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Self-Reported Condom Use Is Associated With Reduced Risk of Chlamydia, Gonorrhea, and Trichomoniasis

Gallo, Maria F. PhD*; Steiner, Markus J. PhD; Warner, Lee PhD; Hylton-Kong, Tina MD§; Figueroa, J Peter MD§; Hobbs, Marcia M. PhD; Behets, Frieda M. PhD∥¶

doi: 10.1097/OLQ.0b013e318073bd71
Article

Objectives: To evaluate the association between self-reported condom use and prevalent and incident chlamydia, gonorrhea, and trichomoniasis.

Study Design: Prospective study of 414 males attending a sexually transmitted infection (STI) clinic in Jamaica. Condom use and STI status were assessed at enrollment and at 4 follow-up visits.

Results: The analyses on condom use and prevalent STI included data from 414 men, while those on incident STI were based on 1111 intervals from 355 men. We diagnosed prevalent STI (chlamydia, gonorrhea, and/or trichomoniasis) in 54.6% (n = 226) of the participants at enrollment. About 14% (n = 51) of participants had at least 1 of the study STIs during follow-up. Follow-up visits in which participants reported consistent condom use (100% of acts) for the past 7 days had less incident STI (adjusted OR, 0.4; 95% CI, 0.2–0.9) compared with visits where no condom use was reported. Self-reported condom use was more closely correlated with incident than prevalent STI. For example, the adjusted OR for prevalent infection for participants reporting consistent versus no condom use in past 7 days was 0.7 (95% CI, 0.4–1.2). Classifications based on the number of unprotected acts yielded findings similar to those based on the proportion of acts protected.

Conclusions: Consistent condom use was associated with reduced risk of incident urethral STI. Research on condom effectiveness should focus on incident STI outcomes, where the temporal relationship between condom use and infection is clearer.

Self-reported consistent condom use was associated strongly with lower incidence of chlamydia, gonorrhea, and trichomoniasis. The relationship between condom use and STI prevalence was weaker.

From the *Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia (Quantell assignee); †Clinical Research, Family Health International, Research Triangle Park, North Carolina; ‡Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia; §Comprehensive Health Centre/Ministry of Health, Kingston, Jamaica; ∥Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; ¶Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

Supported by funds from the United States Agency for International Development (USAID) cooperative agreement #GPO-A-OO-05-00022-00. The views expressed in this document, however, do not necessarily reflect those of the funding agency or of the Centers for Disease Control and Prevention.

Received for publication December 15, 2006, and accepted March 25, 2007.

Correspondence: Maria F. Gallo, PhD, Division of Reproductive Health, 4770 Buford Highway, Mail Stop K-34, Atlanta, GA 30341-3724. E-mail: mgallo@cdc.gov.

© Copyright 2007 American Sexually Transmitted Diseases Association