In Reply: We agree with Dr Adam that condom
refusers may resist counseling. This may be especially common in monogamous
relationships and with a disease such as genital herpes that has a mild course
in most persons. However, in heterosexuals participating in risky behavior,
encouraging trends in the United States suggest that the frequency of condom
use has increased in the 1990s.1
As noted by Mr Meyer, we did not find that condoms protect men from
HSV-2 and we agree that our study should not be used to conclude that condoms
provide no protection for men against genital herpes. Most likely, the very
small number of men (n = 5) who acquired HSV-2 limits the ability to draw
any reliable conclusions about this relationship. While systematic bias is
possible in any study that collects sensitive information, we would be surprised
if social desirability led men to exaggerate condom use more than women.
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