Summary

A study published in the June issue of Archives of Pediatric and Adolescent Medicine evaluates the relationship between consistent and correct condom use and infection with gonorrhea and Chlamydia.

The study involved 509 sexually active adolescents between the ages of thirteen and nineteen who were participants within a larger longitudinal STD study. Young women were eligible if they were not pregnant, were HIV negative, had not had a pap smear within 1 year, had no symptoms requiring evaluation, and had not received antibiotics in the previous month.

Data related to sexual history, condom use, and other associated factors was collected from participants in a face-to-face questionnaire. Participants were asked about vaginal, anal, and oral sex for each of the partners they had had in the previous 90 days. Analysis, however, was limited to vaginal intercourse.

Those who reported condom use were asked about consistency and correctness of use. Consistent use was defined as using condoms for every act of vaginal sex. Correct use was defined as condom use free from errors. Correct use also excluded condom failures such as breakage and slippage that were not necessarily a result of user error.

Data related to Chlamydia or gonorrhea was obtained through a laboratory urine test. Chlamydia was detected in 21% of the study population, gonorrhea in 7%, and 4% had both infections.

Results

• 36% of respondents reported using condoms as their primary form of birth control, 36% reported hormonal contraceptives, 6% reported "other," and 22% reported that they currently used no form of birth control.
• 87% respondents reporting using a condom at least once in the previous 3 months. Of these, 35% reported consistent condom use and 16% reported consistent use with no condom errors or failures.
• 71% of respondents who reported using a condom described a condom error (or failure). Specifically:
  • 43% reported starting sex without a condom.
  • 22% reported taking a condom off before finishing sex.
  • 15% reported condom slippage.
  • 4% reported flipping a condom over.
• Chlamydia was detected in 23% of participants reporting irregular correctness and consistency of condom use, compared to 21% of participants reporting incorrect but consistent condom use, and 10% of participants reporting correct and consistent condom use.
• Gonorrhea was detected in 9% of the participants reporting irregular correctness and consistency of condom use, compared to 7% of participants reporting incorrect but consistent use, and none of the participants reporting consistent and correct use of condoms.

Conclusion

Researchers concluded that correct and consistent use of condoms resulted in a 90% reduction in the risk of gonorrhea and a 60% reduction in the risk of Chlamydia. However, only use that was both consistent and correct was protective against infection. In fact, there was no difference in risk reduction between inconsistent condom use and no condom use among participants.

The researchers suggest that by not controlling for one specific sex act and accounting for both correct and consistent condom use, other studies have underestimated the effectiveness of condoms in reducing the risk of sexually transmitted diseases. This study concludes that "condoms remain the best STD and HIV prevention approach for persons whose sexual behaviors place them at risk for STDs."

Analysis

This study confirms current scientific understanding that condoms provide protection against many common STDs, including Chlamydia and gonorrhea, and adds to our existing knowledge by confirming the importance of consistent and correct use of condoms. SIECUS applauds the researchers for their important contribution.

This research is especially relevant in light of recent attempts by conservative political forces, including the Bush Administration, to denigrate condoms and diminish the public’s confidence in this important method of pregnancy and disease prevention.

This study underscores the importance of correct and consistent condom use. Unfortunately, the government continues to pour millions of taxpayer’s dollars into unproven abstinence-only-until-marriage programs which are forbidden from teaching young people how to use condoms. In fact, many of these programs tell young people that condoms don’t work. Young people in these courses will never learn how to use condoms correctly, and, after being told that condoms don’t work, it is unlikely that they will use them consistently if at all. This study confirms the overwhelming need for young people to learn about correct and consistent use of condoms through comprehensive sexuality education.

This information update was written by Maureen McHugh, SIECUS intern.