Do Condoms Prevent Genital HPV Infection, External Genital Warts, or Cervical Neoplasia?: A Meta-Analysis

MANHART, LISA E. MPH*†; KOUTSKY, LAURA A. PhD†

Article

Background: Although condoms most likely prevent HIV infection, evidence of their effectiveness against other sexually transmitted diseases is mixed.

Goal: The goal of the study was to determine whether condom use prevents genital human papillomavirus (HPV) infection and HPV-related conditions.

Study Design: We conducted a literature review and meta-analysis of the effect of condom use on the prevention of genital warts, subclinical HPV infection, cervical intraepithelial neoplasia (CIN), and invasive cervical cancer (ICC).

Results: Among 27 estimates from 20 studies, there was no consistent evidence that condom use reduces the risk of becoming HPV DNA–positive. However, risk for genital warts, CIN of grade II or III (CIN II or III), and ICC was somewhat reduced.

Conclusions: Available data are too inconsistent to provide precise estimates. However, they suggest that while condoms may not prevent HPV infection, they may protect against genital warts, CIN II or III, and ICC.

While condoms may not prevent infection by HPV, among those infected they may provide partial protection from genital warts, cervical cancer, and its precursor lesion.

From the Departments of *Medicine and Epidemiology, University of Washington, Seattle, Washington

The authors thank Connie Nelson for her assistance in preparing Figure 1.

Supported by grants from the National Institutes of Allergy and Infectious Diseases (AI38383) and Cancer (CA34493) and a training grant to Ms. Manhart from the National Institute of Allergy and Infectious Diseases (NIAID 5T32A107140).

Reprint requests: Laura A. Koutsky, PhD, HPV Research Group, 1914 North 34th Street, Suite 300, Seattle, WA 98103. E-mail: kouts@u.washington.edu

Received for publication October 29, 2001,

revised February 6, 2002, and accepted February 21, 2002.

© Copyright 2002 American Sexually Transmitted Diseases Association