Condom Use and the Risk of Genital Human Papillomavirus Infection in Young Women

Abstract

The use of condoms substantially reduces the risk of transmitting HIV, but whether it has a similar effect on other sexually transmitted infections remains uncertain. Several studies have, in fact, found that condom use does not lower the risk of infection by human papillomavirus (HPV) in women. The present longitudinal study was an attempt to clarify the temporal relationship between condom use and HPV infection in 82 female university students 18 to 22 years of age who either had never had vaginal intercourse or had their first intercourse with one man in the past 3 months. The participants monitored their sexual behavior, and cervical and vulvovaginal samples were taken every 4 months to test for HPV DNA and for Papanicolaou testing. Follow up averaged 34 months. The cumulative 12-month incidence of a first HPV infection after first intercourse was 37%, and the 24-month cumulative incidence of cervical squamous intraepithelial lesions was 15%. Reports of having new partners in the past 8 months correlated with an increased risk of HPV infection. More frequent condom use by partners was associated with a decreased risk as was a report of partners having no previous partners. Neither the number of episodes of vaginal intercourse nor having a circumcised partner significantly influenced the risk of infection. Women whose partners had always used condoms in the past 8 months were significantly less likely to acquire HPV infection than those whose partners used condoms less than 5% of the time. Similar trends were evident for high- and low-risk types of HPV; for HPV types 6, 11, 16, and 18; and for incident cervical and vulvovaginal HPV infection. No incident cervical squamous intraepithelial lesions were found during 32 subject-years at risk in women whose partners always used condoms. In contrast, less consistent or no use of condoms was associated with 14 lesions occurring during 97 subject-years at risk. This study reveals a strong inverse temporal relationship between the use of condoms by male sex partners and the risk of HPV infection in women. Consistent condom use by male partners may protect women against infection by high-risk types of HPV that could lead to cervical cancer.