Specialists express concern over condom report

David Spurgeon Quebec

A US report questioning the effectiveness of condoms in preventing most sexually transmitted diseases could deter people who are sexually active from using them, public health specialists have warned.

The report has been published by a special review panel of the National Institute of Allergy and Infectious Diseases, National Institutes of Health, and the Department of Health and Human Services. The 28 member panel concluded that although male latex condoms can effectively reduce the transmission of HIV and male gonorrhoea, the evidence did not allow the same to be said about chlamydial infection, syphilis, chancroid, trichomoniasis, genital herpes, or genital human papillomavirus infection.

The panel members analysed more than 138 peer reviewed, published studies after a workshop on the topic was held at the request of former Republican congressman and physician Tom Coburn of Oklahoma. Dr Coburn said that the report's conclusions mean that "when condom use is discussed, it is no longer medically accurate... to refer to sex as 'safe' or 'protected.'"

However, the executive summary of the report emphasised that it should not be interpreted as proof of the adequacy or inadequacy of the condom to reduce the risk of STDs [sexually transmitted diseases] other than HIV transmission in men and women and gonorrhea in men.

Edward Hook, a professor of medicine at the University of Alabama and a panel member, said that since the panel had carried out its review, a study has found that condoms provided significant protection against genital herpes infection in women (JAMA 2001;285:3100-6).

Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention is at www.niaid.nih.gov/dmid/stds/condomreport.pdf



studentBMJ 2001;09:305-356 September ISSN 0966-6494