Crosby Richard, Diclemente Ralph J, Yarber William L, Snow Gregory, Troutman Adewale
College of Public Health at the University of Kentucky, Lexington, Kentucky 40506-0003, USA.
Sex Transm Dis. 2008 Feb;35(2):174-7. doi: 10.1097/OLQ.0b013e3181585bf5.
African American men are at high risk of human immunodeficiency virus acquisition. Condom breakage is an understudied aspect of their sexual protective behavior. This study identified user errors leading to condom breakage using an event-specific analysis among young African American men newly diagnosed with a sexually transmitted disease (STD).
Recruitment occurred in a publicly funded STD clinic located in a metropolitan area of the Southern United States. Of 296 African American men screened as eligible, 271 (91.5%) agreed to participate. Men completed a self-administered questionnaire. Men reporting condom use with men were excluded from the analysis, leaving an analytic sample of 264 men. The recall period was for the last time men used condoms for penile-vaginal sex (within the past 3 months).
More than one-fifth (21.2%) reported condom breakage. Each year of advancing age decreased the odds of breakage by 10% [adjusted odds ratio (AOR) = 0.90, 95% confidence interval (CI) = 0.81-0.99, P = 0.028]. Men who had used an oil-based lubricant were more than 3 times as likely to report breakage (AOR = 3.21, 95% CI = 1.48-7.00, P = 0.003) and those who completely unrolled the condom before putting it on were also about 3 times more likely to report breakage (AOR = 3.34, 95% CI = 1.76-6.50, P = 0.0001). The breakage rate for men indicating both errors, i.e., use of an oil-based lubricant and unrolling the condom before application, was 54.5% compared with 33.3% among those indicated either error, and 12.8% among those indicating neither error. Attributable risk for the 2 errors combined was 39%.
Condom breakage among this sample of men at high risk for human immunodeficiency virus infection was common. This problem could be mitigated by counseling men to avoid the use of oil-based lubricants and by teaching them basic condom application skills.
非裔美国男性感染人类免疫缺陷病毒的风险很高。避孕套破裂是其性保护行为中一个研究较少的方面。本研究通过对新诊断为性传播疾病（STD）的年轻非裔美国男性进行特定事件分析，确定了导致避孕套破裂的用户错误。
招募工作在美国南部大都市地区的一家公共资助的性病诊所进行。在296名经筛查符合条件的非裔美国男性中，271名（91.5%）同意参与。男性完成了一份自我管理的问卷。报告与男性使用避孕套的男性被排除在分析之外，留下264名男性的分析样本。回忆期为男性最后一次使用避孕套进行阴茎-阴道性交的时间（在过去3个月内）。
超过五分之一（21.2%）的人报告避孕套破裂。年龄每增加一岁，破裂几率降低10%[调整后的优势比（AOR）=0.90，95%置信区间（CI）=0.81-0.99，P=0.028]。使用油性润滑剂的男性报告破裂的可能性是未使用者的3倍多（AOR=3.21，95%CI=1.48-7.00，P=0.003），而那些在戴上避孕套之前将其完全展开的男性报告破裂的可能性也大约是未展开者的3倍（AOR=3.34，95%CI=1.76-6.50，P=0.0001）。同时出现两种错误（即使用油性润滑剂和在使用前展开避孕套）的男性破裂率为54.5%，相比之下，出现其中一种错误的男性为33.3%，两种错误都未出现的男性为12.8%。两种错误合并后的归因风险为39%。
在这个感染人类免疫缺陷病毒风险较高的男性样本中，避孕套破裂很常见。通过建议男性避免使用油性润滑剂并教授他们基本的避孕套使用技巧，可以缓解这个问题。
