Erection loss in association with condom use among young men attending a public STI clinic: potential correlates and implications for risk behaviour
Cynthia A. Graham A B C J , Richard Crosby C D , William L. Yarber B C E F , Stephanie A. Sanders B C F , Kimberly McBride G , Robin R. Milhausen H and Janet N. Arno C IA Oxford Doctoral Course in Clinical Psychology, Oxford, UK.
B The Kinsey Institute for Research in Sex, Gender, and Reproduction, Bloomington, IN, USA.
C Rural Center for AIDS/STD Prevention at Indiana University, Bloomington, IN, USA.
D College of Public Health at the University of Kentucky, Lexington, KY, USA.
E Department of Applied Health Science, Indiana University, Bloomington, IN, USA.
F Gender Studies, Indiana University, Bloomington, IN, USA.
G Department of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
H Social Justice and Sexual Health Research Lab, Department of Sociology and Anthropology, University of Windsor, Windsor, Ontario, Canada.
I Department of Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, USA.
J Corresponding author. Email: cynthia.graham@hmc.ox.ac.uk
Sexual Health 3(4) 255-260 https://doi.org/10.1071/SH06026
Submitted: 26 April 2006 Accepted: 13 October 2006 Published: 17 November 2006
Abstract
Background: To assess prevalence of condom-associated erection loss and to identify correlates of erection loss among men attending a sexually transmissible infections (STI) clinic. Methods: Men (n = 278) attending an STI clinic responded to an anonymous questionnaire aided by a CD recording of the questions. The sample was screened to include only men who had used a condom during penile–vaginal sex at least three times in the past 3 months. Erection loss was assessed for ‘the last three times a condom was used’. Results: The mean age of the participants was 23.7 years (s.d. = 4.1); 37.1% of the men reported condom-associated erection loss on at least one occasion. Men who had reported condom-associated erection loss were also reported having more frequent unprotected vaginal sex (P = 0.04) and were less likely to use condoms consistently (P = 0.014) than men without erection loss. Men with erection loss were also more likely to remove condoms before sex was over (P = 0.001). Age and race/ethnicity were not associated with erection loss. In multivariate analysis, three significant statistical predictors were identified: low self-efficacy to use condoms (P = 0.001); problems with ‘fit or feel’ of condoms (P = 0.005); and having more than three sex partners during the previous 3 months (P = 0.02). Conclusions: Condom-associated erection loss may be common among men at risk for STIs. This problem may lead to incomplete or inconsistent condom use. Men may be more likely to experience condom-associated erection loss if they lack confidence to use condoms correctly, if they experience problems with the way condoms fit or feel, and if they have sex with multiple partners.
Acknowledgements
Support for this project was provided by the Rural Center for AIDS/STD Prevention, a joint project of Indiana University, University of Colorado, and University of Kentucky, and the Office of the Associate Dean of Research, School of Health, Physical Education, and Recreation, Indiana University. Appreciation is given to the project research staff: Rose Hartzell, Martha Payne, Lauri Legocki, Lindsay Brown and Alexis Rothring.
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