title: Estimating the Prevalence and Predictors of Incorrect Condom Use Among Sexually Active Adults in Kenya: Results From a Nationally Representative Survey.
abstract: BACKGROUND
  Condom use continues to be an important primary prevention tool to reduce the acquisition and transmission of HIV and other sexually transmitted infections. However, incorrect use of condoms can reduce their effectiveness.
  
  
  METHODS
  Using data from a 2012 nationally representative cross-sectional household survey conducted in Kenya, we analyzed a subpopulation of sexually active adults and estimated the percent that used condoms incorrectly during sex, and the type of condom errors. We used multivariable logistic regression to determine variables to be independently associated with incorrect condom use.
  
  
  RESULTS
  Among 13,720 adolescents and adults, 8014 were sexually active in the previous 3 months (60.3%; 95% confidence interval [CI], 59.0-61.7). Among those who used a condom with a sex partner, 20% (95% CI, 17.4-22.6) experienced at least one instance of incorrect condom use in the previous 3 months. Of incorrect condom users, condom breakage or leakage was the most common error (52%; 95% CI, 44.5-59.6). Factors found to be associated with incorrect condom use were multiple sexual partnerships in the past 12 months (2 partners: adjusted odds ratio [aOR], 1.5; 95% CI, 1.0-2.0; P = 0.03; ≥3: aOR, 2.3; 95% CI, 1.5-3.5; P < 0.01) and reporting symptoms of a sexually transmitted infection (aOR, 2.8; 95% CI, 1.8-4.3; P < 0.01).
  
  
  CONCLUSIONS
  Incorrect condom use is frequent among sexually active Kenyans and this may translate into substantial HIV transmission. Further understanding of the dynamics of condom use and misuse, in the broader context of other prevention strategies, will aid program planners in the delivery of appropriate interventions aimed at limiting such errors.
authors.affiliation: From the *Global Health Sciences, University of California, San Francisco, San Francisco, CA; †Prevention Branch, DGHA, CDC-Kenya, Nairobi, Kenya; ‡National AIDS and STI Control Program, Nairobi, Kenya; and §Kenya Medical Research Institution, Nairobi, Kenya.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Grasso
authors.forename: Sandra
authors.initials: S
authors.lastname: Schwarcz
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Galbraith
authors.forename: Helgar
authors.initials: H
authors.lastname: Musyoki
authors.forename: Caroline
authors.initials: C
authors.lastname: Kambona
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Kellogg
mesh_terms: D000293:Adolescent; D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D021841:Safe Sex; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D055815:Young Adult