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Be A Hero Vaccine Preparedness Study |
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Correlates of condom failure in a sexually active cohort of men who have sex with men.
Source:
J Acquir Immune Defic Syndr Hum Retrovirol 1999 Apr 15;20(5):495-501
Authors:
Stone E, Heagerty P, Vittinghoff E, Douglas JM Jr, Koblin BA, Mayer KH, Celum CL,
Gross M, Woody GE, Marmor M, Seage GR 3rd, Buchbinder SP.
Publication Info:
Permanente Medical Group, Oakland, California, USA.
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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