title: Condom-associated erection problems: behavioural responses and attributions in young, heterosexual men.
abstract: Background Previous studies have associated men who experience condom-associated erection problems (CAEP) with incomplete condom use and/or foregoing using condoms altogether. However, how men respond to CAEP and what they attribute CAEP to, remains unclear. Understanding young men's CAEP responses and attributions could help improve sexually transmissible infections (STI)/HIV prevention programs and interventions.
  
  
  METHODS
  Behavioural responses to, and attributions for, CAEP during application (CAEP-Application) and/or during penile-vaginal intercourse (CAEP-PVI) were reported using an online questionnaire by 295 young, heterosexual men (aged 18-24 years) who were recruited via social media websites and university Listservs across major cities in the Midwestern USA.
  
  
  RESULTS
  Behavioural responses to CAEP-Application included receiving oral or manual stimulation, stimulating a partner, self-stimulation, foregoing condom use and applying the condom after starting intercourse. Attributions for CAEP-Application included: distraction, fit and feel problems, application taking too long and having consumed too much alcohol. Behavioural responses to CAEP-PVI included increasing the intensity of intercourse, removing the condom to receive oral or manual stimulation and removing condom and continuing intercourse. Attributions for CAEP-PVI included: lack of sensation, taking too long to orgasm, not being 'turned on' enough, fit and feel problems and partner-related factors.
  
  
  CONCLUSIONS
  Men who report CAEP respond with both STI/HIV risk-reducing and potentially risk-increasing behaviours (e.g. forgoing condom use). Men attribute their experiences to a wide range of individual- and partner-level factors. Addressing men's CAEP behavioural responses and attributions may increase the efficacious value of condom programs and STI/HIV prevention interventions - particularly among men who experience CAEP.
authors.affiliation: The University of Chicago, Department of Obstetrics and Gynecology, Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health, Charles Mott Building, Chicago, IL 60637, USA.
authors.forename: Brandon J
authors.initials: BJ
authors.lastname: Hill
authors.affiliation: The Kinsey Institute for Research in Sex, Gender, and Reproduction, Morrison Hall 313, Bloomington, IN 47405, USA.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Sanders
authors.affiliation: The Kinsey Institute for Research in Sex, Gender, and Reproduction, Morrison Hall 313, Bloomington, IN 47405, USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Crosby
authors.affiliation: The Kinsey Institute for Research in Sex, Gender, and Reproduction, Morrison Hall 313, Bloomington, IN 47405, USA.
authors.forename: Kara N
authors.initials: KN
authors.lastname: Ingelhart
authors.affiliation: The Kinsey Institute for Research in Sex, Gender, and Reproduction, Morrison Hall 313, Bloomington, IN 47405, USA.
authors.forename: Erick
authors.initials: E
authors.lastname: Janssen