Challenges to correct condom use

A 2008 study of men attending an STD clinic reported that in the previous three months

- 29% put the condom on upside down and then turned it over
- 28.4% removed the condom before completing intercourse
- 30% experienced problems with the fit or feel of the condom
- 31% had a condom break
- 28.1% had erection loss while applying the condom

Further, men who experience condom associated erection problems (CAEP) also report inconsistent condom use and not using condoms for the complete act of intercourse.

If condom use is incorrect, it won't protect. Understanding and addressing these reasons is critical to preventing STI transmission and unplanned pregnancy.

The Kinsey Institute Condom Use Research Team (KI-CURT)

The Kinsey Institute Condom Use Research Team (KI-CURT) is an internationally recognized, multidisciplinary team that was formed in 2000 and is vested in advancing global sexual health through its research on the behavioral aspects of male condom use.

KI-CURT comprises:

• Kinsey Institute senior scientists Stephanie Sanders and William Yarber at Indiana University, and
• Kinsey Institute research fellows Cynthia Graham at the University of Southampton, United Kingdom; Richard Crosby at University of Kentucky; and Robin Milhausen of the University of Guelph, Ontario.

KI-CURT has published over 50 articles and two book chapters on various condom use-associated variables such as pleasure, sexual arousal, fit and feel, use errors and problems, erection difficulties, circumcision status, motivation, self-efficacy, relationship type, and alcohol and drug use. In 2012 KI-CURT edited a special issue of the journal Sexual Health: Condom use to prevent sexually transmitted infections: a global perspective.

KI-CURT Research Highlights

• Several of KI-CURT’s projects have focused on identifying barriers to condom use among Black men who have sex with men (MSM) in the Deep South and implementing educational programs to increase condom use efficacy among this population. This focus among Black MSM is particularly significant give that this population is disproportionally impacted by HIV/AIDS. The U.S. Centers for Disease Control and Prevention states that Blacks are the racial/ethnic group most affected by HIV in the United States and that MSM account for a majority of new HIV diagnoses among African Americans.

• Research by KI-CURT has provided the impetus for the development of a new male condom with a unique design, the O-Ring. This condom, recently cleared by the Food and Drug Administration and is now available for purchase. Adam Glickman of O-Ring Products, LLC – the company that developed the O-Ring condom—stated “The work of the Kinsey Institute Condom Use Research Team to identify, document, and explain obstacles and errors in the use of condoms provided the data needed to validate our hunch that condoms are too easy to apply the wrong way.”

• A recent highlight of KI-CURT’s work was the development of home-based and clinic condom use educational programs for both men and women based on the findings of KI-CURT’s prior observational research and behavior-change theory. KI-CURT, in collaboration with the Indiana University Rural Center for AIDS/STD Prevention (RCAP), has created several interventions designed to increase correct and consistent condom use that are consistent with sexual pleasure. These include The Kinsey Institute Homework Intervention Strategy (KI-HIS), which has been tested for MSM and men who have sex with women resulting in manuscripts published in the Journal of Men’s Health (2011) and the Journal of American College Health (2014). Further pilot testing of KI-HIS among African American men was funded by a R21 National Institutes of Health grant. The KI-HIS has also been adapted for use in the United Kingdom (KI-HIS-UK) and a feasibility study has recently been completed. A web-based version of KI-HIS-UK has also been developed and is currently being evaluated. 

• A condom-focused intervention for tourism workers, Tourism Worker Intervention Safer Sex Training (KI-TWIST), was pilot tested in a major tourism destination in Canada and published in The Canadian Journal of Human Sexuality (2016). KI-CURT recently completed a pilot testing of a condom intervention for women on the Indiana University-Bloomington campus, Home-based Exercises for Responsible Sex (KI-HERS); a manuscript was submitted to a professional journal this summer (2017). A condom-based program for couples, The Home-based Exercises for Increasing Responsible Sex (KI-THEIRS), is also currently being pilot-tested on the IUB campus in spring and fall 2017.