Condom Failure During Anal Sex Among MSM and Associated Factors 公开

Prater, Adam Benjamin (2011)

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Condom Failure During Anal Sex Among MSM and
Associated Factors
By Adam Prater, MD

Background: The cornerstone of many HIV prevention programs is the male condom, but failure rate of condoms during anal intercourse (AI) has been estimated to be 0.5%-8%. To date there are few studies to date that have focused on characteristics and behaviors associated with condom breakage in MSM. This study used data from a national online HIV prevention survey of MSM to estimate rates of condom failure, and to identify demographic features and risk behavior characteristics associated with condom breakage during AI.

Methods: Data were collected between March 19 - April 16, 2009 from an online survey of US MSM recruited through a social networking site. Eligible men were at least 18 years of age and reported at least one male sex partner in the last 12 months. Multivariable logistic regression, controlling for demographic and sexual risk behavior predictors, estimated the odds of condom failure during anal intercourse (AI).

Results: A total of 944 (10%) out of 9,005 participants used a condom during last AI. These 944 participants reported a total of 1,114 distinct incidences of AI with condom use (receptive or insertive) during their last sexual activity with their most recent male sexual partner. Condom breakage was reported by 29 (4.5%) participants who engaged in receptive AI and 17 (3.6%) participants who engaged in insertive AI; the overall failure rate was 4.1%. Having a high number of male sex partners was associated with condom failure [adjusted odds ratio per 10 sexual partners (aOR): 1.05, 95% confidence interval (CI): 1.003 - 1.100]

Conclusions: Condoms continue to provide a strong component to prevention policy, and our findings clearly indicate a high risk subgroup that would likely benefit from a prevention policy that focuses on condom education. Specifically, MSM with a higher number of sexual partners are at an increased risk for HIV transmission secondary to condom failure. Further investigation should include a prospective study of condom failure among MSM, particularly focusing on identification of MSM subgroups that exhibit high risk behaviors such as a high number of male sexual partners.

Table of Contents

Table of Contents Section Pages List of Tables vii List of Figures viii List of Appendices ix

Background 1 - 3

Methods 4 - 7

Results 8 - 10

Discussion 11 - 16

Conclusion 17 - 18

References 19 - 21

Tables and Figures 22 - 25

Appendices 26 - 93

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