Background
Incorrect condom use is a common problem that can undermine their prevention impact. We assessed the prevalence of two condom use problems, breakage/slippage and partial use, compared problems by partnership type, and examined associations with respondent, partner, and partnership characteristics.
Methods
Data were collected at 3-month intervals over a 12-month period (1999–2000) among urban STD clinic users. Condom use problems were compared between partnership types using z-tests for equality of proportions. Logistic generalized estimating equations modeling accounted for within-participant correlation of repeated measures.
Results
Overall, 3,297 respondents reported 9,304 main and 6,793 non-main partnerships; condoms were used at least once in 4,942 (53.0%) and 4,523 (66.6%) of these partnerships respectively. Condom breakage/slippage was reported during 6.0% of uses (5.1% main, 9.4% non-main) and partial use during 12.5% of uses (12.8% main, 11.5% non-main). The proportion of respondents experiencing any condom use problem in the prior 3 months was higher among main compared to non-main partnerships: 39.1% v. 29.9% had either problem; 22.5% v. 19.0% had breakage/slippage only; 21.8% v. 18.7%, partial use; and 8.7% v. 7.1% had both use problems. In multivariable analysis, factors associated with condom use problems varied by partnership type and respondent sex. The most common predictors of problems across models were sex while high and inconsistent condom use.
Conclusions
This study highlights the diverse set of risk factors for condom use problems at the individual, partner and partnerships levels.