Study Finds Condom Use Errors Are Common

Researchers Strongly Recommend Condom Education and Instruction

A study conducted by researchers at Emory and Indiana Universities and published in the September issue of Sexually Transmitted Diseases found that various condom use errors were frequent among a small sample of sexually active heterosexual college men. The purpose of the study was to evaluate errors and problems in the use of male latex condoms. Although the findings cannot be generalized to a broader population and assume all of the limitations that come with self-reported data, researchers believe that the findings are significant because they point to a clear need for better condom education and instruction.

Previous studies have shown that consistent and correct use of male latex condoms will provide highly effective protection against HIV and many other sexually transmitted diseases. Although studies have focused on the consistency of condom use, relatively few studies have assessed condom use errors and problems.

"We have known for quite some time that it is vital to get the message out to sexually active young people about the importance of consistent condom use," said lead study author Richard A. Crosby, PhD from Emory University's Center for AIDS Research (CFAR). "This research suggests that promoting consistent condom use may not be enough. It is important to provide adequate condom use education and skills-building instruction so that sexually active young men know how to use condoms correctly."

The study, conducted from November 2000 through January 2001, explored condom use errors and problems among college men at Indiana University. Of 362 men, 158 met the study inclusion criteria (never married, and reporting putting a condom on for sex at least once in the past 3 months). Forty two percent of young men participating in the study reported that they wanted to use a condom but did not have one available.

Some of the other basic problems highlighted by the study included not checking the condom for visible damage (74%), not checking the expiration date (61%), and not discussing condom use with their partner before sex (60%). In addition, various technical errors were found, including
putting on the condom after starting sex (43%), taking off the condom before sex was over (15%), not leaving a space at the tip of the condom (40%), and placing the condom upside down on the penis and then having to flip it over (30%).

In addition, 29% of study participants reported condom breakage and 13% reported that the condom slipped off during sex. Crosby stressed that this is not surprising since those who reported slippage or breakage also had significantly higher error scores. "These problems are likely the result of condom use errors rather than defects in the condom itself, which, again highlights the need for better condom education and instruction," added Crosby.

Comprehensive prevention programs stress abstaining from sex as the first line of defense in the prevention of HIV and other STDs. However, latex condoms are a vital prevention strategy for those who choose to have sex. This study suggests that increasing the focus on correcting potential user errors and problems through increased and more effective education and instruction should be a public health priority.

Study co-authors included Dr. Stephanie Sanders and Dr. Cynthia Graham (Gender Studies at Indiana University and The Kinsey Institute for Research in Sex, Gender, and Reproduction) and Dr. William Yarber (Department of Applied Health Science at Indiana University and Senior Director of the Rural Center for AIDS/STD Prevention at Indiana University) and Brian Dodge (Department of Applied Health Science, now at the HIV Center for Clinical and Behavioral Studies at Columbia University).

Crosby, R. A., Sanders, S.A., Yarber, W. L., Graham, C.A.& Dodge, B. (2002). Condom Use Errors and Problems in College Men. Sexually Transmitted Diseases, 29 (9): 552-557. pdf

Sanders, S. A., Graham, C. A., Yarber, W. L. , & Crosby, R. A. (2003). Condom use errors and problems among young women who apply condoms on males. Journal of American Medical Women's Association, 58 (2), 95-98

Crosby, R. A., Sanders, S. A., Yarber, W. L., Graham, C.A. (2003). Condom-use errors and problems: A neglected aspect of studies assessing condom effectiveness. American Journal of Preventive Medicine, 24 (4), 367-370 (May 2003)

Graham, C. A., Crosby, R. A., Sanders, S. A., Yarber, W. L. (2003). Motivation of self, partner, and couple to use male condoms: Associations with condom use errors and problems. Health Education Monograph, Special Issue, 20 (2), 60-64.