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Because of the absence of randomized controlled trials, the evidence supporting the effectiveness of male condoms for prevention of HIV and other STDs is derived from prospective observational trials or from trials conducted for other reasons in which prevention of HIV infection or STDs was a secondary endpoint.
Consistent and correct use of male condoms has been reported to be 87% effective for prevention of HIV but may be as low as 60% or as high as 95%. However, condom effectiveness rates may be lower in real-life settings than those reported in these studies because participants in study settings are instructed in proper condom usage and are provided with high-quality condoms that may be less likely to fail. Promising data on the typical-use effectiveness of male condoms has been derived from studies performed in HIV-serodiscordant couples. In a study of 3297 HIV-1–serodiscordant couples, self-reported use of male condoms reduced the per-sex act risk of HIV transmission by 78% (relative risk: 0.22; 95% CI: 0.11-0.42).