers think that, since people can’t be trusted to control their sexual urges, we might as well make it as safe for them as possible to have sex with whomever they please.
The government’s weapons of choice were not chastity and monogamy, but “education” and condoms. And so, with intriguing names like “Arouse,” “Embrace,” “Excita,” and “Pleaser,” condoms crowd pharmacy shelves and restroom walls, proclaiming the merits of “family planning” and “safe(r) sex” on their vividly-colored packages.
Unfortunately, members of the public uncritically accept the government — and the condom manufacturers — at their word. And nobody (except a few courageous doctors, who are universally ignored) seems to be asking the most vital question of all. If condoms are so effective at preventing pregnancy and AIDS transmission, why do nations that stress their use continue to experience a rapidly-escalating rate of teen pregnancy and an exploding AIDS epidemic?
Due to the highly-charged aspects of the issues related to contraception (i.e., school-based clinics, the teen pregnancy “epidemic,” and the spread of AIDS), there is much conflicting information on the effectiveness of the most commonly-used nonpermanent true contraceptive method in the world — the humble male condom — at preventing pregnancy, AIDS, and sexually transmitted diseases.
Types of Condoms
Three types of male condoms are available today.
- By far the most commonly used condoms are made from natural rubber latex. These are the most effective at preventing pregnancy and STDs and make up about 97% of all condom sales in the United States.
- A small number of condoms are made from the intestinal caecum of lambs, and are called “natural skin,” “natural membrane” or “lambskin” condoms. Experts generally agree that skin condoms are not as effective as latex condoms at preventing AIDS and STDs.
- A third type, generally becoming more available, are condoms made from synthetic materials, including polyurethane. These are more resistant to deterioration than latex condoms and are generally believed to provide a similar level of protection against pregnancy and STDs.
What Is Failure Rate?
Family planners use two terms when referring to the failure rate of a contraceptive method.
- The “method failure rate” refers to malfunctions of the method itself when it is used perfectly. For condoms, the method failure rate is 2%. This does not mean that 2% of condom uses will result in pregnancy. It means that, if there are one hundred couples that use a condom perfectly over an entire year of use, only two will experience pregnancy.
- By contrast, the “user failure rate” reflects not perfect use, but typical use, and includes all user errors. According to Contraceptive Technology, 18 of 100 typical condom-using couples will experience pregnancy within the first year of use.
The basic problem is that no matter how much “safe(r) sex” education is taught, no matter how many bowls of free condoms are left in plain view, and no matter how much contraceptive marketing is propagated, there are a number of mechanical and human factors that simply cannot be controlled or overcome:
- Condoms break and slip off.
- They age and become less effective.
- Condoms deteriorate in even the best of conditions, but even more rapidly in extremely cold or hot situations. One researcher found that, at major condom distribution points in New Jersey and New York, boxes of condoms were left outdoors in the ice and snow during the dead of winter. During the summer months, the researcher took photographs of eggs frying on the floors of dozens of trucks and containers where condoms were stored in temperatures exceeding 180 degrees. Keep in mind that condoms exported from the United States sit in uninsulated shipping containers in extreme weather conditions for even longer periods of time.
- If taken out of the package and left unused, condoms are vulnerable to ozone deterioration, which causes damage invisible to the eye. Improper use of oil-based lubricants can degrade them. They get broken in their packages. They even have allowable rates of manufacturing defects. For example, the present acceptable quality limit (AQL) set by the World Health Organization directs that 1.75% of all condoms in a lot can be defective, and the lot can still be distributed for people to use.
- Condom users are sometimes caught up in passion and do not properly follow the 7-step to 12-step process for safe usage.
- The judgment and care of the users may be compromised by the use of alcohol, marijuana, illegal drugs, prescription and over-the-counter drugs, or exhaustion.
- Finally, bodily secretions can get around and over a condom even if it performs perfectly, transmitting many STDs, including human papillomavirus, or HPV.
It’s no wonder that Dr. Helen Singer-Kaplan, founder of the Human Sexuality Program at Cornell University, said that “Counting on condoms is flirting with death.”
Pores in Condoms
Much debate exists over whether latex condoms provide effective protection against HIV.
The inherent, naturally occurring flaws in natural rubber (latex) are up to 5 microns (0.0002 inches) in size. The average sperm cell is about 50 microns in diameter, and the average AIDS virus is about 0.1 micron in size. This contrast in size is proportional to a five‑ton bull elephant standing next to a small housefly. In terms of size, an AIDS virus can pass through a latex flaw as easily as a housecat can walk through an open double garage door. However, before concluding that latex condoms do not protect against the AIDS virus, we must take two factors into account.
- First, the effects of surface tension are extremely powerful at the molecular level. It is very doubtful that an AIDS virus in a water‑based suspension of any type would be able to pass through a hole even 100 times its own diameter in the absence of motion, friction, pressure and corrosion stresses.
- And second, latex condoms are “double‑dipped,” meaning that all or most of the voids left from the first layer will be filled by the second.
Repeated SEM (scanning electron microscope) photos of stretched condoms show no apparent voids, even at a magnification of 2,000X.
The Primary Danger is not Pores
It is unfortunate that pro-life activists spend so much time arguing that condoms leak, since the debate over pores in condoms is a damaging distraction. There is an abundance of conflicting medical literature on the permeability of condoms, and so this point will probably never be decisively resolved.
Although latex condoms appear to be almost entirely impermeable to HIV, the greatest danger of infection lies in the propensity of condoms to burst, tear and slip off.
Even if only a few HIV can pass through a porous condom, the risk of infection would still be extremely small; but in those cases where condoms fail catastrophically, massive exposure to HIV is inevitable. In cases of failure during intercourse with an HIV‑infected person, there is the distinct possibility of a protracted and painful death.
Condom Failure Rates
“Family planning” experts use several false comparisons to promote the use of condoms, some of which are widely accepted among the public. However, they all have a fatal flaw — they intentionally omit the safest choice.
The most popular such argument is the “parachutes and prophylactics” parallel. The condom pushers say that, if your child was in an aircraft that was going to crash, wouldn’t you want him or her to have a parachute with them? Of course everyone answers “yes” to this question. So we are presented with two choices ― remain in the airplane as it crashes into the ground and have a 100% chance of dying, or leave the airplane while it is in the air and have a partial chance of living. Naturally, the only logical answer would be to use the parachute.
But what about the “missing choice?” If you know that the aircraft is going to crash, the safest option is to remain on the ground, which carries a 0% chance of dying.
This “missing choice” allows family planners to say that condoms are very effective at preventing pregnancy and transmission of HIV and other sexually transmitted diseases. They certainly are effective ― but only compared to people who use no method of contraception at all.
This leads us to ask exactly how often the “parachute” fails.
As we have seen, the frequency of condom failure depends upon many factors, most of which fall under the category of user error. There have been many studies performed on the real-world failure rates of condoms, which take into consideration “real world” practices.
A compilation of 23 major studies on male condom failure rates published in medical journals involved a total of 57,393 condoms used during heterosexual intercourse. These studies, conducted over the time period 1988-2008, found that 4.00% of all of the condoms broke and 2.06% of them partially or completely slipped off, for a total failure rate of 6.06%.
In other words, condoms provide no protection whatsoever against pregnancy, HIV and other sexually transmitted diseases one time out of every sixteen uses. A 6% failure rate means that a typical couple has six condom failures in a year and a one in four chance of having eight failures in a year. In fact, if we followed one thousand typical condom users, only two will have no failures in a year.
Would anyone in their right mind buy a parachute from a shady character who said “Hey, don’t worry, pal! With this parachute you’ll get to the ground safely fifteen times out of sixteen?” If parachutes had the abysmal safety record of condoms, skydiving would have been banned long ago since the average life span of a person participating in the sport would be about two months.
According to the “family planner’s bible,” Contraceptive Technology, the condom’s user effectiveness rate at preventing pregnancy is 82%. This means that the probability of pregnancy for a woman whose sexual partner(s) always use condoms are 18% in one year, 45% in three years, and 63% in five years.
Keep in mind that these are the lowest rates that can generally be expected, since they assume 100% condom usage all the time.
According to Census Bureau sources, about 6.3 million American couples use condoms regularly for birth control. Eighteen percent of this number means that about 1,134,000 unwanted pregnancies occur every year due to condoms breaking ― a number equivalent to more than 40% of the unintended pregnancies in the United States annually!
This experience is mirrored in many other developed nations such as England, where a major study of 4,666 women seeking abortions at a large abortion mill during the period 1989‑1993 found that 1,609 (34.4%) experienced condom failure. The failure rate in developing nations is inevitably higher due to lax manufacturing practices and distribution and storage of condoms under conditions that increase the failure rate, among other factors.
What about STDs?
The medical literature is replete with studies showing that it is far better to use condoms than not when fighting various sexually transmitted diseases. But once again, these studies universally omit the third option — abstinence — and in some cases actually denigrate it as “unrealistic.”
In reality, science and experience both prove that abstinence and faithfulness are the only effective means of combatting STDs.
Experience has shown us that condoms are even worse at preventing “social diseases” than they are at preventing pregnancy. After all, a woman can get pregnant only during the fertile part of her cycle, but she can get infected by an STD every day of the month. And, while there may be “emergency contraception” to prevent the continuation of a pregnancy (usually causing an early abortion), there is no such thing for a disease. Condoms — even if they do not fail — offer no protection at all against diseases such as human papilloma virus and herpes simplex virus, which frequently infect the entire genital area.
Health authorities agree that condoms (when used perfectly and when they do not break, leak or slip) effectively block such venereal diseases as gonorrhea and syphilis. However, condom misuse or breakage can cause massive exposure to these diseases. This is an unnecessary game of Russian roulette, where the chance of losing is 1 in 16.
These facts account in large part for a resurgence in several STDs:
- Genital chlamydial infection is the most common bacterial STD in the United States, and is the leading cause of preventable infertility and ectopic pregnancies. One and a quarter million new cases of chlamydia (the most common venereal disease) are reported each year.
- Genital warts are caused by human papillomavirus (HPV), the most common viral STD in the United States, accounting for three million new cases each year. HPV is present in an estimated 50% of all sexually active young women, and, as with other STDs, is associated with multiple sexual partners and with earlier intercourse.
- There are about 300,000 new cases of gonorrhea in the United States each year, many of which are caused by strains resistant to treatment, and up to one‑fourth of all infected men have no symptoms. Gonorrhea can also infect other mucous membranes, including the mouth. The disease can have extremely serious consequences if left untreated, including sterility, pelvic abscesses and severe health problems for infants born to infected mothers.
- Hepatitis B is a particularly dangerous problem in some developing countries. It can lead to chronic hepatitis, cirrhosis, cancers, hepatic (liver) failure and death. There is no cure for Hepatitis B, and up to 20% of the population in many developing countries show signs of infection.
- Herpes genitalis is caused by the herpes simplex virus (HSV) and infects about 30 million people in the United States today, most of whom show no symptoms. Those who do show symptoms may have painful ulcers in the genital or mouth area.
- Pelvic inflammatory disease (PID) is a result of infection with other STDs and viruses/bacteria such as gonorrhea and E. Coli. PID afflicts one million American women each year, 20% of whom require hospitalization. PID also inflames the Fallopian tubes and is a leading cause of ectopic pregnancy.
- Syphilis, one of the deadliest STDs, recently reached its highest level in 40 years, with 45,000 people in the United States newly infected in 2009. Untreated syphilis can lead to rashes, lesions, paralysis, aneurisms, blindness and even death.
Health professionals often assert that there are “epidemics” of teen pregnancy, AIDS, alcoholism, drug use, and of course, violence against abortion mills. Most of these allegations are exaggerated and are not supported with proper statistical analysis. But their declarations of an epidemic of STDs are certainly not exaggerated. With more than 100 million people infected with one or more of 20 STDs in the United States alone, it is unrealistic to expect that a paper‑thin, nearly weightless sheath of polyurethane or latex will slow down the epidemic.
The only way to completely eradicate all STDs is to follow God’s plan for our sexual lives ― abstinence before marriage and fidelity during marriage.
Of course, the sex educators and condom sellers tell us that this is not a “realistic” solution. They are wrong. Because abstinence/fidelity is the only solution that will work, it is also the only realistic solution. Perhaps if the health professionals struggle unsuccessfully for another decade or two trying to contain the STD epidemic with impractical means, they too will reach the same conclusion.
There is not a lot of debate about the best way to stop or stem the AIDS epidemic, but there certainly should be. The “family planners” have based their entire modus operandi on a flawed premise ― that people are basically animals that cannot control themselves.
Tragically, this assumption has led to millions of deaths.
Clinical studies are essential, but there is nothing like real-world experience to settle a scientific debate. There are several such scenarios in the developing world that demonstrate beyond any possible doubt that condoms actually promote the spread of HIV/AIDS, and which demonstrate that the only realistic solution to the epidemic is behavior change.
Real Life Examples: Condoms Don’t Work
Case Study #1: Uganda
In 1991, Uganda had one of the highest adult HIV infection rates in the world at 15%. Try imagining an entire country where one in every seven adults carry this dread disease! However, ten years later, Uganda had cut its HIV infection rate by two-thirds, to only 5%. It was one of only two nations in Africa that cut its HIV infection rate during this time period, and its decline in HIV prevalence was the greatest of any country in the world.
The key to this tremendous success was an approach that other nations either ridiculed or declined to embrace: President Yoweri Museveni’s ABC Program — Abstain from sex until marriage, Be faithful to your partner, and use Condoms if you simply cannot practice abstinence or fidelity. The entire focus of the message was not simply to “condomize” the population, but to reduce risky sexual behavior.
In time, the constant broadcasting of the ABC message through all governmental, educational, religious and communications networks built up what researchers called a “highly effective social vaccine against HIV,” or a massive behavioral change among the people of the nation.
By 2000, the Ugandan Demographic and Health Survey found that 93% of Ugandans had changed their sexual behavior to avoid HIV/AIDS.
The lessons we learned from Uganda’s experience were simple but profound.
- Most importantly, we learned yet again that human beings are not mindless, deterministic automatons. We can think — and we can change! After all, we have implemented persistent and very successful publicity programs that discourage smoking, illegal drug use and excessive alcohol consumption, as well as healthier eating patterns. Uganda showed us that high-risk sexual behaviors can be modified into healthier options, such as “zero grazing,” or faithfulness to one partner.
- The second lesson we learned from Uganda is that abstinence and marital fidelity are the most important factors in preventing the spread of HIV/AIDS. Contrary to all expectations, young Ugandans widely embraced the pro-abstinence message. From 1989 to 1995, the percent of unmarried young men having sex plunged from 60% to 23%, and the percent of unmarried young women having sex dropped from 53% to 16%. This proves that not all teenagers are helpless slaves of their “raging hormones.”
- The final lesson is that condoms do not play a primary role in reducing HIV transmission. As President Museveni himself remarked, “We are being told that only a thin piece of rubber stands between us and the death of our continent. Condoms have a role to play as a means of protection, especially in couples who are HIV-positive, but they cannot become the main means of stemming the tide of AIDS.”
The Ugandan government targeted only extremely high-risk groups such as prostitutes and truck drivers with condoms, but the vast majority of Ugandans rejected their use. Anne Peterson, M.D., USAID’s Director of Global Health, said, “Condoms play a role. They are better than nothing, but the core of Uganda’s success story is big A, big B, and little C.”
The ABC program has been intensively studied and deemed effective by many leading international health organizations, including the Joint United Nations Program on HIV/AIDS (UNAIDS); the United Nations World Health Organization (WHO); the Harvard Center for Population and Development Studies; and the United States Agency for International Development (USAID), which said that “This dramatic decline in [HIV/AIDS] prevalence is unique worldwide, and has been the subject of intense scrutiny;” However, all of these groups still aggressively promote condom use all over the world.
In 2004, the journal Studies in Family Planning concluded that “No clear examples have emerged yet of a country that has turned back a generalized epidemic primarily by means of condom promotion.” This is still true a decade later.
Case Study #2: Africa in General
An examination of the HIV/AIDS rates in all of the nations of Africa reveals some very interesting patterns regarding religious practice and HIV prevalence.
In Africa, Catholics and Muslims take their faith seriously, and generally do not use condoms. Africans are not “cafeteria” Catholics and Muslims, like many North Americans and Europeans; they generally either accept their faiths in whole or not at all. Also, African nations that have a high percentage of Catholics and Muslims have very low rates of HIV/AIDS, and countries that have fewer Catholics and Muslims have higher rates.
There are sixteen African nations in which Catholics and Muslims account for an average of 95% of the population. These nations have an average of a miniscule 0.4% HIV infection rate. By comparison, there are fifteen African nations where Catholics and Muslims make up an average of only 26% of the population. These nations have an average HIV infection rate seventeen times higher, at 6.8%. In fact, it is easy to plot a smooth curve showing that, the fewer Catholics and Muslims there are in an African nation, the more HIV/AIDS cases there are going to be.
Case Study #3: Thailand and the Philippines
The third real-life example showing how condoms fail to stop the spread of HIV/AIDS is presented by the Philippines and Thailand, two Southeastern Asian nations with roughly equivalent populations.
In 1983, the first case of HIV was detected in both of these nations. By 1987, Thailand had 112 cases of AIDS, and the Philippines had 135 cases. In 1991, the World Health Organization predicted that, by 1999, Thailand would have suffered 70,000 deaths from the disease, and the Philippines would have lost 85,000 people.
In 1991, both nations took concrete measures against the spread of the HIV virus — but in completely different directions. The Thai Minister of Health enacted a “100% Condom Use Program.” All brothels were required to have supplies of condoms, and condom vending machines were installed in all supermarkets, bars, restaurants, and other public gathering places. This program was widely accepted and implemented by the government and the people of Thailand.
Two years later, Rene Bullecer, M.D., received authorization from the Catholic Bishops Conference of the Philippines (CBCP) to establish the organization AIDS-Free Philippines as its official program to combat HIV/AIDS nationwide. The government signed on to this effort as well. By the end of 2003, the disparity in the effectiveness of both types of programs had become glaringly obvious.
There were 9,000 people living with HIV in the Philippines by 2003; the number was 63 times higher (570,000) in Thailand. 500 Filipinos and 58,000 Thais had lost their lives to AIDS. In other words, for every Filipino who had died, 116 Thais had died.
The latest numbers show that about 15,000 people are living with HIV/AIDS in the Philippines, and about 440,000 in Thailand. So the HIV infection rate per million population is 43 times higher in Thailand than it is in the Philippines. However, the latter nation is being flooded with condoms after the passage of its 2013 Reproductive Health Bill, so we can expect the Philippines to soon start suffering a significant upswing in its HIV infection rate.
Interestingly, the current rate of HIV infection in the United States, with all of our sex education, all of our sexual freedom, all of our advanced antiretroviral drugs, and all of our tens of billions of condoms, is thirty times higher than in the Philippines. USAID has concluded that the reason that the Philippines has such a low incidence of HIV/AIDS is that youth have a very high rate of abstinence and married people largely remain faithful to their spouses. The USAID report even grudgingly admitted that “The Catholic Church must be credited with influencing sexual behavior.”
“Family planners” and other advocates of the Culture of Death pride themselves on their rational thinking, and often claim that they advocate only the most “realistic” solutions. But, as we have seen so many times, these “realistic” solutions invariably end with lethal results at the worst, and mediocre results at the best.
The worst thing we can do is accept the “common wisdom” associated with condom use. As we have seen, using condoms lowers risk in individual cases, but national reliance on them as a solution is disastrous due to the behavior of people who act recklessly in the belief that they are “safe.” Behavior change is the answer.
And when people criticize the Catholic solution of abstinence before marriage and fidelity during, we should ask them how many people would be infected with HIV and other sexually transmitted diseases if everyone followed this formula.
 Lee Warner, Ph.D., M.P.H. and Markus J. Steiner, Ph.D. “Male Condoms.” Chapter 13 in Robert A. Hatcher, M.D., M.P.H., et. al. Contraceptive Technology (20th Revised Edition). New York: Ardent Media, Inc., 2011.
 William B. Vesey. “Condom Failure.” Human Life International Reports, July 1991, pages 1 to 3.
 Condom usage guides list anywhere from 10 to 16 steps involved in using condoms. One article in the American Journal of Public Health says primly: “Condoms are not 100% efficacious and a high degree of individual compliance is required for condoms to be effective in use” [William L. Roper, M.D., M.P.H., Herbert B. Peterson, M.D., and James W. Curran, M.D., M.P.H. “Commentary: Condoms and HIV/STD Prevention — Clarifying the Message.” American Journal of Public Health, April 1993 [Volume 83, Number 4], pages 501 to 503].
 Helen Singer-Kaplan. The Real Truth about Women and AIDS. Simon & Schuster, 1987.
 C.M. Roland, Ph.D., Editor of Rubber Chemistry and Technology and Head of the Polymer Properties Section, Naval Research Laboratory. Letter entitled “Do You Want to Stake Your Life on a Condom?” Washington Times, April 22, 1992.
 “From the Surgeon General, US Public Health Service.” Journal of the American Medical Association, June 9, 1993, page 2,840.
 For an Excel spreadsheet that has calculations and references on these studies, e-mail Brian Clowes at firstname.lastname@example.org and ask for spreadsheet F-21-07.XLS, “Cumulative Probability of Condom Failure.”1
 Robert A. Hatcher, et. al. Contraceptive Technology (20th Revised Edition) [New York City: Ardent Media, Inc.], 2011. Table 3-2, “Percentage of Women Experiencing an Unintended Pregnancy during the First Year of Typical Use and the First Year of Perfect Use of Contraception, and the Percentage Continuing Use at the End of the First Year, United States,” page 50. Interestingly, this 82% efficiency is a significant decline from the 86% efficiency shown in the same table in the Seventeenth Revised Edition of Contraceptive Technology, published in 1998.
 Statistical Abstract of the United States, 2015 Edition [Bethesda, Maryland: ProQuest LLC], 2014. Table 108, “Current Contraceptive Use by Women by Age, Race and Hispanic Origin: 2006 to 2010.” According to Table 98, “Births by Whether Pregnancy Intended at Conception and Selected Characteristics of Mother: 2006 to 2010,” 37.1 percent of the 21,161,000 births during the time period 2006-2010 were the result of unintended pregnancies. This is a total of 7,850,731 births. If we add to this number the total abortions during this time period (5,918,460, from Excel spreadsheet F-19-03.XLS), we arrive at a total of 13,769,191 unintended pregnancies during the time period 2006-2010. So the percentage of unintended pregnancies we can attribute to the condom is (1,134,000 X 5)/13,769,191 = 41.2%.
 Judy Murty and Sue Firth of the Marie Stopes Centre. “Use of Contraception By Women Seeking Termination of Pregnancy.” The British Journal of Family Planning, April 27, 1996, pages 6 to 9.
 Stephen Genuis, M.D. “What About the Condom?” Risky Sex (2nd Edition) [Edmonton, Alberta: KEG Publishing], 1991.
 United States Department of Commerce, Bureau of the Census. Reference Data Book and Guide to Sources, Statistical Abstract of the United States 2012 (132nd Edition) [Washington, D.C.: United States Government Printing Office]. Table 184, “Selected Notifiable Diseases ― Cases Reported: 1980 to 2009.”
 Joint United Nations Program on HIV/AIDS (UNAIDS). “Uganda: Epidemiological Fact Sheet on HIV/AIDS and Sexually Transmitted Diseases,” 2000.
 President Yoweri Museveni of Uganda. What is Africa’s Problem? [Minneapolis: University of Minnesota Press], 2000.
 Tom Carter. “Uganda Leads by Example on AIDS.” The Washington Times, March 13, 2003.
 E.C. Green, V. Nantulya, R. Stoneburner, and J. Stover. “What Happened in Uganda? Declining HIV Prevalence, Behavior Change and the National Response.” United States Agency for International Development (USAID), September 2002.
 Norman Hearst and Sanny Chen. “Condom Promotion for AIDS Prevention in the Developing World: Is It Working?” Studies in Family Planning, March 2004.
 See Telling the Truth: AIDS Rates for Thailand and the Philippines, by Rene Josef Bullecer, M.D., Executive Director, Human Life International-Visayas Mindanao, Philippines, and Director of AIDS-Free Philippines.
 Joint United Nations Program on HIV/AIDS (UNAIDS). “UNAIDS Report on the Global AIDS Epidemic 2013.” Table entitled “HIV Prevalence – Adult (ages 15-49),” pages A4 to A8.
 C. Hermann, E.C. Green, J. Chin, M. Taguiwalo, and C. Cortez. “Evaluation of the Philippines AIDS Surveillance and Education Project.” USAID/Philippines, May 8, 2001.