Condom Breakage and Slippage Among Men In the United States.

Data on condom breakage and slippage from a nationally representative survey show that the average condom breakage rate experienced by 20-39-year-old men who have used a condom in the preceding six months was 2.7%, and that 1.9% of all condoms used during that time broke. Comparable condom slippage rates are 2.7% and 2.0%, respectively. Condom breakage and slippage appear to be 4-5 times higher among black men than among men of other races. Levels of breakage and slippage are also elevated among low-income men and those who used condoms relatively infrequently in the six months before the survey. The data also indicate that men who engage in high-risk sexual behavior, such as having multiple partners and engaging in anal intercourse, are more likely to experience condom breakage and slippage.

(Family Planning Perspectives, 26:107-112, 1994)

Over the last decade, the dramatic rise in the prevalence of AIDS has propelled that disease to the top of the public health agenda. As of 1993, more than 315,000 men and women in the United States had been diagnosed as having AIDS, and more than one million others are believed to be infected with the human immunodeficiency virus (HIV), the virus that causes AIDS.

The public health response to this epidemic has been to launch educational efforts designed to inform people about their risks of acquiring and transmitting AIDS and to convince them to modify their sexual behavior in ways that will minimize these risks. One of these ways is to always use a condom when engaging in vaginal or anal intercourse. However, previous research has shown that even those who consistently use a condom may still be at risk of infection, since condoms sometimes break or slip off during intercourse or withdrawal. (1) Breakage and slippage may also be barriers to use, in that many men consider them common problems with condoms. (2)

Unfortunately, there has been little research on condom breakage and slippage. Furthermore, existing studies have not documented the rates at which these events occur in the general population, and little attention has been paid to whether there are any group differences in these risks. Rather, research has focused on establishing the reliability of the technology itself, and has often used prospective clinical trials to control for user-related factors.

One such study, which examined the experiences of 49 couples who were each supplied with three condoms, found that of the 147 condoms used during the trial, 0.7% broke and 5.4% slipped off. (3) These rates are somewhat lower than those observed in a trial that included 70 couples; in that trial, 1.7% of 405 condoms broke during use and 12.8% slipped off either during coitus or during withdrawal. (4) Noting that 56% of all slippage occurred during withdrawal, the authors attributed much of this slippage to user error.

Breakage rates for the two brands of condoms compared in the latter study did not differ significantly, even though one brand was twice as thick as the other. Brand differences in lubrication also had no significant effect on slippage, although the risk of slippage during withdrawal was found to be significantly increased when additional lubricant had been used (17% of condoms used with additional lubricant, compared with 6% of condoms used with no additional lubricant).