Abstract

PIP: A number of studies have demonstrated that when used consistently and correctly, both male and female condoms prevent unplanned pregnancy and the spread of sexually transmitted diseases (STDs). For example, in a study of US navy personnel who reported having vaginal intercourse with prostitutes who had a high prevalence of gonorrhea, none of the 29 men who reported using condoms during their sex acts contracted gonorrhea or nongonococcal urethritis. However, 14% of the 499 nonusers became infected. The preponderance of evidence from 10 studies of high-risk populations in 7 countries where both the level of condom use and HIV infection were prospectively measured showed the consistent use of male condoms to protect against HIV acquisition in the range of 50-100%. Additional evidence in support of condom use comes from two studies involving HIV-discordant couples. A European study of 123 such couples who consistently and correctly used condoms found that no HIV-uninfected partner became infected with HIV by their partners. Similarly, 1 of 42 seronegative partners in HIV-discordant couples in Haiti became infected with HIV after having consistently used condoms. In both of these studies, 7-14% of couples who used condoms either consistently or not at all became infected. Since the government of Thailand began promoting 100% condom use among prostitutes and their clients, there has been a decline in both the level of curable STDs reported to clinics and HIV prevalence among Thai military recruits. Male and female condoms are effective even under typical imperfect conditions, and their consistent use should be encouraged at every opportunity.