Two heads are better than one: the association between condom decision-making and condom use errors and problems
- 1College of Public Health at the University of Kentucky, Lexington, Kentucky, USA
- 2The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana, USA
- 3Rural Center for AIDS/STD Prevention at Indiana University, Indiana, USA
- 4Department of Family Relations and Applied Nutrition at the University of Guelph, Guelph, Ontario, Canada
- 5Department of Applied Health Science, Indiana University, Indiana, USA
- 6Oxford University, Oxford, UK
- R Crosby, College of Public Health, 121 Washington Ave., Lexington, KY 40506-0003, USA;
- Accepted 29 October 2007
Objectives: This exploratory study compared the frequency of condom use errors and problems between men reporting that condom use for penile–vaginal sex was a mutual decision compared with men making the decision unilaterally.
Methods: Nearly 2000 people completed a web-based questionnaire. A sub-sample of 660 men reporting that they last used a condom for penile–vaginal sex (within the past three months) was analysed. Nine condom use errors/problems were assessed. Multivariate analyses controlled for men’s age, marital status, and level of experience using condoms.
Results: Men’s unilateral decision-making was associated with increased odds of removing condoms before sex ended (adjusted odds ratio (AOR) 2.51, p = 0.002), breakage (AOR 3.90, p = 0.037), and slippage during withdrawal (AOR 2.04, p = 0.019). Men’s self-reported level of experience using condoms was significantly associated with seven out of nine errors/problems, with those indicating less experience consistently reporting more errors/problems.
Conclusions: Findings suggest that female involvement in the decision to use condoms for penile–vaginal sex may be partly protective against some condom errors/problems. Men’s self-reported level of experience using condoms may be a useful indicator of the need for education designed to promote the correct use of condoms. Education programmes may benefit men by urging them to involve their female partner in condom use decisions.
Contributions: RC participated in the conception of the study, analysed and interpreted the data, drafted the manuscript, and finalised the manuscript. RM acquired funding for the study, conceived the methodology for data collection, implemented the study, cleaned the dataset, and provided guidance to RC in the conception of the study and drafting/revisions of the manuscript. WLY, SAS and CAG all participated in the conception of the study, analysis and interpretation of the data, drafting/revision of the manuscript.
Funding: Support for this project was provided by the Canada Research Chair in Social Justice and Sexual Health at the University of Windsor, and the Rural Center for AIDS/STD Prevention and The Kinsey Institute for Research in Sex, Gender, and Reproduction at Indiana University.
Competing interests: None declared.