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NEWS & VIEWS |
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Women who use male condoms every time they have sex are less likely to become infected with human papilloma virus (HPV) than women who use condoms only occasionally, new research shows. Consistent condom use cuts a woman's risk of infection with HPV by 70%, according to a University of Washington study published in the New England Journal of Medicine (2006;354:2645–2654).
The new study provides important information in the recurring debate over the degree of HPV protection offered by condom use. Until now, data on the issue was inconsistent and too weak to draw unassailable conclusions about the true effect of condoms, said gynecologist J. Thomas Cox, MD, who testified at Congressional hearings on condom labeling in 2000 and 2004. He is Director of the Women's Clinic at the University of California, Santa Barbara, Student Health Service and a member of the American Cancer Society Cervical Guidelines Committee and the ACS HPV Vaccine Advisory Committee.
The new study was designed to address the shortcomings of previous research, said lead author Rachel Winer, PhD, an Acting Instructor in the Department of Epidemiology, University of Washington.
It involved 82 female college students who had never had sex before or had their first vaginal intercourse within 2 weeks of the study's start. The women were asked to keep online diaries of their daily sexual activity, including whether a condom was used. That provided greater odds of truthful reports and a more precise indication of condom usage (compared to the measures of "always," "sometimes," or "never" used in prior research), Winer said.
That careful design makes the study "immensely important" even though only 82 women took part, said Cox, who was not involved in the research.
"The women in the study were followed so intensely and had such strict parameters of entry into the study that the validity of the findings are very significant despite the small numbers," he explained.
Women who reported using condoms 100% of the time had a dramatically lower rate of HPV infection than women who said they used condoms only 5% of the time or less. The consistent condom users were 70% less likely to become infected (P = 0.003). Even inconsistent use helped; women who used condoms only half the time cut their risk of HPV infection by 50% (P = 0.02). What's more, there were no incident cervical squamous intraepithelial lesions detected among women who used condoms 100% of the time, but there were 14 such lesions among women who used condoms only 5% of the time or less.
"It certainly gives individuals one more reason to use condoms all the time, at least until they're in a relationship that they consider to be beyond the pale of being at risk for sexually transmitted diseases," said Cox.
It is important to note, though, that condom use was not 100% effective in protecting against HPV. One reason is that the virus can be transmitted from skin to skin contact from areas infected with HPV outside the protection of the condom. Another is that people don't always use condoms correctly.
Nevertheless, Winer and Cox agree physicians should encourage sexually active young women to use condoms consistently, as well as get vaccinated against HPV and have regular Pap tests.
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