Perceptions of condom fit and feel and relations with condom use among men living with HIV

BACKGROUND: Among reasons that men have given for their lack of condom use is their perception that condoms do not fit properly or feel comfortable. While these perceptions have been documented in the literature, they have not been assessed among men living with HIV.

METHODS: Data from 215 men living with HIV were collected during their appointments at HIV care organizations. Participants completed the Condom Fit and Feel Scale and measures related to demographics and condom use during recent sexual behaviors (past 90 days).

RESULTS: Most men were African American (70%) and identified as gay (59%). Over one-third (37%) were also living with AIDS. Most reported that condoms fit fine (63%) yet significant proportions described condoms as being too tight (30%) or too short (24%). Additionally, 26% described condoms as too long and 19% as too loose. Associations were detected between men's perceptions of condom fit and their likelihood of reporting unprotected anal, but not vaginal, intercourse, with men believing that condoms were too loose more likely to report unprotected anal intercourse with women (p < .05) and men describing condoms as too tight more likely to report the same behavior with men (p < .05).

CONCLUSIONS: Given opportunities for incorporating HIV prevention interventions across the HIV care continuum, the Condom Fit and Feel Scale may be a valuable tool for helping providers initiate conversations with men about their resistance to condoms to subsequently help them to select from condoms on the market that they may perceive as better fitting or more comfortable.