Male Condom

Effectiveness of Condoms in Preventing Sexually Transmitted Infections Including HIV

Prevention is the first line of defence against HIV/AIDS and condoms have long been a mainstay of HIV prevention programmes. Recently, however, questions have been raised about the effectiveness of condoms as a means to prevent sexually transmitted infections (STIs), including HIV. An extensive review of all available studies was conducted by a panel convened by...

US National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) in June 2000 in the United States, with the participation of WHO. The review concluded that condoms, when used correctly and consistently, are effective for preventing HIV infection in women and men and gonorrhoea in men. For other STIs, however, the available data are less complete.

The report of this review has been released.

In news items following the release, there appear to have been misunderstandings about the difference between "lack of evidence of effectiveness" and a "lack of effectiveness." Many reasons exist for the current lack of evidence: studies to establish reliably the effectiveness of condoms against specific STIs can be very difficult to conduct in a scientifically valid and ethical manner. Nonetheless, additional studies are already under way and more are planned. Until these or other studies providing additional reliable evidence can be completed, the effectiveness of condoms against some specific STIs will remain a matter of debate.

WHO and UNAIDS Secretariat have been following this debate closely and find the recent NIH/CDC report comprehensive and balanced in addressing this delicate issue.

The key findings of the report reviewing the evidence are the following:

* The consistent use of male latex condoms significantly reduces the risk of HIV infection in men and women and of gonorrhoea in men;
* Laboratory studies have established the impermeability of male latex condoms to infectious agents contained in genital secretions, including the smallest viruses.
* Male condoms may be less effective in protecting against those STIs that are transmitted by skin-to-skin contact, since the infected areas may not be covered by the condom.

The report concluded that additional research was needed to fill the gaps in currently available evidence.

The report underscores the effectiveness of condoms against HIV and nothing in it challenges WHO and UNAIDS Secretariat’s conviction about the importance of condoms in HIV prevention programmes. On the contrary, unclear presentation of the report’s conclusions by some commentators may distract from the vital effort to reduce risk of HIV infection through the use of condoms. It is imperative to continue promoting condoms for HIV prevention while undertaking further studies on their effectiveness for prevention of other STIs. As more studies are conducted to fill the gaps in knowledge identified in this report, WHO and UNAIDS Secretariat will continue to monitor and assess the new information and will keep countries informed of the importance of any new findings.