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  Specialists express concern over condom report

  Study: Condoms Fight HIV, Gonorrhea


Specialists express concern over condom report

BMJ 2001;323:252 ( 4 August )

David Spurgeon, Quebec

A US report questioning the effectiveness of condoms in preventing most sexually transmitted diseases could deter people who are sexually active from using them, public health specialists have warned.

The report has been published by a special review panel of the National Institute of Allergy and Infectious Diseases, National Institutes of Health, and the Department of Health and Human Services. The 28 member panel concluded that, although male latex condoms can effectively reduce the transmission of HIV and male gonorrhoea, the evidence did not allow the same to be said about chlamydial infection, syphilis, chancroid, trichomoniasis, genital herpes, or genital human papillomavirus infection.

The panel members analysed more than 138 peer reviewed, published studies after a workshop on the topic was held at the request of former Republican congressman and physician Tom Coburn of Oklahoma. Dr Coburn said that the report's conclusions mean that "when condom use is discussed, it is no longer medically accurate . . . to refer to sex as "safe" or "protected."

However, the executive summary of the report emphasised that it should not be interpreted as proof of the adequacy or inadequacy of the condom to reduce the risk of STDs [sexually transmitted diseases], other than HIV transmission in men and women and gonorrhea in men.

Edward Hook, a professor of medicine at the University of Alabama and a panel member, said that since the panel had carried out its review, a study has found that condoms provided significant protection against genital herpes infection in women (JAMA 2001;285: 3100-6).

Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention is at


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Study: Condoms Fight HIV, Gonorrhea

By ANJETTA McQUEEN, Associated Press Writer. Thursday July 19, 2001.

WASHINGTON (AP) - Condoms are usually effective against fighting the spread of HIV (news - web sites) and gonorrhea, but there is not enough evidence to say for certain they protect against other sexually transmitted diseases, federal health officials conclude in a draft report. "To definitely answer the remaining questions about condom effectiveness for preventing STD (sexually transmitted disease) infections will require well-designed and ethically sound clinical studies,'' says the National Institutes of Health (news - web sites) study to be released Friday.

The draft report does not draw conclusions about the adequacy of condoms in reducing the risk of disease ``other than HIV transmission in men and women, and gonorrhea in men.'' HIV is the virus that causes AIDS (news - web sites).

AIDS activists distributed the report Thursday, contending that the Bush administration would use it to promote an abstinence-only agenda. The activists argue that abstinence warnings are not as effective in preventing sexually transmitted diseases as encouraging the use of barrier contraceptives such as condoms. "The fact is young people are having sex,'' said Michael Cover, a spokesman for the Whitman-Walker Clinic, a Washington-based clinic that primarily serves people infected with HIV. Accurate information about condoms has to be made available.''

A Health and Human Services (news - web sites) Department official speaking on condition of anonymity on Thursday confirmed the authenticity of the report draft.

A panel of researchers examined dozens of existing studies involving HIV, gonorrhea, syphilis, strains of genital herpes and other sexually transmitted diseases. The group's main focus was trying to answer the question of how effective is latex male condom use in preventing the spread of sexually transmitted diseases during vaginal intercourse.

"The published data documenting effectiveness of the male condom were strongest for HIV,'' the draft said.

The researchers found common problems with many of the other studies on the other diseases. Some lacked the sufficient number of subjects. Many studies were done among high-risk groups such as prostitutes or patients at sexually transmitted disease clinics.

"For most studies the ability to document exposure to disease in relationship to condom use was uncertain,'' the draft said The draft said one in five American adults has a sexually transmitted disease and roughly 15 million new STD infections occur each year. Many of those new infections go undiagnosed, and therefore untreated, the draft said.

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