A special review panel led by HHS' National Institutes of Health has concluded that male latex condoms can effectively reduce transmission of HIV/AIDS. However, the panel's report also finds that epidemiological evidence is insufficient to determine the effectiveness of condoms in actual use for preventing most other sexually transmitted diseases (STDs).
The report confirms that correct and consistent use of condoms can reduce the risk of HIV/AIDS transmission. Epidemiological studies also show condoms can prevent men from acquiring gonorrhea from a female partner, the report concludes.
However, the review panel concluded that epidemiological evidence is currently insufficient to provide an accurate assessment of the effectiveness of condoms in preventing spread of chlamydial infection, syphilis, chancroid, trichomoniasis, genital herpes and genital human papillomavirus (HPV) infection.
The panel said that "because of limitations in study designs, there was insufficient evidence from the epidemiological studies on these diseases to draw definite conclusions" about the effectiveness of condoms in actual use. It noted that "the absence of definitive conclusions reflected inadequacies of the evidence available and should not be interpreted as proof of the adequacy or inadequacy of the condom to reduce the risk of STDs." The panel also recommended further well-designed research to help answer remaining questions.
At the request of former Rep. Tom Coburn of Oklahoma, the National Institutes of Health, the Centers for Disease Control and Prevention, the Food and Drug Administration, and the U.S. Agency for International Development organized the workshop held in June 2000. Twenty-eight expert panel members analyzed more than 138 peer-reviewed, published studies on the properties and user patterns of the male latex condom during penile-vaginal intercourse.
Meta-analysis of several studies showed an 85 percent decrease in risk of HIV transmission among consistent condom users versus non-users. These data provide compelling evidence that consistent use of the latex male condom is a highly effective method for preventing HIV transmission, the report said. Studies also show a 49 percent to 100 percent reduction in risk of gonorrhea among men reporting condom use compared with non-users.
For the other STDs reviewed, existing studies were found insufficient to accurately assess effectiveness. For HPV, the panel found there was no evidence that condom use reduced the risk of HPV infection, but study results did suggest that condom use might afford some reduction in risk of HPV-associated diseases.
STDs, including HIV infection, affect more than 65 million people in the United States. Many STDs can cause infertility, problems with pregnancy, and can be passed from a mother to her infant. Long-term infection with HPV can cause cervical cancer if not diagnosed (through annual pap smears) and treated. In addition, most STDs increase the likelihood of transmitting HIV infection at least 2 to 5-fold. While most STDs can be treated successfully, no vaccine is currently available to prevent infection by organisms that cause STDs, except for hepatitis B.
The workshop summary, "Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention," is available on the Web at http://www.niaid.nih.gov/dmid/stds/condomreport.pdf
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