Jim Shelton's Pearls

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July 30, 2001

Is there a new study questioning the effectiveness of the condom against STIs?

I understand there has been some new assessment or "study" questioning the effectiveness of the condom against STIs. Is this something new?

No, not really. The condom is still clearly highly effective at preventing HIV (the most important STI) when used correctly and consistently, and there is good evidence of effectiveness against some of the other major STIs. Unfortunately, definitive condom studies haven't been carried out with all the major STIs. So the definitive evidence doesn't exist for those. Moreover, as you might expect, there is some reservation about the ability of the condom to protect completely against the so-called "skin-to-skin" STIs such as herpes and papilloma virus (which causes genital warts) because the condom doesn't cover all of the potentially affected area. And, of course, condoms are not always used correctly and break on infrequent occasions.

There really was no new study. Several US government agencies sponsored a workshop last summer to review the available evidence. Because HIV is so important, there have been a number of very high quality studies, which have shown excellent effectiveness for the condom. Such studies meeting current state-of-the-art standards are demanding and expensive, and they have simply not been carried out with many of the other STIs. However, based on the epidemiologic and clinical data available (including those relating to pregnancy), good data on the structural integrity of condoms, and applying biologic plausibility, it is quite reasonable to project that condoms are effective against STIs more generally.

Of course, other means of STI prevention such as abstinence have an important role to play as well. In the meantime the condom remains the good but less than perfect method it has always been.

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The "Pearls" offer answers to commonly asked questions about family planning. These "Pearls" are prepared by Dr. James D. Shelton, Senior Medical Scientist, Office of Population, United States Agency for International Development (USAID)

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