How often do condoms fail? A cross-sectional study exploring incomplete use of condoms, condom failures and other condom problems among black and white MSM in southern USA
- Alfonso C Hernández-Romieu1,
- Aaron J Siegler1,
- Patrick S Sullivan1,
- Richard Crosby2,
- Eli S Rosenberg1
- 1Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- 2Department of Health Behavior, College of Public Health, University of Kentucky, Lexington, Kentucky, USA
- Correspondence to Dr Alfonso C Hernández-Romieu, Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Room 444 GCR, Atlanta, Georgia 30322, USA;
- Received 3 March 2014
- Revised 30 June 2014
- Accepted 5 July 2014
- Published Online First 30 July 2014
Objectives To compare the occurrence of risk-inducing condom events (condom failures and incomplete use) and the frequency of their antecedents (condom errors, fit/feel problems and erection problems) between black and white men who have sex with men (MSM), and determine the associations between risk-inducing condom events and their antecedents.
Methods We studied cross-sectional data of 475 MSM who indicated using a condom as an insertive partner in the previous 6 months enrolled in a cohort study in Atlanta, Georgia, USA.
Results Nearly 40% of black MSM reported breakage or incomplete use, and they were more likely to report breakage, early removal and delayed application of a condom than white MSM. Only 31% and 54% of MSM reported correct condom use and suboptimal fit/feel of a condom, respectively. The use of oil-based lubricants and suboptimal fit/feel were associated with higher odds of reporting breakage (p=0.009). Suboptimal fit/feel was also associated with higher odds of incomplete use of condoms (p<0.0001).
Conclusions Incomplete use of condoms and condom failures were especially common among black MSM. Our findings indicate that condoms likely offered them less protection against HIV/sexually transmitted infection when compared with white MSM. More interventions are needed, particularly addressing the use of oil-based lubricants and suboptimal fit/feel of condoms.