title: How often do condoms fail? A cross-sectional study exploring incomplete use of condoms, condom failures and other condom problems among black and white MSM in southern U.S.A.
abstract: OBJECTIVE
  To compare the occurrence of risk-inducing condom events (condom failures and incomplete use) and the frequency of their antecedents (condom errors, fit/feel problems and erection problems) between black and white men who have sex with men (MSM), and determine the associations between risk-inducing condom events and their antecedents.
  
  
  METHODS
  We studied cross-sectional data of 475 MSM who indicated using a condom as an insertive partner in the previous 6 months enrolled in a cohort study in Atlanta, Georgia, USA.
  
  
  RESULTS
  Nearly 40% of black MSM reported breakage or incomplete use, and they were more likely to report breakage, early removal and delayed application of a condom than white MSM. Only 31% and 54% of MSM reported correct condom use and suboptimal fit/feel of a condom, respectively. The use of oil-based lubricants and suboptimal fit/feel were associated with higher odds of reporting breakage (p=0.009). Suboptimal fit/feel was also associated with higher odds of incomplete use of condoms (p<0.0001).
  
  
  CONCLUSIONS
  Incomplete use of condoms and condom failures were especially common among black MSM. Our findings indicate that condoms likely offered them less protection against HIV/sexually transmitted infection when compared with white MSM. More interventions are needed, particularly addressing the use of oil-based lubricants and suboptimal fit/feel of condoms.
authors: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
authors: Alfonso C
authors: AC
authors: Hernández-Romieu
authors: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
authors: Aaron J
authors: AJ
authors: Siegler
authors: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
authors: Patrick S
authors: PS
authors: Sullivan
authors: Department of Health Behavior, College of Public Health, University of Kentucky, Lexington, Kentucky, USA.
authors: Richard
authors: R
authors: Crosby
authors: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
authors: Eli S
authors: ES
authors: Rosenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D044383:Black People; D015331:Cohort Studies; D017280:Condoms; D003430:Cross-Sectional Studies; D005845:Georgia; D006801:Humans; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment; D044465:White People; D055815:Young Adult; D001741:Black or African American
keywords: Behavioural Interventions; Condoms; HIV; Men; Prevention