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Can condoms prevent sexually transmitted infections other than HIV?
January 25, 2008Head-to-head: Are condoms the answer to rising rates of nonHIV sexually transmitted infection?
Consistent condom use can reduce the spread of HIV, but are they the answer to rising rates of other sexually transmitted infections"
Researchers debate the issue in this week's BMJ.
For people who are sexually active, condoms remain our best solution to reducing risks of acquiring sexually transmitted infections (if uninfected) or transmitting these infections (if infected), say Markus Steiner and Willard Cates of Family Health International.
Despite some inconsistencies in the evidence, studies show that condoms are an effective physical barrier against passage of even the smallest sexually transmitted pathogens, they write.
For example, a recent review provides strong evidence that condoms reduce the risk of gonorrhoea and chlamydia in both men and women. Studies have also shown consistent and correct use of condoms can reduce genital herpes and human papillomavirus infection.
However, the promotion of condoms remains controversial in many countries, including the United States. Another concern is that condom promotion could lead to risk compensation, although the authors point to a recent review of condom related prevention approaches which concluded that sexual risk reduction interventions do not increase unsafe sexual behaviour.
Like any prevention tool (such as seat belts or airbags) condoms are not 100% effective, they say. Accurate messages about condoms must build on a wide range of risk avoidance and risk reduction approaches, such as the ABC strategy: abstinence, be faithful to one partner, and use condoms.
They suggest that clinicians reassure people who are sexually active that condom use reduces the risk of most infections, while emphasising the importance of consistent and correct use for optimal risk reduction.
But Stephen Genuis from the University of Alberta argues that a more comprehensive approach is needed.
Condoms cannot be the definitive answer to sexually transmitted infection, he writes, because they provide insufficient protection against many common diseases. Intercourse generally involves skin to skin contact in the external genital area not covered by a condom.
But the main problem with condoms, he says, is that average people, particularly teenagers and young adults, do not use them consistently, regardless of knowledge or education.
He points to numerous large studies where concerted efforts to promote use of condoms has consistently failed to control rates of sexually transmitted infection - even in countries with advanced sex education programmes like Canada, Sweden, and Switzerland.
Data also suggest that changes in sexual behaviour (fewer partners, less casual sex, and less use of sex workers) rather than widespread condom use is reducing infections in countries such as Thailand and Cambodia.
The World Health Organisation estimates that two thirds of sexually transmitted infections worldwide occur in teenagers and young adults. Yet innumerable adolescents saturated with condom focused sex education end up contracting sexually transmitted infections, he argues.
Although factual information should be included in any discussion of sexually transmitted infections, narrow condom focused initiatives should be replaced with comprehensive evidence-based programmes, he concludes.
BMJ-British Medical Journal
For people who are sexually active, condoms remain our best solution to reducing risks of acquiring sexually transmitted infections (if uninfected) or transmitting these infections (if infected), say Markus Steiner and Willard Cates of Family Health International.
Despite some inconsistencies in the evidence, studies show that condoms are an effective physical barrier against passage of even the smallest sexually transmitted pathogens, they write.
For example, a recent review provides strong evidence that condoms reduce the risk of gonorrhoea and chlamydia in both men and women. Studies have also shown consistent and correct use of condoms can reduce genital herpes and human papillomavirus infection.
However, the promotion of condoms remains controversial in many countries, including the United States. Another concern is that condom promotion could lead to risk compensation, although the authors point to a recent review of condom related prevention approaches which concluded that sexual risk reduction interventions do not increase unsafe sexual behaviour.
Like any prevention tool (such as seat belts or airbags) condoms are not 100% effective, they say. Accurate messages about condoms must build on a wide range of risk avoidance and risk reduction approaches, such as the ABC strategy: abstinence, be faithful to one partner, and use condoms.
They suggest that clinicians reassure people who are sexually active that condom use reduces the risk of most infections, while emphasising the importance of consistent and correct use for optimal risk reduction.
But Stephen Genuis from the University of Alberta argues that a more comprehensive approach is needed.
Condoms cannot be the definitive answer to sexually transmitted infection, he writes, because they provide insufficient protection against many common diseases. Intercourse generally involves skin to skin contact in the external genital area not covered by a condom.
But the main problem with condoms, he says, is that average people, particularly teenagers and young adults, do not use them consistently, regardless of knowledge or education.
He points to numerous large studies where concerted efforts to promote use of condoms has consistently failed to control rates of sexually transmitted infection - even in countries with advanced sex education programmes like Canada, Sweden, and Switzerland.
Data also suggest that changes in sexual behaviour (fewer partners, less casual sex, and less use of sex workers) rather than widespread condom use is reducing infections in countries such as Thailand and Cambodia.
The World Health Organisation estimates that two thirds of sexually transmitted infections worldwide occur in teenagers and young adults. Yet innumerable adolescents saturated with condom focused sex education end up contracting sexually transmitted infections, he argues.
Although factual information should be included in any discussion of sexually transmitted infections, narrow condom focused initiatives should be replaced with comprehensive evidence-based programmes, he concludes.
BMJ-British Medical Journal
Sexually Transmitted Infections Current Events and Sexually Transmitted Infections News RSSTeen girls diagnosed with STI more likely to seek treatment for partners after watching video
A study at Johns Hopkins Children's Center found that girls diagnosed with pelvic inflammatory disease (PID) who watched a short educational video were three times more likely to discuss their condition with their partners and to ensure partner treatment than girls diagnosed and treated without seeing the film.
UIC study finds girls aware of HPV vaccine's benefits
Contrary to concerns that the human papillomavirus vaccine might promote promiscuity, a national survey of girls and young women found that the majority of respondents did not believe the HPV vaccine protected them against other sexually transmitted infections.
Scientists learn why even treated genital herpes sores boost the risk of HIV infection
New research helps explain why infection with herpes simplex virus-2 (HSV-2), which causes genital herpes, increases the risk for HIV infection even after successful treatment heals the genital skin sores and breaks that often result from HSV-2.
Risky sexual behavior among male clients of Tijuana sex workers heightens risk of HIV transmission
A study by a bi-national team of global health researchers at the University of California, San Diego School of Medicine, examining HIV infection among male clients of female sex workers in Tijuana, has found that over half of male clients had recently had unprotected sex.
Teens are heading in wrong direction: Likely to have sex, but not use contraception
Between 2003 and 2007, the progress made in the 1990s and early 2000s in improving teen contraceptive use and reducing teen pregnancy and childbearing stalled, and may even have reversed among certain groups of teens.
Chlamydia that avoids diagnosis
New sequencing and analysis of six strains Chlamydia will result in improved diagnosis of the sexually transmitted infection.
Herpes medication does not reduce risk of HIV transmission
A recently completed international multi-center clinical trial has found that acyclovir, a drug widely used as a safe and effective treatment to suppress herpes simplex virus-2 (HSV-2), which is the most common cause of genital herpes, does not reduce the risk of HIV transmission when taken by people infected with both HIV and HSV-2.
Cancer-causing virus associated with higher risk of new HIV infection
Infection with anal human papillomavirus (HPV), a virus that can cause anal and cervical cancers, is associated with a higher risk of new HIV infection in previously HIV-negative men who have sex with men (MSM), according to new UCSF research.
The key to good foreign aid: Research highlights aid achievements in Solomon Islands
Health aid contributes 60% of funding to the Solomon Islands. The Islands have considerable health concerns including a double burden of both infectious and chronic diseases.
Clinical trial finds microbicide promising as HIV prevention method for women
A clinical trial involving more than 3,000 women in the U.S. and southern Africa demonstrates for the first time the promise of a vaginal microbicide gel for preventing HIV infection in women.
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