Condom-use errors and problems: a neglected aspect of studies assessing condom effectiveness.

OBJECTIVE: To assess and compare condom-use errors and problems among condom-using university males and females.
METHODS: A convenience sample of 260 undergraduates was utilized. Males (n=118) and females (n=142) reported using condoms in the past 3 months for at least one episode of sex (penis in the mouth, vagina, or rectum) with a partner of the other sex. A questionnaire assessed 15 errors and problems associated with condom use that could be observed or experienced by females as well as males.
RESULTS: About 44% reported lack of condom availability. Errors that could contribute to failure included using sharp instruments to open condom packages (11%), storing condoms in wallets (19%), and not using a new condom when switching from one form of sex to another (83%). Thirty-eight percent reported that condoms were applied after sex had begun, and nearly 14% indicated they removed condoms before sex was concluded. Problems included loss of erection during condom application (15%) or during sex (10%). About 28% reported that condoms had either slipped off or broken. Nearly 19% perceived, at least once, that their condom problems necessitated the use of a new condom. Few differences were observed in errors and problems between males and females.
CONCLUSIONS: Findings suggest that condom-use errors and problems may be quite common and that assessment of errors and problems do not necessarily need to be gender specific. Findings also suggest that correcting "user failure" may represent an important challenge in the practice of preventive medicine.