An EFA of a revised Condom Fit and Feel Scale (CoFFee-R): Adding intimacy and pleasure

External condoms are an effective contraceptive and safe-sex practice when used properly. A focus on universal fit has produced a variety of latex, polyurethane, or polyisoprene condoms. However, researchers and manufacturers have given little attention to how condoms subjectively fit and feel for the user. Reece and colleagues (2007) developed the Condom Fit and Feel Scale in 2007 that focused on physical aspects of fit (e.g., loose along penis shaft). Yet, users’ perceptions of emotional intimacy and pleasurable sensations may also predict condom use. The original scale had items corresponding to one of five factors: Condoms Fit Fine, Condoms Feel Too Loose, Condoms Feel Too Tight, Condoms Are Too Long, and Condoms Are Too Short. We revised the measure to include a broader conceptualization of feel and to remove redundant items. This revised scale (CoFFee-R) was tested for its psychometric properties in a sample of 399 participants recruited through a university participant pool. After conducting parallel and exploratory factor analyses, we settled on a four-factor structure. Our resulting CoFFee-R scale contained 18 items with the following factors: Condom Fit, Condom Intimacy and Pleasure, Condom Big, Condom Small. The factor structure of the CoFFee-R accounted for 57.6% of the variance, with structure matrix loadings ranging from .54 to .99, and no cross-loadings above .33. We discuss benefits and uses of the CoFFee-R within a transtheoretical model of predicting condom-use. This study has implications for how researchers measure health behaviours, from the wording of items to the conceptualization of condom fit and feel.

Evidence for behavioural interventions addressing condom use fit and feel issues to improve condom use: a systematic review

Continuing high rates of sexually transmissible infections (STIs) in many countries highlight the need to identify effective behavioural interventions. Consistent and correct use of male condoms is a key strategy for the prevention of STIs. However, some men report problems with condom fit (e.g. the size and shape of the condom) and feel (e.g. tightness, irritation, sensitivity), which inhibits their use. We conducted a systematic review to identify existing interventions addressing condom use fit and feel problems. We searched electronic databases for peer-reviewed articles and searched reference lists of retrieved studies. Five studies met the inclusion criteria. These were generally small-scale pilot studies evaluating behavioural interventions to promote safer sex with men aged under 30 years, addressing, among other things, barriers to condom use relating to fit and feel. There were significant increases in the reported use of condoms, including condom use with no errors and problems. Improvements in some condom use mediators were reported, such as condom use self-efficacy, knowledge, intentions and condom use experience. There were mixed findings in terms of the ability of interventions to reduce STI acquisition. Behavioural interventions addressing condom fit and feel are promising in terms of effectiveness but require further evaluation.

Condom-Associated Erection Problems

Previous research indicates that young men may experience condom-associated erection loss and that these problems may lead to inconsistent or incomplete condom use. The primary aim of this study was to assess, using a retrospective recall period of 2 months, correlates of condom-associated erection problems among young Black men attending sexually transmitted infection (STI) clinics. Data were collected in clinics treating patients with STIs in three southern U.S. cities. Males 15 to 23 years of age who identified as Black/African American and reported recent (past 2 months) condom use were eligible. A total of 494 men participated. Nineteen percent reported that condom-associated erection problems during condom application occurred at least once, and 17.8% indicated erection difficulties occurred during sexual intercourse at least once in the past 2 months. Multivariate analyses identified that condom-associated erection problems were associated with reports of sex with more than one partner during the recall period, reported problems with condom fit and feel, lower motivation to use condoms, and attempts at condom application before having a full erection. Findings suggest that clinic interventions should address possible condom-associated erection problems among young Black men who are at risk of STIs. Encouraging men who may be vulnerable to erection loss when condoms are used to allow sufficient time for sexual arousal to build may be an effective strategy.