How effective are Condoms, Diaphragms and Circumcision in preventing HIV transmission?

Posted by Dr. Julian Ng on Feb 5, 2013 in HIV, STD | 7 comments

Condoms

 87% effective in preventing HIV.

Scientific studies have shown that proper use of the condom can provide anything from 60% to 95% reduction in risk of HIV transmission.

The most often quoted study involved more than 3000 HIV 1 sero-discordant couples. Self reported use of the condom reduced the risk of HIV transmission by 78% per sex act.

The US CDC’s condom report published in the year 2000 estimated that consistent condom use reduced the risk of HIV transmission by 85%.

 Diaphragms and Female Condoms

 No evidence that either one reduces the risk of HIV transmission

 The MIRA study recruited 5000 women to study the use of diaphragms in preventing HIV. Since women who use the diaphragm were also likely to use the male condom, interpretation of the data was not straightforward. However, it is generally accepted that diaphragms do not reduce the risk of HIV infection.

There is very limited research on the effectiveness for female condoms to prevent HIV and STDs in both vaginal as well as anal sex. No conclusions can be drawn from the current data.

There has been a lot of excitement over the development of an anti-viral vaginal gel that has been shown to significantly reduce the risk of HIV transmission. It is also available as a drug infused vaginal ring. This is still under investigation and is not yet commercially available. If it is as effective as it appears, it will make a huge impact on empowering women to protect themselves from HIV.

 Male Circumcision

 60% effective in preventing HIV

There have been 3 randomized trials to study the benefits of male circumcision in preventing HIV transmission. All of them have shown consistent evidence of a 60% reduction in HIV risk that persists for years.

Furthermore, male circumcision has also been shown to reduce the incidence of trichomniasis, bacterial vaginosis and genital ulcers in women. However, it has not been shown to reduce HIV transmission from a circumcised man to a woman.

Circumcision has also not been shown to reduce the risk of any of the other STDs.

Circumcision also has not been shown to reduce the risk of HIV in men who have sex with men (MSM).

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About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.

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