Problems with condoms may be reduced for men taking
ample time to apply them
Richard A. CrosbyA,C,D,G, Cynthia A. GrahamA,C,E,F, William L. YarberA,B,C,E
and Stephanie A. SandersA,B,C
AThe Kinsey Institute for Research in Sex, Gender, and Reproduction, Morrison Hall 313,
Indiana University, Bloomington, IN 47405, USA.
BDepartment of Gender Studies, Memorial Hall E130, Indiana University, Bloomington, IN 47405, USA.
CRural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN 47405, USA.
DCollege of Public Health at the University of Kentucky, 121 Washington Avenue, Suite 113,
Lexington, KY 40506, USA.
EDepartment of Applied Health Science, Indiana University, Bloomington, IN 47405, USA.
FOxford Doctoral Course in Clinical Psychology, University of Oxford, Oxford OX3 7JX, UK.
GCorresponding author. Email: firstname.lastname@example.org
vaginal sex is the amount of time that men (and perhaps women) allow for condom application. To examine whether men
reporting that ample time was available to apply a male condom (the last time a condom was used for penile-vaginal sex)
were also less likely to report problems with condom use such as breakage, slippage and erection difficulties during that
and one small town) and a blog on the website of a condom sales company. Men completed a questionnaire posted on the
website of The Kinsey Institute for Research in Sex, Gender, and Reproduction. Inclusion criteria were that participants
were: at least 18 years old; used condoms for penile-vaginal intercourse in the past 3 months; and able to read English.
Results: In controlled, event-specific analyses, men reporting that they did not have sufficient time for condom application
were ~three times more likely to report breakage and ~2.4 times more likely to report slippage. In addition, men who
reported that they lacked time for condom application were ~2.4 times more likely to experience any of nine sexual
problems, 3.4 times more likely to report difficulty with erection, 2.1 times more likely to report reduced sexual pleasure,
2.2 times more likely to report reduced sexual pleasure of their female partner and 2.6 times more likely to report that the
condom irritated their partner’s vagina. Conclusions: This is the first study using an event-specific analysis to examine the
effect of not having enough time for condom application on condom breakage, slippage and several outcomes related to
sexual pleasure. Sexually transmissible infections and pregnancy prevention messages should include recommendations to
men to take their time applying condoms.
Background: One potentially important antecedent of experiencing problems with condom use during penile-
Additional keywords: erection, men, sexual pleasure, STI risk.
A rapidly expanding body of literature has explored male
condom use errors and problems experienced during penile-
vaginal sex.1–17Although much of this research has been
descriptive, few studies have identified likely causes of these
problems.5,7,8,14For example, allowing condoms to contact
sharp objects, reporting problems with ‘fit-and-feel’ condoms
and having low self-efficacy to use condoms correctly may
predispose men to experience condom breakage.8Loss of
erection and inadequate lubrication have been associated with
slippage.18Breakage and slippage are particularly important
problems as these can result in condom failure and thereby
lessen the value of condom use.2,9,12,13However, other types of
problems also warrant further investigation designed to identify
likely causes. One important but neglected set of problems
pertains to altered sexual sensations associated with condom
use; e.g. loss of pleasure, difficulty reaching orgasm, genital
irritation, erection loss and drying of the vagina. To date, with
the exception of erection loss,6,19,20research documenting the
prevalence of these problems and the correlates to condom use
has been scant.
One potentially important antecedent of experiencing
problems with condom use during penile-vaginal sex is the
amount of time that men (and perhaps women) allow for the
application of condoms. Clearly, those who rush to apply
condoms may not apply them correctly, thereby predisposing
them for subsequent condom-use errors and problems. The
potential utility of this hypothesised antecedent is strong
Sexual Health, 2010, 7, 66–70
? CSIRO 201010.1071/SH090201448-5028/10/010066