Erection loss in association with condom use among young men attending a public STI clinic: potential correlates and implications for risk behaviour.
ABSTRACT To assess prevalence of condom-associated erection loss and to identify correlates of erection loss among men attending a sexually transmissible infections (STI) clinic.
Men (n = 278) attending an STI clinic responded to an anonymous questionnaire aided by a CD recording of the questions. The sample was screened to include only men who had used a condom during penile-vaginal sex at least three times in the past 3 months. Erection loss was assessed for 'the last three times a condom was used'.
The mean age of the participants was 23.7 years (s.d. = 4.1); 37.1% of the men reported condom-associated erection loss on at least one occasion. Men who had reported condom-associated erection loss were also reported having more frequent unprotected vaginal sex (P = 0.04) and were less likely to use condoms consistently (P = 0.014) than men without erection loss. Men with erection loss were also more likely to remove condoms before sex was over (P = 0.001). Age and race/ethnicity were not associated with erection loss. In multivariate analysis, three significant statistical predictors were identified: low self-efficacy to use condoms (P = 0.001); problems with 'fit or feel' of condoms (P = 0.005); and having more than three sex partners during the previous 3 months (P = 0.02).
Condom-associated erection loss may be common among men at risk for STIs. This problem may lead to incomplete or inconsistent condom use. Men may be more likely to experience condom-associated erection loss if they lack confidence to use condoms correctly, if they experience problems with the way condoms fit or feel, and if they have sex with multiple partners.
Full-textDOI: · Available from: Robin Milhausen, Feb 10, 2014
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ABSTRACT: Objectives. We tested the efficacy of a brief intervention to promote correct and consistent use of condoms among Black male youths attending sexually transmitted infection (STI) clinics in 3 southern US cities. Methods. In 2010 to 2012, we screened (n = 1102) and enrolled (n = 702) youths aged 15 to 23 years who identified as Black and reported recent (past 2 months) sexual activity and randomized them to a private, brief, interactive intervention (n = 349) or an attention-equivalent control condition (n = 353). Assessments occurred at baseline and 2 and 6 months after the intervention. Results. At 6 months, with adjustment for age and pretest nonequivalence of the outcome variable, an estimated odds ratio (EOR) of 1.63 (95% confidence interval [CI] = 1.07, 2.49; P = .02) indicated efficacy for correct condom use. An adjusted generalized estimating equations model with both 2- and 6-month condom use variables produced an EOR of 1.49 (95% CI = 1.06, 2.08; P = .02). We did not observe significant effects on chlamydia and gonorrhea incidence. Conclusions. This brief intervention, delivered as part of STI clinical care, could help alleviate the disproportionate STI-HIV burden among young Black men. (Am J Public Health. Published online ahead of print September 11, 2014: e1-e7. doi:10.2105/AJPH.2014.302131).American Journal of Public Health 09/2014; 104(11):e1-e7. DOI:10.2105/AJPH.2014.302131 · 4.23 Impact Factor
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ABSTRACT: Objectives To compare the occurrence of risk-inducing condom events (condom failures and incomplete use) and the frequency of their antecedents (condom errors, fit/feel problems and erection problems) between black and white men who have sex with men (MSM), and determine the associations between risk-inducing condom events and their antecedents. Methods We studied cross-sectional data of 475 MSM who indicated using a condom as an insertive partner in the previous 6 months enrolled in a cohort study in Atlanta, Georgia, USA. Results Nearly 40% of black MSM reported breakage or incomplete use, and they were more likely to report breakage, early removal and delayed application of a condom than white MSM. Only 31% and 54% of MSM reported correct condom use and suboptimal fit/feel of a condom, respectively. The use of oil-based lubricants and suboptimal fit/feel were associated with higher odds of reporting breakage (p=0.009). Suboptimal fit/feel was also associated with higher odds of incomplete use of condoms (p<0.0001). Conclusions Incomplete use of condoms and condom failures were especially common among black MSM. Our findings indicate that condoms likely offered them less protection against HIV/sexually transmitted infection when compared with white MSM. More interventions are needed, particularly addressing the use of oil-based lubricants and suboptimal fit/feel of condoms.Sexually Transmitted Infections 07/2014; 90(8). DOI:10.1136/sextrans-2014-051581 · 3.08 Impact Factor
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ABSTRACT: IntroductionCondom-associated erection problems (CAEPs) are reported by a substantial number of young men and are associated with inconsistent and/or incomplete condom use. The underlying mechanisms of CAEP are not well understood, and research examining the possibility that men who report CAEP differ from other men in their sexual responsivity is lacking.AimThis study used psychophysiological methods to examine whether men who report CAEP have a higher threshold for sexual arousal, a stronger need for tactile stimulation, and/or more easily lose their sexual arousal due to neutral distractors or performance-related demands.MethodsA total of 142 young, heterosexual men (53% reporting CAEP) were presented with four 3-minute erotic film clips. Three film clips were combined with one of the following manipulations: (i) distraction; (ii) performance demand; or (iii) vibrotactile stimulation. One erotic film clip was presented with no further instructions or manipulations.Main Outcome MeasuresAverage penile circumference changes during the first, second, and third minute (time) of the erotic film stimuli (condition) were submitted to a mixed-model analysis of variance with condition and time as within-subjects factors and group (CAEP/no-CAEP) as between-subjects factor.ResultsSignificant main effects of condition and time and a significant interaction of group × time were found. No significant interactions involving condition were found. Men who reported CAEP had smaller erectile responses during the first minute, regardless of film condition, than men who reported no CAEP (F(1,141) = 8.64, P < 0.005).Conclusion The findings suggest that men with and without CAEP differ in the ease with which they become sexually aroused. Men reporting CAEP needed more time and/or more intense stimulation to become aroused. To our knowledge, this study is the first to use psychophysiological methods to assess sexual responsivity in men who report CAEP. Janssen E, Sanders SA, Hill BJ, Amick E, Oversen D, Kvam P, and Ingelhart K. Patterns of sexual arousal in young, heterosexual men who experience condom-associated erection problems (CAEP). J Sex Med **;**:**–**.Journal of Sexual Medicine 06/2014; 11(9). DOI:10.1111/jsm.12548 · 3.15 Impact Factor