Condom, Erection-loss Study Identifies Possible Path to Risky Behavior

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The loss of an erection during sex is more than disheartening. If associated with condom use, it can contribute to risky sexual behavior that could potentially harm both partners by exposing them to sexually transmitted infections.

Researchers at Indiana University’s Kinsey Institute for Research in Sex, Gender and Reproduction found that men who reported erection loss in association with condom use also reported more unprotected intercourse with women and were less likely to use condoms consistently compared with men without condom-associated erection loss.

Nearly 40 percent of their study participants—male patients at an STD clinic—reported condom-associated erection loss at least once in the previous three months.

"Condom use is one of the most important behaviors that can reduce the spread of sexually transmitted infections,” said Cynthia Graham, a research tutor on the Oxford Doctoral Course in Clinical Psychology and an associate research fellow at the Kinsey Institute. “This study has highlighted a difficulty—loss of erection while using condoms—that may make men more reluctant to use condoms. The findings have important implications for education and counseling efforts.”

The study, which will appear in the upcoming November issue of Sexual Health, is part of an ongoing line of research at the Kinsey Institute into condom errors and problems, and is the first to evaluate erection problems associated with condom use.

Men were almost three times more likely to report erection loss if they were less confident about how to use condoms correctly, signaling the need for education on condom application. Men reporting problems with the “fit or feel” of condoms were about 2.2 times more likely to report erection loss compared with men not having these problems. The study authors suggest counseling and educational programs could make available a broader selection of condoms in terms of size and shape, as well as a selection of water-based lubricants.

Men who reported having sex with three or more partners in the past three months were almost twice as likely to report erection loss compared with men having fewer partners. These findings underline the importance of encouraging men to discuss condom use with new lovers.

The study involved 278 men ages 18 to 35 who visited an urban STD clinic in the Midwest between October 2004 and September 2005. The men all reported using a condom at least three times in the previous three months during intercourse with a woman. The men were asked about whether they had lost an erection during the sexual encounters and, if so, when it occurred (when the condom was put on or after sex had begun). The questionnaire also obtained information about whether condoms were removed during sex or not used at all and asked about possible problems, such as slippage or breakage and the ease in using them correctly.

Other key findings include:

* Nearly three in 10 men (28.1 percent) reported that they had lost their erection while putting on a condom. This occurred once during the last three times they used a condom.
* 13.4 percent reported they lost their erection once while using a condom during intercourse; 9.4 percent reported that this happened twice, and 3.6 percent reported that it happened all three times.
* 17.3 percent reported losing an erection both while applying the condom and during sex.
* Condoms were removed prematurely on at least one of the past three occasions by 40.8 percent of the men reporting erection loss, compared with 21.3 percent of men not reporting this problem.
* Erection loss was more likely among men who reported at least one condom breakage (47.1 percent) compared with men not reporting breakage (32.5 percent).

The study coauthors are Richard Crosby, co-director of the IU-based Rural Center for AIDS/STD Prevention and professor at the College of Public Health at the University of Kentucky; William L. Yarber, a fellow of the Kinsey Institute for Research in Sex, Gender and Reproduction, senior director of RCAP and professor in IU Bloomington’s Department of Applied Health Science and Department of Gender Studies; Stephanie A. Sanders, associate director of the Kinsey Institute, research fellow of RCAP and professor in the Department of Gender Studies; Kimberly McBride, a graduate student and researcher at the Kinsey Institute and Department of Applied Health Science; Robin R. Milhausen, assistant professor at the Social Justice and Sexual Health Research Lab, Department of Sociology and Anthropology, University of Windsor, Canada; and Janet N. Arno, affiliate of RCAP, associate professor at the Department of Infectious Diseases, IU School of Medicine, and co-director of RCAP.

The research was supported in part by the RCAP, which is a joint project of IU, the University of Colorado and the University of Kentucky, and by IU Bloomington’s School of Health, Physical Education and Recreation.

“Erection loss in association with condom use among young men attending a public STI clinic: potential correlates and implications for risk behaviour,” Sexual Health, 2006; 3(4).

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