Condom use problems during anal sex among men who have sex with men (MSM): findings from the Safe in the City study.
Open accessAbstract
Our research aims were to: (1) assess the prevalence of two condom use problems: breakage or slippage and partial use (delayed application or early removal) among men who have sex with men (MSM) seeking services in urban US STD clinics; and (2) examine the association between these condom use problems and participant, partner and partnership characteristics. Analysis was restricted to HIV-negative MSM who reported having anal sex at least once in the preceding 3 months and who completed both the baseline and 3 month follow-up assessments. Two models were fitted using the generalized estimating equations (GEE) approach. A total of 263 MSM (median age=32 years) reported 990 partnerships. Partnerships with no condom use 422 (42.6%) were excluded. Thus, 207 MSM and 568 partnerships were included. Among condom users, 100% use was reported within 454 partnerships (79.9%) and <100% within 114 (20.1%), and 21(3.7%) reported both condom use problems, 25 (4.4%) reported only breakage, 67 (11.8%) reported only partial use, and 455 (80.1%) reported no errors. The breakage or slippage and partial use rates per condom used were 3.4% and 11.2%, respectively. A significantly higher rate of breakage or slippage occurred among non-main partnerships. Characteristics associated with increased odds for condom breakage or slippage were: lower education level (OR=2.78; CI: 1.1-7.5), non-main partner status (OR=4.1; CI: 1.5-11.7), and drunk or high during sex (OR=2.0; CI: 1.1-3.8), and for partial use: lower education level (OR=2.6; CI: 1.0-6.6), perceived partner sexually transmitted infections (STI) risk (OR=2.4; CI: 1.3-4.2), and inconsistent condom use (OR=3.7; CI: 2.0-6.6). A high percentage of MSM partnerships reported no condom use and among condom users, a sizable proportion did not use them consistently or correctly. MSM may benefit from interventions designed to increase proficiency for condom use with a particular focus on the behaviors of inconsistent and partial condom use.
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Rates of condom breakage and slippage might be slightly higher during anal intercourse.
“Rates of breakage and slippage might be slightly higher during anal intercourse (28,29).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [29]
The Abstract reports a 3.4% per-condom-use rate of breakage or slippage during anal sex among the MSM studied. The paper does not establish that this rate is higher than during another type of intercourse; the higher rate reported in the Discussion compares non-main with main partnerships, not types of intercourse. No page numbers were provided for these passages. (LLM, conf=0.83)
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- Authors
- D'Anna, L. H., Margolis, A. D., Warner, L., Korosteleva, O. A., O'Donnell, L., Rietmeijer, C. A., Klausner, J. D., Nomura, W., Malotte, C. K., & the Safe City Study Group
- Affiliations
- a Center for Health Care Innovation , California State University , Long Beach , CA , USA
- Centers for Disease Control and Prevention (US)
- California State University, Long Beach (US)
- d Denver Public Health , Denver , CO , USA
- University of San Francisco (US)
- University of California, San Francisco (US)
- Venue
- AIDS Care
- Publisher
- Informa UK Limited
- Published
- 2012-04-23
- Volume
- 24
- Issue
- 8
- Pages
- 1028-1038
- ISSN
- 0954-0121 (ISSN-L)
- 1360-0451
- PMC
- PMC3389178
- OpenAlex
- W2056435433
- Cited by
- 33
- References
- 27
- Citations by year
- 2024: 3 · 2023: 1 · 2021: 2 · 2020: 5 · 2019: 1 · 2018: 3 · 2017: 3 · 2016: 4 · 2015: 5 · 2014: 5
- FWCI
- 2.21
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- AIDS Care (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- Centers for Disease Control and Prevention
- National Institute on Minority Health and Health Disparities (P20MD003942)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
- Keywords
- condom breakage, condom slippage, anal sex, men who have sex with men, HIV-negative MSM, STD clinics, alcohol use during sex, inconsistent condom use, HIV prevention, sexual partnerships, educational attainment, sexual risk behavior, HIV prevention interventions
- MeSH terms
- Adult, Equipment Failure, Humans, Male, Sexual Behavior, United States, Urban Health, Condoms, HIV Seronegativity, Homosexuality, Male
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