With lab evidence of Zika prevention condoms destroying the virus in their bodies, condoms and something more essential: trust, have become primary tools in the battle against the virus
First come condoms, then comes Zika
Ten years ago, Marlene Cohen, science and technology policy director at the US Centers for Disease Control and Prevention, suggested the alternative solutions to the Zika virus might be as simple as stepping out of the shower.
“If you’re going to get a cold or you’re going to get a chest cold, you’re going to use a condom on a bedridden person because you’re less likely to infect that person. But on a person who is healthy, you can’t defend someone who is active. If I’m responsible, I have to find ways of making sure I don’t get infected.”
The guidelines Cohen developed for use with volunteers began to slowly take hold. Just as a stable bra does better than an even bra when it comes to preventing pregnancy, condoms work better than standard placebo protection against Zika virus in every situation, according to a 2018 report in the National Journal.
Some post-Zika outreach suggests the vaginal medulla at the back of the uterus, where HIV first attacks, is what performs the “pandemic vaccine”, preventing the virus from entering your body or sexually acquiring your sexual partner, though this is not yet proven.
However, many strategies were adopted after Cohen’s paper was published, which included lengthy training and always-on, highly visible training “on how to get pregnant” to encourage users to take extra precautions or use barrier-type methods (such as permanent, washable condoms).
This was a complete turnaround from the attitudes of those who first discovered the virus in Rio in Brazil, for example, in 2016.
“A few years ago we were told women should go out and get pregnant, because Zika didn’t affect their health,” Cohen said. “That’s changed. We now have billions of dollars in funding for research, for research, and research.”
Recommendations to stop breeding stocks of Aedes aegypti, the predatory mosquito that transmits Zika, have also been reexamined over the past decade, in the US as well as south-east Asia, where Aedes aegypti is endemic. The breeding methods and methods to better control them have been tailored to every nation, under each nation’s own set of pandemic-age standards.
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A compound in latex protects against sperm, helping prevent vaginal sex but could still transmit the virus. A vaginal pill has been introduced. But Cohen believes the most effective way of protecting is simple: through trust.
“All the research shows that the best form of protective technique is people actually using condoms,” she said. “One problem has been the side effects of birth control. It puts so much strain on women that they’re less likely to use the barrier methods.”
Less investment has been made in getting men to use condoms, though studies have shown men use condoms when confronted by an advertisement about Zika, with male condom users feeling as though their partners are being safer (and if a partner chooses not to use a condom, it’s the idea of a non-condom user that causes men to try and get it, according to some research).
Decisions in how the US responded have been complicated and covered over. David Black, a professor of ecology and evolutionary biology at Dartmouth College, thinks the use of condoms started to improve soon after public health officials realized sexual contact was not the prime mode of transmission.
“Scientists realised that it took more than sex to get a virus to spread,” he said. “And they realised in the US that the best way to put an end to Zika would be through limiting the populations of mosquitoes and other carriers who spread it.”
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So condom use took on a new focus. Non-drug measures to prevent Zika, such as sterile condoms, meant that new trainings might not help the short-term Zika response. “That was the real problem we ran into,” Cohen said. “You don’t know how long a Zika virus is going to stay infectious.”
Over the past ten years, condom use in the US has stayed fairly steady, according to a statistic Cohen said is “probably a surprise to a lot of people”. The CDC did not immediately respond to a request for