Giannou FK, Tsiara CG, Nikolopoulos GK, Talias M, Benetou V, Kantzanou M, Bonovas S, Hatzakis A. Condom effectiveness in reducing heterosexual HIV transmission: a systematic review and meta-analysis of studies on HIV serodiscordant couples.
Expert Rev Pharmacoecon Outcomes Res 2015;
16:489-99. [PMID:
26488070 DOI:
10.1586/14737167.2016.1102635]
[Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE
This systematic review and meta-analysis aimed to reassess the effectiveness of condoms in reducing heterosexual transmission of HIV.
METHODS
Medline, Scopus, and the ISI Web of Science databases were searched up to June 2014. Eligible studies were synthesized using random-effects models.
RESULTS
Twenty-five studies with 10,676 HIV serodiscordant heterosexual couples were analyzed. The risk of HIV transmission was considerably lower among couples that were always using condoms compared to never-users (RR: 0.29, 95% CI: 0.20-0.43) or inconsistent users (RR: 0.23, 0.13-0.40). The protective effect was slightly higher when the male rather than the female partner was infected (RR: 0.31, 0.20-0.48; vs. RR: 0.44, 0.24-0.80), and very high in Asian settings (RR: 0.06, 0.01-0.46).
CONCLUSIONS
Though imperfect, condoms reduce HIV transmission by more than 70% when used consistently by HIV serodiscordant heterosexual couples. Social, cultural and biological differences need to be studied further to inform projection modelers and policy makers.
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