Herpes simplex virus type 2 (HSV-2) infection is endemic, globally. One in five sexually active persons is infected in the USA. Condoms, used alone or in combination with other methods of contraception, should be promoted for protection against HSV-2 and other sexually transmitted infections, as well as prevention of unplanned pregnancies. This recommendation is based on evidence from well-designed, multicentre, clinical trials of an ineffective prophylactic HSV vaccine, which yielded data on the natural history of HSV acquisition among sexually active adults. Condom use was protective among women, with HR = 0.085, 95% CI, 0.01–0.67, for condom use more than 25% of the time. Factors known to affect condom efficacy against HSV transmission include sex education and counselling, accessibility, compliance, gender, clinical and subclinical shedding of HSV, suppressive use of HSV-specific antivirals, behavioural issues, and the composition and physical integrity of the condom. Additional data supporting a recommendation for male condom use are non-clinical study data and analyses of retrospective, cross-sectional, HSV seroprevalence data and condom reporting. Sexual behaviour modification including consistent and correct use of latex condoms should contribute to a reduction in HSV transmission, particularly among non-monogamous populations and those with newly acquired genital herpes infection.

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