STDs, STIs, HIV - Archive

July 2006: STDs, Vaccines, & Condoms

HPV Vaccine – But the Battle Against HPV Is NOT Over (several articles)

30% Still Contract HPV With Condom Use

HPV VACCINE: PROGRESS, BUT THE BATTLE’S NOT OVER AGAINST HPV. Although the new human papilloma virus vaccine offers protection against the two most common strains of the virus, those that cause 70% of cervical cancers, women and their daughters can reliably avoid infection only by abstinence before marriage and faithfulness within marriage. Questions remain as to the practical long term benefits of the vaccine in older women, women in Third World countries, and the nine-year-old girls recommended to be vaccinated.

As one health writer notes, “While mass mandated vaccination of 9-year old girls is being advocated, it is unknown whether vaccination prior to first sexual contact will result in a reduction in overall incidence of cervical cancer since frequent sexual contacts will likely infect women with one of the less common strains of the virus.”
[“Human Papilloma Virus, Cervical Cancer, and the New Vaccine,” Bill Sardi newsletter, 06-18-06,
http://www.knowledgeofhealth.com/report.asp?story=Human%20Papilloma%20Virus%20Cervical%20Cancer%20and%20the%20New%20Vaccine&catagory=Cancer,%20Infectious%20Disease; Abstinence Clearinghouse, June 21, 2006]

 

STUDY: EVEN WITH 100 % CONDOM USE 30% STILL CONTRACT POTENTIALLY DEADLY HPV VIRUS. A new study on condom effectiveness in protecting against the cancer-causing human papilloma virus has shown a discrediting 30% failure rate. The report, however, is being praised as a breakthrough for its claim that condom use offers “significant” protection against the virus.

The study relied on the journals of 82 female university students who kept daily records of their sexual behaviour, and found that 70% of the women, who reported 100% consistent condom use, were virus-free at the end of three years.

The Illinois Family Institute criticized news reports of the study as misleading and inaccurate, saying the 30 per cent failure rate was far more important information than the limited success of the study.

“In fact, the study reports that 12 out of 42 women whose partners always used condoms did get HPV. Thus, 28.5% of the women got HPV even with 100% condom use,” said William Beckman, executive director of Illinois Right to Life Committee.

“Why isn’t the fact that condoms, even under ideal usage conditions, failed 28.5% of the time the real story here? Who would consider this an acceptable failure rate when dealing with a cancer-causing virus?”

Furthermore, Beckman points out, the study itself is inconclusive since it relies on the self-reporting of just 82 university-aged women.

“For those who are still impressed by the “70% less” infection rate, remember that with only 82 women, the sample size is so small that the results have very little statistical significance.”

The author of the study, Rachel Winer of the University of Washington in Seattle, attempted to explain the 30% infection rate which occurred despite supposedly consistent condom use by suggesting that women may have “misreported” key elements in the study, reported the New Scientist, a suggestion that alone calls into question the legitimacy of the study’s findings.

Among those applauding the report was Markus Steiner of Family Health International in Research Triangle Park, NC, who co-wrote an accompanying commentary. He told the New Scientist that the research should put an end to calls for FDA warnings against condom failures in protecting against HPV, by groups advocating abstinence.

“We’re hoping the findings of the paper will dissipate this pressure,” he said.

Beckman responded to such suggestions by saying, “If this study is proof of anything, it is proof that condoms do not provide satisfactory protection against HPV. That was the position taken by supporters of the abstinence-only approach in the first place. This study certainly does not challenge their position.”
Read Illinois Family Institute press release:
http://www.illinoisfamily.org/news/contentview.asp?c=32902
[SEATTLE, 27June06 LifeSiteNews.com, G. Schultz]

 

CONDOMS/CONTRACEPTION : CONDOMS VS HPV: NEW CLAIMS OF EFFECTIVENESS UNDERWHELMING In contrast to most previous studies, new research credits condoms with a higher, although still inadequate, level of protection against the human papilloma virus. Results were based on the self-reported sexual activity and condom use of eighty-two female college students over three years. Testing showed thirty per cent of women who reported 100% condom use had been infected with the virus by the end of the survey period.

The Abstinence Clearinghouse responded: “All the scientists in the world can study condoms, but none will find that condoms stop the internal physiologic responses, the hormonal and brain chemistry releases, and the emotional bonding that result from sexual activity. Studies were released twice in the Journal of Preventive Medicine, and once by the NIH, which show that teen sexual activity affects emotional health; teens who have sex are more likely to become depressed and suicidal than teens who abstain. How did condom use help these teens?”

Congressman Mark Souder (R-IN), a supporter of condom label changes, also questioned the significance of the report: "37.8 percent of the women in the study still became infected with HPV during its eight-month time span-even with correct and consistent condom use-which is a high

failure rate by any standard. Moreover, eight months is a short period of time, so it's expected that the infection rate would only increase during a longer study period.
"One must also consider the results of this study in the broader context of the research on this issue: out of 19 studies, this is only the second one to show some form of HPV risk reduction due to condom use. The overwhelming consensus among the public health community reveals that condoms do not provide effective protection against HPV infection.

"More than five years ago, FDA was directed to develop medically-accurate condom labels. I am disappointed in this agency's continued failure to do its job." [Office of U. S. Representative Mark Souder]

William Beckman, executive director of Illinois Right to Life Committee dismissed the claim that the study proves the “safe sex” argument: “If this study is proof of anything, it is proof that condoms do not provide satisfactory protection against HPV. That was the position taken by supporters of the abstinence-only approach in the first place. This study certainly does not challenge their position.”
[Illinois Family Institute news release, 06-26-06,
http://www.illinoisfamily.org/news/contentview.asp?c=32902) Abstinence Clearinghouse E-Mail Update, 6/28/06]

 

STUDY CLAIMS CONDOMS EFFECTIVE BARRIER AGAINST HPV. The study, conducted over three years, found that women whose partners always wore a condom were 70 percent less likely to contract the STD, HPV, that causes cervical cancer, than women whose partners rarely wore a condom.

In the study, which independent experts said was the most conclusive to examine the role of condoms in preventing infection with the virus, women whose male partners used condoms every time they had sexual intercourse had less than half the rate of infection as did women whose partners used condoms less than 5 percent of the time.

Although the Food and Drug Administration recently licensed a human papillomavirus vaccine that is widely expected to prevent many warts and female cancers, the findings of the study are important because the vaccination protects against just four strains of human papillomavirus.

So, the authors said, consistent condom use may protect women against other dangerous strains of the virus.

The issue has been controversial because a number of earlier studies of condoms and human papillomavirus produced conflicting findings about the degree of protection that condoms offered women.

In 2000, four government agencies convened a panel of condom experts to determine the medical accuracy of condom labels in describing their effectiveness in preventing papillomavirus and other sexually transmitted diseases. The panel concluded that there was inadequate information about condom use in reducing the risk of all sexually transmitted infections except for the AIDS virus [heterosexual] and, among men, gonorrhea, an editorial accompanying the journal article said.

Although the panel emphasized that the lack of information did not mean that condoms were ineffective for those purposes, the Food and Drug Administration was urged to add warnings to condom labels about the lack of protection against papillomavirus.

The Seattle study also illustrates how difficult it is to construct and carry out studies to determine the effectiveness of condoms. Condom use cannot eliminate all papillomavirus infections, because some can be transmitted by other than vaginal or anal intercourse. [skin-to-skin]

Practical considerations are also important. Experience has shown that it is extremely difficult to persuade both the male and female partners who are just starting a sexual relationship to participate in a research study, said Dr. Rachel L. Winer, a co-author of the new report. Winer's team created a study to determine explicitly the relationship between condom use and human papilloma virus infection. The National Institute of Allergy and Infectious Diseases, a federal agency, paid $685,000 for the study, carried out by Dr. Winer's team from December 2000 to June 2005.

In the study, the researchers followed 82 female students at the University of Washington in Seattle ages 18 through 22 from the time they said they had their first sexual intercourse with a male partner.

Every two weeks, the women electronically filed information about their daily sexual behavior and condom use to a protected Web site. Every four months, the researchers tested the women for papillomavirus and early indications of cancer. A researcher also conducted a personal interview.

The researchers used certain statistical measures to determine the findings in the study. For example, no malignant or precancerous cervical lesions were detected in 32 patient years at risk among women reporting 100 percent condom use by their partners. That compared with 14 such lesions in 97 patient years at risk among women whose partners did not use condoms or who used them less consistently.

Linda Klepacki, analyst for sexual health at Focus on the Family Action, said while the information from the study is useful in the quest to lower the risk of transmission of STDs, observers should be cautioned.

"This is a small study with only 82 female college students who knew they were in a condom-effectiveness study," she said. "This study needs to be replicated with multiple populations and multiple times in order to scientifically prove that there is a reduction of HPV transmission with condoms."
In fact, she added, few previous studies have shown a reduction in transmission of HPV with the use of condoms.

"That's why Focus on the Family supports risk elimination rather than risk reduction," Klepacki said. "We believe that all people deserve optimal sexual health, and that is to remain sexually abstinent until marriage and faithful within marriage."

[New England Journal of Medicine, 22June06; http://www.nytimes.com/2006/06/22/health/22condom.html?_r=1&oref=slogin, LAWRENCE K. ALTMAN, June 22, 2006; U.S. Approves Use of Vaccine for Cervical Cancer (June 9, 2006), AP; http://www.family.org/cforum/briefs/a0040996.cfm, June 22, 2006]