Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2009 Jul 13;169(13):1233-40.
doi: 10.1001/archinternmed.2009.177.

A pooled analysis of the effect of condoms in preventing HSV-2 acquisition

Emily T Martin  1 , Elizabeth Krantz, Sami L Gottlieb, Amalia S Magaret, Andria Langenberg, Lawrence Stanberry, Mary Kamb, Anna Wald
Affiliations
Comparative Study

A pooled analysis of the effect of condoms in preventing HSV-2 acquisition

Emily T Martin et al. Arch Intern Med. .

Erratum in

  • Arch Intern Med. 2010 Jun 14;170(11):929

Abstract

Background: The degree of effectiveness of condom use in preventing the transmission of herpes simplex virus 2 (HSV-2) is uncertain. To address this issue, we performed a large pooled analysis.

Methods: We identified prospective studies with individual-level condom use data and laboratory-defined HSV-2 acquisition. Six studies were identified through a review of publications through 2007: 3 candidate HSV-2 vaccine studies, an HSV-2 drug study, an observational sexually transmitted infection (STI) incidence study, and a behavioral STI intervention study. Study investigators provided us individual-level data to perform a pooled analysis. Effect of condom use was modeled using a continuous percentage of sex acts during which a condom was used and, alternatively, using absolute numbers of unprotected sex acts.

Results: A total of 5384 HSV-2-negative people at baseline contributed 2 040 894 follow-up days; 415 persons acquired laboratory-documented HSV-2 during follow-up. Consistent condom users (used 100% of the time) had a 30% lower risk of HSV-2 acquisition compared with those who never used condoms (hazard ratio [HR], 0.70; 95% confidence interval [CI], 0.40-0.94) (P = .01). Risk for HSV-2 acquisition increased steadily and significantly with each unprotected sex act (HR, 1.16; 95% CI, 1.08-1.25) (P < .001). Condom effectiveness did not vary by gender.

Conclusions: To our knowledge, this is the largest analysis using prospective data to assess the effect of condom use in preventing HSV-2 acquisition. Although the magnitude of protection was not as large as has been observed with other STIs, we found that condoms offer moderate protection against HSV-2 acquisition in men and women.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Distribution of average percent condom use during study follow-up
Figure 2
Figure 2. Study-specific hazard ratios (and 95 percent confidence intervals) for the effect of (a) a 25 percent increase in condom use and the effect of (b) increasing unprotected sex acts on HSV-2 acquisition
Size of dark squares are proportional to the inverse variance of the estimate and centered on the hazard ratio. Horizontal lines indicate the 95% confidence interval for effect on time until HSV-2 acquisition. Diamonds are centered on the pooled hazard ratio estimate (dashed line) and width indicates the 95% confidence interval.
See this image and copyright information in PMC

References

    1. Davis KR, Weller SC. The effectiveness of condoms in reducing heterosexual transmission of HIV. Fam Plann Perspect. 1999 Nov-Dec;31(6):272–279. - PubMed
    1. Fact Sheet for Public Health Personnel: Male Latex Condoms and Sexually Transmitted Diseases: Centers for Disease Control and Prevention. 2003
    1. Holmes KK, Levine R, Weaver M. Effectiveness of condoms in preventing sexually transmitted infections. Bull World Health Organ. 2004 Jun;82(6):454–461. - PMC - PubMed
    1. Casper C, Wald A. Condom use and the prevention of genital herpes acquisition. Herpes. 2002 Apr;9(1):10–14. - PubMed
    1. Corey L. Increasing prevalence of HSV-2 points to need for more effective prevention strategies. Herpes. 2002;9:3. - PubMed

Publication types

Substances