A Daily Diary Analysis of Condom Breakage and Slippage During Vaginal Sex or Anal Sex Among Adolescent Women

Summary: The risk of condom slippage (1.94%) and breakage (0.89%) among 3607 condoms was analysed with respect to the use of additional lubricant. Whether or not lubricant was used, the site at which it was applied and the type of lubricant used were all found to vary significantly with the type of sexual act(s) for which the condoms were used. Little evidence was found for differing effects of type of additional lubricant (water-based, saliva or other) or site of lubricant use (on penis/ inside condom, on condom, in vagina/anus). The use of lubricant more than doubles the risk of slippage for vaginal sex. While anal sex is associated with much higher risks of slippage the use of lubricant for this practice actually reduces the risk of slippage to that similar for vaginal sex where lubricant is used. No significant effect of additional lubricant on condom breakage was observed. It is recommended that education messages concerning the use of additional lubricant may need to change to take into account the varied nature of lubricant use practices and the differential effects of lubricant with respect to sexual practices. Specifically, if the use of additional lubricant has little or no impact on condom breakage but increases condom slippage then encouraging its use may be counterproductive if condom users consider slippage to be a reason not to use condoms.

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Individual and poly-substance use and condomless sex among HIV-uninfected adults reporting heterosexual sex in a multi-site cohort

BMC Public Health ◽

10.1186/s12889-021-12026-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

R. J. Fredericksen ◽

B. M. Whitney ◽

E. Trejo ◽

R. M. Nance ◽

E. Fitzsimmons ◽

...

Keyword(s):

Substance Use ◽

Fixed Effects ◽

Hiv Status ◽

Anal Sex ◽

Condomless Sex ◽

Polysubstance Use ◽

Vaginal Sex ◽

Heterosexual Sex ◽

The Impact ◽

Hiv Negative

Abstract Background We analyzed the association between substance use (SU) and condomless sex (CS) among HIV-negative adults reporting heterosexual sex in the Seek, Test, Treat, and Retain (STTR) consortium. We describe the impact of SU as well as person/partner and context-related factors on CS, identifying combinations of factors that indicate the highest likelihood of CS. Methods We analyzed data from four US-based STTR studies to examine the effect of SU on CS using two SU exposures: 1) recent SU (within 3 months) and 2) SU before/during sex. Behavioral data were collected via 1:1 or self-administered computerized interviews. Adjusted individual-study, multivariable relative risk regression was used to examine the relationship between CS and SU. We also examined interactions with type of sex and partner HIV status. Pooled effect estimates were calculated using traditional fixed-effects meta-analysis. We analyzed data for recent SU (n = 6781; 82% men, median age = 33 years) and SU before/during sex (n = 2915; 69% men, median age = 40 years). Results For both exposure classifications, any SU other than cannabis increased the likelihood of CS relative to non-SU (8–16%, p-values< 0.001). In the recent SU group, however, polysubstance use did not increase the likelihood of CS compared to single-substance use. Cannabis use did not increase the likelihood of CS, regardless of frequency of use. Type of sex was associated with CS; those reporting vaginal and anal sex had a higher likelihood of CS compared to vaginal sex only for both exposure classifications (18–21%, p < 0.001). Recent SU increased likelihood of CS among those reporting vaginal sex only (9–10%, p < 0.001); results were similar for those reporting vaginal and anal sex (5–8%, p < 0.01). SU before/during sex increased the likelihood of CS among those reporting vaginal sex only (20%; p < 0.001) and among those reporting vaginal and anal sex (7%; p = 0.002). Single- and poly-SU before/during sex increased the likelihood of CS for those with exclusively HIV-negative partners (7–8%, p ≤ 0.02), and for those reporting HIV-negative and HIV-status unknown partners (9–13%, p ≤ 0.03). Conclusion Except for cannabis, any SU increased the likelihood of CS. CS was associated with having perceived HIV-negative partners and with having had both anal/vaginal sex.

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Peer-Led or Expert-Led Intervention in HIV Prevention Efficacy? A Randomized Control Trial Among Spanish Young People to Evaluate Their Role

Health Promotion Practice ◽

10.1177/1524839917733966 ◽

2017 ◽

Vol 19 (2) ◽

pp. 277-286

Author(s):

Cristina Giménez-García ◽

Rafael Ballester-Arnal ◽

María Dolores Gil-Llario ◽

Pedro Salmerón-Sánchez

Keyword(s):

Young People ◽

Hiv Prevention ◽

Behavioral Interventions ◽

Associated Factors ◽

Safe Sex ◽

Sex Behavior ◽

Anal Sex ◽

The World ◽

Vaginal Sex ◽

Randomized Control

HIV new infections still affect young people around the world. In this context, behavioral interventions seem to be effective in promoting safe sex although some conditions are still inconclusive in different regions. For example, there is insufficient evidence about who may be the best facilitator. For this reason, this study evaluates the effectiveness of peer and expert facilitators for HIV prevention aimed at Spanish young people. For this purpose 225 Spanish college students, aged between 18 and 25 (74.20% women and 25.80% men), were involved in an experimental design to evaluate the facilitators’ effect in a brief intervention for HIV prevention. Participants’ results were measured by three HIV preventive variables (knowledge, beliefs, and protective sex behavior in vaginal sex, anal sex, and sex after drugs consumption). Our findings reveal that both facilitators, experts and peers, have improved the HIV-associated factors and safe sex behaviors. Therefore, facilitators’ status would not be so relevant for effectiveness in HIV prevention aimed at Spanish young people. To facilitate decision making in HIV prevention, we should study in depth what other variables make more effective facilitators.

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Early sexual experiences of teenage heterosexual males in Australia: a cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2017-016779 ◽

2017 ◽

Vol 7 (10) ◽

pp. e016779 ◽

Cited By ~ 4

Author(s):

Eric P F Chow ◽

Rebecca Wigan ◽

Anna McNulty ◽

Charlotte Bell ◽

Mandy Johnson ◽

...

Keyword(s):

Sexual Health ◽

Condom Use ◽

Sexual Debut ◽

Oral Sex ◽

Sexual Experiences ◽

Anal Sex ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Sexual Behaviours ◽

Vaginal Sex

ObjectiveThere are limited data on the patterns of early sexual behaviours among Australian teenage heterosexual boys. This study describes the nature and onset of early sexual experiences in this population through a cross-sectional survey.DesignA cross-sectional survey between 2014 and 2015SettingMajor sexual health clinics and community sources across AustraliaParticipantsHeterosexual men aged 17–19 yearsResultsThere were 191 men in the study with a median age of 19.1 years. Median age at first oral sex was 16.4 years (IQR: 15.5–17.7) and 16.9 years (IQR: 16.0–18.0) for first vaginal sex. Most men had engaged in oral sex (89.5%) and vaginal sex (91.6%) in the previous 12 months with 32.6% reporting condom use at last vaginal sex. Of the total lifetime female partners for vaginal sex reported by men as a group (n=1187): 54.3% (n=645) were the same age as the man, 28.3% (n=336) were a year or more younger and 17.4% (n=206) were a year or more older. Prior anal sex with females was reported by 22% with 47% reporting condom use at last anal sex. Median age at first anal sex was 18.2 years (IQR: 17.3–18.8). Anal sex with a female was associated with having five or more lifetime female sexual partners for oral and vaginal sex.ConclusionsThese data provide insights into the trajectory of sexual behaviours experienced by teenage heterosexual boys following sexual debut, findings which can inform programme promoting sexual health among teenage boys.

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Home Base: Family of Origin Factors and the Debut of Vaginal Sex, Anal Sex, Oral Sex, Masturbation, and Pornography Use in a National Sample of Adolescents

The Journal of Sex Research ◽

10.1080/00224499.2019.1691140 ◽

2019 ◽

Vol 57 (9) ◽

pp. 1089-1099 ◽

Cited By ~ 1

Author(s):

Shelby Astle ◽

Nathan Leonhardt ◽

Brian Willoughby

Keyword(s):

Family Of Origin ◽

National Sample ◽

Oral Sex ◽

Anal Sex ◽

Home Base ◽

Pornography Use ◽

Vaginal Sex

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Between the Back and the Front: Male Love in Humorous Tales of the Edo Period

Vienna Journal of East Asian Studies ◽

10.2478/vjeas-2011-0001 ◽

2011 ◽

Vol 1 (1) ◽

pp. 1-32

Author(s):

Angelika Koch

Keyword(s):

Present Article ◽

Male Sexuality ◽

Anal Sex ◽

Sexual Practice ◽

Edo Period ◽

Gender Perspective ◽

Female Partners ◽

Vaginal Sex ◽

Point Of Departure

Abstract The present article explores representations of male-male sexuality and eroticism in humorous tales of the Edo period. The point of departure for the discussion is the metaphor of ‘back’ and ‘front’, which delineated the sexual options available to a grown-up man, namely anal sex with males and vaginal sex with female partners. A brief preliminary overview of the custom of male love (nanshoku), which forms the unifying theme of the tales under discussion, is provided. After an introduction to the genre of Edo-period humorous tales (shōwa or kobanashi), the article centres on the depiction of male-male intercourse and eroticism in this type of literature, and argues that certain discrepancies, relevant from a gender perspective, become discernible in the respective representations of the two partners of a nanshoku relationship. It is shown how the metaphor of ‘back’ and ‘front’ is grounded in sexual practice, how it functioned and how it is employed for the achievement of a comic effect in the tales. The article then goes on to address the question of the extent to which male sexuality can be said to move ‘between the back and the front’, and some thoughts on gender and desire in the Edo period are offered.

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Double-Blind, Single-Center, Randomized Three-Way Crossover Trial of Fitted, Thin, and Standard Condoms for Vaginal and Anal Sex: C-PLEASURE Study Protocol and Baseline Data (Preprint)

10.2196/preprints.12205 ◽

2018 ◽

Author(s):

Aaron J Siegler ◽

Elizabeth M Rosenthal ◽

Patrick S Sullivan ◽

Lauren Ahlschlager ◽

Colleen F Kelley ◽

...

Keyword(s):

Race And Ethnicity ◽

Crossover Trial ◽

Sexual Pleasure ◽

Recent Experience ◽

Anal Sex ◽

Double Blind ◽

Sexually Transmitted ◽

Vaginal Sex ◽

And Performance ◽

Sex With Men

BACKGROUND Male condoms are underused despite their ability to prevent transmission of HIV and other sexually transmitted infections. The perception of decreased sexual pleasure and poor condom fit are major contributors to condom nonuse. OBJECTIVE The purpose of this study was to compare event-level performance and pleasure using fitted, thin, and standard condoms among men who have sex with men (MSM) and men who have sex with women (MSW). We also sought to assess condom type preference. We present the study design and enrollment data from the trial. METHODS This study recruited sexually active men aged 18 to 54 years in Atlanta, Georgia, United States. We enrolled 252 MSM and 252 MSW in a double-blind, 3-way randomized crossover trial with conditions of fitted, thin, and standard condoms. A permuted block randomization scheme was used to assign each participant to the sequence in which they received each type of study condom. After a baseline screening and enrollment visit, randomized participants were followed for at least 6 and up to 12 weeks depending on their use of study condoms in each 2-week period between scheduled, in-person study visits. Participants were instructed to complete mobile-optimized coital logs as soon as possible after using condoms for anal or vaginal sex acts. The logs collected event-level pleasure and performance measures for the study condoms as well as other relevant data. A questionnaire was administered at the final study visit to assess overall study condom preference. RESULTS The study enrolled 252 MSM and 252 MSW, a total of 504 participants. MSM and MSW study arms were similar for a number of key traits including race and ethnicity, marital status, self-rated condom experience, and recent experience of condom failure. Men in the MSM arm were older, however, and fewer MSM were students. The majority of participants in both arms rated themselves as very experienced with using condoms, and the majority had used condoms recently. Over one-third of participants in each arm reported experiencing condom failure in the last 6 months. CONCLUSIONS This is the first condom trial to compare the performance of standard, thin, and fitted condoms and to use pleasure and preference as primary outcomes. Given the disparate impact of HIV on MSM, equal enrollment of MSM and MSW was a key feature of this study. Trial results may inform an FDA label indication for anal sex and provide new information regarding the relative performance of different types of condoms. CLINICALTRIAL ClinicalTrials.gov NCT02753842; https://clinicaltrials.gov/ct2/show/NCT02753842 (Archived by WebCite at http://www.webcitation.org/76RLTFyf0) INTERNATIONAL REGISTERED REPOR DERR1-10.2196/12205

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