Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor
To the Editor: Dr Wald and colleagues1 reported the surprising finding that inconsistent
condom use offered women greater protection against genital herpes than did
consistent condom use against human immunodeficiency virus (HIV) infection.
What is not surprising is that people do not like to use condoms, even when
they have a regular sexual partner with known disease. The authors reported
that "condom use was low throughout the study, as only 61% of couples reported
ever using condoms during follow-up, despite counseling at each clinic visit.
Only 13% of couples used condoms for each sex act. . . . " This study identifies
2 separate populations: condom users and condom refusers. Condoms were refused
at rates in this study that were consistent with condom refusal rates in previous
studies of HIV serodiscordant couples. This presents a significant issue for
public health. Condoms have not become more user-friendly over the years of
the HIV epidemic. Condom refusers remain so despite repeated educational messages.
Adam MB. Effect of Condoms on Reducing Genital Herpes Transmission. JAMA. 2001;286(17):2095-2096. doi:10.1001/jama.286.17.2091