See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/323728784

Nanotechnology and the Future of Condoms in the Prevention of Sexually

Transmitted Infections

Article in Annals of African Medicine · April 2018

DOI: 10.4103/aam.aam_32_17

CITATIONS READS

14 647

4 authors, including:

Clarence S Yah Percy Hlangothi

University of the Witwatersrand Nelson Mandela University
106 PUBLICATIONS 1,870 CITATIONS 47 PUBLICATIONS 676 CITATIONS

SEE PROFILE SEE PROFILE

Benesh Somai
Nelson Mandela University
23 PUBLICATIONS 343 CITATIONS

SEE PROFILE

All content following this page was uploaded by Clarence S Yah on 16 March 2018.

The user has requested enhancement of the downloaded file.

ISSN 1596-3519

Volume 17 Issue 2 April-2 June 2018

www.annalsafrmed.org
Annals of African Medicine • Volume 17 • Issue 2 • April-June 2018 • Pages 1-***
 Review Article

Nanotechnology and the Future of Condoms in the Prevention of

Sexually Transmitted Infections
Clarence S. Yah1,2, Geoffrey S. Simate3, Percy Hlangothi4, Benesh M. Somai2
Implementation Science Unit, Wits Reproductive Health and HIV Institute (Wits RHI), Faculty of Health Sciences, University of the Witwatersrand, 3School of Chemical
1

and Metallurgical Engineering, University of the Witwatersrand, Johannesburg, 2Department of Biochemistry and Microbiology, Nelson Mandela University, 4Centre for
Rubber Science and Technology, Nelson Mandela University, Port Elizabeth, South Africa

Abstract
Objective: The human immunodeficiency virus (HIV) is among the utmost destructive viruses humankind has ever faced in almost four
decades. It carries with it profound socioeconomic and public health implications. Unfortunately, there is, currently, no effective cure for HIV
infections. This review discusses the various types of condoms, microbicides, and the potential use of nanoparticle‑coated condoms as a means
of diminishing the risk of HIV transmission and sexually transmitted infections (STIs) during sexual intercourse. Methods: We identified 153
articles from 1989 to 2015 indexed in various journal platforms, reports, and magazines. Using the PRISMA guidelines as proxy in performing
the research review process, only 53 articles were selected. Ideally, articles that failed to describe the nature and types of condoms, condom
failures, nanoparticle‑coated condoms, microbicides, and HIV prevention were excluded. Results and Discussion: In general, it has been shown
that antiretroviral therapy (ART) currently available can only limit transmission and acquisition of HIV strains. Apart from ART treatment,
the use of condoms has been identified globally as a cost‑effective intervention for reducing the spread of HIV and other STIs. However,
while condoms are supposed to be effective, reliable, and easy to use, research has shown that they are attributable to 20% failures including
breakages. Nevertheless, other studies have shown that coating condoms with nanoparticles is an important and effective method for reducing
condom breakage and HIV/STI transmission during sexual intercourse. Conclusions: A review of literature cited in this paper has shown that
nanotechnology‑based condom systems have the potential to prevent the spread of HIV and STIs. Furthermore, the antimicrobial nature of some
nanoparticles could provide a safe and efficient way to disrupt and/or inactivate different STIs – including viral, bacterial, and fungal diseases.

Keywords: Antiretroviral therapy, condom, human immunodeficiency syndrome/sexually transmitted infection, microbicide,
nanocomposite‑antimicrobial condoms, prevention

Résumé
Objectif: Le virus d’immunodéficience acquise (VIH) est l’un des virus les plus destructeurs auquel l’humanité toute entière a eu à faire face
durant ces quatre décennies. Loin d’être un sujet de santé publique à prendre à la légère, il traine dans son sillage des profondes conséquences
socio-économiques. Malheureusement, il n’ya pas de traitement effectif à ce jour contre les infections liées au VIH. Cette revue fait donc un
bref étalage des différents types de condoms, de microbicides et de l’utilisation des condoms enrobés de nanoparticules comme méthodes de
prévention de la transmission du VIH et des maladies sexuellement transmissibles (MST) pendant les rapports sexuels. Méthode: Nous avons
identifié153 articles datant de 1989 à 2015 et indexés dans plusieurs plateformes de revues scientifiques et de rapports. Utilisant les indications
de PRISMA comme proxy dans le processus de recherche, seulement 53 articles ont été sélectionnés. Ceux qui n’ont pas traité de la nature et
des types de condoms, de l’échec de l’utilisation des condoms, des condoms enrobés de nanoparticules, des microbicides et de la prévention
du VIH ont été exclus. Résultat et Discussion: Dans l’ensemble,
il a été démontré que la thérapie antirétrovirale (TAR) disponible
Address for correspondence: Dr. Clarence S. Yah,
présentement limite uniquement la transmission des souches de Wits Reproductive Health and HIV Institute, University of the Witwatersrand,
VIH. En plus des traitements par TAR, l’utilisation des condoms a P/Bag 3, Wits 2050, Johannesburg, South Africa.
été reconnue de façon globale comme méthode appropriée et efficace E‑mail: cyahsuh@gmail.com
de réduction de la dissémination du VIH et des MST. Cependant,

This is an open access article distributed under the terms of the Creative Commons
Access this article online Attribution‑NonCommercial‑ShareAlike 3.0 License, which allows others to remix, tweak,
Quick Response Code: and build upon the work non‑commercially, as long as the author is credited and the
Website: new creations are licensed under the identical terms.
www.annalsafrmed.org
For reprints contact: reprints@medknow.com

DOI: How to cite this article: Yah CS, Simate GS, Hlangothi P, Somai BM.
10.4103/aam.aam_32_17 Nanotechnology and the future of condoms in the prevention of sexually
transmitted infections. Ann Afr Med 2018;17:49-57.

© 2018 Annals of African Medicine | Published by Wolters Kluwer - Medknow 49

 Yah, et al.: Fostering condoms in preventing HIV and STIs

nonobstant le fait que les condoms soient considérés comme moyens effectifs, fiables, efficaces et faciles à utiliser, il a été démontré par les
chercheurs que 20% des cas d’échecs sont attribués à la déchirure des condoms. Néanmoins, aucune étude n’a démontré que les condoms
enrobés de nanoparticules offrent une meilleure option face aux déchirures et à la réduction de la transmission du VIH et des MST lors des
rapports sexuels. Conclusion: La revue de littérature citée dans cet article a démontré que les condoms enrobés de nanoparticules ont le
potentiel de prévenir la dissémination du VIH et des MST. Dans le même ordre d’idée, la nature antimicrobienne de certaines nanoparticules
pourrait contribuer efficacement et sûrement à éliminer les différentes MST y compris celles d’origine virale, bactérienne ou fongique.

Mots clés: Thérapie antirétrovirale, condom, syndrome d’immunodéficience acquise /infection sexuellement transmissible, microbicide,
nano-composites antimicrobiens, prévention

Introduction an impact on HIV and other STIs transmission during sexual

The human immunodeficiency virus (HIV) and sexually
transmitted infections (STIs) constitute major global health
burdens, especially in Sub‑Saharan Africa where life expectancy
has fallen because of HIV and HIV‑related diseases. [1]
Unfortunately, there is, currently, no effective cure for HIV
infections. Antiretroviral therapy (ART) including preexposure
prophylaxis (PrEP) and postexposure prophylaxis (PEP),
currently available, can only limit transmission and acquisition
of HIV strains. However, apart from ART treatment used
in reducing the burden of HIV, community engagement,
system strengthening, individual‑centered behavioral change,
advocacy, counseling, and promotion of the use of condoms
have been identified globally as cost‑effective interventions for
reducing the spread of HIV and other STIs.[2] In particular, HIV
counseling and testing (HCT) and the use of condoms have
been scaled up globally, especially in settings with elevated
HIV incidences.[1]
Although HCT and the use of condoms, male circumcision[3‑7]
combined with community education, health care/promotion
delivery systems‑centered approaches, and advocacy
strategies enhance behavioral changes [8] that improve
health‑care quality of HIV and STIs’ acquisition and
transmission, the HIV epidemic persists.[9] This is largely due to
condom‑breakage/slippage, noncompliance, and nonadherence
to ART medications.[10] In fact, earlier meta‑analysis findings
by Weller and Davis[11] showed that condoms are 87% effective
in preventing pregnancy and provide only approximately
69% of HIV transmission risk reduction. However, their
efficacy is much lower than 69% during sexual intercourse.
Other studies indicate that the efficiency and efficacy of
using condoms depend on condom use, health promotion,
and individual lifestyle behavior.[12] Some of the factors
that have influenced poor condom uptake and eroded their
efficacy stem from structural factors such as gender inequality,
stigma, discrimination, partner interest, poverty, length of
relationships, and the extent of partner trust.[13‑21]
The failure and incorrect use of condom have had serious
and devastating effects, especially in terms of HIV and
STIs acquisition, transmission, and other related health
consequences including premature pregnancies.[1] Therefore,
innovative ideas are needed to improve condoms properties
and usage. It is believed that condom innovations are a key
to the adoption and sustained uptake that can eventually have
intercourse.[15]
Previous research studies with respect to innovative approaches
indicate that antimicrobial nanoparticle‑coated condoms have
great qualities of nonspecific broad‑spectrum antimicrobial
properties against viruses, bacteria, and fungi.[16] In addition to
preventing HIV transmission, they potentially destroy secreted
HIV and other STIs in anal and vaginal fluid during sexual
activities, thus reducing HIV and STIs transmission.[15,16] The
antimicrobial nanoparticle‑coated condoms, thus, perform a
dual role of preventing HIV and other STIs’ transmissions,
including inactivating the infectiousness of HIV and other
STIs pathogens. [16] These antimicrobial broad‑spectrum
properties are due to the vast physiochemical properties of
the nanoparticles imparted onto the condom and also the slow
release of antimicrobial agents, thus maintaining a sustained
action.[17] For example, silver nanoparticle (AgNP)‑coated
antimicrobial condoms have extensive physiochemical
properties that impart broad‑spectrum nonspecific antimicrobial
actions that are antiviral, antibacterial, and antifungal.[15,16]
As already stated, the spread of HIV and the risk factors
associated with its transmission have continued to escalate
due to the limited prevention methods.[18‑20] Therefore, the
absence of a complete cure underscores the need for universally
acceptable and innovative alternative prevention approaches
that would augment current treatments such as the use of
AgNP‑coated antimicrobial condoms. Although general topics
on condoms and some of the innovations have been extensively
studied as noted already, a comprehensive review that analyzes
and compares such studies is not available. Therefore, this
paper brings together data derived from a number of distinct
studies and critically analyzes it in terms of the various
types of condoms, microbicides, and the potential use of
nanoparticle‑coated condoms as a means of diminishing the
risk of HIV transmission and STIs during sexual intercourse.
Methods
Research strategy
The strategy for writing this article was guided by the research
question that a condom which is the common and easily
accessible intercourse (anal and vagina) prevention method
against STIs and HIV may not be as effective as described in
basic research. This is due to the fact that body fluid and other
oily substances decrease the tensile strength of condoms by 90%

50 Annals of African Medicine ¦ Volume 17 ¦ Issue 2 ¦ April-June 2018

 Yah, et al.: Fostering condoms in preventing HIV and STIs
in less than a minute[21] when stretched resulting in slippage and
breakages (burst).[21,22] Based on these premises, the study team
was instituted comprising epidemiologists, microbiologists,
chemists, chemical engineers, and bio‑nanotechnologists so as
to critically analyze the ongoing research by the team on the
improvement of condom properties using nanoparticles. To do
this, we reviewed articles, reports, and magazines in relation to
HIV/STIs prevention with respect to condoms, nanotechnology
including microbicides, and ART.
Extraction processes and selection criteria
We reviewed and analyzed articles on the types of
condoms (1989–2015), condom failure, slippage and condom
breakage/burst (1994–2016), and condoms coupled with
nanoparticles that enhanced HIV/STIs prevention (2010–2015)
indexed in various journal platforms, reports, and magazines.
We used the PRISMA guidelines as proxy to perform the
research review process[23] using key search words such as
“types of condoms,” “condom failure,” “condom usage and
breakage/burst,” “condom slippage and breakage/burst,”
“nanotechnology and condom,” and “microbicides and HIV
prevention.” The following indexing sources were used to
identify the relevant articles for the study: PubMed, Science
Direct, Google Scholar, MeSH PsycInfo, and SCOPUS.
The articles were then synthesized and screened. Ideally,
articles that failed to describe nature and types of condoms,
condom failures, nanoparticle‑coated condoms, microbicides,
microbicides, and HIV prevention were excluded as shown in
Figure 1. In general, there were 153 articles identified from
1989 to 2015. Of the 153 studies, only 53 were selected.
CSY conceptualized and designed the study. CSY and GSS
independently collected and reviewed various articles. CSY
and GSS wrote the draft article while BMS and PH consolidated
and reviewed the article. CSY, GSS, and BM gave input in the
nanotechnology and condom latex section while CSY and BM
discussed and analyzed the ART and microbicide sections.
Identification: Articles on types of condoms (56),
condom failure: slippage/breakage/burst (19),
condom and nanotechnology: HIV and STIs
prevention (11), HIV prevention: microbicide-
nanotechnology and ART (67). N = 153
Nonrelevant articles: Condoms
types (48), condom failure (3),
condom and nanotechnology
(9), HIV prevention (30). N = 90
Screening: Condoms types (8), condom
failure (11), condom and nanotechnology
(8), HIV prevention (37). N = 64
Eligibility: Condoms types (8), condom Removal of duplicates and
failure (11), condom and nanotechnology (6), other non-relevant articles
HIV prevention (28). N = 53 Condom and nanotechnology
(2), HIV prevention (9). N = 9
Inclusion: 53 articles and reports were
used as main focus articles for the study
Figure 1: Identification and screening of articles used for fostering
condoms in preventing human immunodeficiency syndrome and sexually
transmitted infection
Annals of African Medicine ¦ Volume 17 ¦ Issue 2 ¦ April-June 2018
Results and Discussion
Condom
Condoms are physical barriers worn on the penis or inserted
into the vagina/anus depending on the type; they are designed to
prevent transmission and acquisition of STIs, including HIV.[24]
In addition, they are used to guard against female pregnancy
resulting from sexual intercourse.[25‑29] These condoms are
composed of materials that are compatible to the body.[30] The
common available condoms include lambskin or sheepskin,
latex, polyurethane, and polyisoprene condoms.[29] These
condoms exist in various types, sizes, colors, and flavors and
all perform the same function, i.e., preventing HIV and other
STIs transmission and unwanted pregnancies. Most of these
condoms are easily available with relatively minimal toxicity
and site effect.[31]
The condoms were formerly designed solely for effective
prevention of HIV and other STIs transmission during sexual
intercourse.[32] In this regard, the main function of the condom
is to prevent the deposition of semen into the anus or vagina
during sexual intercourse.[24,31] Similarly, the condom provides
another vital function, i.e., pregnancy prevention.[24] Because of
this singular important function, the notion of condom use has
removed the perception that contraception is a feminine activity.
Due to the advent of HIV infections, several condom designs
that encourage their acceptability during sexual intercourse
are currently available and more are under development.
Each design is aimed at improvement, boosting the usage
and reduction of STIs and HIV transmission during sexual
intercourse.[24] For example, some condoms are designed
with an erectogenic compound coated on the internal surfaces
that counter male impotency and erectile dysfunction during
sexual intercourse.[33] The erectogenic condoms help give
sustain firm erection, as well as prevent condom slippage.[33]
In another study, Kiser[34] developed a molecular gel condom
that is liquid at room temperature but when inserted into the
vagina coats the vagina walls while reverting to liquid gel form
when in contact with semen. This gel condom has antiviral
properties that protect women and their unborn babies against
HIV infection during labor and delivery.[34]
With regard to the introduction of nanotechnology in condoms,
some condoms are coated with spermicidal lubricant and
antimicrobial agents to improve their functions.[15,27] The
main construct of any condom today is its efficacy and
efficiency as an HIV and other STIs prevention tool during
sexual intercourse.[11] Reports from related studies show that
the male condom, if used correctly and consistently, will
provide 80%–90% effectiveness in reducing HIV and other
STIs[11,35-38] while the female condom will provide 94%–97%
HIV and other STIs risk reduction.[36] However, the failure of
condoms to protect against HIV and other STIs transmission
frequently results from incorrect or inconsistent condom use,
including condom breakage, leakage, and slippage during
sexual intercourse.[15,39‑41] With a single misuse of the condom,
the risk is as high as when having unprotected sex.[41]
51
 Yah, et al.: Fostering condoms in preventing HIV and STIs
Assuming that condom is 85%[15] efficient in protecting HIV
transmission during intercourse and taking into account
that >35 million people are infected with HIV worldwide and
also assuming that all the HIV‑infected individuals acquired
HIV via sexual intercourse, by default, approximately 30
million (0.85 × 35,000,000) people may have been prevented
from HIV acquisition if condom was effectively used. The
remaining 15%(35-30 million) equating to 5 million people
would have been due to condom failures.
A study by Sparrow and Lavill[41] shows that condoms can
break, slip, and leak depending on a number of factors.
A family planning study showed 410 (10.9%) instances of
condom breakage, slippage, and leakage out of 3754 episodes
of condom usage.[41] In a similar study in Sri Lanka, 44.7%
of female sex workers (FSWs) reported condom breakage
in their female sex work professional career.[42] In addition,
a randomized control trial conducted by Walsh et al.[42] to
determine the efficacy of nonlatex and latex condoms in
pregnancy reduction and HIV infection found nonlatex condom
exhibiting higher percentage (4.0%) rate of breakage and
slippage when compared to latex condoms (1.3%), especially
for early condom users. This indicates that the reliability
of condom in HIV and pregnancy prevention is not 100%
efficient. The factors associated with condom breakage and
slippage are varied ranging from dryness, vigorous sex and
tearing,[41] and use of oil‑based lubricants.[21]
Mineral oil‑based lubricants such as body and hand lotions,
Vaseline, and other petroleum jelly products weaken latex
condoms, decreasing the tensile strength of the condom
by 90% in 1 min,[21] thus enhancing condom breakage.[21]
Furthermore, studies show that on average, “heat ejaculation”
during sexual intercourse usually last approximately 2 min
globally.[21] Thus, the longer the exposure of a latex condom
to body lotion lubricants during sexual intercourse activities,
the more likely the rapid deterioration of tensile strength,
development of pores, breakage, and increased risk of HIV
and other STIs transmission or unwanted pregnancies. On the
other hand, the safe use of water and silver‑based lubricants
can prevent condom breakage and the acquisition of HIV and
other STIs.[24] However, the cost and limited availability of
water and silver‑based lubricants in developing countries limit
affordability, scale up and uptake, adoption, sustainability,
and implementation. Furthermore, during sexual intercourse
activity, only a single use of a condom is recommended.[24]
Lambskin condom
Lambskin condoms are composed of a natural material made
mostly from lamb or sheepskin and intestines. [43] These
lambskin condoms, although more expensive when compared
to other types of condoms, provide a more natural sensation
during sexual activities.[44] They are preferred by individuals
who have an allergic reaction to latex condoms.[43] Lambskin
condoms can prevent pregnancy but are less effective in
combating STI organisms during sexual intercourse.[45] This
is because lambskin condoms have large pores capable of
allowing STI organisms through.[46] These pores can measure
52
up to 1500 nm in diameter and are ten times larger than the
diameter of the HIV and 25 times larger than the hepatitis B
virus.[44]
Latex condoms
Latex condoms are made from sulfonated polymer and are
commonly available and very effective in preventing infection
from STI organisms (including viruses) and unwanted
pregnancy.[44] They are impermeable and provide the best
HIV protection if correctly used.[29] These latex condoms
are made in a variety of sizes, colors, flavors, and textures.
According to the Centers for Disease Control and Prevention,
latex condoms, if properly used, provide the most effective
method of preventing all STIs and pregnancy.[24] For example,
findings by Steiner et al.[47] showed that latex condoms are
100% effective in preventing pregnancy. In the same study, a
cohort of 300 women relying on the male latex condom as a
means of contraception were followed up for one menstrual
cycle while reporting for sexual intercourse episodes. The
results showed that none of the women who participated in
the study reported any episode of pregnancy.[47] In a similar
study, earlier randomized findings among 805 monogamous
men by Frezieres et al.[48] had compared frequency of breakage
and slippage of polyurethane and latex condoms during sexual
intercourse for over 6 months. The findings showed that the
frequency of breakage and slippage was 8.5% for polyurethane
and 1.6% for latex condoms.[48] The participants acknowledged
more satisfaction with the latex condom when compared to the
polyurethane condom.[24] This is why public health authorities
have implemented a variety of interventions to escalate the
use of latex condoms in all settings so as to prevent HIV
transmission.[24] Although the latex condom demonstrates high
degree of protection against genital fluid HIV and other STIs,
the exact impact has been difficult to quantify epidemiologically
because of the numerous challenges and difficulties to observe
and measure behavior activities that occur during sexual/
intercourse activities.[29] Other challenges may include the
likely development of allergies resulting from latex condom
use.[15,29] Other limitations include the weakening of the latex
condom and reduction of its strength due to exposure to oil
lubricants, as well as mineral oil, vegetable oil, petroleum jelly
products,[21] and when in contact with intravaginal antifungal
preparations during sexual intercourse.[49]
Polyurethane condoms
Polyurethane nonlatex condoms are synthesized from
nonartificial materials and are polyvinyl/plastic in nature. They
are effective for the prevention of pregnancy and STIs[29,44,50]
but less effective than latex condoms.[49] Most female condoms
are made of polyurethane sheaths which are usually inserted 8 h
before commencement of the sexual act.[51] The polyurethane
sheath condom is efficacious in providing protection against
infection and transmission of all STIs such as chlamydia,
gonorrhea, chancroid, trichomoniasis syphilis, genital herpes,
and human papillomavirus (HPV).[24] The polyurethane condom
can be donned in either direction and is usually packaged with
a silicone‑based lubricant. The nipple‑tipped polyurethane
Annals of African Medicine ¦ Volume 17 ¦ Issue 2 ¦ April-June 2018
 Yah, et al.: Fostering condoms in preventing HIV and STIs
condoms are packaged with a silicone‑based lubricant.[29]
Polyurethane condoms are preferred by those who are allergic
to latex condoms.[29,52] However, the rate of polyurethane
condom breakage is higher when compared to latex condoms.
Some of the nonlatex condoms have breakage rates during use
ranging from 2.64 (95% confidence interval [CI]: 1.6–4.3) to
4.95 (95% CI: 3.7–6.8).[29] In a randomized clinical trial by
Frezieres et al.,[48] it was found that polyurethane condom
breakage and slippage over a period of 6 months was 8.5%
among a cohort of 805 monogamous participants in the study.
Polyethylene condoms
The polyethylene condom is a light‑weighted condom that
can withstand very high temperatures. When subjected to
ultra violet light, the polyethylene condom remains stable; in
addition, it does not deteriorate when stored for long periods
of time.[53] It is odorless and looks transparent in nature with
very limited allergic reactions when compared to other condom
types. However, this condom has limited elasticity when
compared to latex condoms.[24] It is effective in preventing
the transmission of HIV and STIs and also guards against
unwanted pregnancy.[24]
Polyisoprene condoms
Polyisoprene condoms are nonlatex, clinically tested[54] thin
and flexible condoms that provide a useful alternative for
users who have allergic reactions when employing latex
condoms.[55] These condoms feel like natural rubber and
are very comfortable with a very low allergic reaction.[55,56]
They are likely to be more costly than polyurethane and latex
condoms but are less expensive than lambskin condoms.
Polyisoprene condoms provide an effective prophylactic to
pregnancy and STIs such as gonorrhea, chlamydia, herpes,
HIV, HPV, and syphilis.[55]
Microbicides and nanotechnology
Microbicides are vaginal or rectal antimicrobial gels that
are used to prevent STIs.[57,58] Several clinical trials have
shown microbicides’ potential prevention of STIs, including
HIV as well as pregnancy.[5,58,59] They come in various types
including gels, creams, films, sponges, and suppositories
all containing active antimicrobial agents.[57,59] They are
usually inserted before intercourse[57] and some of them are
formulated with a nanotechnology background, especially
the Viva GelTm (SPL7013).[5] The SPL7013 is functionalized
with dendrimer that offers anti‑HIV and anti‑herpes simplex
virus (HSV) activity, with a well‑tolerated minimal in vitro and
in vivo health effect.[5] The limitation of microbicides is that
they are target specific; however, broad‑spectrum microbicides
can provide a wide range of antimicrobial activities.[58]
Condoms on the other hand can provide protection likely to
all types of STIs.[24]
The application of nanotechnology provides a wide range
of support, including targeted, slow and sustained release of
vaginal microbicides.[5] The combination of nanoparticles with
microbicides and condom usage will provide extra prevention
of STIs and other related health consequences. Without
Annals of African Medicine ¦ Volume 17 ¦ Issue 2 ¦ April-June 2018
condoms, microbicides can offer both primary protection
but in conjunction with condoms they can provide back‑up
protection if a condom breaks, leaks, or slips off during sexual
activities.[57,59]
Antiretroviral therapy and human immunodeficiency
syndrome prevention
The WHO and the International AIDS Society have
proposed the administration of ART to all HIV‑positive
individuals irrespective of CD4 cell count. [60] This is
because ART compliance indicates significant reduction in
viral load suppression including level of infectiousness and
transmission by 96%.[61] Similarly, high ART coverage has
shown significant reduction in the reproductive number (Ro)
to <1. [62‑63] However, the need to take ARTs daily has
prompted ART fatigue, ART failure/noncompliance, as well
as nonadherence and uptake.[54,64,65] Apparently, this has
hampered ART ineffectiveness resulting into the emergence
of ART‑resistant strains and health complications in some
settings.[66]
Moreover, despite the need of HIV‑infected individuals to
receive an optimal standard of care, there are also serious
constraints hampering treatment including limited access to
effective ART care in Sub‑Saharan Africa.[1] Second, patients
defaulting on ARTs treatment have reported serious side effects
and other complications of the liver; in addition, renal, glucose,
lipid, cardiovascular, and bone disease problems have also
been reported.[64,67] Studies show that tolerable and sustained
ART treatment plays an essential role in the maximizing and
suppression of proviral DNA and plasma viral loads,[68,69] as
well as improvement of immunological depressed functions
and the reduction of HIV‑related infections and mortality.[5,68,69]
Improved ART adherence with viral load copies
of <400/ml to <50/ml has been shown to reduce HIV
transmission by 90% among serodiscordant partners.[47,70]
However, this does not mean that the person does not have
HIV. The person still has HIV and is liable to transmit HIV
with less risk. The success is based on treatment as prevention
which is a function of treating all HIV positive on ART
irrespective of CD4 counts.[66] According to modeling findings
by Williams and Gouws,[62] HIV transmission can be reduced
by 90% if >90% of people know their status and 90% of
HIV positives are placed on ART and 90% have viral load
reduction. Therefore, novel and effective combination package
of HIV treatment strategies including prevention, biomedical,
behavioral, and structural interventions if adapted can play a
significant role in HIV reduction and elimination.[9] The new
ART cascade for elimination of HIV infections includes the
followings:
1. Provision of ART to all infected with HIV irrespective
of CD4 count[71,72]
2. Provision of PrEP to prevent those who are at risk of
HIV such as FSW, men who have sex with men, people
who inject drugs and other vulnerable groups deem
necessary[71,72]
53
 Yah, et al.: Fostering condoms in preventing HIV and STIs
3. Provision of PEP to all exposed to risk of HIV acquisition
within 72 h of exposure if they are HIV negative within
the specified period of 72 h.[71,72]
This has invigorated the need for a better consensus to enhance
current methods and develop alternative and more easily
available interventions that will reduce the HIV epidemics
associated with sexual intercourse. Indeed, this can help
stem HIV epidemic which is such a huge burden devastating
Sub‑Saharan Africa, the most affected region.[1] Reports from
the Division of Acquired Immunodeficiency Syndrome show
that over 25 different types of ART drugs have been approved
to date, ranging from single to fixed dose triple combinations
and generic formulations with daily dosing of one or more
pills. However, none of these ARTs have provided a total cure
for HIV.[19,20]
Condom and nanotechnology
Nanotechnology/nanomaterials are another new emerging
field with unique physicochemical properties that have the
potential to improve the limitations of biomedical applications
including those with antimicrobial and drug delivery
properties.[73,74] The disruptions of pathogens’ infectivity
through the broad‑spectrum activities of nanoparticles with
antimicrobial properties can play a significant role in decreasing
infectious contact, chain transmission, and spread of diseases,
including STIs. The development of nanocomposite stable
condoms coated with antimicrobials that are able to sustain,
augment, and inactivate mucosal surfaces from sustaining HIV
and STIs during (anal/vaginal) sexual intercourse activities
has opened up another dimension of molecular prevention of
STIs. These nanoparticle antimicrobials are functionalized
on the condoms in such a way that they cannot be washed by
mucosal surfaces of anal or vagina secretions but provide a
sustained release at the mucosal surfaces during usage.[15,75]
The nanotechnology condom may be another innovation
that will greatly overtake the mechanical suppression of HIV
and augment ART outcomes in mucosal surfaces of anal and
vaginal secretions. The reinforcement of the condom by coating
with stable antimicrobial nanoparticles may play a significant
role in reducing condom breakage and slippage during sexual
activities. There are reports[76] that nanoparticles, including
those consisting of carbon nanotubes, have demonstrated
excellent antimicrobial, elastic, mechanical, and reinforcement
polymer nanocomposite properties.[77]
Nanoparticles such as gold, quantum dots, silver, zinc, iron,
platinum, magnesium oxide, titanium, and copper have
the potential to be used in various biomedical applications
of drug delivery, and antimicrobial and diagnostic tests
applications.[73,76‑79] Among these silver nanoparticles[15] and to
a lesser extent, gold[79] and carbon nanotubes[76] have received
greater attention as antimicrobial agents. In addition, AgNPs
have been demonstrated to bind to HIV‑CD4 sites, thereby
preventing HIV‑CD4‑mediated fusion, and thus disrupting viral
replication processes.[80] The development of antimicrobial
nanoparticles‑coated condom as indicated in Figure 2 will
provide additional protection against STIs. For example,
54
Silver Nanoparticles
(AgNPs)
Antimicrobial
AgNP-condom
Composite
Condom-polymer
Chemical functionalization
AgNPs+ Condom
Figure 2: The biohybrid scheme of an antimicrobial nanoparticle condom
composite. The figure describes a simple illustration of silver nanoparticle
condom‑polymer hybrid in producing a potent broad‑spectrum
antimicrobial silver nanoparticle condom[82]
AgNPs‑coated polyurethane condom has been developed by
Mohammed Fayaz et al.[15] with no significant effect on human
HeLa and C8166 T‑cell lines. Their findings showed that these
condoms can effectively destroy HIV‑1 and HSV‑1/2.[15] The
AgNPs were shown to inhibit HIV‑1 and HSV‑1/2, together
with bacteria and fungi, thereby providing another line of
microbial defense. The AgNP‑coated polyurethane condom
therefore provides multiprotection: it ensures disruption of
the infectivity of the STI pathogen and prevention of both
attachment to CD4 cells and transmission of HIV on mucosal
surfaces during sexual intercourse. [15,60,80] These findings
thus indicate that this emerging field of nanoparticle‑coated
condoms can augment and overcome the current treatment
limitations regarding some STIs on mucosal surfaces during
sexual intercourse.
Other studies show that natural rubber latex has features
that can be manipulated and blended with nanoparticles,
improving the physiochemical properties for biomedical
application.[81] Guidelli et al.[81] blended wound dressing
natural rubber latex with 30 nm AgNPs and found that
the AgNPs were gradually released from the rubber latex
into the wound, thus “potentiating” and augmenting the
healing of the wound.[82] The healing process was facilitated
by the broad‑spectrum antimicrobial action of AgNPs, in
combination with the angiogenic properties of the latex
material.[81‑83] The natural rubber latex is under development
for biomedical materials such as condoms, surgical gloves,
and for hospital protective “wears.” [84] Actually, the
benefits of the biohybrid latex condom nanoparticles can
play an essential role in the prevention of STI and HIV
via mucosal surfaces during sexual intercourse. The use
of bio‑hybrid‑condom nanoparticles in the prevention of
STIs and HIV can thus play a vital role in augmenting and
complementing ART treatment as a preventative measure
during sexual intercourse. Figure 1 demonstrates a schematic
synthesis of antimicrobial nanoparticle condoms.[85]
Conclusions
Since the inception of the HIV epidemic almost 4 decades
Annals of African Medicine ¦ Volume 17 ¦ Issue 2 ¦ April-June 2018
 Yah, et al.: Fostering condoms in preventing HIV and STIs
ago, more than 78 million people have been infected; over
39 million deaths and currently over 35 million people
are living with the HIV globally.[1] This review has shown
that the spread of anal and vaginal HIV/STIs disease can
be reduced depending on access to the right information
regarding the required type of condoms, rightful condom
use, sustained ART uptake, and the requisite behavioral
changes. Furthermore, recent research studies have
shown that the use of targeted and universal approaches
in condom promotion and the reinforcement of condoms
with antimicrobial nanoparticles can reduce the burden of
STI and HIV on mucosal surfaces during vaginal and anal
sexual intercourse.[85] It is also advisable that when there
is a diagnosis of HIV, ART should be initiated as per local
national guidelines and this should apply to all the people
who have acute infections and are willing to start their
ART treatment. When a person is on ART, various types of
preventions and safer barrier methods, including condom
use and regular counseling, should also be administered.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
1. UNAIDS. The Gap Report. Geneva: UNAIDS; September, 2014.
2. El‑Sadr WM, Serwadda DM, Sista N, Cohen MS. HIV prevention:
Great achievements, more challenges ahead. J Acquir Immune Defic
Syndr 2013;63 Suppl 2:S115‑6.
3. Johnson KE, Quinn TC. Update on male circumcision: Prevention
success and challenges ahead. Curr Infect Dis Rep 2008;10:243‑51.
4. Global Campaign for Microbicides; 2014. Available from: http://www.
global‑campaignorg. [Last accessed on 2015 Jun 15].
5. Rupp R, Rosenthal SL, Stanberry LR. VivaGel (SPL7013 gel): A
candidate dendrimer – Microbicide for the prevention of HIV and HSV
infection. Int J Nanomedicine 2007;2:561‑6.
6. Sánchez J, Sal Y Rosas VG, Hughes JP, Baeten JM, Fuchs J,
Buchbinder SP, et al. Male circumcision and risk of HIV acquisition
among MSM. AIDS 2011;25:519‑23.
7. Doerner R, McKeown E, Nelson S, Anderson J, Low N, Elford J, et al.
Circumcision and HIV infection among men who have sex with men in
Britain: The insertive sexual role. Arch Sex Behav 2013;42:1319‑26.
8. Yah CS, Tambo E, Khayeka‑Wandabwa C, Ngogang JY. Impact of
telemonitoring approaches on integrated HIV and TB diagnosis and
treatment interventions in sub‑saharan Africa: A scoping review. Health
Promot Perspect 2017;7:60‑65.
9. McNaghten A, Kearns R, Siegler AJ, Phaswana‑Mafuya N, Bekker LG,
Stephenson R, et al. Sibanye methods for prevention packages program
project protocol: Pilot study of HIV prevention interventions for men
who have sex with men in South Africa. JMIR Res Protoc 2014;3:e55.
10. Griffin R, Snook WD, Hoff GL, Cai J, Russell J. Failure to embrace the
barrier/condom use message. J Assoc Nurses AIDS Care 2006;17:24‑9.
11. Weller S, Davis K. Condom effectiveness in reducing heterosexual HIV
transmission. Cochrane Database Syst Rev 2002;1:CD003255.
12. Garcia‑Retamero R, Cokely ET. Simple but powerful health messages
for increasing condom use in young adults. J Sex Res 2015;52:30‑42.
13. Mantell JE, Smit JA, Beksinska M, Scorgie F, Milford C, Balch E, et al.
Everywhere you go, everyone is saying condom, condom. But are they
being used consistently? Reflections of South African male students
about male and female condom use. Health Educ Res 2011;26:859‑71.
14. Adefuye AS, Kennedy SB, Amuwo S, Nolen S, Sayad JV. Condom
use among young African American men: Implications for planning
Annals of African Medicine ¦ Volume 17 ¦ Issue 2 ¦ April-June 2018
interventions. J Health Dispar Res Pract 2014;7:104‑20.
15. Mohammed Fayaz A, Ao Z, Girilal M, Chen L, Xiao X,
Kalaichelvan P, et al. Inactivation of microbial infectiousness by silver
nanoparticles‑coated condom: A new approach to inhibit HIV‑  and
HSV‑transmitted infection. Int J Nanomedicine 2012;7:5007‑18.
16. Walsh TL, Frezieres RG, Peacock K, Nelson AL, Clark VA,
Bernstein L. Evaluation of the efficacy of non latex condom: Results
from a randomized, controlled clinical trial. Perspect Sex Reprod Health
2003;35:79‑86.
17. Jain J, Arora S, Rajwade JM, Omray P, Khandelwal S, Paknikar KM, et al.
Silver nanoparticles in therapeutics: Development of an antimicrobial
gel formulation for topical use. Mol Pharm 2009;6:1388‑401.
18. Needle R, Fu J, Beyrer C, Loo V, Abdul‑Quader AS, McIntyre JA,
et al. PEPFAR’s evolving HIV prevention approaches for key
populations – People who inject drugs, men who have sex with men, and
sex workers: Progress, challenges, and opportunities. J Acquir Immune
Defic Syndr 2012;60 Suppl 3:S145‑51.
19. Gandhi M, Gandhi RT. Single‑pill combination regimens for treatment
of HIV‑1 infection. N Engl J Med 2014;371:248‑59.
20. AIDSinfo. Guidelines for the Use of Antiretroviral Agents in Pediatric
HIV Infection. AIDSinfo 3/16/2015. Available: http://aidsinfo.nih.gov/
guidelines [Last assessed on 2015 Oct 12].
21. Voeller B, Coulson AH, Bernstein GS, Nakamura RM. Mineral oil
lubricants cause rapid deterioration of latex condoms. Contraception
1989;39:95‑102.
22. Bagnol B, Mariano E. Vaginal practices: Eroticism and implications
for women’s health and condom use in Mozambique. Cult Health Sex
2008;10:573‑85.
23. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred
reporting items for systematic reviews and meta‑analyses: The PRISMA
statement. Ann Intern Med 2009;151:264‑9, W64.
24. Centers for Disease Control and Prevention (CDC). Condoms and STDs
Fact Sheet for Public Health Personnel. Atlanta, GA: Center for Disease
Control and Prevention; 2011. Available from: http://www.cdcgov/
condomeffectiveness/latexhtm. [Last accessed on 2015 Mar 12].
25. Workowskin KA, Berman SM. Sexually Transmitted Diseases
Treatment Guidelines, 2006. Division of STD Prevention, National
Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; 2006.
26. Wilkinson D, Tholandi M, Ramjee G, Rutherford GW. Nonoxynol‑9
spermicide for prevention of vaginally acquired HIV and other
sexually transmitted infections: Systematic review and meta‑analysis of
randomised controlled trials including more than 5000 women. Lancet
Infect Dis 2002;2:613‑7.
27. Handley MA, Reingold AL, Shiboski S, Padian NS. Incidence of acute
urinary tract infection in young women and use of male condoms with
and without nonoxynol‑9 spermicides. Epidemiology 2002;13:431‑6.
28. Whaley AL, Winfield EB. Correlates of African American college
students’ condom use to prevent pregnancy, STDs, or both outcomes.
J Natl Med Assoc 2003;95:702‑9.
29. Gallo MF, Grimes DA, Lopez LM, Schulz KF. Non-latex versus
latex male condoms for contraception. Cochrane Database Syst Rev
2006;2:CD003550.
30. Staab RS, Allendale NJ. Condoms for Beneficial Agents Delivery US
Patent No 20070175484 A1; 2007.
31. Mathew V, Bantwal G. Male contraception. Indian J Endocrinol Metab
2012;16:910‑7.
32. Ditmore M, Neth C. Unsafe condoms and other unsafe sex accessories.
Reprod Health Matters 2006;14:171‑3.
33. Kemp CA, Hampshire GB. Condom with an Erectogenic Composition
Patent No 6,840,244; 2015.
34. Kiser PF. A Molecular Condom Against AIDS 2006. Available from:
http://www.unewsutahedu/p/?r=111706–2,1–3. [Last accessed on 2015
May 24].
35. Hearst N, Chen S. Condoms for AIDS Prevention in the Developing
World: A Review of the Scientific Literature University of California;
2003.
36. Pinkerton SD, Abramson PR. Effectiveness of condoms in preventing
HIV transmission. Soc Sci Med 1997;44:1303‑12.
37. Holmes KK, Levine R, Weaver M. Effectiveness of condoms in
preventing sexually transmitted infections. Bull World Health Organ
55
 Yah, et al.: Fostering condoms in preventing HIV and STIs
2004;82:454‑61.
38. Trussell J, Sturgen K, Strickler J, Dominik R. Comparative contraceptive
efficacy of the female condom and other barrier methods. Fam Plann
Perspect 1994;26:66‑72.
39. Frezieres RG, Walsh TL, Nelson AL, Clark VA, Coulson AH. Breakage
and acceptability of a polyurethane condom: A randomized, controlled
study. Fam Plann Perspect 1998;30:73‑8.
40. Yarber WL, Graham CA, Sanders SA, Crosby RA. Correlates of
condom breakage and slippage among university undergraduates. Int J
STD AIDS 2004;15:467‑72.
41. Sparrow MJ, Lavill K. Breakage and slippage of condoms in family
planning clients. Contraception 1994;50:117‑29.
42. Jayawardena H. Use of unsafe condoms and unsafe use of good
condoms. Reproductive Health Matters 2007;15:192.
43. Forsyth AD, Carey MP, Fuqua RW. Evaluation of the validity of the
condom use self‑efficacy scale (CUSES) in young men using two
behavioral simulations. Health Psychol 1997;16:175‑8.
44. Workowski KA, Berman S. Sexually Transmitted Diseases Treatment
Guidelines, 2010. Division of STD Prevention, National Center for
HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Atlanta, GA
30333; 2010.
45. Carey MP, Carey KB, Weinhardt LS, Gordon CM. Behavioral risk for
HIV infection among adults with a severe and persistent mental illness:
Patterns and psychological antecedents. Community Ment Health J
1997;33:133‑42.
46. Lytle CD, Carney PG, Vohra S, Cyr WH, Bockstahler LE. Virus leakage
through natural membrane condoms. Sex Transm Dis 1990;17:58‑62.
47. Steiner MJ, Taylor DJ, Feldblum PJ, Wheeless AJ. How well do male
latex condoms work? Pregnancy outcome during one menstrual cycle of
use. Contraception 2000;62:315‑9.
48. Frezieres RG, Walsh TL, Nelson AL, Clark VA, Coulson AH. Evaluation
of the efficacy of a polyurethane condom: Results from a randomized,
controlled clinical trial. Fam Plann Perspect 1999;31:81‑7.
49. Rosen AD, Rosen T. Study of condom integrity after brief exposure to
over‑the‑counter vaginal preparations. South Med J 1999;92:305‑7.
50. French PP, Latka M, Gollub EL, Rogers C, Hoover DR, Stein ZA, et al.
Use‑effectiveness of the female versus male condom in preventing
sexually transmitted disease in women. Sex Transm Dis 2003;30:433‑9.
51. Drew WL, Blair M, Miner RC, Conant M. Evaluation of the
virus permeability of a new condom for women. Sex Transm Dis
1990;17:110‑2.
52. Zhao R, Wu JQ, Li YY, Zhou Y, Ji HL, Li YR, et al. Efficacy of a
combined contraceptive regimen consisting of condoms and emergency
contraception pills. BMC Public Health 2014;14:354.
53. Legge NR, Mowbray RC. TPE condoms impervious to ozone levels that
damage NR latex condoms. Rubber World 1994;211:43.
54. Palosuo T, Mäkinen-Kiljunen S, Alenius H, Reunala T, Yip E,
Turjanmaa K. Measurement of natural rubber latex allergen levels
in medical gloves by allergen-specific IgE-ELISA inhibition, RAST
inhibition, and skin prick test. Allergy 1998;53:59-67.
55. Carey RF, Herman WA, Retta SM, Rinaldi JE, Herman BA, Athey TW.
Effectiveness of latex condoms as a barrier to human immunodeficiency
virus-sized particles under conditions of simulated use. Sex Transm Dis
1992;19:230-4.
56. Patel VL, Gutnik LA, Yoskowitz NA, O’sullivan LF, Kaufman DR.
Patterns of reasoning and decision making about condom use by urban
college students. AIDS Care 2006;18:918-30.
57. Boyapalle S, Mohapatra S, Mohapatra S. Nanotechnology applications
to HIV vaccines and microbicides. J Glob Infect Dis 2012;4:62‑8.
58. Singh O, Garg T, Rath G, Goyal AK. Microbicides for the treatment of
sexually transmitted HIV infections. J Pharm (Cairo) 2014;2014:352425.
59. Foss AM, Vickerman PT, Heise L, Watts CH. Shifts in condom use
following microbicide introduction: Should we be concerned? AIDS
2003;17:1227‑37.
60. Thompson MA, Aberg JA, Hoy JF, Telenti A, Benson C, Cahn P, et al.
Antiretroviral treatment of adult HIV infection: 2012 recommendations
of the International Antiviral Society‑USA panel. JAMA
2012;308:387‑402.
61. Williams BG, Dye C. Put Your Money Where Your Model Is: ART for
the Prevention and Treatment of HIV/AIDS CROI: 17th Conference on
56
Retroviruses and Opportunistic Infections San Francisco, United States
of America; 2010.
62. Williams BG, Gouws E. R0 and the elimination of HIV in Africa: Will
90-90-90 be sufficient? 2013;arXiv:13043720. Available from: https://
arxiv.org/ftp/arxiv/papers/1304/1304.3720.pdf. [Last accessed on 2015
Nov 14].
63. UNAIDS 90‑90‑90: An Ambitious Treatment Target To Help End the
AIDS Epidemic UNAIDS; 2014. Available from: http://www.unaidsorg/
sites/default/files/media_asset/90‑90‑90_en_0pdf. [Last accessed on
2015 Mar 12].
64. Günthard HF, Aberg JA, Eron JJ, Hoy JF, Telenti A, Benson CA,
et al. Antiretroviral treatment of adult HIV infection: 2014
recommendations of the International Antiviral Society‑USA panel.
JAMA 2014;312:410‑25.
65. Charania MR, Marshall KJ, Lyles CM, Crepaz N, Kay LS, Koenig LJ,
et al. Identification of evidence‑based interventions for promoting HIV
medication adherence: Findings from a systematic review of U.S.‑based
studies, 1996‑2011. AIDS Behav 2014;18:646‑60.
66. World Health Organization (WHO). Antiretroviral Treatment as
Prevention (TasP) of HIV and TB: 2012 Update WHO/HIV/201212.
Geneva: World Health Organization; 2012.
67. Reust CE. Common adverse effects of antiretroviral therapy for HIV
disease. Am Fam Physician 2011;83:1443‑51.
68. Wyl Vv, Gianella S, Fischer M, Niederoest B, Kuster H, Battegay M,
et al. Early antiretroviral therapy during primary HIV‑1 infection results
in a transient reduction of the viral setpoint upon treatment interruption.
PLoS One 2011;6:e27463.
69. Hocqueloux L, Avettand‑Fènoël V, Jacquot S, Prazuck T, Legac E,
Mélard A, et al. Long‑term antiretroviral therapy initiated during
primary HIV‑1 infection is key to achieving both low HIV reservoirs
and normal T cell counts. J Antimicrob Chemother 2013;68:1169‑78.
70. Attia S, Egger M, Müller M, Zwahlen M, Low N. Sexual transmission
of HIV according to viral load and antiretroviral therapy: Systematic
review and meta‑analysis. AIDS 2009;23:1397‑404.
71. Maksud I, Fernandes NM, Filgueiras SL. Technologies for HIV
prevention and care: Challenges for health services. Rev Bras Epidemiol
2015;18 Suppl 1:104‑19.
72. Grant RM, Smith DK. Integrating antiretroviral strategies for human
immunodeficiency virus prevention: Post‑ and pre‑exposure prophylaxis
and early treatment. Open Forum Infect Dis 2015;2:ofv126.
73. Blanco‑Andujar C, Tung LD, Thanh NT. Synthesis of nanoparticles for
biomedical applications. Annu Rep Prog Chem Sect A 2010;106:553‑68.
74. Simate GS, Yah CS. The use of carbon nanotubes in medical
applications – Is it a success story? Occup Med Health Aff 2014;2:146‑7.
75. Haider A, Kang IK. Preparation of silver nanoparticles and their
industrial and biomedical applications: A comprehensive review. Adv
Mater Sci Eng 2015;2015:ID 165257.
76. Venkatesan J, Jayakumar R, Mohandas A, Bhatnagar I, Kim SK.
Antimicrobial activity of chitosan‑carbon nanotube hydrogels.
Materials (Basel) 2014;7:3946‑955.
77. Gupta AK, Harsha SP. Analysis of mechanical properties of carbon
nanotube reinforced polymer composites using continuum mechanics
approach. Procedia Mater Sci 2014;6:18‑25.
78. Sunitha A, Rimal IR, Sweetly G, Sornalekshmi S, Arsula R, Praseetha PK.
Evaluation of antimicrobial activity of biosynthesized iron and silver
Nanoparticles using the fungi Fusarium oxysporum and Actinomycetes
sp on human pathogens. Nano Biomed Eng 2013;5:39‑45.
79. Addae E, Dong X, McCoy E, Yang C, Chen W, Yang L, et al.
Investigation of antimicrobial activity of photothermal therapeutic
gold/copper sulfide core/shell nanoparticles to bacterial spores and cells.
J Biol Eng 2014;8:11.
80. Lara HH, Ayala‑Nuñez NV, Ixtepan‑Turrent L, Rodriguez‑Padilla C.
Mode of antiviral action of silver nanoparticles against HIV‑1.
J Nanobiotechnology 2010;8:1.
81. Guidelli EJ, Kinoshita A, Ramos AP, Baffa O. Silver nanoparticles
delivery system based on natural rubber latex membranes.
J Nanopart Res 2013;15:1536.
82. Tian J, Wong KK, Ho CM, Lok CN, Yu WY, Che CM, et al.
Topical delivery of silver nanoparticles promotes wound healing.
ChemMedChem 2007;2:129‑36.
Annals of African Medicine ¦ Volume 17 ¦ Issue 2 ¦ April-June 2018
 Yah, et al.: Fostering condoms in preventing HIV and STIs

83. Mendonça RJ, Maurício VB, Teixeira Lde B, Lachat JJ, 84. Hasma H, Othman AB, Fauzi MS. Barrier integrity of punctured gloves:
Coutinho‑Netto J. Increased vascular permeability, angiogenesis and NR superior to vinyl and nitrile. J Rubb Res 2003;6:9.
wound healing induced by the serum of natural latex of the rubber tree 85. Yah CS, Simate GS. Nanoparticles as potential new generation broad
Hevea brasiliensis. Phytother Res 2010;24:764‑8. spectrum antimicrobial agents. Daru 2015;23:43.

Annals of African Medicine ¦ Volume 17 ¦ Issue 2 ¦ April-June 2018 57

View publication stats