Correlates of condom failure in a sexually active cohort of men who have sex with men
Stone, E.; Heagerty, P.; Vittinghoff, E.; Douglas, J.M.; Koblin, B.A.; Mayer, K.H.; Celum, C.L.; Gross, M.; Woody, G.E.; Marmor, M.; Seage, G.R.; Buchbinder, S.P.
Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology Official Publication of the International Retrovirology Association 20(5): 495-501
1999
ISSN/ISBN: 1077-9450 PMID: 10225233 DOI: 10.1097/00042560-199904150-00013Document Number: 281979
Although the extent of condom use during anal intercourse has increased considerably among men who have sex with men (MSM) in response to the HIV/AIDS pandemic, condom failure through both slippage and breakage limits the effectiveness of such method use. Condom failure is associated with HIV seroconversion among MSM. 16.6% of the 2592 HIV-seronegative MSM participants in the HIV Network for Prevention Trials (HIVNET) multi-site Vaccine Preparedness Study who reported condom use for anal sex in the 6 months before enrollment reported condom failure. The overall failure rate was 2.1/100 episodes of condom use, with 2.5 failures/100 episodes for receptive anal sex and 1.9/100 episodes for insertive anal sex. Almost half of the men were aged 30 years or younger, 25% were non-White, 60.6% attended college, and 85.7% were employed either part- or full-time. Multivariate analysis of reported failures found more frequent condom use to be associated with a decreased per condom failure rate, and amphetamine and heavy alcohol use with increased rates in both models. Being employed, having private medical insurance, and using lubricants for more than 80% of anal sex acts were significantly associated with decreased failure rates in the insertive model. These findings suggest that safer sex counseling should therefore target men of lower socioeconomic status, promote the proper and consistent use of condoms with appropriate lubricants, and address the impact of drug use upon condom failure.