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Expert Rev Pharmacoecon Outcomes Res. 2016 Aug;16(4):489-99. doi: 10.1586/14737167.2016.1102635. Epub 2015 Oct 21.

Condom effectiveness in reducing heterosexual HIV transmission: a systematic review and meta-analysis of studies on HIV serodiscordant couples.

Author information

1
a Department of Hygiene, Epidemiology and Medical Statistics, Medical School , University of Athens , Athens , Greece.
2
b HIV & STIs Office, Hellenic Centre for Disease Control and Prevention , Athens , Greece.
3
c Postgraduate Program in Healthcare Management , Open University of Cyprus , Nicosia , Cyprus.

Abstract

OBJECTIVE:

This systematic review and meta-analysis aimed to reassess the effectiveness of condoms in reducing heterosexual transmission of HIV.

METHODS:

Medline, Scopus, and the ISI Web of Science databases were searched up to June 2014. Eligible studies were synthesized using random-effects models.

RESULTS:

Twenty-five studies with 10,676 HIV serodiscordant heterosexual couples were analyzed. The risk of HIV transmission was considerably lower among couples that were always using condoms compared to never-users (RR: 0.29, 95% CI: 0.20-0.43) or inconsistent users (RR:  0.23, 0.13-0.40). The protective effect was slightly higher when the male rather than the female partner was infected (RR: 0.31, 0.20-0.48; vs. RR: 0.44, 0.24-0.80), and very high in Asian settings (RR: 0.06, 0.01-0.46).

CONCLUSIONS:

Though imperfect, condoms reduce HIV transmission by more than 70% when used consistently by HIV serodiscordant heterosexual couples. Social, cultural and biological differences need to be studied further to inform projection modelers and policy makers.

KEYWORDS:

HIV; condom effectiveness; heterosexual transmission; meta-analysis; prevention; serodiscordant couples; systematic review

PMID:
26488070
DOI:
10.1586/14737167.2016.1102635
[Indexed for MEDLINE]

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