[Prevention of human immunodeficiency virus infection (HIV): condoms or abstinence (letter)]

This letter to the editor takes issue with several assertions concerning the efficacy of condoms in a previously published article by F. Guillen and I. Aguinaga. The article identified sexual abstinence as the means of completely eliminating risk of HIV infection and argued that condoms have a relatively low efficacy. Guillen and Aguinaga used the preventable fraction as an indicator of efficacy and interpreted its complement as corresponding to condom failure. The authors of this letter believe this interpretation to be erroneous because some of the studies on which the conclusions were based failed to consider whether condoms were always used or to consider outside sexual contacts not protected by condom use. They also argue that extrapolation of results of an experimental in vitro model ignores receptor factors such as sex age and sexually transmitted diseases as well as the phase of infection. Maintaining that there is insufficient scientific evidence for the efficacy of condoms in prevention of sexually transmitted diseases shows a lack of scientific objectivity. Failure to mention other riskier practices such as sharing of needles runs the risk of distorting the magnitude of the problem. Efforts should not be spared to promote teach and facilitate condom use for prevention of sexually transmitted diseases including AIDS. A more careful review of the literature would have demonstrated that messages on the importance of condoms are rigorous and do not exclude abstinence or underestimate the risks of sexual relations.