Condoms protect against herpes, study shows
Results from a just-published study indicate that consistent use of condoms is associated with lower rates of infection with herpes simplex virus-2 (HSV-2) and should be routinely recommended.1
The 18-month study, which included 1,843 adults who had a sexually transmitted disease (STD) or four or more sexual partners in the last year, found that participants who used condoms at least three-quarters of the time were 25% less likely to acquire HSV-2 than others in the study. According to lead researcher Anna Wald, MD, MPH, professor of medicine at the University of Washington in Seattle, the analysis is one of the first studies to show that condoms can reduce the risk of HSV-2 transmission.
"It showed that condoms work for both men and women, and in the past, that has not been very clear," she says.
Strengths of the study include its multicenter design, the large number of carefully evaluated participants, and use of serologic measures for detection of infection, states Edward Hook III, MD, professor of medicine at the University of Alabama in Birmingham, in an accompanying commentary to the study.2 "In the last two years, we have removed the question as to whether condoms prevent some of the most common STDs we see," he says. "That includes herpes, which affects 45 million Americans and for which there are a million new cases a year, as well as gonorrhea and chlamydia, which between the two of them, there are over 4 million new cases every year."3,4
Latex highly effective
According to Contraceptive Technology, clinical studies have shown latex condoms to be highly effective against HIV infection, the most serious STD, and should be promoted to sexually active patients at risk for STDs for this reason alone.5
Most people have no signs or symptoms from HSV-1 and 2 infections; when signs do occur, they typically appear as one or more blisters around the genitals or rectum.6 The blisters break, leaving tender ulcers that may take two to four weeks to heal the first time they appear. Another outbreak can occur weeks or months after the first, but usually is less severe and shorter in duration. While the infection can stay in the body indefinitely, the number of outbreaks tends to decrease over a period of years.6
Men and women who were involved in the condom study were participants in a study of a herpes vaccine that did not work. Investigators evaluated the participants 11 times over 18 months and collected information about sexual activity and frequency of condom use at each visit. Blood samples also were taken at each visit to check for HSV-1 and HSV-2 infection.
To conduct the analysis, investigators looked at the relationship between frequency of condom use and HSV infection. During the study, 118 of the 1,843 participants developed HSV-2 infection, and 19 developed HSV-1 infection. Participants reporting more frequent condom use were less likely to develop HSV-2 infection than patients who reported less frequent condom use. The researchers found no association between frequency of condom use and HSV-1 infection; too few participants were exposed to the infection during the study to determine such a link, researchers note.1
FDA eyes new labeling
The impact of condoms on STD prevention has been a source of ongoing debate. Some conservative groups have claimed that condoms are less than effective in STD protection.
The debate has flared with the Food and Drug Administration (FDA) issuance of a draft guidance for condom labeling. (Access the guidance on-line at www.fda.gov/cdrh/comp/guidance/1548.pdf.)
The new research on HSV and condoms adds further scientific evidence to the effectiveness of condoms, says Hook.
"In the last year or two, we have had good, well-conducted, published studies and analyses that show that condoms prevent these very common STDs and adds assurance to what many clinicians already believe," states Hook. It also adds empirical evidence and scientific proof to demonstrate to those people who would argue whether condoms really work," he says.
Wald adds, "I think recommendations should be based on scientific evidence, and scientific evidence shows that condoms can reduce the risk of many STDs, including HSV."
References
- Wald A, Langenberg AG, Krantz E, et al. The relationship between condom use and herpes simplex virus acquisition. Ann Intern Med 2005; 143:707-713.
- Hook EW 3rd. An ounce of prevention. Ann Intern Med 2005; 143:751-752.
- Niccolai LM, Rowhani-Rahbar A, Jenkins H, et al. Condom effectiveness for prevention of Chlamydia trachomatis infection. Sex Transm Infect 2005; 81:323-325.
- Warner L, Newman DR, Austin HD, et al. Condom effectiveness for reducing transmission of gonorrhea and chlamydia: The importance of assessing partner infection status. Am J Epidemiol 2004; 159:242-251.
- Warner L, Hatcher RA, Steiner MJ. "Male Condoms." In: Hatcher RA, Trussell J, Stewart F, et al. Contraceptive Technology: 18th revised edition. New York City: Ardent Media; 2004.
- Centers for Disease Control and Prevention. Genital Herpes. Fact sheet. Accessed at: www.cdc.gov/std/Herpes/herpes.pdf.
Resource
To comment on the FDA guidance, Class II Special Controls Guidance Document: Labeling for Male Condoms Made of Natural Rubber Latex (70 FR 69,156 [2005]), submit written comments to the Division of Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Room 1061, Rockville, MD 20852. Electronic comments may be submitted at www.fda.gov/dockets/ecomments. (Search for docket ID 2004N-0556.) All comments should be identified with the docket number 2004D-0555 and should be submitted by Feb. 13, 2006.
Results from a just-published study indicate that consistent use of condoms is associated with lower rates of infection with herpes simplex virus-2 (HSV-2) and should be routinely recommended.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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