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Condom Promotion for AIDS Prevention in the Developing World: Is it Working?

Running Head: Condoms for AIDS Prevention

Norman Hearst, Sanny Chen
May 26, 2003

Abstract
Objective: Two decades of experience give new insights into the role of condoms for AIDS prevention in the developing world. This article reviews available evidence and gives recommendations for condom promotion and research.
Design: Literature review and synthesis
Methods: Computerized searches of scientific literature and review of conference presentations, publications of national and international organizations, and lay media
Results: Condoms are about 90% effective for preventing HIV transmission, and condom use has grown rapidly in many countries. Condoms have produced substantial benefit in countries like Thailand, where both transmission and condom promotion are concentrated in commercial sex, but the public health benefit of condom promotion in settings with widespread heterosexual transmission remains unclear. In countries like Uganda that have curbed generalized epidemics, reducing numbers of partners appears to have been more important than condoms. Other countries continue with high HIV transmission despite high condom use. Impact of condoms may be limited by inconsistent use, which provides little protection, low use among those at highest risk, and negative interactions with other strategies, such as partner reduction.
Conclusions: Recommendations include more condom promotion for groups at high risk, more rigorous measurement of the impact of condom promotion, and more research on how best to integrate condom promotion with other prevention strategies.
Key words: AIDS, condoms, developing countries, HIV, prevention, transmission

Untitled Document

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