HIV incidence and sexually transmitted disease prevalence associated with condom use
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Date
2001
Authors
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Journal ISSN
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Publisher
PubMed
Abstract
Objective: Evidence of condom effectiveness for HIV and sexually transmitted disease
(STD) prevention is based primarily on high-risk populations. We examined condom
effectiveness in a general population with high HIV prevalence in rural Africa.
Methods: Data were from a randomized community trial in Rakai, Uganda. Condom
usage information was obtained prospectively from 17 264 sexually active individuals
aged 15±59 years over a period of 30 months. HIV incidence and STD prevalence
was determined for consistent and irregular condom users, compared to non-users.
Adjusted rate ratios (RR) of HIV acquisition were estimated by Poisson multivariate
regression, and odds ratios of STDs estimated by logistic regression.
Results: Only 4.4% reported consistent condom use and 16.5% reported inconsistent
use during the prior year. Condom use was higher among males, and younger,
unmarried and better educated individuals, and those reporting multiple sex partners
or extramarital relationships. Consistent condom use signi®cantly reduced HIV incidence [RR, 0.37; 95% con®dence interval (CI), 0.15±0.88], syphilis [odds ratio
(OR), 0.71; 95% CI, 0.53±0.94] and gonorrhea/Chlamydia (OR, 0.50; 95% CI, 0.25±
0.97) after adjustment for socio-demographic and behavioral characteristics. Irregular
condom use was not protective against HIV or STD and was associated with increased
gonorrhea/Chlamydia risk (OR, 1.44; 95% CI, 1.06±1.99). The population attributable
fraction of consistent use for prevention of HIV was ÿ4.5% (95% CI, ÿ8.3 to 0.0), due
to the low prevalence of consistent use in the population.
Conclusions: Consistent condom use provides protection from HIV and STDs,
whereas inconsistent use is not protective. Programs must emphasize consistent
condom use for HIV and STD prevention. & 2
Description
Keywords
Africa, Condom, Effectiveness, HIV, Prevention, Sexually transmitted disease
Citation
Ahmed, S., Lutalo, T., Wawer, M., Serwadda, D., Sewankambo, N. K., Nalugoda, F., ... & Gray, R. (2001). HIV incidence and sexually transmitted disease prevalence associated with condom use: a population study in Rakai, Uganda. Aids, 15(16), 2171-2179.