Condom effectiveness against non-viral sexually transmitted infections: a prospective study using electronic daily diaries

• Type of Material: Article
• Authors: Richard Crosby, University of Kentucky; Richard A. Charnigo, University of Kentucky; Chandra Weathers, University of Kentucky; Angela Caliendo, Emory University; Lydia A. Shrier, Harvard University
• Language: English
• Date: 2012-11-01
• Publisher: BMJ Publishing Group
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: Published by the BMJ Publishing Group Limited.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1136/sextrans-2012-050618
• Title of Journal or Parent Work: Sexually Transmitted Infections
• ISSN: 1368-4973
• Volume: 88
• Issue: 7
• Start Page: 484
• End Page: 489
• Grant/Funding Information: Supported by a grant from NIAID to Dr. Crosby (RA1068119A); and this work was supported in part by the Center for AIDS Research (P30 AI050409)
• Keywords: RISK; BREAKAGE; GONORRHEA; Science & Technology; Life Sciences & Biomedicine; AFRICAN-AMERICAN MEN; WOMEN; CHLAMYDIA; DESIGN; SLIPPAGE; TRANSMISSION; CLINICS; Infectious Diseases
• Research Categories: Health Sciences, Public Health

Abstract

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 treat sexually transmitted infections (STIs) were prospectively followed for up to 6 months. Urine STI nucleic acid amplification testing was performed at baseline, 3 months and 6 months. Participants were instructed to respond to daily prompts from a handheld device by completing a report for each penile-vaginal sexual intercourse event. Generalised estimating equation models examined associations of consistent as well as consistent and correct condom use with STI incidence over 3-month intervals. Results: Consistent condom use was not significantly associated with STI incidence (Estimated OR (EOR) =0.75; 95% CI (CI) 0.43 to 1.30; p=0.31). However, individuals who used condoms both correctly and consistently were estimated to have 59% lower odds of acquiring an STI (EOR=0.41; 95% CI 0.19 to 0.90; p=.026), compared to those who did not. Conclusions: The correct as well as the consistent use of condoms greatly reduces the odds of non-viral STI acquisition.