Condom use errors and problems: a global view

Stephanie A. Sanders; William L. Yarber; Erin L. Kaufman; Richard A. Crosby; Cynthia A. Graham; Robin R. Milhausen

doi:10.1071/SH11095

RESEARCH ARTICLE (Open Access)

Condom use errors and problems: a global view

Stephanie A. Sanders ^A ^B ^C ^H , William L. Yarber ^A ^C ^D , Erin L. Kaufman ^E , Richard A. Crosby ^A ^C ^E , Cynthia A. Graham ^A ^C ^F and Robin R. Milhausen ^A ^C ^G

+ Author Affiliations

- Author Affiliations

^A The Kinsey Institute for Research in Sex, Gender, and Reproduction, Indiana University, Bloomington, IN 47405, USA.

^B Department of Gender Studies, Indiana University, Bloomington, IN 47405, USA.

^C Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN 47405, USA.

^D Department of Applied Health Science, Indiana University, Bloomington, IN 47405, USA.

^E College of Public Health at the University of Kentucky University, Lexington, KY 40506, USA.

^F Department of Psychology, University of Southampton, Southampton SO17 1BJ, UK.

^G Department of Family Relations and Applied Nutrition at the University of Guelph, Ontario N1G2W1, Canada.

^H Corresponding author. Email: sanders@indiana.edu

Sexual Health 9(1) 81-95 https://doi.org/10.1071/SH11095
Submitted: 3 July 2011 Accepted: 24 November 2011 Published: 17 February 2012

Journal Compilation © CSIRO Publishing 2012 Open Access CC BY-NC-ND

Abstract

Background: Significantly more research attention has been devoted to the consistency of condom use, with far fewer studies investigating condom use errors and problems. The purpose of this review was to present the frequency of various condom use errors and problems reported worldwide. Methods: A systematic literature search was conducted for peer-reviewed articles, published in English-language journals between 1995 and 2011. Results: Fifty articles representing 14 countries met criteria for inclusion. The most common errors included not using condoms throughout sex, not leaving space at the tip, not squeezing air from the tip, putting the condom on upside down, not using water-based lubricants and incorrect withdrawal. Frequent problems included breakage, slippage, leakage, condom-associated erection problems, and difficulties with fit and feel. Prevalence estimates showed great variation across studies. Prevalence varied as a function of the population studied and the period assessed. Conclusion: Condom use errors and problems are common worldwide, occurring across a wide spectrum of populations. Although breakage and slippage were most commonly investigated, the prevalence of other condom use errors and problems found in this review were substantially higher. As a framework for understanding the role of condom errors and problems in inadequate protection, we put forward a new model: the Condom Use Experience model. This model can be used to generate testable hypotheses for future research. Addressing condom use errors and problems in research and interventions is crucial to closing the gap between the perfect use and typical use of condoms.

Additional keywords: condom breakage, condom slippage, sexual behaviour, sexually transmissible infections.

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