Place in Therapy:
Efficacy:
Latex condoms are effective for both pregnancy prevention and prevention of sexually transmitted infections (STIs). They act as a mechanical barrier that prevents contact between semen and the sexual partner; sperm cannot penetrate the thickness of the condom (0.3-0.8mm). When used appropriately, accidental pregnancy is estimated at 3%; whereas typical failure rate is closer to 14%. Latex condoms are most efficacious against chlamydia, gonorrhea, trichomoniasis and HIV; and less efficacious against HPV. It is important to note that condoms lubricated with spermicides are no more effective than latex condoms without spermicide for prevention of STIs. (1,2)
Despite the public health importance of increasing condom use there is little reliable evidence on the effectiveness of condom promotion interventions . However, consistent condom use will likely provide greater protection as familiarity with proper application will increase. Condoms can also provide additional protection when used in combination with other methods of birth control. (1-3)
Safety:
Adverse effects occur when there is an allergy to latex resulting in irritation. Be aware that when spermicides are used, there is an increased incidence of urinary tract infections reported. Some men also report a loss of erection due to decreased sensation, which may be avoided with the use of polyurethane condoms. (2,4)
In a study looking at the most commonly used latex condoms, it was reported that they rarely broke or slipped off during intercourse and provided high contraceptive efficacy, especially when used consistently. The risk of semen leakage from intact condoms was also reported to be very low. Breakage can be attributed to opening packaging with sharp objects, unrolling condom before donning and larger penile circumference than condom, which can be avoided through appropriate education and experience using condoms. (5,6)
Cost/Convenience:
Condoms are only needed during intercourse or sexual activity; however, they may not always be available when needed. Overall they are relatively inexpensive depending on desired brand and are available for free at many public health clinics and family planning centers. (2,6)
References
1. Warner L., Newman DR., Austin HD., et al. Condom effectiveness for reducing transmission of gonorrhea and chlamydia: the importance of assessing partner infection status. Am J Epidemiol 2004;159:242–251. DOI: 10.1093/aje/kwh044.
2. Black A., Francoeur D., Rowe T., et al. Canadian Contraception Consensus: Chapter 8: Barrier Methods. J Obstet Gynaecol Can 2004;26(4):347–87.
3. Free C., Roberts IG., Abramsky T., et al. A systematic review of randomized control trials of interventions promoting effective condom use. J Epidemiol Community Health 2011;65:100e110. DOI:10.1136/jech.2008.085456.
4. Liccardi G, Senna G, Rotiroti G, et al. Intimate behavior and allergy: a narrative review. Ann Allergy Asthma Immunol. 2007; 99:394-400.
5. Walsh TL., Frezieres RG., Peacock K., et al. Effectiveness of the male latex condom: combined results for three popular condom brands used as controls in randomized clinical trials. Contraception 70 (2004) 407– 413. DOI:10.1016/j.contraception.2004.05.008.
6. Belanger, Denis. Contraception. [book auth.] Canadian Pharmacists Association. Patient Self-Care: Helping patients make therapeutic choices. Ottawa, Ont : CPhA, 2002.
.
Efficacy:
Latex condoms are effective for both pregnancy prevention and prevention of sexually transmitted infections (STIs). They act as a mechanical barrier that prevents contact between semen and the sexual partner; sperm cannot penetrate the thickness of the condom (0.3-0.8mm). When used appropriately, accidental pregnancy is estimated at 3%; whereas typical failure rate is closer to 14%. Latex condoms are most efficacious against chlamydia, gonorrhea, trichomoniasis and HIV; and less efficacious against HPV. It is important to note that condoms lubricated with spermicides are no more effective than latex condoms without spermicide for prevention of STIs. (1,2)
Despite the public health importance of increasing condom use there is little reliable evidence on the effectiveness of condom promotion interventions . However, consistent condom use will likely provide greater protection as familiarity with proper application will increase. Condoms can also provide additional protection when used in combination with other methods of birth control. (1-3)
Safety:
Adverse effects occur when there is an allergy to latex resulting in irritation. Be aware that when spermicides are used, there is an increased incidence of urinary tract infections reported. Some men also report a loss of erection due to decreased sensation, which may be avoided with the use of polyurethane condoms. (2,4)
In a study looking at the most commonly used latex condoms, it was reported that they rarely broke or slipped off during intercourse and provided high contraceptive efficacy, especially when used consistently. The risk of semen leakage from intact condoms was also reported to be very low. Breakage can be attributed to opening packaging with sharp objects, unrolling condom before donning and larger penile circumference than condom, which can be avoided through appropriate education and experience using condoms. (5,6)
Cost/Convenience:
Condoms are only needed during intercourse or sexual activity; however, they may not always be available when needed. Overall they are relatively inexpensive depending on desired brand and are available for free at many public health clinics and family planning centers. (2,6)
References
1. Warner L., Newman DR., Austin HD., et al. Condom effectiveness for reducing transmission of gonorrhea and chlamydia: the importance of assessing partner infection status. Am J Epidemiol 2004;159:242–251. DOI: 10.1093/aje/kwh044.
2. Black A., Francoeur D., Rowe T., et al. Canadian Contraception Consensus: Chapter 8: Barrier Methods. J Obstet Gynaecol Can 2004;26(4):347–87.
3. Free C., Roberts IG., Abramsky T., et al. A systematic review of randomized control trials of interventions promoting effective condom use. J Epidemiol Community Health 2011;65:100e110. DOI:10.1136/jech.2008.085456.
4. Liccardi G, Senna G, Rotiroti G, et al. Intimate behavior and allergy: a narrative review. Ann Allergy Asthma Immunol. 2007; 99:394-400.
5. Walsh TL., Frezieres RG., Peacock K., et al. Effectiveness of the male latex condom: combined results for three popular condom brands used as controls in randomized clinical trials. Contraception 70 (2004) 407– 413. DOI:10.1016/j.contraception.2004.05.008.
6. Belanger, Denis. Contraception. [book auth.] Canadian Pharmacists Association. Patient Self-Care: Helping patients make therapeutic choices. Ottawa, Ont : CPhA, 2002.
.