Advertisement

Prospective Associations Between Perceived Barriers to Condom

Use and “Perfect Use”

      Background

      Identifying malleable predictors of condom use in a clinic-based population may benefit efforts to prevent sexually transmitted infections (STIs).

      Purpose

      To prospectively test associations between three measures (relational-trust factors, fit and feel, and dislike of condom use) and perfect condom use in patients attending clinics diagnosing STIs.

      Methods

      A convenience sample was recruited from five clinics in three U.S. cities. Data were collected from December 2007 through April 2011. Daily electronic diaries were completed for up to 180 days. Occasions of penile−vaginal intercourse (PVI) involving condom use without any of four errors/problems were classified as “perfect use.” Three subscales (relational-trust factors, fit and feel, and dislike of condom use) were developed from baseline data. Generalized estimating equations were used to account for non-independence of PVI events.

      Results

      Among 17,156 reported occasions of PVI, condoms were either not used or used with errors/problems in 8,857 (51.6%) instances. The remaining 8,829 occasions (48.4%) involved perfect use. Relational-trust (p=0.054) and fit and feel (p=0.13) issues were not significantly associated with perfect use. Dislike of condom use (p=0.005) was significantly associated with perfect use (estimated OR=0.93, 95% CI=0.89, 0.98). Significant interactions with race, age, or gender were not observed.

      Conclusions

      Clinic attendees may be more likely to use condoms perfectly if three perceptions are reduced in magnitude: I won’t use condoms, condoms spoil the mood, and I get turned off when my partner suggests we use condoms. Findings support a paradigm shift in the way clinics promote condom use to patients.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Crosby R.A.
        • Charnigo R.
        • Weathers C.
        • Caliendo A.M.
        • Shrier L.A.
        Condom effectiveness against non-viral sexually transmitted infections: a prospective study using electronic daily diaries.
        Sex Transm Infect. 2012; 88: 484-489
        • Crosby R.A.
        • Milhausen R.
        • Sanders S.A.
        • Graham C.A.
        • Yarber W.L.
        Two heads are better than one: the association between condom decision-making and condom use errors and problems.
        Sex Transm Infect. 2008; 84: 198-201
        • Crosby R.A.
        • DiClemente R.J.
        • Yarber W.L.
        • Snow G.
        • Troutman A.
        Young African American men having sex with multiple partners are more likely to use condoms incorrectly: a clinic-based study.
        J Mens Health. 2008; 2: 340-343
        • Graham C.A.
        • Crosby R.A.
        • Milhausen R.R.
        • Sanders S.A.
        • Yarber W.L.
        Incomplete use of condoms: the importance of sexual arousal.
        AIDS Behav. 2011; 15: 1328-1331
        • Yarber W.L.
        • Graham C.A.
        • Sanders S.A.
        • Crosby R.A.
        Correlates of condom breakage and slippage among university undergraduates.
        Int J STD AIDS. 2004; 15: 467-472
        • Sanders S.A.
        • Graham C.A.
        • Yarber W.L.
        • Crosby R.A.
        Starting late, ending early: correlates of incomplete condom use among young adults.
        Health Educ Mono Series. 2008; 25: 45-50
        • Crosby R.A.
        • Yarber W.L.
        • Sanders S.A.
        • et al.
        Men with broken condoms: who and why?.
        Sex Transm Infect. 2007; 83: 71-75
        • Crosby R.A.
        • Yarber W.L.
        • Graham C.A.
        • Sanders S.A.
        Does it fit okay? Problems with condom use as a function of self-reported poor fit.
        Sex Transm Infect. 2010; 86: 36-38
        • St. Lawrence J.S.
        • Chapdelaine A.P.
        • Devieux J.G.
        • O’Bannon 3rd, R.E.
        • Brasfield T.L.
        • Eldridge G.D.
        Measuring perceived barriers to condom use: psychometric evaluation of the Condom Barriers Scale.
        Assessment. 1999; 6: 391-404
        • Crosby R.A.
        • Shrier L.A.
        • Charnigo R.
        • et al.
        Negative perceptions about condom use in a clinic population: comparisons by gender, race, and age.
        Int J STD AIDS. 2013; 24: 100-105