Edmonton Journal (Canada), July 30, 2004
Condoms really do work against
bacterial diseases: Study challenges notion
that abstinence is the only option
Condoms significantly reduce a woman's risk of
venereal diseases and infertility, according
to the first long-term study of its kind.
While scientifically proven to reduce the chance
of getting AIDS, condoms' ability to guard
against more common sexually transmitted diseases,
although strongly suspected, hadn't been formally
demonstrated until now.
A three-year, multi-centre study involving more
than 680 American women reveals that women
who insist their sexual partners always wear
a condom are half as likely to get a recurring
case of pelvic inflammatory disease, and 60
per cent less likely to become infertile.
The study, published in the August issue of the
American Journal of Public Health, confirms
strong suspicions that condoms can help prevent
common venereal infections, such as gonorrhea,
chlamydia and pelvic inflammatory disease.
The findings are bound to be controversial in
the U.S., where critics say a previous lack
of research was seized upon by the Republican
administration of President George W. Bush
to justify a socially conservative public health
policy advising abstinence.
"It's the best study out there that has
backed this collective wisdom that condoms
were effective" in fighting sexually transmitted
diseases, said lead author Dr. Roberta B. Ness,
an internist and chair of epidemiology at the
University of Pittsburgh School of Medicine.
"It's really the beginning of closing
the information gap."
Her study followed 684 women age 14 to 37, who
arrived at 13 U.S. medical centres beginning
in March 1996 with symptoms of pelvic inflammatory
disease -- or PID. Over the next three years,
the women were periodically interviewed about
their sexual behaviour to see which of them
came down with the illness again, and why.
The study found a "clear association between
regular condom use and a reduced risk not only
for recurrent PID, but also related complications,"
such as chronic pelvic pain and infertility.
Women whose sexual partners didn't always use
condoms were as vulnerable to PID as those
whose partners never used them, which the researchers
speculate may be because partners with a more
casual attitude to condom use tended not to
be monogamous, Ness said.
Her work counters a 1997 report by the Institute
of Medicine, the main scientific advisory panel
to the president, called the Hidden Epidemic:
Confronting Sexually Transmitted Disease, which
surveyed existing research before concluding
that while condoms reduce cases of HIV, there
was insufficient evidence for their effectiveness
in fighting bacterial STDs.
The 1997 report instantly became a political
football: public health activists denounced
it, while the Bush administration continues
to cite it as the scientific basis for a credo
known as ABC, which stands for "Abstinence,
Being Faithful, and Condom Use," in descending
order of importance.
"The subtext is that the only good and scientifically
valid way to protect against (venereal) diseases
is through abstinence," said Ness. "They've
used it to suggest there isn't a complete science
to support condoms. So this report really fills
in a gap where the data was missing."
PID is caused when chlamydia or gonorrhea bacteria
infecting the cervix migrate into the upper
genital tract. About eight per cent of U.S.
women will get PID during their reproductive
life, and as many as one in five women who
become infertile can trace the cause to PID.
A single episode boosts a woman's chance of
becoming infertile as high as 15 per cent,
In Canada, between 1984 and 1994, 2.3 per cent
of women had a severe enough case of PID that
they were hospitalized. Over the same period
-- the latest for which figures are available
-- the number of Canadians contracting the
disease fell by 51 per cent for reasons that
Canadian hospitals spend at least $34 million
a year to treat women with PID, according to
the Canadian Institute for Health Information.
The study is an important one that will "absolutely
... provoke more debate" in Canada as
well as the U.S. around the merits of condom
use, said Bhagirath Singh, an immunologist
and scientific director of the Institute of
Infection and Immunity, based in London, Ont.,
one of the federally funded Canadian Institutes
of Health Research.
Ness's results were "not rocket science,"
he added. "But the social implications
(of the research) are going to become interesting.
It's a splitting hair kind of debate, but condoms
clearly, clearly are good public health policy,
and I think that message comes across loud
<< Edmonton Journal -- 7/30/04 >>
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