An Indiana University study found that men who were highly motivated to wear condoms - who thought they should for one reason or another - were more likely to put the condom on before having sex with a woman. Men who had trouble with the fit and feel of their condoms or experienced an erection loss while wearing one were more likely to take the condoms off before finishing intercourse with a woman.

“The incomplete use of condoms is a big issue,” said William L. Yarber, senior director of the Rural Center for AIDS/STD Prevention at Indiana University Bloomington. “It can lead to exposure to STIs (sexually transmitted infections) and unintended pregnancies. We need to inform people about the importance of using a condom for the entire sexual intercourse episode.”

* Background: More and more evidence is pointing to condom use as being the best method for reducing the risk of receiving or spreading sexually transmitted diseases, such as HIV, the virus that causes AIDS. Health care professionals know that condom use is effective but more research is needed to identify factors related to incorrect condom use. This study specifically looked at the factors involved in why male patients at an STD clinic would put on condoms after vaginal intercourse with a woman started and take the condoms off before sex ended. The results come from 278 male patients at an urban Midwestern STD clinic.

* Findings: Nearly one in five men (18.7 percent) reported starting sex and putting the condom on later at least once during the past three times a condom was used. Of the 278 men in the study, 88 reported that their condom broke on one or more occasions; of the remaining 190 men, 23.7 percent reported they had removed the condom before sex ended during at least one of the past three times they used condoms.

* Implications for preventive medical practice: Because motivation to wear condoms correctly was key to the correct use of them, it might be important in clinic-based education and counseling efforts to provide men with ample reason to wear them correctly. This could include talking with patients about pre-ejaculate and how small amounts of semen can be enough to cause pregnancy or transmit STDs; or talking about how their chances of acquiring an STD, such as HIV, from a female lover increase significantly if they begin sex before putting on a condom. Other targeted educational efforts could include talking with men about how erection loss is relatively common for most men and providing a wider range of condom sizes and brands.

The study, “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,” was published in the American Journal of Men’s Health, appearing online in May.

Co-authors are Richard A. Crosby, University of Kentucky; Stephanie A. Sanders, The Kinsey Institute for Research in Sex, Gender and Reproduction at Indiana University in Bloomington, Ind.; Cynthia A. Graham, Kinsey Institute and the Oxford Doctoral Course in Clinical Psychology, Oxford, U.K.; Janet Arno, M.D., Bellflower Clinic in Indianapolis; Robin Milhausen, University of Guelph, Guelph, Ontario; Lindsay Brown, Boston Medical Center, Boston; Martha Payne, Substance Abuse and Mental Health Services Administration, Indianapolis; and Alexis Rothring, San Carlos Park and Rescue District, Fort Myers, Fla; Rose M. Hartzell, Kimberly McBride and Laurie J. Legocki, Indiana University.

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Source: Indiana University