Study: Condoms often misused, increasing STI risk

Research shows that even sexually experienced condom users often don't use the contraceptive properly, resulting in an elevated risk of sexually transmitted infections (STIs).

The results are based on the condom use behaviours of more than 1,100 men and women who were treated at an STI clinic in the United States.

Researchers found a prevalence of erroneous use and breakage of the condom, frequently leading to a heightened risk of gonorrhea in men.

"The overall findings indicate that a considerable proportion of individuals seeking care at this STI clinic reported incorrect condom use ... potentially contributing to lower condom efficacy for protection against STIs, as well as unintended pregnancy," write Diane Grimley and colleagues in the study, published in the American Journal of Health Behavior.

Among the study participants, more than 15% tested positive for gonorrhea, chlamydia, or both of these STIs. Moreover, almost a quarter of the participants indicated they had made errors in using a condom during the last month.

Common mistakes included putting on the condom inside out and then flipping it over to have sex, not leaving a space at the tip of the condom, not holding the base during withdrawal, reusing a condom, and starting to have sex and then putting on the condom during intercourse. Among men, condom breakage was the only condom error to be associated with gonorrhea infections. Researchers speculate that this association was not seen with chlamydial infections because "gonorrhea is a more highly infectious pathogen."

Although the participants were considerably sexually active, with three quarters of them having six or more partners, more than half of them did not report using a condom during their last sexual encounter. "The importance of proper condom use seems obvious, yet the results from this study demonstrate it must be taught even to sexually experienced individuals and that the lack of correct use can be linked to infection," the researchers conclude.

The authors emphasized that these findings demonstrate the importance of safe and proper condom use and the need to educate people about it. Behavioral interventions that promote consistent condom use must provide the necessary skills associated with proper condom use," the study adds.