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Condom effectiveness for HIV prevention by consistency of use among men who have sex with men in the United States. While PrEP offers us excellent prevention against HIV, when condoms are combined with other HIV-prevention methods-like PrEP and TasP-they will work even better. They have served us well for years! It would not be imprudent to rely solely on one source of protection.Ĭondoms are an easily accessible, affordable and additional tool that also offer the added benefit of reducing the risk of other STI infections. So, we should not kick condoms to the curb so easily. Although this is not perfect protection, we still strongly encourage vaccination for health prevention especially for at-risk groups. For perspective, the Centers for Disease Control and Prevention reports flu vaccine effectiveness at around 59 percent this season. If you use them-correctly and strategically-the percentage of protection could be even higher. While the percentage of protection is on average 70%, condoms still offer great protection against HIV.
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You can see that “always” using condoms comes with the lowest risk for HIV infection for all types of sex. Here are those HIV incidence rates (per 100 person-years). In other words, out of everyone reporting a certain type of condom use, and/or a certain type of sex, how well do condoms work? In addition to looking at “effectiveness,” you can also look at data on HIV risk. The difference in condom effectiveness for topping and bottoming (72% compared to 63%) was not statistically significant.
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Or, there are times when people just forget, don’t have access to condoms, or don’t think about it if they’re drunk or high. For instance, some people decide to stop using condoms with longer-term partners. Many times, people will decide to use or not to use condoms based on a variety of outside influences. Among the thousands of men in the two studies, only 16.4% reported “always” using condoms with all sexual partners over the year or more the study lasted. Condom effectiveness for men who say they “sometimes” use condoms This is estimate is slightly less than the effectiveness reported for heterosexuals who always use condoms (80%). This is pretty good (although not perfect) protection from HIV-and certainly less robust protection than that offered by PrEP when taken daily. The estimated effectiveness of condom use for gay men with HIV-positive partners is 70%-but only for those who report “always” using condoms. Condom effectiveness for men who say they “always” use condoms It’s important to note that this research is not without limitations-for instance, the data collected relied upon participants’ self-reporting of frequency, consistency and proper use of condoms. Both of these studies included HIV-negative men who reported having sex with an HIV-positive partner. These studies were conducted in the late 90s/early 2000s (i.e., before PrEP). In their sample, they included data from two big studies: VAX 004 (4,492 men) and EXPLORE (3,233 men). In 2015, Dawn Smith, MD, MS, MPH and colleagues at the Centers for Disease Control published an article in JAIDS analyzing condom effectiveness data for men who have sex with men. Here’s what the research tells us.įirst-a quick note about where the data in this article are coming from. Since we are human and tend to not have laboratory-style sex, how well do they actually work in reality to prevent HIV for gay men? It’s a question I get from time to time at the clinic-and I can tell you, the effectiveness is different for gay men than it is for people having penis/vagina sex. In laboratory testing, condoms used perfectly according to directions should be 99.5% effective against HIV with only mechanical failure (i.e. I’m here to offer a gentle reminder: Let’s not throw condoms out with the bath water! They still have a role to play in protecting the sexual health of gay men-since they can protect against STIs in addition to HIV.
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With all the news and research related to PrEP these days, it’s almost easy for gay men to forget about condoms for HIV prevention.