BACKGROUND: Although growing evidence suggests that condoms offer moderate protection against herpes simplex virus type 2 (HSV-2), inability to control for unknown or unmeasured confounders associated with sexual activity may reduce the accuracy of the estimates. The case-crossover design offers increased control of individual-level confounders, and was thus used with the aim of producing a more accurate estimate of the effect of condom use on HSV-2 acquisition. METHODS: Data were pooled from 6 prospective studies that measured HSV-2 status at enrollment and over follow-up, and included periodic self-reported condom use and sexual activity. Sexual activity contemporaneous with acquisition was assigned to a case period; earlier sexual activity was assigned to a control period. Conditional logistic regression was used to assess differences in behavior during the case and control periods. RESULTS: One hundred ninety-one eligible participants acquired HSV-2 during follow-up. This approach detected a 3.6% increase in the odds of HSV-2 acquisition with each unprotected act (odds ratio = 1.036; 95% confidence interval: 1.021-1.052), but no increase in the odds of acquisition associated with protected acts (odds ratio = 1.008; 95% confidence interval: 0.987-1.030). CONCLUSIONS: This analysis suggests that condoms offer significant protection against HSV-2 transmission.
BACKGROUND: Although growing evidence suggests that condoms offer moderate protection against herpes simplex virus type 2 (HSV-2), inability to control for unknown or unmeasured confounders associated with sexual activity may reduce the accuracy of the estimates. The case-crossover design offers increased control of individual-level confounders, and was thus used with the aim of producing a more accurate estimate of the effect of condom use on HSV-2 acquisition. METHODS: Data were pooled from 6 prospective studies that measured HSV-2 status at enrollment and over follow-up, and included periodic self-reported condom use and sexual activity. Sexual activity contemporaneous with acquisition was assigned to a case period; earlier sexual activity was assigned to a control period. Conditional logistic regression was used to assess differences in behavior during the case and control periods. RESULTS: One hundred ninety-one eligible participants acquired HSV-2 during follow-up. This approach detected a 3.6% increase in the odds of HSV-2 acquisition with each unprotected act (odds ratio = 1.036; 95% confidence interval: 1.021-1.052), but no increase in the odds of acquisition associated with protected acts (odds ratio = 1.008; 95% confidence interval: 0.987-1.030). CONCLUSIONS: This analysis suggests that condoms offer significant protection against HSV-2 transmission.
Authors: T A Peterman; L S Lin; D R Newman; M L Kamb; G Bolan; J Zenilman; J M Douglas; J Rogers; C K Malotte Journal: Sex Transm Dis Date: 2000-09 Impact factor: 2.830
Authors: A Wald; A G Langenberg; K Link; A E Izu; R Ashley; T Warren; S Tyring; J M Douglas; L Corey Journal: JAMA Date: 2001-06-27 Impact factor: 56.272
Authors: M L Kamb; M Fishbein; J M Douglas; F Rhodes; J Rogers; G Bolan; J Zenilman; T Hoxworth; C K Malotte; M Iatesta; C Kent; A Lentz; S Graziano; R H Byers; T A Peterman Journal: JAMA Date: 1998-10-07 Impact factor: 56.272
Authors: George K Siberry; Mark J Abzug; Sharon Nachman; Michael T Brady; Kenneth L Dominguez; Edward Handelsman; Lynne M Mofenson; Steve Nesheim Journal: Pediatr Infect Dis J Date: 2013-11 Impact factor: 2.129
Authors: Amalia S Magaret; Andrew Mujugira; James P Hughes; Jairam Lingappa; Elizabeth A Bukusi; Guy DeBruyn; Sinead Delany-Moretlwe; Kenneth H Fife; Glenda E Gray; Saidi Kapiga; Etienne Karita; Nelly R Mugo; Helen Rees; Allan Ronald; Bellington Vwalika; Edwin Were; Connie Celum; Anna Wald Journal: Clin Infect Dis Date: 2015-11-17 Impact factor: 9.079