title: A Daily Diary Analysis of Condom Breakage and Slippage During Vaginal Sex or Anal Sex Among Adolescent Women.
abstract: Adolescent women are disproportionately impacted by the adverse outcomes associated with sexual activity, including sexually transmitted infections (STI). Condoms as a means of prevention relies on use that is free of usage failure, including breakage and/or slippage. This study examined the daily prevalence of and predictors of condom breakage and/or slippage during vaginal sex and during anal sex among adolescent women.
  
  
  
  Adolescent women (N = 387; 14 to 17 years) were recruited from primary care clinics for a longitudinal cohort study of STIs and sexual behavior. Data were daily partner-specific sexual diaries. Random intercept mixed-effects logistic regression was used to estimate the fixed effect of each predictor on condom breakage/slippage during vaginal or during anal sex (Stata, 13.0), adjusting model coefficients for the correlation between repeated within-participant diary entries.
  
  
  
  Condom slippage and/or breakage varied across sexual behaviors and was associated with individual-specific (eg, age and sexual interest) and partner-specific factors (eg, negativity). Recent behavioral factors (eg, experiencing slippage and/or breakage in the past week) were the strongest predictors of current condom slippage and/or breakage during vaginal or anal sex.
  
  
  
  Factors associated with young women's condom breakage/slippage during vaginal or during anal sex should be integrated as part of STI prevention efforts and should be assessed as part of ongoing routine clinical care.
authors: From the *Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine; †Department of Sociology, Indiana University Purdue University-Indianapolis, Indianapolis, IN; and ‡Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC.
authors: Devon J
authors: DJ
authors: Hensel
authors: Sarah
authors: S
authors: Selby
authors: Amanda E
authors: AE
authors: Tanner
authors: J Dennis
authors: JD
authors: Fortenberry
mesh_terms: D000293:Adolescent; D017280:Condoms / Q000009:adverse effects* / Q000706:statistics & numerical data; D004868:Equipment Failure / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008499:Medical Records; D012725:Sexual Behavior; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D014621:Vagina