The Protective Effect of Condoms and Nonoxynol-9 against HIV Infection

Abstract:
[ARCHIVED] Whether or not spermicides can reduce the risk of HIV transmission remains an important question for the control of heterosexual HIV transmission. This study provides estimates from a reanalysis of one of the few observational studies on the efficacy of condoms and spermicides (used separately and together) per vaginal contact. In this reanalysis, three different models were used to assess the efficacy of spermicides and condoms: linear (Pearl index), exponential (maximum likelihood), and monotonic (marginal likelihood). Under all three models, the results indicate a strong protective effect for spermicidal suppositories. The authors conclude that data from this study suggest that spermicides may be efficacious in reducing the risk of HIV transmission. They note that because the design of randomized clinical trials to test spermicide efficacy is fraught with difficulties, these observational data represent some of the best evidence available regarding this question. Nonetheless, they point out, an observational study is not a definitive design, so the results must be interpreted with caution. Much of the article consists of detailed statistical analysis which will best be appreciated by readers with a strong background in statistics.

Author(s): WITTKOWSKI, Knut M.; SUSSER, Ezra; and DIETZ, Klaus

Publication: American Journal of Public Health


Date Published: 4/1/1998

Pages: 7

Location Code: 14139