Monday, February 2, 2004

The best ways to protect against a widespread sexual disease are to abstain from sexual relations or stay in a monogamous relationship with an uninfected partner, a federal health agency says in a report that downplays condom use.

“The surest way to eliminate risk for future genital [human papillomavirus] infections is to refrain from any genital contact with another individual,” the Centers for Disease Control and Prevention says in its report to Congress released last week.

If sexually active, the best way to avoid HPV is by having only one uninfected partner, says the report issued by CDC Director Dr. Julie Gerberding.

All sexually active women should get regular cervical screenings, and women and men not in monogamous relationships should reduce the number of sexual partners and choose partners who haven’t had a lot of sexual partners, it says.

The report surprisingly does not recommend condoms as a “primary prevention strategy” for HPV.

“While a few studies on genital HPV and condom use showed a protective effect, most studies … did not show a protective effect,” it says. “The available scientific evidence is not sufficient to recommend condoms as a primary prevention strategy” for HPV.

The report says, however, that consistent condom use is useful because evidence suggests that it is likely to reduce some HPV transmission and/or block other sexual infections.

HPV, which can manifest into genital warts, is the most common sexually transmitted disease in the country, with about 20 million people infected.

HPV can be confusing, though: Many strains of the virus cause no clinical problems and “go away on their own without treatment,” the report says. The problem is that a few HPV strains cause cell abnormalities and HPV is associated with almost every case of cervical cancer, which kills more than 4,000 women annually.

The CDC report on HPV was due in December, and Rep. Mark Souder, Indiana Republican, took the agency to task for missing the deadline.

Yesterday, Mr. Souder, who is chairman of the House Government Reform subcommittee on criminal justice, drug policy and human resources, thanked Dr. Gerberding for the “comprehensive, scientific report.”

“The obvious next step,” he said, “is for the CDC to educate the public by promoting these recommendations for prevention.”

Separately, the Bush administration called for doubling abstinence-education funds, from $135 million to more than $270 million.

The bulk of the money — $186 million — is proposed in a new Community-Based Abstinence Education grant program, run by the Department of Health and Human Services’ Administration for Children and Families. The program would replace a regional program run by the department’s Health Resources and Services Administration.

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