Academic journal article The Canadian Journal of Human Sexuality

The Effectiveness of Latex Condoms for Prevention of STI/HIV

Academic journal article The Canadian Journal of Human Sexuality

The Effectiveness of Latex Condoms for Prevention of STI/HIV

Article excerpt

Abstract: Guidelines and statements issued from the Public Health Agency of Canada and the World Health Organization state that the proper and consistent use of latex condoms reduces the risk of infection with human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). This report summarizes research indicating that latex condoms provide an essentially impermeable barrier to STI/HIV pathogens and, from epidemiological studies, that proper and consistent latex condom use substantially reduces the risk of infection with HIV, Chlamydia, gonorrhea, herpes simplex virus type-2 (HSV-2), and human papillomavirus (HPV). Clinicians, pharmacists, and educators should strongly recommend proper and consistent latex condom use to reduce the risk of STI/HIV infection.

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According to the Public Health Agency of Canada (2002), "Condoms used consistently and correctly provide protection against getting or spreading STIs--including HIV" (p. 1) and the Canadian Guidelines on Sexually Transmitted Infections (Public Health Agency of Canada, 2006) indicate that clinical and public health professionals, including physicians and nurses, should strongly recommend consistent condom use to prevent STIs among at-risk persons (p. 334-338). The importance of condom use for the prevention of STIs is echoed by the World Health Organization (WHO, 2000): "Condoms are the only contraceptive method proven to reduce the risk of all sexually transmitted infections (STIs), including HIV" (p. 1).

There are two major ways in which the effectiveness of condoms in preventing STI and HIV has been assessed. The first type is laboratory studies (also known as in vitro studies) in which researchers test a condom's ability to provide a barrier against particles the size of STI/HIV pathogens. The other main type is epidemiological studies which can take several forms. For example, an epidemiological study may compare rates of STI/HIV infection between individuals or couples who use condoms versus individuals or couples who do not use condoms. Another type of epidemiological study may examine rates of infection among people who don't use condoms compared to people who use condoms some of the time (inconsistent users) or every time (consistent users) they have penetrative sex. As documented below, both types of studies have clearly indicated that the consistent use of latex condoms significantly reduces the risk of STI/HIV infection.

Impermeability of latex condoms to STI/HIV-sized particles

According to the United States Centers for Disease Control and Prevention (CDC, 2000), "Laboratory studies have demonstrated that latex condoms provide an essentially impermeable barrier to particles the size of STD pathogens" (p. 2). Once it became clear that most cases of HIV/AIDS were sexually transmitted, determining the effectiveness of latex condoms in preventing sexual transmission of the virus became a scientific priority. As a result, a number of laboratory-based studies were conducted to determine if latex condoms block HIV. The United States Food and Drug Administration Division of Physical Sciences conducted laboratory tests and found that under extreme and highly unlikely conditions of stress (i.e., "worst-case condom barrier effectiveness") using a latex condom was estimated to reduce exposure to HIV by at least 10,000 times compared to not using a condom (Carey et al., 1992). Other laboratory studies have confirmed that HIV-sized particles do not permeate latex condoms or, if leakage does occur, it is in an amount so small that it makes infection extraordinarily unlikely (Conant et al., 1986; Lytle et al., 1992; Lytle et al., 1997; Rietmeijer et al., 1988; Van de Perre, Jacobs, & Sprecher-Goldberger, 1987).

Laboratory studies have also demonstrated that latex condoms provide an impermeable barrier to Chlamydia, gonorrhea, hepatitis B virus, herpes simplex virus, and cytomegalovirus (CDC, 1988; CDC, 1993). …

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