Effectiveness of Testing/Condoms alone and in combination

[Nomoreh1b]

Do you have a good reference to a study in which the relative effectiveness of
a) consistent use of condoms with all partners
b) consistent selection of partners that are tested HIV negative
c) consistent selection of partners that are tested negative for HIV and other STD's
d)  both consistent use of condoms and restriction of  activities to partners with no recent history of
     HIV or other STD's

are compared? I've seen a lot of folks make the claim that use of condoms is the "best" means to prevent HIV  spread. I also see a lot of folks claim that testing is "useless", but the lower levels of HIV and other STD's we've seen among porn actors since AIM(aim-med.org) instituted their testing protocol and the experience with widespread testing in Cuba suggests there is some value to regular testing. Has anyone actually done an empirical study in other populations that tells us in numerical terms the relative value of condoms and regular testing-and the value when both condoms and regular testing are used together.

I see a lot of different numbers coming out on just how effective condoms are(WHO says 90%, CDC claims higher numbers). What is clear is a lot of folks are hesitant about using them-or have trouble using them consistently.

Products like Oraquick are available for $35--and a PCR HIV test/Chlamydia/Gonorrhea test can be done for $135. This might not be cost effective to many folks compared to condoms-but if we don't have the numbers, that is hard to evaluate.

Also has anyone evaluated if any risk reduction  is associated with regularly monitoring temperature of a partner and avoiding sexual contact until a good test can be obtained after a fever has been noted?
Since we now have PCR tests that are now relatively inexpensive, this might seem worth it to some folks(i.e. someone in a relationship with a partner that has  a history of contact with others). That seems interesting because temperature elevation happens before PCR or antibody tests are likely to show any evidence of infection-and when HIV is highly contagious.

The price of STD testing is going to come down. I've heard of one vendor that is working on a product that would do a battery of STD tests at $5 per battery(this product would use a DNA chip). The question I have is how that kind of low cost technology might really be used  most effectively?

[Nomoreh1b]

I've seen varying claims of just how effective condoms are.
http://projects.publicintegrity.org/aids/report.aspx?aid=810
"Norman Hearst, a professor of medicine at the University of California, San Francisco, has spent 20 years researching HIV/AIDS in developing countries. In a 2003 report funded by UNAIDS, he concluded that condoms were effective 90 percent of the time based on an aggregate study of all studies done on condom effectiveness."
There are other numbers that are higher or lower.

I'm asking for a numbers on "very effective" that gives a head to head comparison with a) HIV testing alone b) HIV testing plus testing for other STD's c) HIV testing, STD testing and condoms.

I've heard the verbiage many times. I want to know if there are actual empirical studies that compared these methods-and what the data shows.

http://www.annals.org/cgi/content/full/143/10/I-40
Here is one study on just how much condoms reduced spread of HSV-2--HSV was spread 25% less among the group that consistently reported condom use(8% for the no condoms group got HSV-2, 6% of the reported consistent condom users did).  I understand there are all kinds of problems with reporting in this kind of study-but it is at least a head to head comparison of sorts.

I've heard a lot of folks claim that testing has "no value" in reducing aids spread. I'm looking for real data that says that is the  case--or an indication that it a purely theoretical claim.

Even if it isn't supported by CDC, we do have folks in relationships in which condoms aren't used. Has anyone looked at how these folks vary in outcome for HIV and other STD's vs. similar folks that use condoms  and  and both groups when offered access to STD/HIV testing services or instant test kits?


Instant test kits are starting to come down in price-and become readily available. It would cost $95 per month per participant to test all partners for HIV, Gonnorhea and Chlamydia.  That price could drop substantially.
AIM Foundation claims to have significantly reduced STD's among a  population that is extremely sexually active and reluctant to use condoms through use of a program of monthly testing of a pool of partners. Has there been any experimentation on how this relates to the general public?

[Teak]

Sexually transmitted diseases, including HIV

Latex condoms, when used consistently and correctly, are highly effective in
preventing transmission of HIV, the virus that causes AIDS. In addition, correct
and consistent use of latex condoms can reduce the risk of other sexually
transmitted diseases (STDs), including discharge and genital ulcer diseases.
While the effect of condoms in preventing human papilloma virus (HPV) infection
is unknown, condom use has been associated with a lower rate of cervical
cancer, an HPV-associated disease. Laboratory studies have demonstrated that latex condoms provide an essentially impermeable barrier to particles the size of STD pathogens.