4 specific reasons why condoms--even those of high quality--break have been identified following a series of studies in 8 countries among 1700 people. According to the studies, breakage falls into 4 general categories: incorrect methods of putting on condoms, use of oil-based lubricants, reuse of condoms, and duration or intensity of coitus. The studies, conducted by Family Health International, a North Carolina based contraceptive research and AIDS prevention organization, was the 1st large scale effort to examine condom breakage. Used properly and consistently, condoms are considered to be highly reliable for prevention of pregnancy and sexually transmitted diseases. An estimated 40 million couples worldwide currently use condoms for pregnancy prevention. The studies found that human factors caused condoms to break at rates that ranged up to 13%, with a 4-5% average breakage rate reported at most sites. Preliminary research data indicate that the vast majority of condom users very seldom experienced condom failure. Past condom "failure," as defined by the number of accidental pregnancies among US couples who used condoms for contraception, was estimated at 12% (12 of 100 couples using condoms for 1 year will experience a pregnancy). But the 12% failure rate was attributable primarily to nonuse or inconsistent use of condoms, not breakage. "W now have some guideposts as to what types of behavior lead to breakage," said Dr. Nancy Williamson, director of Family Health International's program evaluation division, which directed the studies. "We need to inform condom users and providers about which errors users make." The studies provide an important cross-cultural data base on condom use. "The causes of condom breakage were usually associated with individual behavior, not with culturally based practices," said Dr. Williamson. the 8 countries where the studies were conducted are: Ghana, Kenya, Mali, Sri Lanka, the Dominican Republic, Jamaica and Mexico.