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.
Condom use errors were common, and error scores were associated with breakage and slippage. Increasing the focus on correcting potential user failures may be an important public health strategy.
The goal of this study was to improve our understanding of men's sexual response and its components as well as the factors or types of situations that men describe as facilitating or interfering with sexual arousal. Six focus groups, involving 50 mostly white, heterosexual men (M age = 35.2 years; range, 18-70), were conducted. As it was previously found in women (Graham, Sanders, Milhausen, & McBride, Archives of Sexual Behavior, 33, 527-538, 2004), men described a wide range of physical (genital as well as nongenital) and cognitive/affective cues for sexual arousal. Also, men described the relationship between sexual desire and arousal as being variable and complex, presented a wide range of factors that increased or decreased sexual arousal, and showed substantial variability in both the importance and direction of their effects. The findings may help further development of models of sexual response and inform discussions about gender differences in sexual desire and arousal.
An exploratory study compared the prevalence of multiple types of condom-associated 'turn offs' in men and women. Nearly 2000 people completed a web-based questionnaire. Data were analysed from 464 men and women who reported that condoms had turned them off the last time they were used. Gender differences were not observed for the majority (9) of 15 turn offs. The most common turn offs related to loss of pleasure. For example, more than three-quarters of the men and nearly 40% of the women reported decreased sexual sensation (P = 0.0001). Putting on condoms was reported by 43.2% of the men versus 30.2% of the women (P = 0.02). Smell was a relatively frequent turn off, with about one-third indicating this issue and no significant gender difference (P = 0.32). Turn offs pertaining to arousal and orgasm were also common. Findings suggest that numerous physical and psychological condom turn offs may be experienced by men and women while using male condoms. Although some turn offs differed as a function of gender, there was remarkable similarity between men and women.
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