A study based on a convenience sample of 177 couples who each used 11 condoms found that 103 condoms (5.3%) broke before or during intercourse and 67 condoms (3.5%) slipped off during sex. Couples who had not used a condom in the past year were almost twice as likely to experience condom failure as were couples who had used at least one during that period (p < .001). Of the couples who had used a condom in the previous year, the failure rate among those who reported at least one condom break during that period was more than twice the failure rate among those who reported no breaks (p < .001). Among couples who had used condoms in the past year without breaking any, those who did not live with their partner and those who had a high school education or less were at increased risk of condom failure (adjusted odds ratios of 3.2 and 2.7, respectively).
PIP: Condoms, when in good physical condition and used properly, protect against the transmission of HIV and other sexually transmitted diseases. When condoms break or slip off during intercourse or withdrawal, however, their effectiveness is seriously compromised. Studies have found breakage rates in the range of 1-12%. This paper explores possible explanations for this wide range of breakage rates seen in the literature and tries to provide a basis for identifying condom users who are at increased risk of breaking condoms. The analysis is conducted upon a subset of data from a study conducted by Family Health International to assess the value of laboratory tests in predicting condom breakage. 177 couples of median age 30 years and with a median education of 15 years each used 11 condoms, for a total of 1947 condoms. 84% of the sample were Caucasian and 84% were either married or living together. 103 (5.3%) condoms broke before or during intercourse and 67 (3.5%) slipped off during intercourse. The study found a small group of users responsible for a disproportionate number of condom failures. Specifically, couples with no condom experience in the previous year, couples who had experienced condom breakage over that period, couples who were not living together, and couples in which the male partner had a high school education or less experienced comparatively higher rates of condom failure. Qualitative data suggest that incorrect methods of putting on condoms, use of oil-based lubricants, reuse of condoms, and duration and intensity of coitus may explain why higher rates of condom failure are found among couples in less stable relationships and couples who are less educated.