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Who uses condoms with whom? Evidence from national probability sample surveys
  1. J A Cassell1,
  2. C H Mercer1,
  3. J Imrie1,
  4. A J Copas1,
  5. A M Johnson2
  1. 1Centre for Sexual Health and HIV Research, Department of Primary Care and Population Sciences, University College London, Mortimer Market Centre, off Capper Street, London WC1E 6JB, UK
  2. 2Department of Primary Care and Population Sciences, Royal Free and University College Medical School, University College London, Rowland Hill Street, London NW3 3PF, UK
  1. Correspondence to:
 Dr Jackie Cassell
 Centre for Sexual Health and HIV Research, Department of Primary Care and Population Sciences, Mortimer Market Centre off Capper Street, London WC1E 6JB, UK; j.cassell{at}


Objectives: To explore the changing pattern of condom use from 1990 to 2000; to identify sociodemographic and behavioural factors associated with condom use; and reasons for condom use in 2000.

Methods: Large probability sample surveys administered among those resident in Britain aged 16–44 (n = 13 765 in 1990, n = 11 161 in 2000). Face to face interviews with self completion components collected sociodemographic, behavioural, and attitudinal data.

Results: Condom use in the past year among sexually active 16–24 year old men increased from 61.0% in 1990 to 82.1% in 2000 (p<0.0001), and from 42.0% to 63.2% (p<0.0001) among women of the same age, with smaller increases among older age groups. Among individuals reporting at least two partners in the previous 4 week period, approximately two thirds reported inconsistent or no condom use (63.1% (95% CI 55.9% to 69.8%) of the men and 68.5% (95% CI 57.6% to 77.7%) of the women).

Conclusions: Rates of condom use increased substantially between 1990 and 2000, particularly among young people. However, inconsistent condom use by individuals with high rates of partner acquisition may contribute significantly to the recent resurgence in STIs. This group is an important target for intensive and specific sexual health interventions.

  • CASI, computer assisted self interviewing
  • MSM, men who have sex with men
  • Natsal, National Surveys of Sexual Attitudes and Lifestyles
  • PAPI, pen and paper interviewing
  • STI, sexually transmitted infections
  • condoms
  • sexual behaviour
  • risk
  • sexually transmitted infections

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  • Funding: Natsal 1990 was supported by a grant from the Wellcome Trust. Natsal 2000 was supported by a grant from the Medical Research Council with funds from the Department of Health, the Scottish Executive, and the National Assembly for Wales.

  • Competing interest statement: none.

  • Ethical approval: The Natsal study was approved by the University College Hospital and North Thames Multi-Centre Research Ethics Committee and all the local research ethics committees in Britain.