Condom-associated erection problems: behavioural responses and attributions in young, heterosexual men
Brandon J. Hill A B G , Stephanie A. Sanders B C , Richard A. Crosby B D , Kara N. Ingelhart B E and Erick Janssen B FA The University of Chicago, Department of Obstetrics and Gynecology, Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health, Charles Mott Building, Chicago, IL 60637, USA.
B The Kinsey Institute for Research in Sex, Gender, and Reproduction, Morrison Hall 313, Bloomington, IN 47405, USA.
C Indiana University, Department of Gender Studies, Indiana University, Memorial Hall 130, Bloomington, IN 47405, USA.
D University of Kentucky, College of Public Health, Department of Health Behavior, Lexington, KY 40536, USA.
E The University of Chicago, The Law School, Chicago, IL 60637, USA.
F University of Leuven, Department of Neurosciences, Institute for Family and Sexuality Studies, Kapucijnenvoer 7 blok g, 3000, Leuven, Belgium.
G Corresponding author. Email: brjhill@indiana.edu
Sexual Health 12(5) 397-404 https://doi.org/10.1071/SH14051
Submitted: 31 May 2013 Accepted: 4 May 2015 Published: 13 July 2015
Abstract
Background: Previous studies have associated men who experience condom-associated erection problems (CAEP) with incomplete condom use and/or foregoing using condoms altogether. However, how men respond to CAEP and what they attribute CAEP to, remains unclear. Understanding young men’s CAEP responses and attributions could help improve sexually transmissible infections (STI)/HIV prevention programs and interventions. Methods: Behavioural responses to, and attributions for, CAEP during application (CAEP-Application) and/or during penile-vaginal intercourse (CAEP-PVI) were reported using an online questionnaire by 295 young, heterosexual men (aged 18–24 years) who were recruited via social media websites and university Listservs across major cities in the Midwestern USA. Results: Behavioural responses to CAEP-Application included receiving oral or manual stimulation, stimulating a partner, self-stimulation, foregoing condom use and applying the condom after starting intercourse. Attributions for CAEP-Application included: distraction, fit and feel problems, application taking too long and having consumed too much alcohol. Behavioural responses to CAEP-PVI included increasing the intensity of intercourse, removing the condom to receive oral or manual stimulation and removing condom and continuing intercourse. Attributions for CAEP-PVI included: lack of sensation, taking too long to orgasm, not being ‘turned on’ enough, fit and feel problems and partner-related factors. Conclusions: Men who report CAEP respond with both STI/HIV risk-reducing and potentially risk-increasing behaviours (e.g. forgoing condom use). Men attribute their experiences to a wide range of individual- and partner-level factors. Addressing men’s CAEP behavioural responses and attributions may increase the efficacious value of condom programs and STI/HIV prevention interventions – particularly among men who experience CAEP.
References
[1] Sanders SA, Yarber WL, Kaufman EL, Crosby RA, Graham CA, Milhausen RR. Condom use errors and problems: a global view. Sex Health 2012; 9 81–95.| Condom use errors and problems: a global view.Crossref | GoogleScholarGoogle Scholar | 22348636PubMed |
[2] Sanders SA, Hill BJ, Crosby RA, Janssen E. Correlates of condom-associated erection problems in young, heterosexual men: condom fit, self-efficacy, perceptions, and motivations. AIDS Behav 2014; 18 128–34.
| Correlates of condom-associated erection problems in young, heterosexual men: condom fit, self-efficacy, perceptions, and motivations.Crossref | GoogleScholarGoogle Scholar | 23404098PubMed |
[3] Graham CA, Crosby RA, Yarber WL, Sanders SA, McBride KR, Milhausen RR, Arno JN. Erection loss in association with condom use among young men attending a public STI clinic: potential correlates and implications for risk behaviour. Sex Health 2006; 3 255–60.
| Erection loss in association with condom use among young men attending a public STI clinic: potential correlates and implications for risk behaviour.Crossref | GoogleScholarGoogle Scholar | 17112437PubMed |
[4] Crosby RA, Sanders SA, Yarber WL, Graham CA, Dodge B. Condom use errors and problems among college men. Sex Transm Dis 2002; 29 552–7.
| Condom use errors and problems among college men.Crossref | GoogleScholarGoogle Scholar | 12218848PubMed |
[5] Crosby RA, Shrier LA, Charnigo RJ, Weathers C, Sanders SA, Graham CA, Milhausen RR, Yarber WL. A prospective event-level analysis of condom use experiences following STI testing among patients in three US cities. Sex Transm Dis 2012; 39 756–60.
| A prospective event-level analysis of condom use experiences following STI testing among patients in three US cities.Crossref | GoogleScholarGoogle Scholar |
[6] Yarber WL, Graham CA, Sanders SA, Crosby RA. Correlates of condom breakage and slippage among university undergraduates. Int J STD AIDS 2004; 15 467–72.
| Correlates of condom breakage and slippage among university undergraduates.Crossref | GoogleScholarGoogle Scholar | 15228732PubMed |
[7] Yarber WL, Crosby RA, Graham CA, Sanders SA, Arno J, Hartzell RM, McBride KR, Milhausen RR, Brown L, Legocki LJ, Payne M, Rothring A. Correlates of putting condoms on after sex has begun and of removing them before sex ends: a study of men attending an urban public STD clinic. Am J Men Health 2007; 1 190–6.
| Correlates of putting condoms on after sex has begun and of removing them before sex ends: a study of men attending an urban public STD clinic.Crossref | GoogleScholarGoogle Scholar |
[8] Crosby RA, Yarber WL, Graham CA, Sanders SA. Does it fit okay? Problems with condom use as a function of self-reported poor fit. Sex Transm Infect 2010; 86 36–8.
| Does it fit okay? Problems with condom use as a function of self-reported poor fit.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3c7gvVymtg%3D%3D&md5=d4354c64e8831affeafab1928fd1c5dfCAS | 20157178PubMed |
[9] Graham CA, Crosby RA, Sanders SA, Milhausen RR, Yarber WL. Condom-associated erection problems: a study of high-risk young Black males residing in the southern United States. Am J Men Health 2015;
| Condom-associated erection problems: a study of high-risk young Black males residing in the southern United States.Crossref | GoogleScholarGoogle Scholar |
[10] Crosby RA, Charnigo RJ, Shrier LA. Condom-use errors and problems among teens attending clinics: better or worse than young adults? Open Access J Contracept 2012; 3 17–22.
| Condom-use errors and problems among teens attending clinics: better or worse than young adults?Crossref | GoogleScholarGoogle Scholar |
[11] Fortenberry JD, Tu W, Harezlak J, Katz BP, Orr DP. Condom use as a function of time in new and established adolescent sexual relationships. Am J Public Health 2002; 92 211–3.
| Condom use as a function of time in new and established adolescent sexual relationships.Crossref | GoogleScholarGoogle Scholar | 11818293PubMed |
[12] Hill BJ, Janssen E, Kvam P, Amick EE, Sanders SA. The effect of condoms on penile vibrotactile sensitivity thresholds in young, heterosexual men. J Sex Med 2014; 11 102–6.
| The effect of condoms on penile vibrotactile sensitivity thresholds in young, heterosexual men.Crossref | GoogleScholarGoogle Scholar | 24168347PubMed |
[13] Janssen E, Sanders SA, Hill BJ, Amick E, Oversen D, Kvam P, Ingelhart K. Patterns of sexual arousal in young, heterosexual men who experience condom-associated erection problems (CAEP). J Sex Med 2014; 11 2285–91.
| Patterns of sexual arousal in young, heterosexual men who experience condom-associated erection problems (CAEP).Crossref | GoogleScholarGoogle Scholar | 24787349PubMed |
[14] Napper LE, Fisher DG, Reynolds GL, Johnson ME. HIV risk behavior self-report reliability at different recall periods. AIDS Behav 2010; 14 152–61.
| HIV risk behavior self-report reliability at different recall periods.Crossref | GoogleScholarGoogle Scholar | 19475504PubMed |
[15] Yates F. Contingency table involving small numbers and the χ2 test. Suppl J Royal Stat Soc 1934; 1 217–35.
| Contingency table involving small numbers and the χ2 test.Crossref | GoogleScholarGoogle Scholar |
[16] Maticka-Tyndale E. Sexual scripts and AIDS prevention: variations in adherence to safer-sex guidelines by heterosexual adolescents. J Sex Res 1991; 28 45–66.
| Sexual scripts and AIDS prevention: variations in adherence to safer-sex guidelines by heterosexual adolescents.Crossref | GoogleScholarGoogle Scholar |
[17] Milhausen RR, Wood J, Sanders SA, Crosby RA, Yarber WL, Graham CA. A novel, self-guided, home-based intervention to promote condom use. J Men’s Health 2011; 8 274–81.
| A novel, self-guided, home-based intervention to promote condom use.Crossref | GoogleScholarGoogle Scholar |
[18] Emetu RE, Marshall A, Sanders SA, Yarber WL, Milhausen RR, Crosby RA, Graham CA. A novel, self-guided home-based intervention to improve condom use among young men who have sex with men. Am J Coll Health 2014; 62 118–24.
| A novel, self-guided home-based intervention to improve condom use among young men who have sex with men.Crossref | GoogleScholarGoogle Scholar |
[19] George WH, Davis KC, Norris J, Heiman JR, Schacht RL, Stoner SA, Kajumulo KF. Alcohol and erectile response: the effects of high dosage in the context of demands to maximize sexual arousal. Exp Clin Psychopharmacol 2006; 14 461–70.
| Alcohol and erectile response: the effects of high dosage in the context of demands to maximize sexual arousal.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD28Xhtlajs7fL&md5=d0df828766d7931257e87e283043fff6CAS | 17115874PubMed |
[20] Crosby RA, Milhausen RR, Sanders SA, Graham CA, Yarber WL. Being drunk and high during sex is not associated with condom use behaviors: a study of high-risk young Black males. Sex Health 2014; 11 84–6.
| Being drunk and high during sex is not associated with condom use behaviors: a study of high-risk young Black males.Crossref | GoogleScholarGoogle Scholar | 24588939PubMed |
[21] Crosby RA, Graham CA, Yarber WL, Sanders SA. Problems with condoms may be reduced for men taking ample time to apply them. Sex Health 2010; 7 66–70.
| Problems with condoms may be reduced for men taking ample time to apply them.Crossref | GoogleScholarGoogle Scholar | 20152099PubMed |
