Barrier to pelvic disease.

Women who have had pelvic inflammatory disease (PID) can reduce their risk of its recurrence if they use condoms consistently. (1) In a multisite U.S. study of 684 sexually active women who had an episode of PID in 1996-1999, those subsequently reporting consistent condom use (defined as use in six of the 10 sexual encounters preceding a follow-up interview) had a 50% lower risk of recur rent PID than those reporting no use of condoms. Their risk of infertility, a possible effect of PID, also was reduced (relative risk, 0.4). The investigators point out that because prospective data have not demonstrated that condoms are effective in preventing bacterial sexually transmitted diseases that cause PID, the use of condoms in primary prevention is surrounded by controversy. However, they conclude that their findings--which are based on a large, diverse sample and prospective data adjusted for potentially confounding factors--"support the use of condoms for the prevention of PID sequelae."

(1.) Ness RB et al., Condom use and the risk of recurrent pelvic inflammatory disease, chronic pelvic pain, or infertility following an episode of pelvic ins flammatory disease, American Journal of Public Health, 2004, 94(8):1327-1329.