208514 Factors associated with condom breakage/slippage or partial use during vaginal sex with main partners

Monday, November 9, 2009: 11:30 AM

Laura Hoyt D'Anna, DrPH , Center for Health Care Innovation, California State University, Long Beach, Long Beach, CA
Elisabeth McIlvaine, BS , Center for Health Care Innovation, California State University, Long Beach, Long Beach, CA
Olga Korosteleva, PhD , Department of Mathematics and Statistics, California State University, Long Beach, Long Beach, CA
Lee Warner, PhD , Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA
John Douglas, MD , Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Carol Metcalf, MB, ChB , Human Sciences Research Council, Cape Town, South Africa
Sindy M. Paul, MD, MPH , New Jersey Department of Health and Senior Services, Trenton, NJ
Kevin Malotte, DrPH , Center for Health Care Innovation, California State University, Long Beach, Long Beach, CA
OBJECTIVES: Examine how characteristics of heterosexual main sexual partnerships affect the odds of experiencing condom breakage/slippage or partial use (applying late/removing early) during vaginal sex.

METHODS: Secondary analysis of data from an STI prevention trial (RESPECT-2) conducted in 3 public STD clinics. Participants described sexual behaviors, personal and partner characteristics for up to three partners on computer-assisted interviews every 3 months for a year. We analyzed rates of condom breakage/slippage and partial use. Logistic GEE models were used to account for within-participant correlation of repeated measures.

RESULTS: 2758 participants reported vaginal sex in the prior 3 months in at least one interview (8807 partnerships). Condoms were used in 4557 partnerships; 22% reported breakage/slippage and 26% reported partial use. The odds for both condom problems increased by 1% with each use (p<.05). Breakage/slippage was more likely in partnerships when the respondent was drunk/high (OR=1.55, p=<.001), had perceived partner STI risk (OR=1.48, p=<.001), or had a partner < 21 years (OR=1.30, p=.007). Partial use was more likely in partnerships when the respondent was drunk/high (OR=1.70, p<.001), or had perceived partner STI risk (OR=1.21, p=.008). Participant gender, length of relationship and partner's age approached significance.

CONCLUSIONS: The unexpected relationship between perceived partner STI risk and partial use suggests that condoms are used for reasons other than STI/HIV prevention even in high risk partnerships. STI/HIV prevention interventions should address sexual health risks associated with substance use and other relationship factors such as relationship length and partner's age that may influence effective condom use.

Learning Objectives:
1. Differentiate between types of condom use problems. 2. Describe sexual partnership characteristics associated with distinct condom use problems. 3. Identify areas of focus for future STI/HIV prevention interventions.

Keywords: Condom Use, HIV Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a senior research fellow for CSULB, with over 15 years experience developing and evaluating HIV/STI prevention programs and research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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