Adding lubricant to condoms during vaginal intercourse: An event level analysis

Background: While public health professionals routinely recommend the addition of lubricant to condoms during sexual activity, virtually no research has assessed the characteristics of sexual situations during which such recommendations are followed.

Methods: During their enrollment in a prospective daily diary study, 1,834 men provided data about the extent to which lubricant was added to condoms during 8,876 vaginal intercourse events. Analyses included generalized estimating equation logistic regression in SUDAAN with all effects significant at p<.05.

Results: Of 8,876 coital events, 46.8% were protected with a latex condom and 24.7% involved the addition of lubricant. Most frequently, lubricant was added to the external tip of the condom after penile application (22.5%), directly in or around the partner's vagina (16.2%), and to both the condom and vagina (16.2%). The addition of lubricant to condoms was more likely during intercourse with a spouse than with a non-committed partner (OR = 1.53), during intercourse events of longer duration (OR = 1.12), when a female partner applied the condom to their penis (OR = 1.29), and when a female partner used Nuva Ring (OR=3.56), IUD (OR=2.81) or spermicidal jelly/foam (OR=4.31) as a method of contraception.

Conclusions: These findings offer unique event-level insights into the situational factors that influence when men and their female partners add lubricants to condoms. An understanding of these factors can be beneficial to those who implement programs that seek to encourage the use of products that may simultaneously improve health outcomes and enhance the sexual experience.