title: Partner characteristics, intensity of the intercourse, and semen exposure during use of the female condom.
abstract: The objective of this study was to assess how characteristics of the intercourse and the couple relate to semen exposure during use of the female condom. From 1996 to 1998, 210 women in Birmingham, Alabama, were trained to use the female condom and follow study procedures during a group session and individually practiced inserting the device. The outcome was semen exposure as defined by comparing pre- and postcoital prostate-specific antigen levels in vaginal fluid. Women who had high income levels had lower rates of semen exposure (odds ratio (OR) = 0.3, 95% confidence interval (CI): 0.2, 0.7), while those in a relationship of less than 2 years were at greater risk (OR = 2.4, 95% CI: 1.3, 4.1). Couples with a large disparity in vaginal fundus size and penis size were at increased risk of semen exposure (OR = 2.7, 95% CI: 1.2, 6.0). Engaging in very active intercourse also increased the risk (OR = 1.7, 95% CI: 1.1, 2.6). Thus, the protective effect of the female condom appears to be a function of user- and intercourse-specific characteristics. Future studies of male condom efficacy should focus on collecting detailed data about the users and characteristics of intercourse to predict failure accurately.
authors.affiliation: Department of Epidemiology and International Health, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA. Lawsonml@chkd.com
authors.forename: M Louise
authors.initials: ML
authors.lastname: Lawson
authors.forename: Maurizio
authors.initials: M
authors.lastname: Macaluso
authors.forename: Ann
authors.initials: A
authors.lastname: Duerr
authors.forename: Glen
authors.initials: G
authors.lastname: Hortin
authors.forename: Karen R
authors.initials: KR
authors.lastname: Hammond
authors.forename: Richard
authors.initials: R
authors.lastname: Blackwell
authors.forename: Lynn
authors.initials: L
authors.lastname: Artz
authors.forename: Amy
authors.initials: A
authors.lastname: Bloom
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis*; 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; D010413:Penis / Q000033:anatomy & histology; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000032:analysis*; D012307:Risk Factors; D012661:Semen / Q000737:chemistry; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D014621:Vagina / Q000033:anatomy & histology / Q000737:chemistry
chemical_list: D015415:Biomarkers; D017430:Prostate-Specific Antigen