Condom use and use-effectiveness in high-risk populations.

In vitro evidence strongly suggests that latex condoms provide an impenetrable barrier for the passage of infectious agents, but few have studied the use-effectiveness of condoms in preventing sexually transmitted diseases. In 1971, a prospective evaluation of the condom failed to demonstrate efficacy against infections with gonorrhea because users were exposed to infectious secretions before the condom was used. An ongoing multicenter study of female prostitutes in the United States shows that none of 22 women who always use condoms with all male partners has antibody to human immunodeficiency virus (HIV), but differences in HIV antibody status by patterns of condom use are not statistically significant. An educational campaign to promote the proper and consistent use of condoms as prophylactics is needed to stop the spread of gonorrhea, infections with HIV, and other sexually transmitted diseases.