Possible Barriers to Correct Condom Use

DESCRIPTION:

Condom use is a critical public health strategy for reducing the likelihood of transmitting and acquiring sexually transmissible infections, including HIV, in adult men and women. Consistent and correct use of male condoms can be a highly effective method of preventing the transmission of HIV and many STIs, but this method relies on men’s willingness and ability to use condoms.

What is this study about?

10-28% of men report erection problems associated with condom use. Men who experience condom associated erection problems (CAEP) also report inconsistent condom use and not using condoms for the complete act of intercourse. Addressing these problems is critical to preventing STI transmission and unplanned pregnancy.

This research is not about why men in general might not like condoms. Instead, this project aims to advance our understanding of condom-associated erection problems and the role of factors that may negatively impact sexual response (e.g., distraction and performance demand), of penile sensitivity, and of condom application skills.

Need for the Research

• One in two sexually active persons will contract an STD/STI by age 25.

• Erection-enhancing drugs, like Viagra, do not overcome this problem.

• In 2006, heterosexual contact accounted for 33% of HIV/AIDS diagnoses among adults and adolescents in the USA (CDC, 2008). Men who have sex with women play a major role in HIV transmission to women who can also pass it on to offspring. In 2006, 80% of HIV/AIDS diagnoses among females in the USA were attributed to heterosexual transmission (CDC, 2008).

• About half of the new HIV infections in the US are among people under age 25 years with the majority infected through sexual behavior. About one in three new diagnoses with HIV/AIDS are attributed to heterosexual transmission. Men who have sex with women play a major role in HIV transmission to women who can also pass it on to offspring.

• The Institute of Medicine has estimated that “the annual direct and indirect costs of selected major STDs are approximately $10 billion or if sexually transmitted HIV infections are included, $17 billion.”

• Consistent and correct condom use provides substantial protection against the many STDs/STIs, including statistically significant risk reduction against HIV, Chlamydia, gonorrhea, herpes, and syphilis.

• According to NIH (2006), “there are serious shortcomings in this field because of inadequate knowledge concerning heterosexual men's perspectives and behaviors.” Correct and consistent condom use remains the most effective way to reduce HIV/STI transmission during sex, but this method relies on men’s willingness and ability to use male condoms. 

INVESTIGATORS:

Erick Janssen, Ph.D. and Stephanie Sanders, Ph.D. The Kinsey Institute for Research in Sex, Gender, and Reproduction. Seven additional research staff were employed on this project.

FUNDED BY :
Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health (NIH).

The project was funded from June 1, 2009 to May 31, 2012.

PUBLICATIONS

Published

Sanders, S. A., Hill, B., Crosby, R., & Janssen, E. (2013). Correlates of condom-associated erection problems in young, heterosexual men: Condom fit, self-efficacy, perceptions, and motivations. AIDS and Behavior. DOI 10.1007/s10461-013-0422-3

Pubmed: http://www.ncbi.nlm.nih.gov/pubmed/23404098

Under review or in preparation

Crosby, R. Sanders, S.A., Hill, B.J., Janssen, E., Milhausen, R.R., Graham, C.A., & Yarber, W.L. Individual- and relationship-level moderators of associations between condom-associated erection problems (CAEP) and late application and early removal of condoms.

Hill, B. J., Janssen, E., Kvam, P., Amick, E., & Sanders, S. A. The effect of condoms on penile sensory and vibratory thresholds in young, heterosexual men.

Hill, B.J., Sanders, S.A., Crosby, R., Ingelhart, K.N., Janssen, E.  Condom-associated erection problems (CAEP): Behavioral responses and attributions in young, heterosexual men.

Hill, B.J., Sanders, S.A., Crosby, R., Ingelhart, K.N., & Janssen, E. Attributions for late condom application and early condom removal among Young, heterosexual men.

Hill, B.J., Sanders, S.A., & Janssen, E. Condom use errors and problems among young, heterosexual men who do and do not experience condom-associated erection problems (CAEP).

Janssen, E., Sanders, S., Hill, B., Amick, E., Oversen, D., Kvam, P., & Ingelhart, K. Psychophysiological response patterns in young, heterosexual men with condom associated erection problems (CAEP).

Janssen, E., Sanders, S., & Hill, B. Erectile responses during condom application in young, heterosexual men with condom associated erection problems (CAEP).

Sanders, S.A., Hill, B.J., Janssen, E., Graham, C.A., Milhausen, R.R., Yarber, W.L., & Crosby, R. General erectile functioning and sexual excitation/inhibition among young, heterosexual men with condom-associated erection problems (CAEP).

Yarber, W. L., Sanders, S.A., Hill, B.J., Janssen, E., & Crosby, R. (2012). Condom-associated erection problems correlate with problems with fit and feel and sensation of condoms.

PRESENTATIONS

Hill, B., Amick, E., Janssen, E., Kvam, P., & Sanders, S. (2012). The effect of condoms on penile sensitivity in young heterosexual men: Preliminary findings. Paper presented at the Annual Meeting of the Society for the Scientific Study of Sexuality, Joint Eastern and Midcontinent Region (SSSS-E/MR), Bloomington, IN, May.

Hill, B.J., Ingelhart, K.N., Janssen, E., & Sanders, S.A. (2011). Condom use errors and problems in heterosexual men reporting condom-associated erection problems. Paper presented at the Annual Meeting of the Society for the Scientific Study of Sexuality (SSSS), Houston, TX, November.

Hill, B.J., Janssen, E., & Sanders, S.A. (2011). Barriers to correct condom Uue: Considering sexual arousal and sensation. Poster presented at the Annual Meeting of the International Academy of Sex Research (IASR), Los Angeles, CA, August.

Ingelhart, K., Hill, B. J., Janssen, E., & Sanders, S. A. (2011). Inconsistent and incomplete condom use: Exploring the late application and early removal of condoms in heterosexual men. Women In Science Program (WISP) Research Conference, Bloomington, IN, March.

Hill, B.J., Janssen, E. & Sanders, S.A. (2011). Barriers to correct condom use: Considering sexual arousal and sensation during condom application. Poster presented at the Biannual National Rural Center for AIDS/STD Prevention (RCAP) Conference, Bloomington, Indiana, April.

Ingelhart, K.N., Hill, B.J., Janssen, E. & Sanders, S.A. (2011). Inconsistent and incomplete  condom use: Exploring the late application and early removal of condoms in heterosexual men. Poster presented at the Biannual National Rural Center for AID/STD Prevention (RCAP) Conference, Bloomington, Indiana, April.

Sanders S.A. (2010). Erection problems associated with condom use. Part of symposium titled “Condom use errors and problems: A decade of research by the Kinsey Institute Condom Use Research Team.”  Annual Meeting of the Society for the Scientific Study of Sexuality (SSSS), Las Vegas, Nevada, November.

Hill, B.J., Janssen, E., & Sanders, S.A. (2010). Barriers to correct condom use: Considering sexual arousal and sensation. Poster presented at the Annual Meeting of the International Academy of Sex Research (IASR), Prague, Czech Republic, July.

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