The Relationship between Condom Use and Herpes Simplex Virus Acquisition

  1. Anna Wald, MD, MPH;
  2. Andria G.M. Langenberg, MD;
  3. Elizabeth Krantz, MS;
  4. John M. Douglas, Jr, MD;
  5. H. Hunter Handsfield, MD;
  6. Richard P. DiCarlo, MD;
  7. Adaora A. Adimora, MD, MPH;
  8. Allen E. Izu, MD;
  9. Rhoda Ashley Morrow, PhD; and
  10. Lawrence Corey, MD
  1. From University of Washington, Seattle, Washington; Chiron Corporation, Emeryville, California; Denver Department of Public Health, Denver, Colorado; Louisiana State University School of Medicine, New Orleans, Louisiana; University of North Carolina School of Medicine, Chapel Hill, North Carolina; and Fred Hutchinson Cancer Research Center, Seattle, Washington.

    Abstract

    Background: Few studies have evaluated the relationship between condom use and herpes simplex virus type 2 (HSV-2) and HSV type 1 (HSV-1) acquisition.

    Objective: To assess the relationship between condom use and acquisition of HSV-2 and HSV-1 among men and women.

    Design: Analysis of data collected as part of a clinical trial of an ineffective candidate vaccine for HSV-2.

    Setting: Sexually transmitted disease clinics.

    Participants: Men and women at risk for HSV-2 acquisition, defined as having 4 or more sexual partners or having a sexually transmitted disease in the past year.

    Measurement: Acquisition of HSV-2 and HSV-1 as measured by viral culture or change to positive HSV serostatus.

    Results: Of 1843 participants, 118 (6.4%) became infected with HSV-2. In multivariate analyses, participants reporting more frequent use of condoms were at lower risk for acquiring HSV-2 than participants who used condoms less frequently (hazard ratio, 0.74 [95% CI, 0.59 to 0.95]); categories of increasing condom use were 0% to 25%, 25% to 75%, and greater than 75% of sexual acts. Nineteen (2.9%) of 659 participants at risk for infection with HSV-1 became infected. No statistically significant association between condom use and infection with HSV-1 was found (hazard ratio, 0.79 [CI, 0.48 to 1.31]).

    Limitations: Use of condoms was measured by self-report, and persons who used condoms may have differed from those who did not.

    Conclusions: Consistent use of condoms is associated with lower rates of infection with HSV-2 and should be routinely recommended.

    Article and Author Information

    • Note: This paper was presented in part at the 2002 National STD Prevention Conference, San Diego, California, 4–7 March 2002.

    • Grant Support: In part by National Institutes of Health Herpes Program Project Grant AI-30731 and Centers for Disease Control and Prevention Prevention Research Initiative UR6/CCU017828-02.

    • Potential Financial Conflicts of Interest: Employment: A.G.M. Langenberg (Chiron Corp., Corgentech, Inc.), A.E. Izu (Chiron Corp.); Stock ownership or options (other than mutual funds): A.G.M. Langenberg (Chiron Corp.), A.E. Izu (Chiron Corp.); Grants received: R.A. Morrow (Chiron Corp.), L. Corey (Chiron Corp.).

    • Requests for Single Reprints: Anna Wald, MD, MPH, University of Washington, Virology Research Clinic, 600 Broadway, Suite 400, Seattle, WA 98122; e-mail, annawald{at}u.washington.edu.

    • Current Author Addresses: Dr. Wald and Ms. Krantz: University of Washington, Virology Research Clinic, 600 Broadway, Suite 400, Seattle, WA 98122.

    • Dr. Langenberg: Corgentec, Inc., 650 Gateway Boulevard, South San Francisco, CA 94080.

    • Dr. Douglas: Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333.

    • Dr. Handsfield: University of Washington, 325 Ninth Avenue, Seattle, WA 98104.

    • Dr. DiCarlo: Louisiana University School of Medicine, 2020 Gravier Street, Suite 102, New Orleans, LA 70012.

    • Dr. Adimora: Division of Infectious Disease, University of North Carolina School of Medicine, CB 7030, Chapel Hill, NC 27599.

    • Dr. Izu: Chiron Corporation, 4560 Horton Street, Emeryville, CA 94608.

    • Dr. Morrow: University of Washington, Box 359300-W8814, Seattle, WA 98195.

    • Dr. Corey: Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, Seattle, WA 98109.

    • Author Contributions: Conception and design: A. Wald, A.G.M. Langenberg, A.E. Izu, L. Corey.

    • Analysis and interpretation of the data: A. Wald, E. Krantz, A.E. Izu, L. Corey.

    • Drafting of the article: A. Wald, E. Krantz.

    • Critical revision of the article for important intellectual content: A. Wald, A.G.M. Langenberg, J.M. Douglas Jr, R.P. DiCarlo, R.A. Morrow, L. Corey.

    • Final approval of the article: A. Wald, A.G.M. Langenberg, E. Krantz, J.M. Douglas Jr., H.H. Handsfield, R.P. DiCarlo, A.A. Adimora, A.E. Izu, R.A. Morrow, L. Corey.

    • Provision of study materials or patients: J.M. Douglas Jr., H.H. Handsfield, R.P. DiCarlo, A.A. Adimora.

    • Statistical expertise: E. Krantz.

    • Obtaining of funding: A. Wald, L. Corey.

    • Administrative, technical, or logistical support: A. Wald, R.A. Morrow, L. Corey.

    • Collection and assembly of data: A.G.M. Langenberg, J.M. Douglas Jr., H.H. Handsfield, R.P. DiCarlo, A.A. Adimora, A.E. Izu, R.A. Morrow.

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    1. Ann Intern Med November 15, 2005 vol. 143 no. 10 707-713
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