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The failure rate ratio is calculated by dividing the pregnancy rate associated with use of a contraceptive method by the rate related to no method use for a given time period.

These probabilities can be transformed into rates,* providing an estimate of condom effectiveness for preventing pregnancy of 90.7% to 98.6%.

The effectiveness of the condom as a contraceptive provides insight into its usefulness as a barrier device capable of preventing HIV transmission.

Defined as the proportionate reduction in pregnancies caused by use of a contraceptive method, effectiveness is estimated as one minus the ratio of two failure rates.

In 1988, 2% of male AIDS cases and 30% of female cases reported in the United States were attributed to heterosexual contact.

Although new treatments appear promising for retarding the progression of HIV-related disease, prevention remains the most effective weapon against the epidemic. (see reference 19); European Study Group on Heterosexual Transmission of HIV, 1989, op.

Recommendations for the prevention of sexually transmitted HIV infection include abstinence, long-term monogamy with a seronegative partner, a limited number of lifetime sexual partners and condom use for each and every act of intercourse.

although the absolute amount of protection they provide has not been accurately established.

An additional source of bias occurs in recent estimates of HIV incidence among condom nonusers. Heyward WL and Curran JW, The epidemiology of AIDS in the U.

Because condom use is no longer independent of HIV risk factors, as it was prior to the AIDS era, the association between condom use and seroconversion is biased by the self-selection of individuals into the groups always or never using condoms.

For both contraception and HIV prevention, condom failure has two sources: user failure and method failure.

User failure includes nonuse and incorrect use, and is attributed to the person using the condom.

It is not established whether the condom is as effective at preventing heterosexual transmission of HIV as it is for preventing conception.


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