Graham CA, Crosby R, Yarber WL, et al. Erection loss in association with condom use among young men attending a public STI clinic: potential correlates and implications for risk behaviour

Oxford Doctoral Course in Clinical Psychology, Oxford, UK.
Sexual Health (Impact Factor: 1.37). 01/2007; 3(4):255-60. DOI: 10.1071/SH06026
Source: PubMed


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.

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Available from: Robin Milhausen, Feb 10, 2014
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    • "In a recent study, for example, one of the most commonly cited complaints with male condom use was that ''the condom just didn't feel right'' (Crosby, Milhausen, Yarber, Sanders, & Graham, 2008). Poor condom fit and feel has been associated with breakage (Crosby, Yarber, Graham, & Sanders, 2010; Crosby et al., 2007); slippage (Crosby et al., 2007, 2010); condom-associated erection loss (Crosby et al., 2010; Graham et al., 2006); incomplete use of condoms (Yarber et al., 2007); and lack of sexual pleasure (Crosby et al., 2010). Although the prevalence of fit and feel complaints has been extensively documented in the published literature (Crosby et al., 2008, 2010; Reece et al., 2007; Reece, Herbenick, & Dodge, 2009; Sturges et al., 2009), little is known about the specific issues surrounding people's reports of poor fit and feel. "
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    ABSTRACT: The purpose of this study was to investigate gender differences and other demographic correlates of condom fit and feel problems among a diverse sample of adult condom users and to examine men's and women's perceptions and experiences with condom fit and feel problems. Participants were recruited from an electronic mailing list. The analytic sample (N = 949) included self-identified heterosexual men (n = 771) and women (n = 178) who reported using condoms for penile-vaginal or penile-anal intercourse in the past 3 months. Both quantitative and qualitative methods were applied. Of the sample, 38.3 % reported experiencing at least one condom fit or feel problem. Problems with condom fit during sex did not differ significantly by gender (p = .73). Perceptions of specific condom use problems were organized into five themes: (1) decreased sensation, (2) lack of naturalness, (3) condom size complaints, (4) decreased pleasure, and (5) pain and discomfort. In this diverse sample, there was a high prevalence of condom fit and feel issues among women as well as men. These issues, mostly focused on loss of pleasure, represent a substantial public health problem and thus warrant attention in safer sex programs.
    Full-text · Article · Jan 2013 · The Journal of Prevention
    • "Females have less maneuverability with respect to condom negotiating power. On the other hand, it could be argued that males may be at higher risk for HIV infection compared to females because men in general are more reluctant to use condoms (Graham et al., 2006; Public Health Agency of Canada, 2006a). "
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    ABSTRACT: Street youth are increasingly at risk for HIV infection due to high-risk sexual behaviors and injection drug use. The purpose of this study was to assess the extent to which demographic characteristics of street youth in Toronto were predictive of HIV status. Age, gender, and ethnicity, education, length of time street-involved, and income were measured among a cross-sectional sample of 18- to 30-year-old street youth (N = 140). Results revealed statistically significant relationships between Age and HIV status (β = 2.413, p < .001, OR = 11.169, 95.0% CI = 3.344–37.303), as well as Ethnicity and HIV status (β = 2.051, p = .005, OR = 7.773, 95.0% CI = 1.836–32.900). Findings suggest that HIV prevention intervention programs may need to be refined or extended appropriately to older street youth in those 26–30 years of age, especially to meet the cultural needs of Black, Aboriginal, and other ethnic homeless youth populations. Further investigation of the duration of street involvement relating to HIV-risk–taking behaviors is necessary.
    No preview · Article · Oct 2009 · Journal of HIV/AIDS & Social Services

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