Abstract
Objective: To evaluate the acceptability (comfort, ease of use, lubrication, and pleasure) of internal and external condom use in stable couples. Metodology: This randomized cross-over trial included 54 couples (108 adult individuals). Participants were asked to evaluate acceptability measures of both types of condoms using the Visual Analogue Scale. We developed a three-level hierarchical model [level 1= three repeated measures (wave, type of condom); level 2= individual (gender, age); level 3= couple (sequence of presentation of female versus external condom)]. Results: The "ease of use" dimension represented the biggest difference between the types of condoms for men (Hedges 'g = 0.96; p <0.0001) and women (Hedges' g = 1.62; p <0.0001). Regardless of gender, external condoms performed better (1.61; 95% HPD = 1.41 – 1.81). Men gave lower scores in general (-0.62; 95% HPD = -1.16 − -0.10). Conclusion: The external condom scored better than the internal condom for women and their male partners. The scores tended to improve with the repetitive use of the condom. There is no evidence of the influence of the age of the individuals or the randomly selected sequence of use of condoms with regards to the mean score of the four dimensions.
Highlights
Researchers have focused efforts on increasing condom use for HIV/AIDS prevention
In spite of the importance of condom acceptability and performance for consistent use, currently existing scales have had mostly behavioral approaches, such as Condom Uses Self Efficacy Scale (CUSES), by Brafford and Beck (1991), validated in Ghana (Asante & Doku, 2010); Condom Self Scale (CSE), the same instrument validated in Brazil (Sousa et al, 2017); Attitude Toward Condoms Scale (ATC), by Brown (1984); Condom Attitude Scale (CAS) by Sacco, Levine, Reed, and Thompson (1991); Sexual Attitude Scale (SAS) by Alferes (1999); Multi-factor Attitude Toward Condoms (MFACS), by Hollub, Reece, Herbenick, Hensel, and Middlestadt (2011); Sexual Sensation Suking Scale (SSSS) evaluated by Kalichman and Rompa (1995), and validated in Spain (Iglesias, Moyano, Castro, Granados, & Sierra, 2018)
During the 3-month recruitment period, 120 eligible individuals agreed to participate at the beginning of the study
Summary
Researchers have focused efforts on increasing condom use for HIV/AIDS prevention. Proper and consistent condom use remains the most effective way to reduce sexually transmitted infections (STI), including HIV/AIDS and unplanned pregnancies This method depends on the acceptability of the device, and the couple’s willingness and acceptability to use it in all sexual relations (Sanders, Hill, Crosby, & Janssen, 2014; Jones, Tiwari, Salazar, Crosby, 2018; Shen et al, 2019). The objectives of this research are to evaluate the acceptability of internal and external condom use in steady couples; compare the acceptability of the external condom with the internal condom and assess differences in perception according to sex We quantitatively evaluated both devices in four dimensions (comfort, ease of use, lubrication, and pleasure) as well as by making predictions of the average mean score of such dimensions
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