Study: Only 16 Percent Of Men Who Have Sex With Men Report Using Condoms 'Always'

By Todd Heywood

A new study by CDC researcher Dawn Smith has found that only 16 percent of men who have sex with men reported consistent condom use during the study period. That same study was used to estimate the efficacy of condoms in preventing HIV transmission during anal sex. Smith found condoms were 70 percent effective in preventing transmission of the virus that causes AIDS.

"The point estimate in our analysis of condom effectiveness when 'always' used by MSM during anal sex with any HIV-positive male partners is 70 percent, modestly less than the 80 percent estimate for condoms when 'always' used by heterosexual HIV-discordant couples," the study concludes. "Although these point estimates do not differ by tests of statistical significance, it is more appropriate to use the MSM specific point estimate of 70 percent effectiveness for discussions and models involving anal sex among MSM than to continue use of the heterosexual 80 percent effectiveness point estimate for MSM.

"This study found that inconsistent ('sometimes') condom use with HIV-positive male partners over months to years offers minimal or no protection, underscoring the importance of the inclusion of messaging by their HIV prevention providers that supports the adoption and continuation of consistent condom use for MSM. In these analyses and in many prior epidemiologic studies, inconsistent condom use with partners of any HIV status is more frequently reported by MSM than consistent condom use. While condom use is often measured over short time frames (e.g., at last sex, in past three months), rates of 'always' use fall significantly when measured over longer time frames. HIV prevention providers should inform MSM who are not using condoms consistently of the low protection offered by inconsistent use and additional prevention options should be considered."

So what does it all mean?

"Our findings of strong but partial effectiveness for consistent condom use, minimal effectiveness for inconsistent condom use and low rates of consistent condom use over 1-2 years, even among persons receiving high quality risk-reduction counseling, may contribute to a better understanding of the persistent rates of HIV infection among MSM in the U.S., despite current levels of condom use promotion and provision," the study reports.

The study reviewed data from two studies and included information on nearly 8,000 men who have sex with men with nearly 50,000 follow up visits. The data was drawn from the VAX 004 study from 1998-1999 and Project Explore which enrolled men from 1999-2001. The Project Explore data contributed information on 3,233 men, while VAX 004 contributed data on 4,492 men.


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