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Consistently used condoms provide significant protection against HIV, pregnancy and sexually transmitted infections (STIs).

The degree of protection they offer against HIV and STIs is significantly better than any other single prevention method, taken in isolation, other than sexual abstinence or complete mutual monogamy between two people who have tested negative for HIV.

While condoms offer useful and vital protection, they have also become associated with promiscuity and infidelity.For these reasons, HIV transmission within long-term serodiscordant relationships, especially heterosexual ones, may be rarer than it is between casual sex partners.For all these reasons, large studies may be needed to establish differences in HIV (and HSV and HPV) incidence between condom users and non-users.Studies of condom efficacy have therefore largely contrasted HIV and STI incidence or prevalence in people who claim 100% consistent use against people who use them inconsistently or not at all.Because these studies involve private behaviours that investigators cannot observe directly, it is difficult to determine accurately whether an individual is a condom user and whether condoms are used consistently and correctly.The main findings of studies we look at in more detail below are as follows: These degrees of protection may be lower than some readers expect, and rates of 98% reliability are still sometimes quoted for condoms.These are based upon observations of their use in contraception: studies have shown that 98% of women relying on condoms as their sole form of contraception remain pregnancy free if condoms are used perfectly, meaning that they are used consistently and correctly at every act of sexual intercourse.The efficacy of an intervention is how well it works in a scientific trial or when people use it as indicated, i.e.consistently; its effectiveness is how well it actually works to prevent disease or infection in a given population, given actual levels of use.Women were much less likely to report inconsistent use of condoms than never using them: over the course of the study, 46% of women said they used condoms ‘always’, 48% ’never’ and only 6% ’sometimes’.For the reasons described above, there is a convention to use two different words when describing the effect of prevention interventions.

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