title: Efficacy of the female condom as a barrier to semen during intercourse.
abstract: In 1996-1998, the authors measured prostate-specific antigen (PSA) in vaginal fluid to assess the frequency of female condom failure and to evaluate the association of self-reported failure with semen exposure. Women at low risk of sexually transmitted diseases (n = 210) were recruited in Birmingham, Alabama. They were trained to use the female condom, sample vaginal fluid before and after condom use, and complete forms to report problems during each use. Semen exposure was assessed by comparing pre- and postcoital PSA levels in vaginal fluid. A total of 175 women used 2,232 condoms. The rate of semen exposure ranged from 7% to 21% of condom uses, depending on the exposure criterion. Exposure was more likely (21-34%) and more intense (mean postcoital PSA, 24.7 ng/ml) if participants reported a mechanical problem versus other problems or no problems (exposure rate, 5-20% in both instances; mean postcoital PSA, 9.6 and 7.8 ng/ml, respectively). In logistic regression analyses for repeated measurements, user-reported problems accounted for less than 59% of the instances of semen exposure. The female condom prevented semen exposure in 79-93% of condom uses. Exposure was associated with user-reported problems but also occurred in their absence. Reported problems and semen exposure decreased with user experience.
authors.affiliation: Department of Epidemiology and International Health, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA. mmacaluso@cdc.gov
authors.forename: Maurizio
authors.initials: M
authors.lastname: Macaluso
authors.forename: M Louise
authors.initials: ML
authors.lastname: Lawson
authors.forename: Glen
authors.initials: G
authors.lastname: Hortin
authors.forename: Ann
authors.initials: A
authors.lastname: Duerr
authors.forename: Karen R
authors.initials: KR
authors.lastname: Hammond
authors.forename: Richard
authors.initials: R
authors.lastname: Blackwell
authors.forename: Amy
authors.initials: A
authors.lastname: Bloom
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis*; D016009:Chi-Square Distribution; D003075:Coitus; D019111:Single-Use Internal Condom; D003268:Contraception Behavior; D004868:Equipment Failure; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000032:analysis*; D012661:Semen / Q000737:chemistry; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D014621:Vagina / Q000737:chemistry
chemical_list: D015415:Biomarkers; D017430:Prostate-Specific Antigen