Government officials in the Marshall Islands say the virtually non-existent use of condoms is a potentially dangerous situation.
The Marshalls already has the region's highest teen pregnancy rate and high rates of sexually transmitted diseases.
The lack of condom use may also force health officials to dump thousands of donor-donated condoms that will expire in January.
A Marshall Islands government report on the state of health services says there is a continuing high rate of sexually transmitted diseases, particularly syphilis.
The report also found that many infections are not being caught early, leading to more health complications and higher treatment costs.
Although the numbers diagnosed with HIV remain relatively low, the information is providing little comfort to health providers who are aware of the linkage between high syphilis rates and HIV infection.