Academic journal article American Journal of Health Education

'Do You Know What You're Doing?' College Students' Experiences with Male Condoms

Academic journal article American Journal of Health Education

'Do You Know What You're Doing?' College Students' Experiences with Male Condoms

Article excerpt

ABSTRACT

Background: Although quantitative assessment of male condom use errors and problems has received increased research attention, few studies have qualitatively examined this sexual health behavior. Purpose: This study examined problems of male condom use as experienced by college men and women at a large, public Midwestern university. Methods: Single-sex focus groups were conducted, two involving men (n=9, n=9) and two involving women (n=7 n=13 ). Eight research questions guided the discussion. Results: Six categories of problems and errors were identified: availability and provision of condoms, condom application, "fit and feel" of condom use, erection problems, incomplete use, and breakage and slippage. Participants expressed concerns, including mistrust of each gender for supplying and applying condoms, inadequate lubrication during condom use, condoms partially or fully slipping off, "losing" part or all of the condom in the vagina, delayed application, and reduced sensation and irritation. Some men expressed concern that vigorous sex might cause condom breakage, while some women indicated the;, did not like the smell of condoms. Discussion: Both male and female students expressed numerous concerns and issues related to condom use. Translation to Health Education Practice: Greater attention to correct condom use as well as the sexual relationship dynamics related to condom use is needed in college health education programming.

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Quantifying user errors and problems is an important emphasis of research on male condom use. (1) Indeed, several studies have assessed the frequency of user errors and problems among young adults. (1-8) Collectively, these studies strongly suggest that condom use errors and problems are highly prevalent among young adults.

The initial value of research investigating the prevalence of condom use errors and problems was to address analytic discrepancies between measures of self-reported condom use and the presence or absence of sexually transmitted infections (STIs). (4,9-11) The prevalence of errors and problems can also provide justification for prevention education designed to promote the correct use of condoms. However, the current evidence cannot fully guide the development of this education because it lacks qualitative insight into the occurrence of such problems.

Several types of user errors clearly warrant greater understanding gained through qualitative investigation. For example, one common error involves placing a condom on the penis wrong side up. (8,12) Whether this is a consequence of inadequate condom use education, deficient application skills, or other factors warrants investigation. Studies have also shown that couples often apply condoms after sex has begun or that they remove condoms before sex ends. (8,11-14) Problems such as dryness, inappropriate size, discomfort, slippage, and condom-associated erection loss have also been identified as prevalent, (3-8,11,12,15-19) yet the contextual and relational reasons for the occurrence of these problems is not adequately understood.

Qualitative approaches to the investigation of condom use errors and problems could be beneficial for several reasons. First, it could reveal what difficulties young adults may experience using condoms. Clearly, such difficulties may become substantial barriers to the consistent use of condoms among young adults. Understanding the dynamics of these difficulties could then be useful in the construction of education programs designed to protect young adults from STIs and unplanned pregnancy. Second, the contextual background (including arousal states and sexual scripts) is an important but understudied aspect of condom use errors and problems. Understanding the context may contribute to an improved understanding that, in turn, can lead to improved educational programs. Finally, a more in-depth understanding can greatly improve the validity of survey instruments designed to assess the scope and degree of condom user errors and problems that might occur among young adults. …

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