title: Condom type may influence sexual behavior and ejaculation and complicate the assessment of condom functionality.
abstract: BACKGROUND
  Studies that evaluate condom effectiveness are affected by factors related to how the condom was used, and these factors may not be consistent between different types of condoms. Also, subjective assessments of the sexual act may be unreliable.
  
  
  METHODS
  We performed a secondary data analysis of a randomized crossover trial of male and female condoms among 108 couples.
  
  
  RESULTS
  Self-reported duration and activeness of coital acts were significantly different for uses of the male condom compared to uses of the female condom. Fewer individuals reported ejaculation occurring with the female condom. Reliability of self-reports of ejaculation compared to a biological marker of semen detected inside the used male and female condoms was not strong.
  
  
  CONCLUSIONS
  We found that sexual behaviors appear to differ by the type of condom used for the coital act. Studies should consider sexual behavior when evaluating condom effectiveness. Furthermore, studies would be strengthened by the use of a biological marker of semen to determine whether ejaculation, and therefore a true risk of exposure, occurred.
authors.affiliation: Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA 30303, USA. lbhadda@emory.edu
authors.forename: Lisa
authors.initials: L
authors.lastname: Haddad
authors.forename: Maria F
authors.initials: MF
authors.lastname: Gallo
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Jamieson
authors.forename: Maurizio
authors.initials: M
authors.lastname: Macaluso
mesh_terms: D000328:Adult; D000407:Alabama; D015415:Biomarkers / Q000032:analysis; D017280:Condoms / Q000009:adverse effects; D019111:Single-Use Internal Condom / Q000009:adverse effects; D003268:Contraception Behavior; D018592:Cross-Over Studies; D004542:Ejaculation; D005260:Female; D006801:Humans; D008297:Male; D008422:Materials Testing / Q000379:methods*; D017430:Prostate-Specific Antigen / Q000032:analysis; D034121:Reproductive Health Services; D057566:Self Report; D012661:Semen / Q000737:chemistry; D012725:Sexual Behavior; D012747:Sexual Partners; D013499:Surface Properties; D014621:Vagina / Q000737:chemistry
chemical_list: D015415:Biomarkers; D017430:Prostate-Specific Antigen