The acceptability of the female and male condom: a randomized crossover trial.
BACKGROUND
Although studies have assessed the acceptability of male and female condoms, comparative trial data are lacking.


METHODS
A sample of 108 women in stable relationships recruited from an urban, reproductive health clinic were randomly assigned to use 10 male or female condoms, followed by use of 10 of the other type. A nurse provided instruction in correct method use. Demographic information was collected in a baseline questionnaire; acceptability data were collected in follow-up and exit questionnaires and coital logs. Nonparametric and chi-square statistics were used to analyze measures of the methods' relative acceptability. Bowker's test of symmetry was adapted to test the null hypothesis of no difference in acceptability between condom types.


RESULTS
Participants used 678 female and 700 male condoms. Although neither method scored high on user satisfaction measures, the 63 women completing the study protocol preferred the male condom to the female condom for ease of application or insertion, ease of removal, general fit, feel of the condom during intercourse and ease of penetration. Participants reported that their partner also favored the male condom, although women generally appeared to like this method more than their partner did. In a direct comparison between the methods at the end of the study, women generally judged male condoms superior on specified preference criteria.


CONCLUSIONS
Across a range of criteria, the female condom was less acceptable than the male condom to most women and their partners. Although both types had low acceptability, they are needed and valid methods of pregnancy and disease prevention. That neither rated high on user satisfaction measures underscores the need for more barrier methods that women and men can use.
School of Public Health, University of Alabama at Birmingham, USA. andrzej@uab.edu
Andrzej
A
Kulczycki
Dhong-Jin
DJ
Kim
Ann
A
Duerr
Denise J
DJ
Jamieson
Maurizio
M
Macaluso
D000328:Adult; D016009:Chi-Square Distribution; D017280:Condoms / Q000706:statistics & numerical data*; D019111:Single-Use Internal Condom / Q000706:statistics & numerical data*; D003258:Consumer Behavior / Q000706:statistics & numerical data*; D018592:Cross-Over Studies; D005260:Female; D015438:Health Behavior; D006266:Health Education; D006801:Humans; D008297:Male; D021841:Safe Sex / Q000523:psychology*; D012736:Sex Education; D012747:Sexual Partners / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors