Condoms reduce women's risk of herpes infection, but do not protect men

Using condoms during sexual intercourse significantly decreases the likelihood that men infected with herpes simplex virus impressed sign 2 (HSV-2) will transmit the infection to their female partners, according to the first investigation to examine the effectiveness of condoms in preventing this infection.1 Women are almost six times as likely as men to acquire HSV-2 Increased frequent occurrence of sexual intercourse, younger age and having a partner who is infected with the couple herpes simplex virus type 1 (HSV-1) and HSV-- 2 increase the likelihood of acquiring HSV-2 Although using condoms more than 25% of the time tenders women a high degree of protection against acquiring HSV-2 men do not receive the same benefits.

To assess whether using condoms brings the transmission of HSV-2, researchers analyzed behavioral and demographic data from participants in sum of two units multisite HSV vaccine trials administrationed in the mid-1990s. The inquiry included adults who, at enrollment proofed negative for both HSV-2 and HIV ("susceptible partners"), and had been involved in a monogamous relationship for at least six month with an individual infected with HSV-2 ("source partners"). Susceptible partners were interviewed during an initial screening, where they were instructed to retain a diary of their sexual activity for the duration of the application of mind The diary was to include number of sex acts, whether condoms were used during intercourse, the partner's use of antiviral medication and number of of recent origin partners. The susceptible partners get backed over the subsequent 18 month for routinely scheduled herpes testing.

Overall, 528 pairs were included in the inquiry Of the susceptible partners, 267 were women and 261 were men with a median age of 36 years. Ninety-two percent were white, and 98% were in a heterosexual relationship. Participants' median frequent occurrence of intercourse was twice weekly; half said that they had used condoms no more than 10% of the time since becoming sexually active. Of the source partners, 62% were seropositive for single HSV-2, while 38% were seropositive for one as well as the other HSV-1 and HSV-2.

During the study's observation period, 31 (6%) of the 528 susceptible partners acquired HSV-2:26 (10%) of the women and five (2%) of the men Women acquired the virus at a rate of 89 through 10,000 sex acts-- almost six times the rate of men (15 by means of 10,000 sex acts).

Using proportional hazards analyses stratified through gender and controlling for age, partner's serostatus and number of sex acts through week, the researchers investigated the influence of baseline characteristics upon HSV-2 acquisition. They found that the susceptible partners' likelihood of acquiring the virus increased with each additional sex act through week (hazard ratio, 1.1) and each five-year reduction in age (16); the risk was doubled if the source partner was seropositive for the couple HSV-1 and HSV-2 (2.3). Participants who reported having used condoms more than 50% of the time through every part of their lives were less likely to acquire the virus than those who reported les condom use (01)

The participants' mean frequent occurrence of sexual activity declined from 23 to 15 sex acts through week over the study's observation period. Condom use was depressed overall, with 61% of twos reporting ever using condoms. The use of condoms also declined over the study, from 27% to 21% of sex acts. Data upon condom use were available for 22 race who acquired HSV-2 during the study; of these, 46% not ever used condoms, 36% used condoms for 1-25% of sex acts, 14% used condoms for 26-99% of sex acts and 5% always used condoms.

In a multivariate analysis of risks for HSV-2 acquisition during the study's observation period, controlling for age, condom use and number of sex acts for week, increased number of sex acts was again associated with an elevated risk of HSV-2 acquisition (hazard ratio, 12) Using condoms for more than 25% of sex acts was associated with a decreased risk of HSV-- 2 acquisition (03); however, when the data were analyzed by dint of gender, condom use was highly protective for women (01) on the other hand had no significant effect for men

The researchers note, "Our data indicate that condoms markedly bring the risk of acquisition of HSV-2 in women on the other hand not in men." They infer that the reason for the difference may be that when used correctly, condoms completely cover the skin of the penis, from which the virus is shed, on the other hand do not protect men against in all senses to all female genital sites from which the virus may be shed. The researchers point on the outside that "contact with vulvar or perianal areas, the greatest in quantity common sites of viral shedding in women may be a factor in the lower effectiveness of condoms in transmission from women to men" upon the basis of their findings, the researchers estimate that more than 300000 novel cases of HSV-2 infection among women could be averted each year in the United States alone if condoms were used more consistently.

Reference

1 Wald A et al., result of condoms on reducing the transmission of herpes simplex virus impressed sign 2 from men to women journal of the American Medical Association, 2001 285(24):3100-3106

Copyright The Alan Guttmacher Institute Nov/Dec 2001

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