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Correlates of condom failure in a sexually active cohort of men who have sex with men.

Abstract

Condom failure (slippage or breakage) has been shown to be associated with HIV seroconversion among men who have sex with men (MSM), but predictors of failure have been poorly elucidated. Of 2592 HIV-seronegative MSM participants in the HIV Network for Prevention Trials (HIVNET) multisite Vaccine Preparedness Study who reported condom use for anal sex in the 6 months before enrollment, condom failure was reported by 16.6%, with failure rates of 2.1/100 episodes of condom usage (2.5 failures/100 episodes for receptive anal sex and 1.9/100 episodes for insertive anal sex). In separate multivariate models evaluating predictors of condom failure reported by the insertive and receptive partners, more frequent condom use was 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 >80% of anal sex acts were significantly associated with decreased failure rates in the insertive model. Safer sex counseling should particularly target men of lower socioeconomic status, promote proper and consistent use of condoms with appropriate lubricants, and address the impact of drug use, especially amphetamines and alcohol, on condom failure.

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  • Authors+Show Affiliations

    ,

    Permanente Medical Group, Oakland, California, USA.

    , , , , , , , , , ,

    Source

    MeSH

    Adult
    Cohort Studies
    Condoms
    Homosexuality, Male
    Humans
    Male

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    10225233

    Citation

    TY - JOUR T1 - Correlates of condom failure in a sexually active cohort of men who have sex with men. AU - Stone,E, AU - Heagerty,P, AU - Vittinghoff,E, AU - Douglas,J M,Jr AU - Koblin,B A, AU - Mayer,K H, AU - Celum,C L, AU - Gross,M, AU - Woody,G E, AU - Marmor,M, AU - Seage,G R,3rd AU - Buchbinder,S P, PY - 1999/5/4/pubmed PY - 2001/3/28/medline PY - 1999/5/4/entrez KW - Americas KW - Anal Sex--men KW - Barrier Methods KW - Behavior KW - Biology KW - Bisexuals--men KW - Condom KW - Contraception KW - Contraception Failure--determinants KW - Contraceptive Methods KW - Contraceptive Usage KW - Developed Countries KW - Drug Usage KW - Economic Factors KW - Employment Status KW - Family Planning KW - Financial Activities KW - Health Insurance KW - Homosexuals--men KW - Ingredients And Chemicals KW - Lubricants KW - Men KW - North America KW - Northern America KW - Research Report KW - Risk Factors KW - Risk Reduction Behavior--men KW - Sex Behavior KW - Socioeconomic Factors KW - Socioeconomic Status KW - United States SP - 495 EP - 501 JF - Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association JO - J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. VL - 20 IS - 5 N2 - Condom failure (slippage or breakage) has been shown to be associated with HIV seroconversion among men who have sex with men (MSM), but predictors of failure have been poorly elucidated. Of 2592 HIV-seronegative MSM participants in the HIV Network for Prevention Trials (HIVNET) multisite Vaccine Preparedness Study who reported condom use for anal sex in the 6 months before enrollment, condom failure was reported by 16.6%, with failure rates of 2.1/100 episodes of condom usage (2.5 failures/100 episodes for receptive anal sex and 1.9/100 episodes for insertive anal sex). In separate multivariate models evaluating predictors of condom failure reported by the insertive and receptive partners, more frequent condom use was 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 >80% of anal sex acts were significantly associated with decreased failure rates in the insertive model. Safer sex counseling should particularly target men of lower socioeconomic status, promote proper and consistent use of condoms with appropriate lubricants, and address the impact of drug use, especially amphetamines and alcohol, on condom failure. SN - 1077-9450 UR - https://www.unboundmedicine.com/medline/citation/10225233/abstract/Correlates_of_condom_failure_in_a_sexually_active_cohort_of_men_who_have_sex_with_men L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=10225233.ui ER -