Condom Use and Genital Herpes

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The summary below is from the full report titled "The Relationship between Condom Use and Herpes Simplex Virus Acquisition." It is in the 15 November 2005 issue of Annals of Internal Medicine (volume 143, pages 707-713). The authors are A. Wald, A.G.M. Langenberg, E. Krantz, J.M. Douglas, H.H. Handsfield, R.P. DiCarlo, A.A. Adimora, A.E. Izu, R.A. Morrow, and L. Corey.

What is the problem and what is known about it so far?

Genital herpes is a common disease caused by infection with the herpesviruses. There are 2 types of herpesvirus that cause genital herpes: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). Infection with HSV causes painful sores in the genital area. Infection spreads from one person to another through sexual contact. Infection can occur even when open herpes sores are not present. Doctors and other health care providers recommend using condoms to prevent the spread of herpes infection. However, the evidence supporting this recommendation is limited.

Why did the researchers do this particular study?

To determine whether condoms protect men and women with infected partners from acquiring HSV-1 and HSV-2.

Who was studied?

1843 men and women who were high risk for herpes infection because they had 4 or more sexual partners, had another sexually transmitted disease during the previous year, or both. All of the patients were participants in a study of a herpes vaccine that did not work.

How was the study done?

The researchers evaluated the participants 11 times over 18 months. At each visit, the researchers collected information about sexual activity and frequency of condom use. They also obtained blood samples to test whether each patient had acquired HSV-1 or HSV-2 infection. The researchers then looked at the relationship between frequency of condom use and HSV infection while accounting for other factors, such as the number of sexual partners.

What did the researchers find?

Over the course of the study, 118 of the 1843 participants developed HSV-2 infection and 19 developed HSV-1 infection. Participants reporting more frequent condom use were less likely to develop HSV-2 infection than patients who reported less frequent condom use. The researchers found no association between frequency of condom use and HSV-1 infection.

What were the limitations of the study?

Participant reports about the frequency of condom use may not accurately reflect how often they actually used condoms. One reason that this study found no association between condom use and HSV-1 infection might be that too few participants were exposed to this infection during the study.

What are the implications of the study?

Frequent condom use appears to protect against infection with HSV-2.