A Cochrane review [Abstract] 1 included 11 studies with a total of 4 416 couples. The Peto odds ratio (OR) of total clinical failure for the nonlatex vs latex condoms ranged from 1.9 (95% CI: 1.3 to 3.0) to 4.4 (95% CI: 3.5 to 5.5) for eight comparisons and was not statistically significantly different for three comparisons. Clinical breakage was responsible for the higher rates of condom failures with the nonlatex condoms. The OR of clinical breakage for the nonlatex vs latex condoms ranged from 2.6 (95% CI: 1.6 to 4.3) to 5.0 (95% CI: 3.6 to 6.8) except for four comparisons that did not show statistically significant differences. Substantial proportions of participants preferred the nonlatex condom or reported that they would recommend its use to others.
Only one trial found an important difference in contraceptive efficacy: eZ·on condom did not protect against pregnancy as well as the nonlatex Kimono Select condom. Overall, the OR of pregnancy, calculated with the number of condoms or the number of women as the denominator, did not show any statistically significant advantages of either condom group in contraceptive efficacy.
Comment:Pregnancy rates were usually not compared. Breakage has not been established as a valid proxy measure for contraceptive efficacy. Quality of evidence is downgraded by indirectness and inconsistency.
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