Condoms are more effective when applied by males: a study of young black males in the United States

PurposeTo determine, among a sample of young black male (YBM), whether female application of male condoms for penile–vaginal intercourse would be associated with higher or lower rates of breakage or slippage. A secondary aim was to investigate if higher rates of breakage or slippage were associated with increased odds of acquiring chlamydia and/or gonorrhea.MethodsA cross-sectional study of 412 YBM, aged 15 to 23 years, was conducted in three US cities located in the Southern United States.ResultsAmong YBM reporting frequent female application of condoms, 43.5% reported one or more instance of breakage or slippage, compared with those reporting less frequent female application (27.2%, P = .003). Among YBM reporting one or more event of breakage or slippage, 25.4% tested positive for chlamydia and/or gonorrhea. In contrast, among those not reporting breakage or slippage, 17.2% tested positive (P = .047).ConclusionsFindings suggest that educational and behavioral interventions should seek to improve young women's skills relative to condom application and use. Further studies could also investigate whether intervention efforts should encourage some YBM to be responsible for their own condom application

Condom-Associated Erection Problems: A Study of High-Risk Young Black Males Residing in the Southern United States

Previous research indicates that young men may experience condom-associated erection loss and that these problems may lead to inconsistent or incomplete condom use. The primary aim of this study was to assess, using a retrospective recall period of 2 months, correlates of condom-associated erection problems among young Black men attending sexually transmitted infection (STI) clinics. Data were collected in clinics treating patients with STIs in three southern U.S. cities. Males 15 to 23 years of age who identified as Black/African American and reported recent (past 2 months) condom use were eligible. A total of 494 men participated. Nineteen percent reported that condom-associated erection problems during condom application occurred at least once, and 17.8% indicated erection difficulties occurred during sexual intercourse at least once in the past 2 months. Multivariate analyses identified that condom-associated erection problems were associated with reports of sex with more than one partner during the recall period, reported problems with condom fit and feel, lower motivation to use condoms, and attempts at condom application before having a full erection. Findings suggest that clinic interventions should address possible condom-associated erection problems among young Black men who are at risk of STIs. Encouraging men who may be vulnerable to erection loss when condoms are used to allow sufficient time for sexual arousal to build may be an effective strategy

A theory-based approach to understanding condom errors and problems reported by men attending an STI clinic

The official published version can be accessed from the link below - Copyright @ 2008 Springer VerlagWe employed the information–motivation–behavioral skills (IMB) model to guide an investigation of correlates for correct condom use among 278 adult (18–35 years old) male clients attending a sexually transmitted infection (STI) clinic. An anonymous questionnaire aided by a CD-recording of the questions was administered. Linear Structural Relations Program was used to conduct path analyses of the hypothesized IMB model. Parameter estimates showed that while information did not directly affect behavioral skills, it did have a direct (negative) effect on condom use errors. Motivation had a significant direct (positive) effect on behavioral skills and a significant indirect (positive) effect on condom use errors through behavioral skills. Behavioral skills had a direct (negative) effect on condom use errors. Among men attending a public STI clinic, these findings suggest brief, clinic-based, safer sex programs for men who have sex with women should incorporate activities to convey correct condom use information, instill motivation to use condoms correctly, and directly enhance men’s behavioral skills for correct use of condoms

Condom-use errors and problems: the neglected aspect of studies assessing condom effectiveness

ObjectiveTo assess and compare condom-use errors and problems among condom-using university males and females.MethodsA convenience sample of 260 undergraduates was utilized. Males (n=118) and females (n=142) reported using condoms in the past 3 months for at least one episode of sex (penis in the mouth, vagina, or rectum) with a partner of the other sex. A questionnaire assessed 15 errors and problems associated with condom use that could be observed or experienced by females as well as males.ResultsAbout 44% reported lack of condom availability. Errors that could contribute to failure included using sharp instruments to open condom packages (11%), storing condoms in wallets (19%), and not using a new condom when switching from one form of sex to another (83%). Thirty-eight percent reported that condoms were applied after sex had begun, and nearly 14% indicated they removed condoms before sex was concluded. Problems included loss of erection during condom application (15%) or during sex (10%). About 28% reported that condoms had either slipped off or broken. Nearly 19% perceived, at least once, that their condom problems necessitated the use of a new condom. Few differences were observed in errors and problems between males and females.ConclusionsFindings suggest that condom-use errors and problems may be quite common and that assessment of errors and problems do not necessarily need to be gender specific. Findings also suggest that correcting “user failure” may represent an important challenge in the practice of preventive medicine

Condom discomfort and associated problems with their use among university students.

In addition to consistent use, condoms must be used correctly. The purpose of this study was to identify prevalence and types of condom-associated discomfort among university students, the outcomes of this discomfort, and the role of discomfort in condom breakage. We conducted a cross-sectional study of 206 students attending a private university in the southern United States. We assessed 3 potential outcomes: breakage, not using condoms throughout sex, and low condom-use motivation. Nearly one third reported discomfort, including tightly fitting condoms, vaginal irritation, and loss of sensation. Discomfort was associated with breakage (p = .0001), incomplete use (p = .0001), and less motivation to use condoms (p = .018). Gender moderated the latter 2 findings. Adjusted findings indicate that students reporting discomfort were 3.6 times more likely to also report breakage (p = .0009). Continued investigation of this topic is warranted. Prevention education may benefit university students by promoting several key practices, such as adding lubricant to condoms before they dry out and acquiring condoms that fit properly