Incorrect Condom Use Is "Common"

A study by international researchers finds 14 common usage errors with condoms hampers their efficacy against STDs and pregnancy.

The analysis of 50 studies of sex workers, STI clinic attendees, monogamous married couples, university students, and adolescents spanning 14 countries between 1995 and 2011 revealed problems including:

• late application (17 percent to 51 percent);
• early removal (13 percent to 44.7 percent);
• failure to fully unroll the condom;
• incorrect storage;
• condom re-use;
• completely unrolling before applying to the penis (25.3 percent) rather than unrolling on the penis;
• failure to leave space for semen collection (24.3 percent to 45.7 percent);
• inside-out application that is then reversed (4 percent to 30.4 percent);
• exposure to sharp objects (like teeth) during package removal (2.1 percent to 11.2 percent); and
• not checking for damage before use (74.5 percent of men and 82.7 percent of women).

According to lead researcher Stephanie Sanders of Indiana University's Kinsey Institute for Research in Sex, Gender and Reproduction, "closing the gap" between typical and perfect condom use is essential to "greatly reducing the epidemics of STIs and unintended pregnancies."

Researchers acknowledge the study is limited by the wide variation of problems reported in the 50 studies analyzed, as well as by the majority presence of studies from developed countries primarily in North America.

Although researchers note "more research is needed on condom use errors and problems in a wider range of countries," they suggest the problems cited "may be affecting millions of people." For example, "re-use of condoms ... may be more common in less economically developed countries or among the poor."

"Collecting data on condom use errors and problems among a larger diversity of populations may help better inform condom intervention strategies tailored to those populations," said the researchers.

The study, "Condom Use Errors and Problems: A Global View," was published in Sexual Health (2012;9:81-95).

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