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Is phosphodiesterase type 5 inhibitor use associated with condom breakage?
  1. R Crosby1,2,3,
  2. W L Yarber2,3,4,
  3. S A Sanders2,3,4,
  4. C A Graham2,3,4,5,6
  1. 1
    College of Public Health at the University of Kentucky, Kentucky, USA
  2. 2
    The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana, USA
  3. 3
    Rural Center for AIDS/STD Prevention at Indiana University, Indiana, USA
  4. 4
    Department of Applied Health Science, Indiana University, Indiana, USA
  5. 5
    Department of Gender Studies, Indiana University, Indiana, USA
  6. 6
    Oxford Doctoral Course in Clinical Psychology, Oxford, UK
  1. Richard Crosby, College of Public Health, 121 Washington Ave. Lexington, Kentucky 40506-0003, USA; crosby{at}


We tested the hypothesis that phosphodiesterase type 5 inhibitor (PDE5i) use would be associated with increased likelihood of condom breakage using an event-specific analysis.

A convenience sample of 440 men completed an internet-based questionnaire that assessed variables pertaining to the last time they used condoms for penile-vaginal intercourse (PVI). A bivariate (screening) analysis was performed to identify covariates for a multivariate analysis using logistic regression.

Altogether, 5.9% of the men reported breakage and 9.5% reported PDE5i use during the last time a condom was used for PVI. Among men who had used PDE5i during the last condom-protected occasion of PVI, 11.9% reported breakage compared with 5.3% of those not reporting PDE5i use. Adjusting for men’s age, ethnic minority status, marital status, reported duration of PVI and alcohol use at last PVI, those using PDE5i were about four times more likely to also report condom breakage (AOR 4.02; 95% CI 1.20 to 13.48; p = 0.04). Of note, duration of PVI was independently associated with breakage (AOR 1.36; CI 1.02 to 1.83; p = 0.04).

Findings suggest that PDE5i use may potentially be associated with increased odds of condom breakage among some men.

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  • Funding: Support for this project was provided, in part, by the Rural Center for AIDS/STD Prevention, a joint project of Indiana University, University of Colorado and the University of Kentucky, and by The Kinsey Institute, Indiana University.

  • Competing interests: None.

  • Ethics approval: Obtained from the Indiana University Institutional Review Board.

  • Contributors: Study implementation and oversight was conducted by SAS and WLY. RC, CAG, WLY and SAS each shared in the development of the questionnaire and the conceptualisation and writing of this manuscript. RC performed the analyses.

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