Condom breakage among African-American men.
African-American men are at high risk of HIV acquisition. Condom
breakage is an understudied aspect of their sexual protective behaviour.
This study identified user errors leading to condom breakage among 264
young, African-American men newly diagnosed with an STI at an STI clinic
in a city in southern USA. The condom breakage rate was high, with 21%
self-reporting condom breakage the last time a condom was used for
penile-vaginal sex. Breakage declined with advancing age. Men who had
used an oil-based lubricant were more than three times as likely to
report breakage. Although the deteriorating effect of oil-based
lubricants on latex condoms is well known, nearly one in seven of the
men applied one the last time they used a condom. Men who completely
unrolled the condom before putting it on were about three times as
likely to report breakage. It may be that men excessively stretch an
unrolled condom to place it on their penis, and that unrolled condoms
are often misapplied and prone to friction and breakage. The breakage
rate for men indicating both errors (use of oil-based lubricant and
unrolling the condom before application) was 55% compared with 33% among
those indicating either error, and 13% among those indicating neither
error. These common problems could be mitigated by counselling men to
avoid using oil-based lubricants and by teaching them basic condom
application skills. The modest requirements of these two prevention
messages make their implementation feasible.
(1.) Crosby R, DiClemente RJ, Yarber WL, et al. An event-specific
analysis of condom breakage among African American men at risk of HIV
acquisition. Sexually Transmitted Diseases 2008;35(2):174-77.