Condoms found to reduce HPV risk

Study shows lower infection rate in women whose partners use prophylactics often

June 23, 2006|By BONNIE MILLER RUBIN AND JUDY PERES | BONNIE MILLER RUBIN AND JUDY PERES,CHICAGO TRIBUNE

In a groundbreaking study that could influence the debate over sex education, researchers have found that consistent and proper use of condoms significantly reduces the risk of contracting a sexually transmitted virus that can cause cervical cancer.

University of Washington researchers reported yesterday that female college students were 70 percent less likely to become infected with human papilloma virus, or HPV, if their partners always wore a condom during sex than those whose partners used condoms less than 5 percent of the time.

Condoms have long been marketed as a barrier against pregnancy and sexually transmitted diseases. But advocates of sexual abstinence programs have argued that they are ineffective against HPV, which can be transmitted through skin-to-skin contact even if a condom is worn.

The Food and Drug Administration is considering whether to revise the labeling of condoms after some conservatives in Congress demanded that manufacturers' claims about disease prevention be evaluated for "medical accuracy."

The new study brings solid data to the debate, experts said.

"Those who are opposed to condoms claim condoms are not very effective, particularly against HPV," said James Trussell, director of the Office of Population Research at Princeton University. "Here we have an actual study, rather than just an assertion. Condom use prevented HPV infection 70 percent of the time. That's pretty good."

But abstinence advocates noted that the study also showed that some women whose partners used condoms did become infected. Under the Bush administration, schools and other groups that accept federal funding have been required to promote abstinence until marriage and play down the effectiveness of contraception.

"I think it has no bearing on whether abstinence is the best thing to teach kids," said Peter LaBarbera of the Illinois Family Institute. "Clearly, abstinence until marriage is a healthy message ... and this study shows that even partners who always use condoms show it is not a cure-all for HPV. This is hardly a panacea."

The virus is the most common sexually transmitted disease. Approximately 20 million people in the United States have HPV and at least 50 percent of sexually active men and women will experience an infection in their lifetime, according to the Centers for Disease Control and Prevention.

Although most cases of HPV produce no symptoms and clear up on their own, the virus can cause genital warts and lesions that lead to cervical and other reproductive cancers. Many cases of HPV infection are detected through Pap smears.

The FDA recently approved a new vaccine to protect against HPV, but it does not work on all forms of the virus and is approved for use only in girls and women ages 9 to 26. It is unclear whether the vaccine would be effective in women already exposed to HPV.

The new study, published yesterday in the New England Journal of Medicine, followed 82 female college students for several years, beginning with the first time they had sex with a male partner. They kept a diary about their sexual behavior and were checked periodically for HPV.

The methodology provided a more precise assessment of the effect of condom use than had been available previously, said Rachel Winer, an epidemiologist who was the study's lead author.

"By following [the subjects] over time and collecting information on condom use before HPV, you are more likely to see cause and effect," Winer said. "In the past, you couldn't be sure if the infections were new or had been around."

Dr. Lauren Streicher, a gynecologist and assistant clinical professor at Northwestern University, said the study was an important demonstration of condoms' effectiveness against HPV.

"The medical community has been advising women for a long time to use condoms for prevention of STDs," she said. "This reinforces that advice."

Under pressure from conservatives in Congress, the FDA in November proposed changing the labels on condom packages. The current labeling says latex condoms, if used properly, help reduce the risk of getting HIV and other sexually transmitted diseases.

The proposed new language of the label would say condoms provide "less protection" from herpes and HPV because those diseases are spread via skin contact "outside the area covered by the condom."

Activists with an interest in the outcome said they expected the new study will influence the discussion.

"This study proves that claims by condom-use opponents suggesting that condom use leads to increased numbers of HPV infections are false and alarmist," said Tracy Fischman, a vice president for public policy of Planned Parenthood, Chicago area.

"For the people who feel that we should only be stressing the safest method, this supports their view," said Sarah Brown, director of the National Campaign to Prevent Teen Pregnancy. "But for those who take the position that we live in the real world, they will feel that science has vindicated them."

Bonnie Miller Rubin and Judy Peres write for the Chicago Tribune.

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