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A pooled analysis of the effect of condoms in preventing HSV-2 acquisition.

Martin, Emily T and Krantz, Elizabeth and Gottlieb, Sami L and Magaret, Amalia S and Langenberg, Andria and Stanberry, Lawrence and Kamb, Mary and Wald, Anna (2009) A pooled analysis of the effect of condoms in preventing HSV-2 acquisition. Archives of internal medicine, 169 (13). pp. 1233-1240. ISSN 1538-3679

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Abstract

BACKGROUND: The degree of effectiveness of condom use in preventing the transmission of herpes simplex virus 2 (HSV-2) is uncertain. To address this issue, we performed a large pooled analysis. METHODS: We identified prospective studies with individual-level condom use data and laboratory-defined HSV-2 acquisition. Six studies were identified through a review of publications through 2007: 3 candidate HSV-2 vaccine studies, an HSV-2 drug study, an observational sexually transmitted infection (STI) incidence study, and a behavioral STI intervention study. Study investigators provided us individual-level data to perform a pooled analysis. Effect of condom use was modeled using a continuous percentage of sex acts during which a condom was used and, alternatively, using absolute numbers of unprotected sex acts. RESULTS: A total of 5384 HSV-2-negative people at baseline contributed 2 040 894 follow-up days; 415 persons acquired laboratory-documented HSV-2 during follow-up. Consistent condom users (used 100% of the time) had a 30% lower risk of HSV-2 acquisition compared with those who never used condoms (hazard ratio [HR], 0.70; 95% confidence interval [CI], 0.40-0.94) (P = .01). Risk for HSV-2 acquisition increased steadily and significantly with each unprotected sex act (HR, 1.16; 95% CI, 1.08-1.25) (P < .001). Condom effectiveness did not vary by gender. CONCLUSIONS: To our knowledge, this is the largest analysis using prospective data to assess the effect of condom use in preventing HSV-2 acquisition. Although the magnitude of protection was not as large as has been observed with other STIs, we found that condoms offer moderate protection against HSV-2 acquisition in men and women.

Item Type: Article
Additional Information: This article is available to subscribers only via the URL above.
DOI: 10.1001/archinternmed.2009.177
PubMed ID: 19597073
NIHMSID: NIHMS192381
PMCID: PMC2860381
Grant Numbers: P01 AI030731-19
Keywords or MeSH Headings: Adolescent; Adult; Aged; Antibodies, Viral/analysis; Condoms/utilization; Female; Follow-Up Studies; Herpes Genitalis/epidemiology/prevention & control/transmission; Herpesvirus 2, Human/immunology; Humans; Incidence; Male; Middle Aged; Prospective Studies; Risk Factors; Time Factors; United States/epidemiology; Young Adult;
Depositing User: Library Staff
Date Deposited: 31 Mar 2010 20:24
Last Modified: 14 Feb 2012 14:43
URI: http://authors.fhcrc.org/id/eprint/421

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