title: Self-reported condom use is associated with reduced risk of chlamydia, gonorrhea, and trichomoniasis.
abstract: OBJECTIVE
  To evaluate the association between self-reported condom use and prevalent and incident chlamydia, gonorrhea, and trichomoniasis.
  
  
  METHODS
  Prospective study of 414 males attending a sexually transmitted infection (STI) clinic in Jamaica. Condom use and STI status were assessed at enrollment and at 4 follow-up visits.
  
  
  RESULTS
  The analyses on condom use and prevalent STI included data from 414 men, while those on incident STI were based on 1111 intervals from 355 men. We diagnosed prevalent STI (chlamydia, gonorrhea, and/or trichomoniasis) in 54.6% (n = 226) of the participants at enrollment. About 14% (n = 51) of participants had at least 1 of the study STIs during follow-up. Follow-up visits in which participants reported consistent condom use (100% of acts) for the past 7 days had less incident STI (adjusted OR, 0.4; 95% CI, 0.2-0.9) compared with visits where no condom use was reported. Self-reported condom use was more closely correlated with incident than prevalent STI. For example, the adjusted OR for prevalent infection for participants reporting consistent versus no condom use in past 7 days was 0.7 (95% CI, 0.4-1.2). Classifications based on the number of unprotected acts yielded findings similar to those based on the proportion of acts protected.
  
  
  CONCLUSIONS
  Consistent condom use was associated with reduced risk of incident urethral STI. Research on condom effectiveness should focus on incident STI outcomes, where the temporal relationship between condom use and infection is clearer.
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3724, USA. mgallo@cdc.gov
authors.forename: Maria F
authors.initials: MF
authors.lastname: Gallo
authors.forename: Markus J
authors.initials: MJ
authors.lastname: Steiner
authors.forename: Lee
authors.initials: L
authors.lastname: Warner
authors.forename: Tina
authors.initials: T
authors.lastname: Hylton-Kong
authors.forename: J Peter
authors.initials: JP
authors.lastname: Figueroa
authors.forename: Marcia M
authors.initials: MM
authors.lastname: Hobbs
authors.forename: Frieda M
authors.initials: FM
authors.lastname: Behets
mesh_terms: D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D002690:Chlamydia Infections / Q000517:prevention & control / Q000635:transmission; D017280:Condoms; D006069:Gonorrhea / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D021841:Safe Sex; D012749:Sexually Transmitted Diseases / Q000382:microbiology / Q000469:parasitology / Q000517:prevention & control* / Q000635:transmission; D014245:Trichomonas Infections / Q000517:prevention & control / Q000635:transmission; D014521:Urethra / Q000382:microbiology / Q000469:parasitology