title: Erection loss in association with condom use among young men attending a public STI clinic: potential correlates and implications for risk behaviour.
abstract: BACKGROUND
  To assess prevalence of condom-associated erection loss and to identify correlates of erection loss among men attending a sexually transmissible infections (STI) clinic.
  
  
  METHODS
  Men (n = 278) attending an STI clinic responded to an anonymous questionnaire aided by a CD recording of the questions. The sample was screened to include only men who had used a condom during penile-vaginal sex at least three times in the past 3 months. Erection loss was assessed for 'the last three times a condom was used'.
  
  
  RESULTS
  The mean age of the participants was 23.7 years (s.d. = 4.1); 37.1% of the men reported condom-associated erection loss on at least one occasion. Men who had reported condom-associated erection loss were also reported having more frequent unprotected vaginal sex (P = 0.04) and were less likely to use condoms consistently (P = 0.014) than men without erection loss. Men with erection loss were also more likely to remove condoms before sex was over (P = 0.001). Age and race/ethnicity were not associated with erection loss. In multivariate analysis, three significant statistical predictors were identified: low self-efficacy to use condoms (P = 0.001); problems with 'fit or feel' of condoms (P = 0.005); and having more than three sex partners during the previous 3 months (P = 0.02).
  
  
  CONCLUSIONS
  Condom-associated erection loss may be common among men at risk for STIs. This problem may lead to incomplete or inconsistent condom use. Men may be more likely to experience condom-associated erection loss if they lack confidence to use condoms correctly, if they experience problems with the way condoms fit or feel, and if they have sex with multiple partners.
authors.affiliation: Oxford Doctoral Course in Clinical Psychology, Oxford, UK. cynthia.graham@hmc.ox.ac.uk
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Graham
authors.forename: Richard
authors.initials: R
authors.lastname: Crosby
authors.forename: William L
authors.initials: WL
authors.lastname: Yarber
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Sanders
authors.forename: Kimberly
authors.initials: K
authors.lastname: McBride
authors.forename: Robin R
authors.initials: RR
authors.lastname: Milhausen
authors.forename: Janet N
authors.initials: JN
authors.lastname: Arno
mesh_terms: D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data*; D007172:Erectile Dysfunction / Q000209:etiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D010410:Penile Erection; D012309:Risk-Taking; D012725:Sexual Behavior; D011795:Surveys and Questionnaires