This article is from the AIDS FAQ, by Dan Greening with numerous contributions by others.
Source: Michael Howe <email@example.com>, AIDS News Service, VAMC
Condom Failure Rates
(Arranged Chronologically - Reverse Order)
AU - Park JS ; Kim CK
TI - The effective prevention of HIV by female condom (Femidom).
AB - As part of a widely implemented prevention strategy, condom
use exemplifies the empowerment of individuals and interaction
between people who want to protect themselves and others against
HIV infection. The serious consequences of condom failure has
placed added emphasis on condom quality. Correct condom use can be
learned and practiced with the result being more condom use with
less breakage. The newest female barrier, Female Condom (Femidom)
could protect against HIV transmission. Female Condom is a
lubricated polyurethane bags with a soft ring. As sexually
transmitted diseases are a high risk factors in HIV transmission,
then the use of Female Condom has an obvious indirect value in HIV
control. Comparative studies have been initiated whether female
condom will be as good as better than male condom in directly
ffecting HIV transmission. Female Condom is a choice for HIV
prevention as well as a useful method of contraception.
SO - Int Conf AIDS. 1994 Aug 7-12;10(2):288 (abstract no. PC0531).
AU - Thompson JL ; Yager TJ ; Martin JL
TI - Estimated condom failure and frequency of condom use among
AB - OBJECTIVES. Condoms are designed to bar transmission of the
human immunodeficiency virus (HIV), but they sometimes fail. This
paper explores the effect of experience with condoms on condom
failure among gay men. METHODS. Risk of condom failure (breakage
or slippage) on a single occasion is estimated for four sexual acts
reported over 12 months by a sample of gay New York City men (n =
741). The estimation procedure assumes that each episode in which
a condom is used is an independent event. Evidence is offered to
support this assumption. RESULTS. Risk of condom failure in a
single episode was fairly high, particularly in anal intercourse,
for men who had engaged in each act only a few times in the
previous year. It declined rapidly with experience (e.g., to below
1% for receptive anal intercourse after about 10 episodes in the
previous year). Condoms failed less often in oral than anal sex,
but estimated risk of failure also decreased with experience.
CONCLUSIONS. Gay men should be especially cautious the first few
times they use a condom; after moderate experience, however, they
may expect a low risk of condom failure.
SO - Am J Public Health. 1993 Oct;83(10):1409-13.
AU - Joffe A
TI - Adolescents and condom use.
AB - Increasing condom use among adolescents is an essential
component of a public health strategy aimed at decreasing rates
of sexually transmitted infections and the spread of human
immunodeficiency virus infection. This article reviews current data
about the contraceptive and prophylactic characteristics of
condoms. Data about current levels of use among adolescents and
factors demonstrated to affect such use are also summarized. Except
where data are scanty or nonexistent, the research studies are
limited to those focusing primarily on adolescents and,
occasionally, college students. Based on these data, suggestions
for increasing condom use among adolescents are presented.
SO - Am J Dis Child. 1993 Jul;147(7):746-54.
AU - Weller SC
TI - A meta-analysis of condom effectiveness in reducing sexually
transmitted HIV [see comments]
AB - Before condoms can be considered as a prophylaxis for
sexually transmitted human immunodeficiency virus (HIV), their
efficacy must be considered. This paper reviews evidence on condom
effectiveness in reducing the risk of heterosexually transmitted
human HIV. A meta-analysis conducted on data from in vivo studies
of HIV discordant sexual partners is used to estimate the
protective effect of condoms. Although contraceptive research
indicates that condoms are 87% effective in preventing pregnancy,
results of HIV transmission studies indicate that condoms may
reduce risk of HIV infection by approximately 69%. Thus, efficacy
may be much lower than commonly assumed, although results should
be viewed tentatively due to design limitations in the original
SO - Soc Sci Med. 1993 Jun;36(12):1635-44.
AU - de Wit JB ; Sandfort TG ; de Vroome EM ; van Griensven GJ ;
TI - The effectiveness of condom use among homosexual men [letter]
SO - AIDS. 1993 May;7(5):751-2.
AU - Richters J ; Donovan B ; Gerofi J
TI - How often do condoms break or slip off in use?
AB - Men attending 3 sexually transmissible disease clinics and
a university health service in Sydney were given a questionnaire
asking how many condoms they had used in the past year and how many
broke during application or use or slipped off. Respondents were
544 men aged 18 to 54 years. Of these, 402 men reported using
13,691 condoms for vaginal or anal intercourse; 7.3% reportedly
broke during application or use and 4.4% slipped off. Men having
sex with men reported slightly higher slippage rates than those
having sex with women. Breakage and slippage were unevenly
distributed among the sample: a few men experienced very high
failure rates. A volunteer subsample reported 3 months later on
condoms supplied to them: 36 men used 529 condoms, of which 2.8%
broke during application or use and 3.4% slipped off. Many of these
failures pose no risk to the user, especially those occurring
during application, as long as they are noticed at the time, but
failure may discourage future use. Research is needed to identify
user behaviours related to breakage.
SO - Int J STD AIDS. 1993 Mar-Apr;4(2):90-4.
TI - HIV infection in European female sex workers: epidemiological
link with use of petroleum-based lubricants. European Working Group
on HIV Infection in Female Prostitutes.
AB - OBJECTIVES: To assess the prevalence of and risk factors
associated with HIV infection in European female sex workers,
particularly sexual risk factors. DESIGN: Multicentre
cross-sectional study performed in nine European countries.
METHODS: Female sex workers voluntarily enrolled between September
1990 and November 1991. Face-to-face interviews were conducted in
various settings (health care, prostitute organizations, outreach)
to collect information on over 150 behavioural, health and
sociodemographic variables. Enrollment of intravenous drug users
(IVDU) was limited to a maximum of 25% of the total sample. The
HIV-1 and HIV-2 antibody status of blood or saliva samples was
tested using enzyme-linked immunosorbent assay and confirmed by
Western blot. RESULTS: Eight hundred and sixty-six (91.6%) of the
945 interviewees provided blood (n = 824) or saliva (n = 42)
samples. HIV seroprevalence was 5.3% [44 HIV-1-positives and two
HIV-2-positives (from Lisbon)] overall, 31.8% (35 out of 110) in
IVDU and 1.5% (11 out of 756) in non-IVDU [odds ratio (OR), 31.6;
P < 0.001]. Lack of condom use (P = 0.002, test for trend) and
previous ulcerative sexually transmitted disease (OR, 3.6; P =
0.06) were associated (on logistic regression) with HIV infection
in both IVDU and non-IVDU. Previous hepatitis B (OR, 13.8; P =
0.02) and needle-sharing (OR, 4.1; P = 0.04) were associated with
HIV infection in IVDU, and low education level (P = 0.02, test for
trend), previous transfusion (OR, 9.1; P = 0.003), origin from
sub-Saharan Africa (OR, 5.4; P = 0.05) and use of petroleum-based
lubricants (OR, 15.2; P = 0.001) in non-IVDU. CONCLUSIONS: HIV
prevalence remains relatively low among non-IVDU prostitutes in
Europe. While intravenous drug use remains the most important risk
factor for HIV, petroleum-based lubricants (used by 10% of women
in this study) may be a risk factor for HIV among European female
sex workers; over 80% of those interviewed always used condoms with
SO - AIDS. 1993 Mar;7(3):401-8.
AU - de Graaf R ; Vanwesenbeeck I ; van Zessen G ; Straver CJ ;
TI - The effectiveness of condom use in heterosexual prostitution
in The Netherlands.
AB - OBJECTIVES: To assess the extent to which condoms are used
effectively in commercial heterosexual intercourse. Data on the
number of condoms that had broken or slipped off, the sexual
technique during which this had occurred and the perceived cause
of failure were collected. The use of non-water-soluble lubricants
and non-fortified condoms during anal intercourse, and the demand
for a greater variety of condom sizes were also examined. SUBJECTS
AND METHODS: One hundred and twenty-seven female prostitutes and
91 male clients from different parts of The Netherlands were
interviewed face-to-face between July 1990 and March 1991. RESULTS:
Of those who used condoms during vaginal intercourse, 49% of the
prostitutes had experienced condom breakage in the previous 6
months, and 16% of the clients in the previous 12 months. The
breakage rate was 0.8% for prostitutes and 1.5% for clients. Condom
quality was seldom reported as the cause; breakage was generally
attributed to human factors, such as rough or prolonged
intercourse, incorrect handling of the condom or the use of
insufficient lubricant. Prostitutes also identified penis size as
a cause. Condoms slipping off before or after ejaculation was
reported less frequently than breakage. Thirteen per cent of
clients and 36% of prostitutes expressed a need for either smaller
or larger condoms. Of the prostitutes, 9% used oil or vaseline as
a lubricant. CONCLUSIONS: In view of the low rate of condom failure
in heterosexual prostitution in The Netherlands, the potential
spread of HIV by this means is small. The use of a greater variety
of condom sizes may further reduce the failure rate. Few
prostitutes remain ignorant about the adverse effects of oil-based
lubricants on condoms.
SO - AIDS. 1993 Feb;7(2):265-9.