266438 Condom effectiveness against non-viral STIs: Findings from a multisite prospective study

Wednesday, October 31, 2012 : 10:45 AM - 11:00 AM

Richard A. Crosby, PhD , College of Public Health, University of Kentucky, Lexington, KY
Richard J. Charnigo, PhD , College of Public Health, University of Kentucky, Lexington, KY
Lydia A. Shrier, MD, MPH , Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA
Objectives: To prospectively evaluate the protective value of consistent and correct use of latex condoms against the acquisition of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Methods: Patients (N=929) attending clinics that diagnose and treat sexually transmitted infections (STIs) were recruited and prospectively followed for up to six months. Evaluation for the three pathogens was conducted by urine nucleic acid amplification testing at baseline, three months, and six months. Participants were instructed to respond to daily prompts, delivered by a hand-held device, by completing a report regarding condom use with each penile-vaginal sexual intercourse event. Generalized Estimation Equations models examined associations between consistent as well as consistent and correct condom use and STI incidence over the 3-month intervals, controlling for age, gender, and history of STIs. Results: Participants reported a total of 14,970 penile-vaginal sex events, of which 9,545 (63.8%) involved use of a condom. Of the sex events involving a condom, 2,285 (23.9%) included one or more condom use errors or problems, leaving 7,260 events where condoms were used correctly. Consistent condom use was not significantly associated with STI incidence (Estimated Odds Ratio [EOR]=.75; 95% CI=.43-1.30; P=.31). However, significant differences were observed when accounting for correct use. Participants who used condoms both correctly and consistently were estimated to have 56% lower odds of acquiring an STI (EOR=.44; 95% CI=.20-.94; P=.03) compared to those not reporting consistent and correct use. Conclusions: The correct as well as consistent use of condoms greatly reduces the odds of non-viral STI acquisition.

Learning Areas:
Planning of health education strategies, interventions, and programs
Protection of the public in relation to communicable diseases including prevention or control
Public health biology
Public health or related education
Social and behavioral sciences

Learning Objectives:
Describe the differential protective value of consistent condom against non-viral STIs versus consistent and correct use against non-viral STIs.

Keywords: Condom Use, Contraceptives

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am PI of this NIH study and I am a recognized authority in the topic area.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.