The relationship between condom use and herpes simplex virus acquisition

Ann Intern Med. 2005 Nov 15;143(10):707-13. doi: 10.7326/0003-4819-143-10-200511150-00007.


Background: Few studies have evaluated the relationship between condom use and herpes simplex virus type 2 (HSV-2) and HSV type 1 (HSV-1) acquisition.

Objective: To assess the relationship between condom use and acquisition of HSV-2 and HSV-1 among men and women.

Design: Analysis of data collected as part of a clinical trial of an ineffective candidate vaccine for HSV-2.

Setting: Sexually transmitted disease clinics.

Participants: Men and women at risk for HSV-2 acquisition, defined as having 4 or more sexual partners or having a sexually transmitted disease in the past year.

Measurement: Acquisition of HSV-2 and HSV-1 as measured by viral culture or change to positive HSV serostatus.

Results: Of 1843 participants, 118 (6.4%) became infected with HSV-2. In multivariate analyses, participants reporting more frequent use of condoms were at lower risk for acquiring HSV-2 than participants who used condoms less frequently (hazard ratio, 0.74 [95% CI, 0.59 to 0.95]); categories of increasing condom use were 0% to 25%, 25% to 75%, and greater than 75% of sexual acts. Nineteen (2.9%) of 659 participants at risk for infection with HSV-1 became infected. No statistically significant association between condom use and infection with HSV-1 was found (hazard ratio, 0.79 [CI, 0.48 to 1.31]).

Limitations: Use of condoms was measured by self-report, and persons who used condoms may have differed from those who did not.

Conclusions: Consistent use of condoms is associated with lower rates of infection with HSV-2 and should be routinely recommended.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Condoms / statistics & numerical data*
  • Disease Transmission, Infectious / prevention & control
  • Double-Blind Method
  • Female
  • Herpes Genitalis / prevention & control*
  • Herpes Genitalis / transmission*
  • Herpes Simplex Virus Vaccines
  • Herpesvirus 1, Human* / immunology
  • Herpesvirus 2, Human* / immunology
  • Humans
  • Male
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Safe Sex
  • United States / epidemiology


  • Herpes Simplex Virus Vaccines