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Effect of Condoms on Reducing Genital Herpes Transmission—Reply

Anna Wald, MD, MPH; Katherine Link, MS; Lawrence Corey, MD; Andria Langenberg, MD
JAMA. 2001;286(17):2095-2096. doi:10.1001/jama.286.17.2091.
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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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