Condoms can't prevent unwanted pregnancy and sexually transmitted disease if they're used incorrectly. Unfortunately, a new review of research finds that condom use errors are all too common.
Some of the most frequent mistakes include putting a condom on partway through intercourse or taking it off before intercourse is over, failing to leave space at the tip of the condom for semen, and failing to look for damage before use. These errors can contribute to breakage or leakage, researchers reported Feb. 17 in the journal Sexual Health.
"We chronically underestimate how complicated condom use can be," University of Kentucky professor Richard Crosby, who co-authored the study, said in a statement. "It involves the use of a condom, while negotiating the condom use and sex with a partner all at the same time."
With perfect use, condoms prevent pregnancy with 98 percent success, according to the World Health Organization. Typically, however, the rate of unintended pregnancy with condoms is around 15 percent. [The History & Future of Birth Control]
Led by Stephanie Sanders of The Kinsey Institute for Research in Sex, Gender, and Reproduction at Indiana University, the researchers pulled together 16 years of research on condom errors and failures going back to 1995. They found 50 studies from 14 countries, though western nations such as the United States and the United Kingdom predominated. The studies involved diverse groups of participants, from married individuals to sex workers to college students; as such, there were a range of condom use-error rates.
An analysis of all 50 studies found a laundry list of reported errors in condom use. For example, between 17 percent and 51.1 percent of people queried in the studies said they'd put on a condom partway through intercourse — negating any disease-controlling benefits, since fluids are exchanged throughout intercourse not just during ejaculation. Other studies found that between 1.5 percent and 24.8 percent of sexual experiences involved putting a condom on too late in the process of intercourse. [Sidebar: 14 Common Condom Errors]
The research also turned up multiple mistakes in how people put condoms on. Up to 25.3 percent said they unrolled the condom's sheath before putting on the condom, rather than unrolling the condom on the penis. Between a quarter and almost half of respondents said they'd failed to leave room at the tip of the condom for semen to collect. About 75 percent of men and 82 percent of women failed to check condoms for damage before using them.
Between 0.8 percent and 40.7 percent of participants had experienced a condom break, and between 13.1 percent and 19.3 percent had one leak, depending on the study. Improper condom use, including the wrong kind of lubricant or storage, can contribute to these problems. For instance, oil-based lubricants will degrade latex condoms.
"Closing the gap between perfect use and the errors characterizing typical use is one of the most crucial challenges of future condom promotion programs," the researchers wrote.