Study Looks at Condoms, Wart Virus Transmission

While condoms can help prevent other sexually transmitted diseases, evidence remains inconsistent as to whether or not they will prevent transmission of the human papillomavirus (HPV), a new report suggests.

HPV, which can cause genital warts and increase the risk of cancers of the cervix, vulva, vagina, anus, and penis, infects up to 50 percent of sexually active men and women ages 15 to 49 at some point in life. Most clear the infection on their own and do not develop cancer.

Lisa E. Manhart and Laura A. Koutsky of the University of Washington-Seattle analyzed 20 previously published studies of condoms, genital warts, and HPV. Their full report, "Do Condoms Prevent Genital HPV Infection, External Genital Warts, or Cervical Neoplasia? A Meta-Analysis," was published in the November issue of Sexually Transmitted Diseases (2002;29:725-735). The report stated, "The studies included here represent the best available data describing the relationship between condoms and HPV-related conditions."

The investigators found that condom use did seem to protect against genital warts, though the effect was slightly stronger in men than women. Results varied in terms of protection from some other HPV-related problems. Six of eight studies showed that women whose partners used condoms had at least some protection from advanced precancerous changes in the cervix; four out of five studies showed at least some protection from invasive cervical cancer.

The authors noted that their analysis was limited because the studies lacked information about how and when participants used condoms -- either before or after HPV infection. "Complete protection from genital HPV infection may be impossible because infections may occur at ... sites not covered by the condom," they wrote.

They stated that people using condoms for contraception -- as opposed to disease prevention -- might be more likely to have genital contact allowing transmission of the virus. The findings suggest that condoms may help prevent warts and other HPV-related problems, possibly by cutting down on the amount of the virus transmitted, "but perhaps not actual infection by HPV," the researchers concluded.

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