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Condom use within marriage: a neglected HIV intervention
Mohamed M Ali1, John Cleland, Iqbal H Shah
1Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland. alim@who.int
Bulletin of the World Health Organization
|April 28, 2004
Summary
A shift from oral contraceptive pills to condoms would not increase abortions or unwanted births, as most arise from no method use. Condom use may offer additional human immunodeficiency virus (HIV) prevention, especially in high-prevalence areas.
Area of Science:
- Reproductive Health
- Contraception
- Public Health
Background:
- Oral contraceptive pills are widely used but have higher effectiveness rates than condoms.
- Condoms offer dual protection against unintended pregnancy and sexually transmitted infections.
Purpose of the Study:
- To compare the contraceptive effectiveness of condoms and oral contraceptive pills.
- To estimate the impact of shifting contraceptive use from pills to condoms on reproductive outcomes.
- To assess potential benefits, such as HIV prevention, of increased condom use.
Main Methods:
- Secondary analysis of nationally representative cross-sectional surveys.
- Involved data from women in 16 developing countries.
Main Results:
- Condom use (2%) was significantly lower than pill use (13%) in married couples.
- Condom users experienced higher failure (9% vs 6%) and discontinuation (44% vs 30%) rates.
- Shifting from pills to condoms had minor estimated reproductive consequences due to high rates of unintended pregnancy from non-use of any method.
Conclusions:
- A large-scale shift from oral contraceptive pills to condoms would not negatively impact goals for reducing abortions and unwanted births.
- Increased condom use could provide additional benefits in preventing human immunodeficiency virus (HIV) infections, particularly in generalized epidemic settings.