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November 7, 2001

Effect of Condoms on Reducing Genital Herpes Transmission

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor

JAMA. 2001;286(17):2095-2096. doi:10.1001/jama.286.17.2091

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.