Condoms are one of the oldest form of contraceptive and the best recognized form of protection against sexually transmitted diseases. Their use, however, is limited by both behavioral factors and device-related factors, including complaints about decreased sensitivity and sexual enjoyment. To address these limitations, a male condom made of polyurethane was developed. Polyurethane is a strong impermeable material with good heat transfer characteristics that is less susceptible to deterioration during storage than latex. Because little information is available comparing polyurethane and latex condoms in terms of consumer preferences as well as breakage and slippage, we reviewed four pre-marketing studies of polyurethane condoms, one of which included comparison to latex. No significant differences in slippage and breakage rates between latex and polyurethane condoms were reported in the study that included a latex comparator, and other studies of polyurethane condoms alone resulted in rates in the same range as published for latex condoms. Subjectively, consumers expressed significantly greater preference for the polyurethane condom over latex in regard to appearance, lack of smell, likelihood of slippage, comfort, sensitivity, natural look, natural feel, and overall. While additional testing is needed, these preliminary results suggest that the male polyurethane condom reviewed performed at least as well as latex condoms and is preferred by consumers. If preference translates to greater use, the male polyurethane condom may address important barriers that have been linked with inadequate condom use in the past. These results, however, may not be generalizable to other brands of polyurethane condom currently under development.
PIP: A literature review of four pre-marketing studies of the Avanti male polyurethane condom was conducted to compare consumer preferences, breakage, and slippage of polyurethane and latex condoms. The condom manufacturer, London International, recruited participants for these studies throughout the UK. In the only study that had two comparison groups, the polyurethane condom had the highest overall consumer reference rating (7.4 vs. 6.8; p = 0.002) and the lower breakage and slippage rates (0.9% vs. 2.1% and 0.4% vs. 1.1%, respectively). Slippage and breakage rates in the other three studies were similar to those in the literature for latex condoms. Consumers preferred the polyurethane condom to the latex condom because they perceived it as having a natural feel and look with no smell and enhanced sensitivity and comfort. The number of patients lost to follow-up was low for all four studies (no greater than 9%). The leading reason for not using any of the different condoms provided to study participants was lack of opportunity (56%). Additional research is needed, particularly studies with a comparison latex group. Clinical trials of the male polyurethane condom examining contraceptive efficacy, breakage, and slippage data are currently being conducted among 800 couples recruited in many centers. Nevertheless, the findings of the literature review suggest that the Avanti polyurethane condom perform at least as well as the latex condom and that consumers prefer the polyurethane condom. If preference increases use, the Avanti polyurethane condom may overcome barriers that have been associated with poor condom use in the past.