Condom use to prevent incident STDs. In response [letter]

The authors respond to Weir and Feldblums and Galavotti et al.s critiques of their study on condom use and incident sexually transmitted diseases (STDs) in a high-risk Baltimore cohort. The authors have concluded that self-reported condom use was not associated with the incidence of STD. In this response they focus upon the validity of self-reported condom use in the heterosexual populations which are at highest risk for HIV infection. Almost all evaluations of STD/HIV risk reduction interventions in such risk groups are based upon self-reported sexual behaviors. The authors believe that the context of public health clinics may bias respondents to provide affirmative responses to the question of whether they use condoms. Categorical responses are given to critiques on the study with regard to STDs as an outcome measure loss to follow-up timing and misclassification of outcome and exposure determination of condom use the interview context and analytic issues.