Decreased condom breakage and slippage rates after counseling men at a sexually transmitted infection clinic in Jamaica

Abstract

Purpose Our objective was to evaluate condom failure (breakage and slippage) rates before and those during a trial that provided instructions on correct condom use. Method Our analysis was based on 314 men who presented with urethral discharge at Jamaica's largest sexually transmitted infection clinic and were enrolled into our 6-month trial. Results Participants reported breaking 18.5% (95% confidence interval=12.8–24.1%) of their condoms during the 7 days prior to the screening visit and having 3.5% (95% confidence interval=1.2–5.7%) of their condoms slip off completely. After the condom counseling provided during the screening visit, breakage rates decreased (p<.05) and remained below 10% throughout the trial. During in-depth interviews, the men who reported frequent condom failures cited (1) improper storage/exposure to heat, (2) improper handling while putting on condoms and (3) use of lubricants/improper lubricants as the possible reasons for their high failure rates. Conclusion Although the rates of reported condom breakage and slippage decreased significantly after counseling, we need to improve the quality of condom counseling to further reduce failure rates.