Any sexually active person—whether married or not—should use condoms to avoid STIs unless that person and his or her sex partner are not infected and have no other partners. At the same time, condoms are also an effective contraceptive method that many couples rely on to prevent unintended pregnancies.

The need for condoms is becoming increasingly urgent due to the rapid spread of Acquired Immune Deficiency Syndrome (AIDS), which is caused by the human immunodeficiency virus (HIV). HIV/AIDS is now among the top 10 causes of death worldwide and may soon move into the top 5. In 1998 about 2.5 million people died of AIDS-related causes, and an estimated 5.8 million—about 16,000 per day—became infected with HIV (266). (For more on HIV/AIDS and other STIs, see The HIV/AIDS Epidemic sidebar.)

There is no vaccine against HIV and, although treatments are improving, no cure. For the foreseeable future, changing behavior, including encouraging widespread condom use, is the only way to curb the AIDS epidemic (24, 269, 280, 491, 587).

To narrow the condom gap, a coordinated, strategic approach is needed. Everyone should contribute—national governments, international donors and agencies, nongovernmental organizations (NGOs), social marketing programs, individual health care providers, educators and communicators, and the commercial sector. If condom use worldwide could rise to the level of the need, millions of lives would be saved, millions more would avoid misery, and enormous medical costs would be reduced, along with the economic and social consequences of widespread illnesses and death.