Commentary Sexual Health

No, Teens Did Not Create a Working Condom That Changes Colors if You Have an STI, and Maybe They Shouldn’t

Martha Kempner

Last week, the media went wild discussing a condom that could change colors if it came in contact with an STI. Not only is this condom chameleon just an idea at this point, it might not be the best idea.

Last week, the story broke about teens who had invented a new condom that could detect sexually transmitted infections (STIs) and alert a partner by changing colors. Media outlets blared: “High School Students Come Up With Brilliant Way To Detect Sexually Transmitted Infections;” “Revolutionary Color Changing Condom Detects STDs;” and “Roses are red, condoms are blue … if you have syphilis;” just to name a few. 

Despite the attention-grabbing nature of these headlines, don’t be fooled: They—and sometimes the pieces they accompanied—do not carry entirely accurate implications. This condom-and-STI-test-wrapped-in-one is not coming soon to a pharmacy near you. It’s an interesting idea, but that’s all it is: just an idea. It’s a thought with theory behind it on how it might work. It has not gotten past the concept stage. There is no operational prototype.

That does not mean we shouldn’t celebrate potential innovation—and the young people who dreamt it up. But in the process of doing so, most media outlets didn’t bother to question whether it was scientifically possible to mass produce such an item or whether it was actually the best way to test for STIs. Nor did they bother to point out that until an option like this can actually be purchased, people need to continue going to their clinic or doctor for STI screening and treatment. As a sexuality educator focused on preventing STIs, I feel this leaves a pretty gaping hole in the commentary.

First, the true story. Three young teenagers who attend the Isaac Newton Academy in London had an idea for a condom that would not just protect against STIs but detect them as well. Inspired by the high rates of STIs in the United Kingdom, the teens theorized that they could make a condom that would include a layer of antibodies that would recognize a virus or bacteria—such as chlamydia—and cause the condom to change color. They cleverly called the concept the S.T. EYE; entered it into the TeenTech Awards, which encourages teenagers to explore science, engineering, and technology; and won £1,000 (or $1,568). In October, they will go to Buckingham Palace to be honored along with the other teen winners. The students told MTV that they hoped to have a working prototype by then.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

In the interview with MTV, one of the teens explained more about how this condom could work. In a typical HIV test, he explained, “Antigens are attached to a dish—blood or seminal fluid is added and if HIV antibodies are present, they attach to the antigen.”

“With our concept,” he continued, “You would have to have the antibodies already attached to the latex of the condom, so once you add the fluid onto the latex, it would then trigger the reaction and cause a color change similar to the HIV test.”

In other words, in order for their idea to work, the teens would have to figure out a way to attach the antibodies to latex. It’s unclear whether this is feasible, but certainly no one has done it yet. William Smith, executive director of the National Coalition of STD Directors (NCSD), told Rewire, “While I can applaud these smart young people’s ingenuity in approaching a serious sexual health issue, this is but a concept and one where I think the science would be elusive in making it happen.”

It’s also unclear how expensive such a device would be. Ward Cates, a researcher who has been studying condoms for years, applauded the idea as a way to promote testing among young people, but told CNN: “It would be quite sophisticated and my guess is quite costly.” He added that testing for more than one STI at a time might be cost-prohibitive. One of the benefits of condoms as a method of STI protection and pregnancy prevention has always been that they’re very inexpensive, and thus, widely available.

Even this condom were to be possible and affordable, I have some other practical concerns about the concept. It’s meant to detect STIs in both the male wearer and his partner, but that can’t happen until it comes in contact with blood, semen, or vaginal or cervical secretions. In most cases, this would mean the condom wouldn’t change colors until well into the sexual act—likely too late to provide added protection for that encounter.

After-the-fact knowledge isn’t entirely useless—the condom’s wearer or his partner would know moving forward that he or she had an STI, which could prompt them to seek treatment and also prevent the spread to any further partners. It is always good for people to be aware of their STI status, and we should keep thinking of innovative ideas to get people tested.

But I don’t think the heat of the moment is the best time to find out whether you or your partner has an STI. It’s a very vulnerable time to give or receive that kind of news, especially unexpectedly. At a minimum it could be painfully embarrassing; in the worst-case scenario, I fear it could provoke a potentially violent reaction.

In his interview with Rewire, Smith agreed that the timing would be all wrong. “STD testing should be a normal routine for sexually active people, not something that occurs after penile penetration. Does someone really want to discover their partner has an STD after sex begins? Frankly, I couldn’t think of a more ill-timed occasion for finding out your partner has gonorrhea or syphilis.”

These are things that I hope the teens who came up with this idea and anyone who wants to help them make it a reality would consider when moving forward with the concept. Perhaps it would be better to put the time and effort into creating an instant, at-home test kit that can test for a variety of STIs and can be used when you’re alone and haven’t yet initiated sexual activity. At-home kits exist, but most need to be sent to a lab for analysis. Instant results would be a huge step forward.

In the meantime, I think it’s important to remember that despite last week’s hype, we do not yet have a condom chameleon—but we do have good options for both condoms and STI testing.

Today’s condoms have been shown to provide protection against the very STIs we’re talking about, such as chlamydia, gonorrhea, and HIV. As Smith noted, “The point of condoms are to prevent disease transmission, which they do incredibly well, not to test for it.”

As for the testing we already have, it’s really not that bad. Many organizations help to cover the cost nowadays in cases when insurance doesn’t. It can involve peeing in a cup, being dabbed with a cotton swab, or giving blood. Smith noted, “In their rush to discuss this new idea, too many media reports got STI testing itself wrong, describing it as overly invasive and a dreadful experience. It’s not. It’s easy, highly accessible, and utterly noninvasive in almost all cases.”

And best of all, you don’t get the results when you’re already naked, potentially in someone else’s bed.

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.

Commentary Sexual Health

Fewer Teens Are Having Sex, But Don’t Pop the Champagne Yet

Martha Kempner

The number of teens having sex may be less important than the number having protected sex. And according to recent data from the Centers for Disease Control and Prevention, condom use is dropping among young people.

Every two years, the Centers for Disease Control and Prevention’s Division of Adolescent and School Health (CDC-DASH) surveys high school students to gauge how often they engage in perceived risky behaviors. The national Youth Risk Behavior Surveillance (YRBS) is wide ranging: It asks about violence, guns, alcohol, drugs, seat belts, bicycle safety, and nutrition. It also asks questions about “sexual intercourse” (which it doesn’t define as a specific act) and sexual behaviors.

Started in 1991, this long-running study can provide both a picture of what high school students are doing right now and a historical perspective of how things have changed. But for more than a decade, the story it has told about sexual risk has been the virtually the same. Risk behaviors continually declined between 1991 and 2001, with fewer high school students having sex and more of them using condoms and contraception. But after the first 10 years, there has been little change in youth sexual risk behaviors. And, with each new release of almost unchanging data, I’ve reminded us that no news isn’t necessarily good news.

This year, there is news and it looks good—at least on the surface. The survey showed some significant changes between 2013 and 2015; fewer kids have ever had sex, are currently sexually active, or became sexually active at a young age. More teens are relying on IUDs and implants, which are virtually error-proof in preventing pregnancy.

In 2015, 41 percent of high school students reported ever having had sexual intercourse compared to 47 percent in 2013. The researchers say this is a statistically significant decrease, which adds to the decreases seen since 1991, when 54 percent of teens reported ever having had sexual intercourse.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Another change is in the percentage of students who had sex for the first time before age 13. In 2015, 4 percent of high school students reported this compared to almost 6 percent in 2013. This is down from a full 10 percent in 1991. As for number of overall partners, that is down as well, with only 12 percent of students reporting four or more partners during their lifetime compared to 15 percent in 2013 and 19 percent in 1991. Finally, the percentage of students who are currently sexually active also decreased significantly between 2013 (34 percent) and 2015 (30 percent).

These are all positive developments. Delaying sex can often help prevent (at least temporarily) the risk of pregnancy or STIs. Having fewer partners, especially fewer concurrent partners, is frequently important for reducing STI risk. And those teens who are not currently having sex are not currently at risk for those things.

While I want to congratulate all teens who took fewer risks this year, I’m not ready to celebrate those statistics alone—because the number of teens having sex is less important to me than the percentage of teens having sex that is protected from both pregnancy and sexually transmitted infections. And that number is lower than it once was.

Among sexually active teens, there were no significant positive changes in measures of safer sex other than an increase in the number of sexually active high school students using the IUD or implant (up to 4 percent from 2 percent in 2013).

Moreover, some results indicate that today’s teens are using less protection than those who were teens a decade ago. The most telling finding might be the percentage of teens who used no method of contraception the last time they had sex. This decreased between 1991 and 2007 (from 17 percent to 12 percent), inched up to 14 percent in 2013, and stayed the same in 2015 (14 percent). There was also little to no change in the percentage of high school students who say that either they or their partner used birth control pills between 2013 (19 percent) and 2015 (18 percent) or those who say they used the contraceptive shot, patch, or ring (5 percent in 2013 and 2015).

For me, however, the most distressing finding is the backward progress we continue to see in condom use. The prevalence of high school students who used a condom at last sex went up from 45 percent in 1991 to 63 percent in 2003. But then it started to drop. In 2015, only 57 percent of sexually active high school students used condoms the last time they had sex, less than in 2013, when 59 percent said they used condoms.

It’s not surprising that teens use condoms less frequently than they did a decade ago. In the 1990s, the HIV epidemic was still front and center, and condoms were heavily promoted as a way to avoid infection. As this threat waned—thanks to treatment advances that now also serve as prevention—discussions of the importance of condoms diminished as well. The rise of abstinence-only-until-marriage programs may have also affected condom use, because these programs often include misinformation suggesting condoms are unreliable at best.

Unfortunately, some of the negative messages about condoms inadvertently came from public health experts themselves, whether they were promoting emergency contraception with ads that said “oops, the condom broke”; encouraging the development of new condoms with articles suggesting that current condoms are no fun; or focusing on teen pregnancy and the use of highly effective contraceptive methods such as long-acting reversible contraceptives (LARC). The end result is that condoms have been undersold to today’s teenagers.

We have to turn these condom trends around, because despite the decreases in sexual activity, young people continue to contract STIs at an alarming rate. In 2014, for example, there were nearly 950,000 reported cases of chlamydia among young people ages 15 to 24. In fact, young people in this age group represented 66 percent of all reported chlamydia cases. Similarly, in 2014, young women ages 15 to 19 had the second-highest rate of gonorrhea infection of any age group (400 cases per 100,000 women in the age group), exceeded only by those 20 to 24 (489 cases per 100,000 women).

While we can be pleased that fewer young people are having sex right now, we can’t fool ourselves into believing that this is enough or that our prevention messages are truly working. We should certainly praise teens for taking fewer risks and use this survey as a reminder that teens can and do make good decisions. But while we’re shaking a young person’s hand, we should be slipping a condom into it. Because someday soon (before high school ends, for more than half of them), that teenager will have sex—and when they do, they need to protect themselves from both pregnancy and STIs.