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Condoms an important form of protection from HIV

25 March 2009 -- Do condoms help in the prevention of HIV/AIDS transmission? We find out in this episode.

Transcript of the podcast

Veronica Riemer: You’re listening to the WHO podcast, and my name is Veronica Riemer. In this episode, we ask: do condoms help in the prevention of HIV/AIDS transmission?

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In a remote village in Malawi, community volunteers discuss HIV/AIDS transmission and its prevention. At the end of 2007, there were about 33 million people living with HIV/AIDS: 2.7 million people were estimated to have acquired the HIV infection that year. Although the epidemic has stabilized, it remains a leading challenge for global health.

Condoms are one of the main forms of protection from sexually transmitted diseases such as HIV/AIDS. Dr Kevin De Cock from WHO's HIV/AIDS department tells us why it is vital to promote their use.

Dr Kevin De Cock: The evidence around use of male condoms to prevent HIV transmission is that latex condoms if used consistently and correctly are highly effective in preventing the transmission of HIV. They are not the only important prevention strategy but they are an important component of comprehensive prevention efforts worldwide in association with other interventions. Importantly, there is no scientific evidence that promoting the correct and consistent use of condoms has led to alterations in sexual behaviour or increased risk taking.

Veronica Riemer: Studies have shown that using condom is effective in controlling HIV transmission.

Dr Kevin De Cock: The best information on the effectiveness of condoms comes from looking at large numbers of couples where one person is infected and the other is not, and following those over time and comparing the rates of transmission of infection in those groups. Comparing high condom users and people who did not use condoms. Such studies suggest that condoms are at least 80%, and possibly more, effective in reducing the transmission of HIV for co-habiting couples.

Veronica Riemer: One of the main reasons for the rapid spread of HIV in Asia is the high transmission rate among sex workers and their clients. In the 1980s, the Thai government introduced a programme to promote the practice of ‘‘No condom – No sex’’. This meant that sex workers were able to refuse unprotected sex. The result was a major reduction not only in HIV transmission, but also in other sexually transmitted infections. Dr Wiwat, currently working as the WHO Representative in Mongolia, was in Thailand at the time. He explains the results of the programme.

Dr Wiwat: When the programme started in 1989 in one province, it was a surprise that the sex worker who usually had a very high level of sexually transmitted infection (STI), the STI became almost zero. So it was very effective. Because of that effectiveness, the government scaled up the programme to become nationwide in 1991. and it was very clear that sexually transmitted infections, which is a very good indicator for HIV, it was clear that STIs dropped more than 95%, and subsequently HIV decline was also observed. The Prime Minister of Thailand Thaksin Shinawatra reported to one international conference that this programme had prevented more than 5 million HIV infections in Thailand from 1991 up to 2003.

Veronica Riemer: Although condoms play an important part in HIV/AIDS prevention, there are other approaches. Dr Kevin De Cock tells us more.

Dr Kevin De Cock: Condoms are an important component of a comprehensive prevention programme but only one component of what today we refer to as combination prevention. And, I think other factors that are important are reducing numbers of sex partners, abstinence is an important strategy for certain age groups, and for those who choose it, some choose that method of protection.

But there are additional prevention approaches: testing and counselling so that one knows one's HIV status and that of one's regular sex partner. The control of other sexually transmitted infections, particularly in high risk groups such as sex workers and men who have sex with men, is important. In heterosexual epidemics, male circumcision protects against the acquisition of HIV in men in those who are circumcised.

Veronica Riemer: Among the other prevention methods are a number of new technologies that are coming along.

Dr Kevin De Cock: Microbicides are compounds used by women, applied in the vagina, usually prior to sex and such products are now being studied and actually the first successful result has just been achieved. And then antiretroviral drugs themselves have preventive benefit, either in HIV infected people taking the drugs, lowering the amount of virus so that they become less infectious themselves or use of drugs by HIV negative people taking it before they are exposed to HIV.

Veronica Riemer: Use of antiretroviral drugs and microbicides for prevention of HIV is now being studied, so they are not yet recommended by WHO. But these are emerging areas to watch.

If you would like to learn more about this subject, look for the links on the transcript page of this episode. You can find the link to the podcast on the home page of our web site, at www.who.int

That's all for this episode of the WHO podcast. Thanks for listening.

If you have any comments on our podcast or have any suggestions for future health topics drop us a line. Our email address is Podcast@who.int.

For the World Health Organization, this is Veronica Riemer in Geneva.

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