Condom Breakage and Slippage Rates Among Study Participants in Eight Countries

Abstract

Family Health International staff used data from six studies (5711 condoms used by 1758 couples during vaginal intercourse at 13 sites) in the Dominican Republic Ghana Kenya Mali Mexico Nepal Sri Lanka and the US to examine slippage breakage and total failure rates. The 52-mm lubricated latex condoms were all manufactured by the same US company and came from six different manufacturing lots all of which passed the tensile test of the American Society for Testing and Materials and the airburst test of the International Standards Organization. Most couples (75-100%) at seven of the nine sites where marital status data were collected were married or living in union with their partner. Only 39% of those in the Dominican Republic and 46% of those in Mali were married or living in union with their partner. Breakage rates ranged from 0.6% in Sri Lanka to 13.3% in Ghana. At 11 sites breakage rates were less than 5%. Qualitative research identified four types of behavior associated with condom breakage: incorrect method of putting on the condom use of oil-based lubricants reuse of condoms and the duration and intensity of intercourse. Slippage rates ranged from 0 in Ghana to 9.3% in Kenya. About 66% of condom breaks occurred during intercourse or removal. 47% of the condoms that broke were broken at the tip or the closed end. 26% broke along the shaft. 27% broke near the open end. A secondary analysis conducted as part of one of the US studies revealed that a small portion of condom users comprise a disproportionate of condom failures. The factors linked to condom breakage were: couples with no condom experience in the last 12 months couples who did not live together at least one condom broke in the last year and couples with no more than 12 years of education. These findings suggest that most condom users use condoms correctly and therefore condoms protect them from pregnancy and sexually transmitted diseases.