For all of the condom's benefits – no prescription, no side effects, extremely effective in preventing STDs and pregnancy – most guys just don't like wearing one. Condoms decrease sensitivity and pleasure ("like taking a shower in a raincoat," as the saying goes), and they're a hassle to put on. Unfortunately, reluctance to use them has real consequences. HIV-infection rates may have stabilized in the U.S., but they remain alarmingly high globally; AIDS is now the leading cause of death in sub-Saharan Africa. So, last March, the Bill & Melinda Gates Foundation called for proposals to develop the "Next Generation of Condom." The ultimate goal, says Dr. Papa Salif Sow, a senior program officer in HIV prevention and treatment at the foundation, is to boost usage while "improving the sensation so that the loving distance between the two partners will be reduced."
Over the next two months, the foundation collected 812 proposals. Some, including a partial condom for the tip of the penis and a spray-on condom, were rejected immediately. Ultimately, the foundation narrowed the group to 11 finalists and, last November, awarded them $100,000 each to develop their ideas. Next year the most promising will receive $1 million for further testing, with the aim of soon bringing a new condom to market.
So what does the condom of the future look like? A few of the Gates finalists proposed new methods for donning condoms more easily, like the Rapidom, an applicator that pulls on a condom in one fluid motion. But most are experimenting with different materials, including polyurethane (an elastic plastic typically thinner and stronger than latex), polyethylene (a thin plastic possibly stronger than polyurethane but less elastic), nanomaterials like graphene, and materials that simulate human mucosal tissue.
But, while the latex model is clearly imperfect, these other substances have their own drawbacks. Most researchers have tried to tackle the sensitivity issues with ever-thinner yet more durable materials, but the stronger a material is, the stiffer it becomes, which diminishes sensitivity. A condom too thin and compact, however, could constrict blood flow. "Tensioning down on the nerve receptors is not good for sensitivity," says Mark McGlothlin, president and CEO of Apex Medical Technologies in San Diego, a Gates recipient. "It's a tough balancing act."
McGlothlin, who patented the first polyurethane condom in the 1990s, took inspiration for his proposal from condoms of antiquity, when natural materials like fish bladders and animal intestines (the forerunner of today's lambskin condom, which provides good sensitivity but is a less than optimal barrier) were used. He devised a condom made of highly refined collagen, which could potentially be harvested from fish skin ("one of the most environmentally sound sources to use") or the ankle tendons from cattle, which are strong enough to support a 1,000-pound animal. McGlothlin says his biodegradable condom will be soft like microthin leather but will conform to skin like a "wet piece of Kleenex," which would increase sensitivity. "We're not trying to put an alien material in; we're using something that's very close to what Mother Nature had in mind," says McGlothlin.
On the other hand, Ron Frezieres, vice president of research for the California Family Health Council, went synthetic. His condom is made of polyethylene, which is used in the food industry for ultrathin gloves, containers, and shopping bags. It's one-fifth as thick as latex yet in preliminary tests has proved significantly stronger. "Condoms generally squeeze the penis," says Frezieres, but his condom "pulls over an erect penis like a sock, and then it clings," like a stretchier, non-crinkly Saran Wrap. Polyethylene is transparent, odorless, unaffected by UV light, and can withstand very high temperatures – which would make it ideal for storage in warehouses in sub-Saharan Africa. And, for the heat of a passionate moment, Frezieres says, there's "a unique donning system with pull tabs that can be pulled in only one direction, so no one can get confused."
Not all of the progress in reinventing the rubber has come via the Gates competition. For Los Angeles–based Origami Condoms founder Danny Resnic, the endeavor has been a personal crusade: He was infected with HIV in 1993 as a result of a broken condom. "I was really troubled that a product we all depend on for safety could fail so easily," he says. "It was a dark period for me."
Resnic holed up in the Miami Beach public library, researching condom history and Xeroxing old patent schematics of "condoms that looked like spaceships." "I was shocked," Resnic says. "I couldn't imagine another product that most people found objectionable but that had produced no major innovations over the years."
In 2000, after years of hard work and dozens of failed ideas, Resnic finally hit on something promising. Rather than merely scoping out new materials, he reimagined the condom itself, putting the idea of pleasure, rather than protection, first. "What I realized about condoms was that they were a barrier that did not move, a snug wrapper that interfered with the natural operation of intercourse, where the penis receives stimulation from fluid contact," he says. "So I challenged myself to come up with a way to restore that environment inside the condom."
His solution: an accordion-like condom, lubricated on the inside, that moves with the body during sex. "Because we have this reciprocating motion, we're not reliant on a condom being microthin," Resnic says. "We're not transferring sensation from the outside to the inside – we're creating sensation on the inside. So it's not about material; it's about mechanics and engineering."
Origami has one study to complete before it submits data for regulatory approval and expects its condom (most likely to be made of silicone) to be available for sale in 2015. It is also working on a female condom and an anal model, which, Resnic says, would be the first of its kind endorsed by the FDA.
Like Origami, the Gates winners will have to jump FDA hurdles if their condoms have any hope of being manufactured. Four of the 11 finalists plan on using nanomaterials (microscopic particles), whose impact on humans and the environment is still unknown and faces rigorous scrutiny. The potential applications of graphene, a single-atom-thick layer of graphite that was first isolated in 2004, still may be more science fiction than fact. No one has yet made a continuous layer of graphene, and it's unclear whether millimeter-size chunks of it, added to an existing material like latex, would actually make a condom significantly stronger.
"One of the problems with the condom industry is the technology is 30 years behind the times," says Richard Chartoff, director of the Polymer Characterization and Thermal Analysis Laboratory at the University of Oregon, and another Gates recipient. (Chartoff's condom is a one-size-fits-all model made from polyurethane elastomers he calls "shape-memory materials," which will conform to the individual's size when the temperature is raised.) "There's no incentive for people to do a lot of research because they've got a captive market."
Indeed, the global condom market is dominated by a few major players – Trojan, Durex, Australian maker Ansell, and Japanese company Okamoto. Because latex is best used fresh, much manufacturing occurs in Malaysia, Thailand, or tropical countries with direct access to it, which has allowed these firms to establish a kind of latex cartel – and, Resnic says, to cling tight to their existing infrastructure. "They are locked into this tight-fitting rolled condom because their factories are set up with that equipment. To move to anything else is a very expensive proposition."
The FDA and regulatory authorities, too, may be guilty of what McGlothlin terms "latex mentality." "There's a vested interest on the part of the government, including the Centers for Disease Control and Prevention, to make a statement that you have to use a latex condom," says McGlothlin. "They have so much money invested in that public relations sound bite, it's going to be very difficult, even with good data, to get anyone to back off that statement."
All of which may go a long way toward explaining why, after centuries of trying, something as seemingly basic as a protective yet comfortable sheath for your junk is still such an elusive target. Then again, it doesn't help that, for all the thinking we dudes do with our penis, sometimes we just can't make up our minds. "I don't think any one of the 11 is going to be the perfect condom that everyone is going to go and use," says Frezieres. "It's a hard question to answer, because for every man who wants a supersheer condom he can't see and is invisible, there's the man who wants a red neon condom that glows in the dark, and for every man who wants it superthin, there's a man who wants it thick with ridges on it. People are looking for different things."