BACKGROUND: It has not been well established whether common indices of male condom failure are valid predictors of biologically meaningful exposure during condom use. METHODS: To address this gap, the authors compared self-reported condom malfunctions (i.e., breakage and slippage) and incorrect condom practices to 2 following objective measures of failure: prostate-specific antigen (PSA) detected in vaginal swabs collected after condom use and structural integrity of used condoms. The study, conducted in 2000-2001, evaluated 635 male condoms used by 77 women attending an outpatient, reproductive-health clinic in Birmingham, AL. RESULTS: Women reported breakage or slippage for 7.9% of condoms; 3.5% of postcoital swabs had moderate or high levels of PSA; and laboratory testing of used condoms revealed breaks (1.1%) and leaks (2.0%). Self-reported breakage and slippage was associated with moderate/high PSA concentrations in postcoital swabs only when the malfunctions were not accompanied by reports of corrective actions to reduce exposure (adjusted odds ratio [aOR], 6.9; 95% confidence interval [CI], 1.8-26.2). Defects observed in postcoital laboratory testing were related to PSA detection (aOR, 8.0; 95% CI, 1.5-42.6). Incorrect practices defined on the condom label were frequent, but not all types were associated with semen exposure. Furthermore, other practices not currently label-defined were associated with semen exposure: touching the tip of the penis with his hands (aOR, 6.2; 95% CI, 2.3-17.0) or with her hands (aOR, 2.8; 95% CI, 1.1-72) before donning the condom. CONCLUSIONS: Used correctly, male condoms afforded good protection based on objective measures of failure.
BACKGROUND: It has not been well established whether common indices of male condom failure are valid predictors of biologically meaningful exposure during condom use. METHODS: To address this gap, the authors compared self-reported condom malfunctions (i.e., breakage and slippage) and incorrect condom practices to 2 following objective measures of failure: prostate-specific antigen (PSA) detected in vaginal swabs collected after condom use and structural integrity of used condoms. The study, conducted in 2000-2001, evaluated 635 male condoms used by 77 women attending an outpatient, reproductive-health clinic in Birmingham, AL. RESULTS:Women reported breakage or slippage for 7.9% of condoms; 3.5% of postcoital swabs had moderate or high levels of PSA; and laboratory testing of used condoms revealed breaks (1.1%) and leaks (2.0%). Self-reported breakage and slippage was associated with moderate/high PSA concentrations in postcoital swabs only when the malfunctions were not accompanied by reports of corrective actions to reduce exposure (adjusted odds ratio [aOR], 6.9; 95% confidence interval [CI], 1.8-26.2). Defects observed in postcoital laboratory testing were related to PSA detection (aOR, 8.0; 95% CI, 1.5-42.6). Incorrect practices defined on the condom label were frequent, but not all types were associated with semen exposure. Furthermore, other practices not currently label-defined were associated with semen exposure: touching the tip of the penis with his hands (aOR, 6.2; 95% CI, 2.3-17.0) or with her hands (aOR, 2.8; 95% CI, 1.1-72) before donning the condom. CONCLUSIONS: Used correctly, male condoms afforded good protection based on objective measures of failure.
Authors: Kimberly K Repp; Carrie M Nielson; Rongwei Fu; Sean Schafer; Eduardo Lazcano-Ponce; Jorge Salmerón; Manuel Quiterio; Luisa L Villa; Anna R Giuliano Journal: J Infect Dis Date: 2012-03-06 Impact factor: 5.226
Authors: Shirley L Shih; Chelsea A Kebodeaux; Gina M Secura; Jenifer E Allsworth; Tessa Madden; Jeffrey F Peipert Journal: Sex Transm Dis Date: 2011-11 Impact factor: 2.830
Authors: Deborah J Anderson; Joseph A Politch; Jeffrey Pudney; Cecilia I Marquez; Margaret C Snead; Christine Mauck Journal: Sex Transm Dis Date: 2012-12 Impact factor: 2.830