| a) Male condoms? Yes, couples who use the male latex condom correctly and
consistently have a lower risk of acquiring all sexually transmitted diseases (STDs),
including human immunodeficiency virus (HIV), compared to non-users. The average reduction
is about 50%, although recent studies of HIV show that protection with consistent condom
use can be close to 100%. |
a) All studies have found that
male latex condom users have a lower risk of STD than non-users. The overall risk
reduction appears to be about 50%, but that figure is a gross estimate that includes
consistent and correct users as well as inconsistent users. In Thailand, a condom-only
campaign in brothels is associated with population-based reductions in gonorrhea and HIV
rates. Full-time latex condom users may reduce
their risk to near-zero. A multi-center Italian study followed seronegative female sexual
partners of HIV-infected men for a median of 24 months. The HIV incidence rate was reduced
by 90% in women whose partners always used condoms compared with women whose partners used
them inconsistently or never; women whose partners were inconsistent condom users did not
benefit.
In a multi-country European collaborative study, about
half of 343 couples used condoms at every coital act, and no new HIV infections occurred
among the consistent users. For the couples who used condoms inconsistently, new HIV
infections occurred at the rate of 4.8 per 100 per year, even though 50% of the
inconsistent users reported using condoms at least half the time. These two studies show
that consistent condom use is highly effective protection against HIV transmission, but
that inconsistent use carries considerable risks of HIV infection.
- Feldblum PJ, Morrison CS, Roddy RE,
Cates W Jr. The effectiveness of barrier methods of contraception in preventing the spread
of HIV. AIDS 1995;9(Suppl A):S85-S93.
- Cates W Jr, Stone KM. Family planning,
sexually transmitted diseases and contraceptive choice: a literature update-part 1. Family
Planning Perspectives 1992;24:75-84.
- Hanenberg RS, Rojanapithayakorn W,
Kunasol P, Sokal DS. Impact of Thailand's HIV-control programme as indicated by the
decline of sexually transmitted diseases. Lancet 1994;344:243-5.
- Saracco A, Musicco M, Nicolosi A,
Angarano G, Arici C, Gavazzeni G, et al. Man-to-woman sexual transmission of HIV:
longitudinal study of 343 steady partners of infected men. Journal of Acquired Immune
Deficiency Syndrome 1993;6:497-502.
- de Vincenzi I, for the European Study
Group on Heterosexual Transmission of HIV. A longitudinal study of human immunodeficiency
virus transmission by heterosexual partners. New England Journal of Medicine
1994;331(6):341-6.
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| b) Female condoms? If used correctly and consistently, the female condom should be
very effective in preventing STDs (including HIV), but this has not been confirmed in
human use studies. |
b) Only one cross-sectional
study of the female condom and STD re-occurrence has been done. Women with trichomoniasis
were treated, enrolled and followed for 45 days. Consistent users had no re-infections,
while 14% of inconsistent users and non-users were re-infected. The plastic membrane of
the female condom is impermeable to HIV and other STD organisms, so the device may reduce
the risk of HIV and other STDs in consistent users.
- Soper DE, Shoupe D, Shangold GA,
Shangold MM, Gutmann J, Mercer L. Prevention of vaginal trichomoniasis by compliant use of
the female condom. Sexually Transmitted Diseases 1993;20:137-9.
- Drew WL, Blair M, Miner RC, Conant M.
Evaluation of the virus permeability of a new condom for women. Sexually Transmitted
Diseases 1990;17:110-2.
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