Condom-associated erection problems: behavioural responses and attributions in young, heterosexual men

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.

Factors associated with non-use of condoms among heterosexually-active single people in Germany: Results from the first representative, population-based German health and sexuality survey (GeSiD)

“…28,30 While sex-related alcohol consumption played a role in nearly 40% of the heterosexual singles' sexual encounters in the present study, there was no association with the non-use of condoms, unlike other studies suggest. 7,29 Limitations Among those participants identified as being single for at least 1 year prior to interview, almost 40% reported sexual activity with someone of the opposite-sex during this timeframe. On the one hand, this means that the majority of singles live a "healthy" lifestyle in terms of STI risk simply by having no sex at all.…”

Hombres heterosexualmente activos, masculinidades, prevención de infección por VIH y búsqueda de profilaxis posexposición sexual consentida

“…Tanto los problemas relacionados con el desempeño sexual y la calidad de la erección, como con problemas emocionales (depresión y ansiedad), ya fueron señalados como barreras para la adhesión al método. Además, desde la óptica de los hombres heterosexuales, el uso del condón con la pareja estable puede revelar infidelidad y complicar la dinámica de la relación (25,26,27,28,29,30,31) . Otros métodos de prevención, como el gel lubricante y el condón femenino fueron mencionados solo por dos entrevistados, lo que indica poca inserción de estos insumos en el cotidiano de la prevención.…”

“…El protagonismo del condón masculino en las narrativas de prevención del VIH y, al mismo tiempo, su falla, señalada como la principal motivación para decidir buscar la profilaxis posexposición sexual, demuestran la complejidad de la relación entre riesgo y placer, lo que ha sido destacado como un tema a ser explorado en las investigaciones de género y sexualidad en el campo del VIHsida (2,4,5) . Además, ciertos estudios cualitativos sobre las representaciones del uso del condón para hombres sugieren que los ideales hegemónicos de masculinidad, creencia en la fidelidad femenina, percepciones de que el condón influye en la potencia o en la performance sexual son argumentos frecuentemente relatados (25,28,30,31) , que corroboran los hallazgos de la presente investigación.…”

Masculinidades e juventudes na prevenção combinada frente ao HIV/aids: um estudo sobre risco/vulnerabilidade e contexto assistencial de homens jovens que buscam profilaxia pós-exposição sexual (PEPSexual) em cinco cidade

“…A literatura tem revelado que o uso do preservativo por homens é influenciado por diversos fatores intrínsecos e extrínsecos ao indivíduo, como, por exemplo, o tipo da parceria sexual (parceria estável ou casual), perfil da parceria (profissional do sexo, dependentes químicos etc. ), proximidade com os ideais hegemônicos de masculinidade, fatores estéticos ("pênis ficar feio"), dentre outros (Guerriero;Hearst, 2002;Garcia;De Souza, 2010;Rebello, 2011;Dourado et al, 2015;Hill et al,2015;Kanda;Mash, 2018;. A presença do álcool e drogas no contexto da exposição sexual que motivou o uso da PEPSexual é bastante explorado na literatura científica.…”