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Even if a condom could detect sexually transmitted infections, is that a good idea?

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Writing on the Mall

On June 24th, the news media burst forth with an exciting tale of three British wunderkinds poised to revolutionize sexual health with an STI-detecting condom. Multiple outlets picked up the story, but in all the excitement, few stopped to ask two very simple questions: was this magical, microbe-detecting condom actually feasible? And, assuming it was, would making it available to the masses actually be a good idea?

So — is it feasible? Not really. S.T.EYE, a concept dreamed up for the TeenTech Awards (effectively a UK-wide science fair), is more a pipe dream than a prototype — and one that doesn’t do much to factor in the existing science of STI detection. As outlined by Muaz Nawaz, 13; Daanyaal Ali, 14; and Chirag Shah, 14; students at the Isaac Newton Academy in East London, S.T.EYE would contain antibodies for a variety of STIs. If one of those STIs happened to be present in the genitals of a condom wearer or their partner, the antibodies would recognize the antigens and cause the condom to change color — a different one for each STI.

To work as proposed, the S.T.EYE would have to make use of a rapid-acting test. At present, HIV is the only STI that has a rapid test on the market. And Oraquick — an at-home test that detects HIV antibodies in saliva — wouldn’t fit the model proposed by the S.T.EYE team: it takes 20 minutes to provide results.

Perhaps the closest model to the S.T.EYE dream is the rapid strep test, which uses antibodies to detect antigens. But even that test takes several minutes to register results — not quite like the magical, instant diagnosis envisioned by much of the media. Add in the fact that you’d need something that could test for a wide range of STIs in one go — which no current test is able to do — and we’re clearly off in the realm of science fiction rather than science fact.

Of course, the fact that the science isn’t there yet is not an indication that it never will be. So it’s still worth asking whether an STI-diagnosing condom is actually a good idea — and here, the answer is a bit more complex.

Colin Adamo, the sex educator behind Hooking Up and Staying Hooked, is at least heartened to know that the young men behind S.T.EYE are thinking about sexual health. "They recognized that sexually transmitted infections are a problem among their classmates, and their peers across the country, and they’re approaching that problem creatively. That’s great."

But while he applauds their intent, he sees issues with the execution. "I think the fact that they created this as a solution is evident of the larger problems related to sexual health education and discourse" in both the United States and the UK. The idea that it might be more desirable to learn about a STI diagnosis from a condom, rather than a conversation with your partner about sexual health and safer sex practices is troubling — and, what’s more, suggests we’re not providing young people with the skills needed to have these very important conversations.

And if young people can’t talk about sexual health with their partners, what makes us think that those same young people (or any of us, really) have the emotional maturity to handle receiving the diagnosis of a highly stigmatized infection at an incredibly vulnerable moment? "If you don’t possess the emotional intelligence or communication skills to have conversations about sexual health before a sexual encounter with a partner, and then all of the sudden you have this meter that tells you you are at risk of contracting a sexual infection from someone you are inside of, or just pulling out of, what does that mean in terms of what you do next?" Adamo continues.

Even though one in two people will contract an STI at some point in their life, these infections are still highly stigmatized — and it’s easy to envision in a scenario in which the reveal leads to shame, anger, and, potentially, violence. "In a perfect world, where there was no stigma related to STIs… and the response would just be, ‘Oh, hey I should get treated for that,’ you could see how something like this could be a really interesting innovation," says Dr. Leslie Kantor, vice president of education for the Planned Parenthood Federation of America. We don’t live in that world.

"We’re actually doing some work on the link between HIV and intimate partner violence — and, sad to say, but there are times when, as a result of a partner disclosing their HIV status, they are met with both verbal and sometimes physical violence," Kantor says. Even if that’s an extreme scenario, it seems rather likely that few couples would greet an unexpected STI diagnosis calmly. Add in the likelihood of false positives, and suddenly a couple winds up angry and ashamed over an STI that neither one of them has — and, given that they were using a condom, that they would have been unlikely to transmit to one another regardless.

Which leads us to the truly ironic aspect of an STI-detecting condom: anyone using such a product consistently and correctly wouldn’t actually need the added tech that it provides. By and large, condoms — even just the boring, low-tech condoms we have today — are very, very good at preventing STI transmission. To the extent that STIs continue to be a problem among sexually active people, it’s not because condoms themselves are failing to protect us: it’s because many of us just aren’t using them.

"The big message we need to get to people is that the best kind of condom is one that makes you wear it," says Kantor. "If somebody can do that, then we should definitely give them all the science prizes." Adamo, on the other hand, thinks the answer we’re looking for is already in our hands. "There are way easier solutions than a really high-tech, Star Trek condom," he says. If a better condom is all you’re looking for, you don’t have to wait years for something like S.T.EYE to actually hit the market. If and when high-tech condoms actually arrive, they’re likely to be significantly more expensive than your standard Trojan. Anyone who’s willing to spend more on condoms already has a wide range of more upscale options available.

None of which is to say that we don’t need better tech to improve sexual health outcomes, or that would-be tech entrepreneurs should steer away from this topic. But for a better model than S.T.EYE, look to the apps recently released by Planned Parenthood. Planned Parenthood Direct — which launched this month in California — offers access to at-home (though not instant) STI testing; when paired with Planned Parenthood Care, users also get access to video visits with Planned Parenthood health care providers. While these programs address the same desire for discretion and privacy met by S.T.EYE, they also ensure that users get the care, consideration, and education associated with a clinic visit — as well as connecting them to appropriate treatment, should their test come back positive. Though the programs are still in pilot stages, they’ve shown great promise as options for individuals interested in accessing STI testing in a comfortable, private setting. Innovative new technology may one day dramatically change how we think about sexual health: it’s just far more likely to come from dedicated sexual health programs than a group of teenagers at a science fair.