Condom Slippage and Breakage Rates.

A prospective study using two brands of condoms found that of 405 condoms used for intercourse, 7.9% either broke during intercourse or withdrawal or slipped off during intercourse; none of these events were related to condom brand, past condom use or use of additional lubricant. Of the remaining condoms, 7.2% slipped off during withdrawal; slippage was not related to condom brand or past use of condoms, but it was significantly higher when additional lubricant was used.

(Family Planning Perspectives, 24:20,1992)

Since the time that infection with the human immunodeficiency virus (HIV) was linked conclusively to sexual behavior, public education campaigns have stressed several behavioral messages. These messages point out that the only certain way to avoid sexually transmitted infection is to be celibate or to limit one's sexual activity to behaviors that do not involve the potential for exchange of body fluids. Although a mutually monogamous relationship with a partner who is not infected and who does not use intravenous drugs will also eliminate any risk, one can never be truly certain that one's partner neither uses intravenous drugs nor participates in risky sexual activity. For those who do not wish to remain celibate or cannot achieve a mutually monogamous sexual relationship, public health officials recommend reducing the number of one's partners, avoiding anal intercourse and using condoms (with or without spermicide).

Despite these recommendations, it is unclear whether a sizable proportion of sexually active men and women can be persuaded to use condoms. Both men and women complain that condoms decrease sensitivity, and men frequently say that condoms are too thick. (1) Presumably, there is a trade-off between the thickness of condoms and sexual pleasure, although the precise relation between thickness and sensitivity has never been documented.

Moreover, even those who use condoms consistently may be at risk of infection if a condom breaks or slips off during intercourse or withdrawal. Unfortunately, we know very little about the frequency with which these problems occur among users in the United States. In one retrospective study, 106 women reported using a total of 2,484 condoms during the previous year, of which 104(4.2%) either had broken or were not on the penis when it was withdrawn. (2) Although these data may be biased by inaccurate recall, they are similar to those found by Mary Ann Leeper and Mary Conrardy in a prospective study involving 49 women who each used three condoms. These authors reported that 6.1% of 147 condoms either broke or fell off; an additional 2.0% slipped down the shaft of the penis, but did not fall off. (3)

The study described in this article sheds further light on the prevalence of condom breakage and slippage during use by couples in the United States, and on the factors associated with these problems. It also seeks to determine whether a condom can be designed so that it can be thicker than currently available condoms without reducing sexual pleasure. (*)

Materials and Methods