Male Latex Condoms
and Sexually Transmitted Diseases
The surest way to avoid transmission of sexually transmitted diseases is to abstain
from sexual intercourse, or to be in a long-term mutually monogamous relationship
with a partner who has been tested and you know is uninfected.
For persons whose sexual behaviors place them at risk for STDs, correct and
consistent use of the male latex condom can reduce the risk of STD transmission.
However, no protective method is 100 percent effective, and condom use cannot
guarantee absolute protection against any STD. Furthermore, condoms lubricated
with spermicides are no more effective than other lubricated condoms in protecting
against the transmission of HIV and other STDs. In order to achieve the protective
effect of condoms, they must be used correctly and consistently. Incorrect use can
lead to condom slippage or breakage, thus diminishing their protective effect.
Inconsistent use, e.g., failure to use condoms with every act of intercourse, can lead
to STD transmission because transmission can occur with a single act of intercourse.
While condom use has been associated with a lower risk of cervical cancer, the use
of condoms should not be a substitute for routine screening with Pap smears to
detect and prevent cervical cancer.
Sexually transmitted diseases, including HIV
Latex condoms, when used consistently and correctly, are highly effective in
preventing transmission of HIV, the virus that causes AIDS. In addition, correct and
consistent use of latex condoms can reduce the risk of other sexually transmitted
diseases (STDs), including discharge and genital ulcer diseases. While the effect of
condoms in preventing human papillomavirus (HPV) infection is unknown, condom
use has been associated with a lower rate of cervical cancer, an HPV-associated
disease.
There are two primary ways that STDs can be transmitted. Human immunodeficiency
virus (HIV), as well as gonorrhea, chlamydia, and trichomoniasis – the discharge
diseases – are transmitted when infected semen or vaginal fluids contact mucosal
surfaces (e.g., the male urethra, the vagina or cervix). In contrast, genital ulcer
diseases – genital herpes, syphilis, and chancroid – and human papillomavirus are
primarily transmitted through contact with infected skin or mucosal surfaces.
Laboratory studies have demonstrated that latex condoms provide an essentially
impermeable barrier to particles the size of STD pathogens.
Theoretical basis for protection. Condoms can be expected to provide different
levels of protection for various sexually transmitted diseases, depending on
differences in how the diseases are transmitted. Because condoms block the
discharge of semen or protect the male urethra against exposure to vaginal
secretions, a greater level of protection is provided for the discharge diseases. A
lesser degree of protection is provided for the genital ulcer diseases or HPV because
these infections may be transmitted by exposure to areas, e.g., infected skin or
mucosal surfaces, that are not covered or protected by the condom.
Epidemiologic studies seek to measure the protective effect of condoms by
comparing rates of STDs between condom users and nonusers in real-life settings.
Developing such measures of condom effectiveness is challenging. Because these
studies involve private behaviors that investigators cannot observe directly, it is
difficult to determine accurately whether an individual is a condom user or whether
condoms are used consistently and correctly. Likewise, it can be difficult to determine
the level of exposure to STDs among study participants. These problems are often
compounded in studies that employ a “retrospective” design, e.g., studies that
measure behaviors and risks in the past.
As a result, observed measures of condom effectiveness may be inaccurate. Most
epidemiologic studies of STDs, other than HIV, are characterized by these
methodological limitations, and thus, the results across them vary widely--ranging
from demonstrating no protection to demonstrating substantial protection associated
with condom use. This inconclusiveness of epidemiologic data about condom
effectiveness indicates that more research is needed--not that latex condoms do not
work. For HIV infection, unlike other STDs, a number of carefully conducted studies,
employing more rigorous methods and measures, have demonstrated that
consistent condom use is a highly effective means of preventing HIV transmission.
Another type of epidemiologic study involves examination of STD rates in populations
rather than individuals. Such studies have demonstrated that when condom use
increases within population groups, rates of STDs decline in these groups. Other
studies have examined the relationship between condom use and the complications
of sexually transmitted infections. For example, condom use has been associated
with a decreased risk of cervical cancer – an HPV associated disease.
The following includes specific information for HIV, discharge diseases, genital ulcer
diseases and human papillomavirus, including information on laboratory studies, the
theoretical basis for protection and epidemiologic studies.
HIV / AIDS
HIV, the virus that causes AIDS. Latex condoms, when used consistently and
correctly, are highly effective in preventing the sexual transmission of HIV, the virus
that causes AIDS.
AIDS is, by far, the most deadly sexually transmitted disease, and considerably more
scientific evidence exists regarding condom effectiveness for prevention of HIV
infection than for other STDs. The body of research on the effectiveness of latex
condoms in preventing sexual transmission of HIV is both comprehensive and
conclusive. In fact, the ability of latex condoms to prevent transmission of HIV has
been scientifically established in “real-life” studies of sexually active couples as well
as in laboratory studies.
Laboratory studies have demonstrated that latex condoms provide an essentially
impermeable barrier to particles the size of STD pathogens.
Theoretical basis for protection. Latex condoms cover the penis and provide an
effective barrier to exposure to secretions such as semen and vaginal fluids, blocking
the pathway of sexual transmission of HIV infection.
Epidemiologic studies that are conducted in real-life settings, where one partner is
infected with HIV and the other partner is not, demonstrate conclusively that the
consistent use of latex condoms provides a high degree of protection.
Discharge Diseases, Including
Gonorrhea, Chlamydia, and Trichomoniasis
Discharge diseases, other than HIVLatex condoms, when used consistently and
correctly, can reduce the risk of transmission of gonorrhea, chlamydia, and
trichomoniasis.
Genital Ulcer Diseases and Human Papillomavirus
Genital ulcer diseases and HPV infectionsGenital ulcer diseases and HPV infections
can occur in both male or female genital areas that are covered or protected by a latex
condom, as well as in areas that are not covered. Correct and consistent use of latex
condoms can reduce the risk of genital herpes, syphilis, and chancroid only when the
infected area or site of potential exposure is protected. While the effect of condoms in
preventing human papillomavirus infection is unknown, condom use has been
associated with a lower rate of cervical cancer, an HPV-associated disease.
Genital ulcer diseases include genital herpes, syphilis, and chancroid. These
diseases are transmitted primarily through “skin-to-skin” contact from sores/ulcers or
infected skin that looks normal. HPV infections are transmitted through contact with
infected genital skin or mucosal surfaces/fluids. Genital ulcer diseases and HPV
infection can occur in male or female genital areas that are, or are not, covered
(protected by the condom).
Laboratory studies have demonstrated that latex condoms provide an essentially
impermeable barrier to particles the size of STD pathogens.
Theoretical basis for protection. Protection against genital ulcer diseases and HPV
depends on the site of the sore/ulcer or infection. Latex condoms can only protect
against transmission when the ulcers or infections are in genital areas that are
covered or protected by the condom. Thus, consistent and correct use of latex
condoms would be expected to protect against transmission of genital ulcer
diseases and HPV in some, but not all, instances.
Epidemiologic studies that compare infection rates among condom users and
nonusers provide evidence that latex condoms can protect against the transmission
of syphilis and genital herpes. However, some other epidemiologic studies show
little or no protection. Many of the available epidemiologic studies were not designed
or conducted in ways that allow for accurate measurement of condom effectiveness
against the genital ulcer diseases. No conclusive studies have specifically
addressed the transmission of chancroid and condom use, although several studies
have documented a reduced risk of genital ulcers in settings where chancroid is a
leading cause of genital ulcers. More research is needed to assess the degree of
protection latex condoms provide for the genital ulcer diseases.
While some epidemiologic studies have demonstrated lower rates of HPV infection
among condom users, most have not. It is particularly difficult to study the
relationship between condom use and HPV infection because HPV infection is often
intermittently detectable and because it is difficult to assess the frequency of either
existing or new infections. Many of the available epidemiologic studies were not
designed or conducted in ways that allow for accurate measurement of condom
effectiveness against HPV infection.
A number of studies, however, do show an association between condom use and a
reduced risk of HPV-associated diseases, including genital warts, cervical dysplasia
and cervical cancer. The reason for lower rates of cervical cancer among condom
users observed in some studies is unknown. HPV infection is believed to be
required, but not by itself sufficient, for cervical cancer to occur. Co-infections with
other STDs may be a factor in increasing the likelihood that HPV infection will lead to
cervical cancer. More research is needed to assess the degree of protection latex
condoms provide for both HPV infection and HPV-associated disease, such as
cervical cancer.
and Sexually Transmitted Diseases
The surest way to avoid transmission of sexually transmitted diseases is to abstain
from sexual intercourse, or to be in a long-term mutually monogamous relationship
with a partner who has been tested and you know is uninfected.
For persons whose sexual behaviors place them at risk for STDs, correct and
consistent use of the male latex condom can reduce the risk of STD transmission.
However, no protective method is 100 percent effective, and condom use cannot
guarantee absolute protection against any STD. Furthermore, condoms lubricated
with spermicides are no more effective than other lubricated condoms in protecting
against the transmission of HIV and other STDs. In order to achieve the protective
effect of condoms, they must be used correctly and consistently. Incorrect use can
lead to condom slippage or breakage, thus diminishing their protective effect.
Inconsistent use, e.g., failure to use condoms with every act of intercourse, can lead
to STD transmission because transmission can occur with a single act of intercourse.
While condom use has been associated with a lower risk of cervical cancer, the use
of condoms should not be a substitute for routine screening with Pap smears to
detect and prevent cervical cancer.
Sexually transmitted diseases, including HIV
Latex condoms, when used consistently and correctly, are highly effective in
preventing transmission of HIV, the virus that causes AIDS. In addition, correct and
consistent use of latex condoms can reduce the risk of other sexually transmitted
diseases (STDs), including discharge and genital ulcer diseases. While the effect of
condoms in preventing human papillomavirus (HPV) infection is unknown, condom
use has been associated with a lower rate of cervical cancer, an HPV-associated
disease.
There are two primary ways that STDs can be transmitted. Human immunodeficiency
virus (HIV), as well as gonorrhea, chlamydia, and trichomoniasis – the discharge
diseases – are transmitted when infected semen or vaginal fluids contact mucosal
surfaces (e.g., the male urethra, the vagina or cervix). In contrast, genital ulcer
diseases – genital herpes, syphilis, and chancroid – and human papillomavirus are
primarily transmitted through contact with infected skin or mucosal surfaces.
Laboratory studies have demonstrated that latex condoms provide an essentially
impermeable barrier to particles the size of STD pathogens.
Theoretical basis for protection. Condoms can be expected to provide different
levels of protection for various sexually transmitted diseases, depending on
differences in how the diseases are transmitted. Because condoms block the
discharge of semen or protect the male urethra against exposure to vaginal
secretions, a greater level of protection is provided for the discharge diseases. A
lesser degree of protection is provided for the genital ulcer diseases or HPV because
these infections may be transmitted by exposure to areas, e.g., infected skin or
mucosal surfaces, that are not covered or protected by the condom.
Epidemiologic studies seek to measure the protective effect of condoms by
comparing rates of STDs between condom users and nonusers in real-life settings.
Developing such measures of condom effectiveness is challenging. Because these
studies involve private behaviors that investigators cannot observe directly, it is
difficult to determine accurately whether an individual is a condom user or whether
condoms are used consistently and correctly. Likewise, it can be difficult to determine
the level of exposure to STDs among study participants. These problems are often
compounded in studies that employ a “retrospective” design, e.g., studies that
measure behaviors and risks in the past.
As a result, observed measures of condom effectiveness may be inaccurate. Most
epidemiologic studies of STDs, other than HIV, are characterized by these
methodological limitations, and thus, the results across them vary widely--ranging
from demonstrating no protection to demonstrating substantial protection associated
with condom use. This inconclusiveness of epidemiologic data about condom
effectiveness indicates that more research is needed--not that latex condoms do not
work. For HIV infection, unlike other STDs, a number of carefully conducted studies,
employing more rigorous methods and measures, have demonstrated that
consistent condom use is a highly effective means of preventing HIV transmission.
Another type of epidemiologic study involves examination of STD rates in populations
rather than individuals. Such studies have demonstrated that when condom use
increases within population groups, rates of STDs decline in these groups. Other
studies have examined the relationship between condom use and the complications
of sexually transmitted infections. For example, condom use has been associated
with a decreased risk of cervical cancer – an HPV associated disease.
The following includes specific information for HIV, discharge diseases, genital ulcer
diseases and human papillomavirus, including information on laboratory studies, the
theoretical basis for protection and epidemiologic studies.
HIV / AIDS
HIV, the virus that causes AIDS. Latex condoms, when used consistently and
correctly, are highly effective in preventing the sexual transmission of HIV, the virus
that causes AIDS.
AIDS is, by far, the most deadly sexually transmitted disease, and considerably more
scientific evidence exists regarding condom effectiveness for prevention of HIV
infection than for other STDs. The body of research on the effectiveness of latex
condoms in preventing sexual transmission of HIV is both comprehensive and
conclusive. In fact, the ability of latex condoms to prevent transmission of HIV has
been scientifically established in “real-life” studies of sexually active couples as well
as in laboratory studies.
Laboratory studies have demonstrated that latex condoms provide an essentially
impermeable barrier to particles the size of STD pathogens.
Theoretical basis for protection. Latex condoms cover the penis and provide an
effective barrier to exposure to secretions such as semen and vaginal fluids, blocking
the pathway of sexual transmission of HIV infection.
Epidemiologic studies that are conducted in real-life settings, where one partner is
infected with HIV and the other partner is not, demonstrate conclusively that the
consistent use of latex condoms provides a high degree of protection.
Discharge Diseases, Including
Gonorrhea, Chlamydia, and Trichomoniasis
Discharge diseases, other than HIVLatex condoms, when used consistently and
correctly, can reduce the risk of transmission of gonorrhea, chlamydia, and
trichomoniasis.
Genital Ulcer Diseases and Human Papillomavirus
Genital ulcer diseases and HPV infectionsGenital ulcer diseases and HPV infections
can occur in both male or female genital areas that are covered or protected by a latex
condom, as well as in areas that are not covered. Correct and consistent use of latex
condoms can reduce the risk of genital herpes, syphilis, and chancroid only when the
infected area or site of potential exposure is protected. While the effect of condoms in
preventing human papillomavirus infection is unknown, condom use has been
associated with a lower rate of cervical cancer, an HPV-associated disease.
Genital ulcer diseases include genital herpes, syphilis, and chancroid. These
diseases are transmitted primarily through “skin-to-skin” contact from sores/ulcers or
infected skin that looks normal. HPV infections are transmitted through contact with
infected genital skin or mucosal surfaces/fluids. Genital ulcer diseases and HPV
infection can occur in male or female genital areas that are, or are not, covered
(protected by the condom).
Laboratory studies have demonstrated that latex condoms provide an essentially
impermeable barrier to particles the size of STD pathogens.
Theoretical basis for protection. Protection against genital ulcer diseases and HPV
depends on the site of the sore/ulcer or infection. Latex condoms can only protect
against transmission when the ulcers or infections are in genital areas that are
covered or protected by the condom. Thus, consistent and correct use of latex
condoms would be expected to protect against transmission of genital ulcer
diseases and HPV in some, but not all, instances.
Epidemiologic studies that compare infection rates among condom users and
nonusers provide evidence that latex condoms can protect against the transmission
of syphilis and genital herpes. However, some other epidemiologic studies show
little or no protection. Many of the available epidemiologic studies were not designed
or conducted in ways that allow for accurate measurement of condom effectiveness
against the genital ulcer diseases. No conclusive studies have specifically
addressed the transmission of chancroid and condom use, although several studies
have documented a reduced risk of genital ulcers in settings where chancroid is a
leading cause of genital ulcers. More research is needed to assess the degree of
protection latex condoms provide for the genital ulcer diseases.
While some epidemiologic studies have demonstrated lower rates of HPV infection
among condom users, most have not. It is particularly difficult to study the
relationship between condom use and HPV infection because HPV infection is often
intermittently detectable and because it is difficult to assess the frequency of either
existing or new infections. Many of the available epidemiologic studies were not
designed or conducted in ways that allow for accurate measurement of condom
effectiveness against HPV infection.
A number of studies, however, do show an association between condom use and a
reduced risk of HPV-associated diseases, including genital warts, cervical dysplasia
and cervical cancer. The reason for lower rates of cervical cancer among condom
users observed in some studies is unknown. HPV infection is believed to be
required, but not by itself sufficient, for cervical cancer to occur. Co-infections with
other STDs may be a factor in increasing the likelihood that HPV infection will lead to
cervical cancer. More research is needed to assess the degree of protection latex
condoms provide for both HPV infection and HPV-associated disease, such as
cervical cancer.
| Content Source: Centers for Disease Control and Prevention Divisions of HIV/AIDS Prevention National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention |
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