Abstract

Objectives: To identify the prevalence of condom breakage and demographic and sexuality-related differences between young men who have sex with women reporting and not reporting this event. Also, to identify condom-specific behaviors associated with breakage.

Methods: Young men (N = 278) attending an STI clinic responded to an anonymous questionnaire aided by a CD-recording of the questions. The sample was screened to include only men who had used a condom during penile- vaginal sex at least 3 times in the past 3 months. Condom-specific behaviors (including breakage) were assessed using these last 3 acts of condom use as the recall period. Correlates achieving bivariate significance were subjected to multivariate analysis.

Results: Nearly one-third (31.3%) reported recent breakage. The breakage rate was 15%. Three correlates significantly distinguished several differences between men who did and did not report breakage. Men having past STIs were more likely to report breakage (AOR=2.08), as were men who also reported condom slippage (AOR=2.72). Less self-efficacy to use condoms correctly was also significantly associated with breakage (AOR=1.07). Further, 3 condom-specific behaviors were significantly associated with breakage. These were: allowing condoms to contact sharp objects (AOR=2.6), experiencing problems with the "fit or feel" of condoms (AOR=2.3), and not squeezing air from the receptacle tip (AOR=2.0).

Conclusions: Breakage may be common and may occur in a larger context of difficulties with condoms. STI clinics could potentially benefit some men by providing instruction in the correct use of condoms.