When biomedical engineer Robert Gorkin saw the Bill and Melinda Gates Foundation’s 2013 call for submissions for a next-generation condom, he was hardly a contraceptive innovator. Rather, his work focused on 3D-printing organs and prosthetics. But when he reviewed the initiative’s goals — funding would be awarded to applicants who proposed a pleasurable, easy-to-use condom, thus encouraging regular use worldwide — Gorkin, a research fellow at Australia’s University of Wollongong, saw an opportunity. The materials he and his team used to make prosthetic organs had physical similarities to human tissue and skin. Why couldn’t he engineer a condom with these same products to create a prophylactic that felt like the user wasn’t wearing one at all?
So Gorkin submitted his proposal for a hydrogel condom, a material both durable and touch-sensitive, and he and ten other applicants were awarded $100,000 to continue development. Six years later, Gorkin is still working. Consumers aren’t yet able to find his stretchy, skin-like prophylactic at drugstores, but he’s getting close: Gorkin’s condoms are heading into clinical trials this year, he says, which puts his invention about two or three years away from mass consumption.“We’re looking at a new condom platform that is to replace the legacy materials of latex with a new experience,” Gorkin says. “We approached this not just as a scientific innovation, but as what does a condom need to be?” (Three other grant recipients received phase-two funding of $1 million each and progressed to the clinical trial stage, according to the Gates Foundation.)
After more than 100 years on the market, modern condom use is still plagued by a perceived lack of sensation. In a 2007 study, both male and female survey respondents preferred unprotected penetrative vaginal sex over intercourse with a condom. And there’s research to back up why: In 2014, researchers examining penile sensitivity to vibrations found condom use “was associated with higher vibratory thresholds than a penis without a condom, indicating that condoms may decrease penile sensitivity.”
But if the Gates Foundation could encourage scientists to dream up a condom people would actually enjoy wearing — not to mention an affordable rubber which could be distributed to developing nations — this might encourage more consistent contraceptive use. Think even bigger, and our society might be able to lower new HIV transmissions and unplanned pregnancies. Because, after all, when used correctly, condoms are incredibly effective (98 percent efficacious, according to Planned Parenthood) at preventing the spread of sexually transmitted infections like gonorrhea, chlamydia, trichomoniasis, HIV and pregnancy.
“There are scientists out there who are pushing the cutting edge,” Nomi Fuchs-Montgomery, deputy director of the Bill and Melinda Gates Foundation’s family planning team, tells Rolling Stone. “And can we apply that to contraception? What would an innovation and technology look like that would speak to users needs and improve continuation and use?”
The condom, as it exists today, has roots dating back to 3,000 B.C. when King Minos of Crete utilized a goat bladder to protect his wife and mistresses from the supposed serpents and scorpions in his semen. Ancient Egyptians and Romans also fashioned sheaths from linen and animal intestines and bladder for contraceptive and disease prevention. Even more recently, Renaissance Europeans adopted animal product sheaths, with the first use of the word “condom” appearing in a London dictionary in 1785.
During the Industrial Revolution, rubber condoms became the norm, thanks to rubber vulcanization, a chemical process that allowed for tough, but elastic, rubber. However, the development of latex in the 1920s and assembly-line manufacturing brought thinner and stronger condoms to the masses. Save for the introduction of the reservoir tip in the 1950s, condoms with added lubricant, condoms have remained largely unchanged.
That doesn’t mean companies haven’t tried. Because condoms are considered medical devices, the requisite U.S. Food and Drug Administration approval process is long and arduous. Manufacturers providing upgrades to latex condoms (like adding flavor or texture) can get their product to market quicker by adhering to pre-approved guidelines for safe and effective condoms. For innovators like Gorkin, who are using a new material entirely, condoms must be tested for safety, slippage, contraceptive effectiveness and more. Bringing a condom to market can cost as much as $10 million, Gorkin says.
For their part, legacy brands like Trojan, Durex and LifeStyles have continued to evolve, making their rubbers thinner and thinner while maintaining strength and elasticity. Take, for example, LifeStyles’ SKYN condoms, made of a soft substance called polyisoprene in lieu of polyurethane. SKYN hit the market in 2008, but had been in development for over a decade, says Matthew Groskorth, LifeStyles’ vice president of global marketing. “The thing we’re most interested in is the material science,” he says. “Conventional wisdom is the thinner and thinner you make it, the more comfortable. What we’ve learned is that it’s the softness of the material that contributes more toward the comfort of the condom.”
In 2016, luxury sex toy company LELO unveiled their HEX condom after seven years of development, says LELO brand manager Stuart Nugent. The difference between the HEX and other latex condoms is its structure: a web of superthin interlocking hexagonal latex panels. Though LELO experimented with other materials, like lambskin and polyurethane, developers determined latex to be a superior condom material. The design was inspired by graphene, which consists of a single layer of hexagonal carbon molecules and is touted as one of the thinnest and strongest materials available. However, until producing a graphene condom becomes less costly, Nugent says, LELO will continue to use latex.
“In the meantime, there are things that you can do to innovate and to push the technology forward, which is where HEX comes in,” he continues. “We managed to use relatively conventional production techniques, but we didn’t completely reinvent the wheel. What we have is a reengineering of the condom, something to show the industry that people are ready for innovation while we try to make the true materials of the future more viable.”
In addition to altering condom design, organizations are working to get contraceptives into more bedrooms. The Gates Foundation is focusing on user feedback, Fuchs-Montgomery says, by funding research and investing in family planning programs to find where existing forms of birth control fall short. By identifying the reasons both men and women stop using contraceptives, including condoms and hormonal pills, the Foundation can solve for those problems, Fuchs-Montgomery continues. “When we think about the global problem, not just in developing countries, but individuals around the world who have safe and effective contraceptives but in fact they’re not using them, what can we do to make that better?” she says. “There’s been zero-percent growth in the contraceptive market from 2010 to 2015. Condoms are safe and effective, IUDs are safe and effective [but] people are not speaking out that you can actually do better.” Through their research, the Gates Foundation is aiming to discover the ways consumers would imagine their birth control in an ideal world.
And when it comes to condom access, the internet has lowered the barrier to entry for shopping considerably. Global Protection sells their eight brands — including myOne which offers 60 sizes — almost exclusively online. “You can’t have 60 sizes at the retail shelf,” says Davin Wedel, CEO of Global Protection. The web empowers consumers to shop around for specs they want — like proper size and material, for example — and have them delivered to their doorstep.
But even when such varieties of prophylactics are at the ready, what gets consumers to actually use them? The advertising supporting condom use during the HIV/AIDS epidemic of the 1980s and 1990s was successful in increasing condom sales, however with the advancement of antivirals that make living with HIV manageable and the emergence of HIV-preventative drugs like Pre-Exposure Prophylaxis (known as PrEP), an HIV diagnosis is no longer as dire as it was once was. In recent years, various campaigns like MTV’s “It’s Your (Sex) Life” and the return of the Trojan man attempted to spark modern conversations around protected sex and normalize condom use.
The solution doesn’t exist solely in advertising campaigns or manufacturing a superior product, but instead in a comprehensive overhaul, Gorkin says. In continuing to develop his hydrogel condom, Gorkin has surveyed condom users and determined “the whole experience could be improved” from the way the sheath looks and smells to the messaging around the item. “The narratives need to be changed so we can accept there’s a major part of sex that’s about pleasure,” he says. “There should be positive connotations: [condoms are] allowing you to be intimate with somebody but not necessarily have a disease or pregnancy.”
The need for condoms will never wane, simply because they work so well, Gorkin says. But manufacturers and researchers should find value in making investments in pushing the needle forward, he continues. Within the next five years, he anticipates new products will emerge, including his hydrogel condom and brands offering condom customization. But perhaps the most impactful advancement would be the integration of sexual health and general health, that to promote overall wellness, one must make proactive choices in the bedroom, too.
“We do think we can make a better feeling condom,” Gorkin says. “The impacts of that are yet to be seen, but it would be fantastic if that spread to more people using condoms, less STIs, more planned pregnancies, and a conversation of how we have better relationships. That’s that holistic approach.”