Bill Gates is paying big for better contraception. Here’s what scientists came up with.
This story first appeared on the New Republic
Perhaps the best thing that can be said about condoms is that they work. Once negotiated out of their crinkly wrappers, they reliably protect against pregnancy and sexually transmitted diseases, including HIV. They are simple to make, cheap to buy, and easy to obtain, whether you’re in Norway or rural Niger. Using a condom doesn’t require a prescription or a healthcare provider, and there are rarely any adverse effects – unless you consider the loss of pleasure, which, this being sex, matters a great deal.
On Wednesday, the Bill & Melinda Gates Foundation announced it was disbursing $1 million in grants for a next-generation condom that does the job without the perceived pleasure trade-off. “The undeniable and unsurprising truth is that most men prefer sex without a condom, while the risks related to HIV infections or unplanned pregnancies are disproportionately borne by their partners,” said Dr Papa Salif Sow, a senior program officer on the HIV team at the Gates Foundation. “The common analogy is that wearing a condom is like taking a shower with a raincoat on. A redesigned condom that overcomes inconvenience, fumbling, or perceived loss of pleasure would be a powerful weapon in the fight against poverty."
Many of the grantees are tackling the sensation problem by turning to materials other than latex. Latex, which is derived from natural rubber, has been the industry standard since Youngs Rubber Company, the first makers of Trojan condoms, rolled them out in 1920. While the latex of today is a marked improvement over yesteryear’s rubbers, researchers say further advancements are unlikely. The only modifications now are further design flourishes, like texture and cherry flavor. The advantages of latex are chiefly its cost (low) and durability (strong enough), while the drawbacks are well-known: it smells, slips, is thick, and, for some, allergenic.
Materials scientists from the University of Oregon are using their $100,000 grant from Gates to develop an ultra-thin condom of a polyurethane polymer with “shape memory” properties. Think of something similar to shrink wrap that conforms to the shape of an object as it is heated. Now think of a penis: during intercourse, body heat would cause molecules in the condom to contract, molding it to the user. The material also would be thinner – about half as thin as current condoms – and twice as strong, says Oregon’s Richard Chartoff. As a bonus, antimicrobial nanoparticles embedded into the condom would guard against sexually transmitted diseases.
“The goal is to make a condom that has the same texture as human skin – you won’t even know it’s there,” said Jimmy Mays of the University of Tennessee, another grantee, who believes he can get there with thermoplastic elastomers, a stretchy, durable class of plastic he’s been researching for 25 years. Thermoplastic elastomers, which feel soft and rubbery, can flex for a longer period than latex without breaking and then recover their initial dimensions, making them a favored material in consumer products like toothbrush grips and iPhone covers. “I’m not a condom guy – I’m a polymer chemist, and our material was tailor-made for this purpose,” he told me.
If the Holy Grail is to simulate human skin, then by a certain logic animal tendons make perfect sense. Mark McGlothlin, of Apex Medical Technologies in San Diego, will use his grant to produce a male condom using collagen fibrils from cow tendons, a material he’d once investigated as an alternative to latex in the mid-1980s at the height of the AIDS epidemic. (He eventually put out a polyurethane condom instead, which stayed on the market for 15 years.) “A lot people are trying to get stronger and thinner material – that was always my focus,” he said the other day. “But the texture of collagen is very much like the mucous membrane: the feel of it, the heat transfer of it, and to the touch, it feels very much like skin.” As McGlothlin explained, you can think of collagen condoms as a bio-safe, micro-thin cow leather, without the nasty tanning chemicals. Another advantage is that, as a raw material, collagen is ubiquitous across the world. McGlothlin will be getting his beef tendon from a Chinese food store in California, but slaughterhouses, or even fish markets, are other potential sources for the beef tendon condoms.
Meanwhile, the California Family Health Council, working with the Colombian inventor Innova Quality SAS, says it has a material that’s “going to revolutionise the way condoms are used,” according to Ron Frezieres, the Council’s vice president of research. That material is polyethylene, the same transparent, odorless, hypoallergenic, sheer plastic used in the gloves worn by food handlers. It clings rather than squeezes, promising to be less restrictive than standard condoms. Polyethylene is more environmentally stable than latex – it can sit for longer periods of time on the shelf of a sweltering warehouse before breaking down, for instance – and is also stronger, as proven by blowing air into it until it pops, the standard test by which the industry evaluates condom strength.
CFHC is basically taking an existing polyethylene condom which is made in Colombia and currently sold in eight countries, perfecting its design, replacing the oil-based lubricant for one that’s silicone-based, and working through the requisite FDA approvals. The real innovation, it says, is in the way the new condom is put on – or “donned,” in the jargon. You don’t unroll it, feeling and fumbling in the dark for the correct side. Rather, the condom, which comes rolled up with pull tabs, is pulled over the penis like a sock. (Here's a somewhat NSFW illustrated demonstration.) They will come as a set of three, packaged in the same kind of thin, credit card-shaped box as Orbit gum, and printed with catchy designs.
Other grantees are also exploring novel ways to don a condom. With his Gates money, Willem van Rensburg, a South African, will be improving upon a condom applicator he invented a few years ago. The new product, called Rapidom, works likes this: a foil condom wrapper, perforated down the middle, is held over the penis and pulled apart using both hands. Still attached to the condom, a plastic applicator inside the wrapper then guides the condom down until it is fully applied. With a final tug, the applicator and the wrapper come off, leaving the condom in place – all one motion, with only minimal disruption to the moment. “People don’t want to think – the sequence should flow logically and naturally,” said van Rensburg, who plans to spend eight weeks testing the Rapidom in “resource poor” areas of Africa.
The Gates Foundation is hoping that somewhere out there is an idea for a condom that men would prefer to no condom at all. Ultimately, said Dr Sow, the field is moving toward so-called multi-purpose prevention technologies (MPTs) – silver bullets that can effectively stanch both the 86 million unintended pregnancies and the 2.7 million new HIV cases around the world every year. A one-size-fits-all diaphragm, easier to use vaginal rings, improved gels and injectables – hormone shots – are some of the MPTs currently being developed. But the most promising MPT remains the most modest: a penis sheath.
This story first appeared on the New Republic.
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