Abstract
In this study, we examined the correlates of condom use errors and problems in a population-based study conducted in 2010 among young Croatian adults aged 18–25 years. Out of a total sample of 1,005 participants, 679 reported condom use in the preceding year. The analyses focused on four outcomes: condom breakage, condom slippage, condom-related erection loss, and delayed condom application. Eighteen percent of participants experienced breakage, 13% reported slippage, 17% reported erection loss, and 34% applied a condom after intercourse started. Multivariate logistic regression analyses were performed to examine the correlates of these condom use errors and problems. Condom breakage was less likely to be reported by women and older participants. The odds of breakage were increased for participants who reported being under the influence of drugs during sex and who reported other condom use errors and problems in the past year. Condom slippage was more likely to occur among younger participants and those who reported condom breakage and delayed condom application. Condom-related erection loss was positively associated with a higher number of sexual partners in the preceding year, condom breakage, and a higher score on the Anti-Erotic Obstacles to Condom Use Scale. Odds of delayed condom application were increased for participants who experienced condom breakage and for those who consumed alcohol before sex in the past year. Having used a condom at first sex significantly reduced the odds of applying a condom after intercourse started. In comparison to non-habitual condom users, habitual users were found less likely to report any of the assessed condom use errors and problems. Improving condom use skills remains an important task in Croatia, which is currently hampered by the absence of evidence-based sex education in schools.
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Bagić, D. (2004). Utjecaj odbijanja ankete na valjanost telefonskih predizbornih istraživanja: slučaj parlamentarnih izbora 2003 [Influence of refusals on the validity of the pre-election telephone survey: The case of the 2003 parliamentary elections]. Društvena istraživanja, 13, 439–461.
Bancroft, J. (2009). Human sexuality and its problems (3rd ed.). Edinburgh: Churchill Livingstone.
Benković, V., Štulhofer, A., & Baćak, V. (in press). Konstrukcija i evaluacija višedimenzionalnog instrumenta za procjenu prepreka uporabi kondoma [Development and validation of a multi-dimensional measure for assessing barriers to condom use]. Društvena istraživanja.
Bijelić, N. (2008). Sex education in Croatia: Tensions between secular and religious discourses. European Journal of Women’s Studies, 15, 329–343.
Crosby, R. A., Milhausen, R., Sanders, S., Graham, C., & Yarber, W. (2008a). Two heads are better than one: The association between condom decision-making and condom use errors and problems. Sexually Transmitted Infections, 84, 198–201.
Crosby, R. A., Salazar, L. F., Yarber, W. L., Sanders, S. A., Graham, C. A., Head, S., et al. (2008b). A theory-based approach to understanding condom errors and problems reported by men attending an STI clinic. AIDS and Behavior, 12, 412–418.
Crosby, R. A., Sanders, S., Yarber, W. L., & Graham, C. A. (2003). Condom-use errors and problems: A neglected aspect of studies assessing condom effectiveness. American Journal of Preventive Medicine, 24, 367–370.
Crosby, R. A., Sanders, S. A., Yarber, W. L., Graham, C. A., & Dodge, B. (2002). Condom use errors and problems among college men. Sexually Transmitted Diseases, 29, 552–557.
Crosby, R. A., Yarber, W. L., Sanders, S. A., Graham, C. A., McBride, K., Milhausen, R. R., et al. (2007). Men with broken condoms: Who and why? Sexually Transmitted Infections, 83, 71–75.
Fromme, K., D’Amico, E. J., & Katz, E. C. (1999). Intoxicated sexual risk taking: An expectancy or cognitive impairment explanation? Journal of Studies on Alcohol, 60, 54–63.
George, W. H., & Stoner, S. A. (2000). Understanding acute alcohol effects on sexual behavior. Annual Review of Sex Research, 11, 92–124.
Graham, C. A., Crosby, R. A., Milhausen, R. R., Sanders, S. A., & Yarber, W. L. (2009). Incomplete use of condoms: The importance of sexual arousal. AIDS and Behavior. doi:10.1007/s10461-009-9638-7.
Graham, C. A., Crosby, R. A., Sanders, S. A., & Yarber, W. L. (2005). Assessment of condom use in men and women. Annual Review of Sex Research, 16, 20–52.
Graham, C. A., Crosby, R., Yarber, W. L., Sanders, S. A., McBride, K., Milhausen, R. R., et al. (2006). Erection loss in association with condom use among young men attending a public STI clinic: Potential correlates and implications for risk behaviour. Sexual Health, 3, 255–260.
Hair, J. F., Anderson, R. E., Tatham, R. L., & Black, W. C. (1998). Multivariate data analysis. Upper Saddle River, NJ: Prentice-Hall.
Halpern-Felsher, B. L., Millstein, S. G., & Ellen, J. M. (1996). Relationship of alcohol use and risky sexual behavior: A review and analysis of findings. Journal of Adolescent Health, 19, 331–336.
Hensel, D. J., Stupiansky, N. W., Herbenick, D., Dodge, B., & Reece, M. (2011). When condom use is not condom use: An event-level analysis of condom use behaviors during vaginal intercourse. Journal of Sexual Medicine, 8, 28–34.
Hindmarch, I., Kerr, J. S., & Sherwood, N. (1991). The effects of alcohol and other drugs on psychomotor performance and cognitive function. Alcohol and Alcoholism, 26, 71–79.
Kirkkola, A., Mattila, K., & Virjo, I. (2005). Problems with condoms: A population-based study among Finnish men and women. European Journal of Contraception & Reproductive Health Care, 10, 87–92.
Lane, S. D., Yechiam, E., & Busemeyer, J. R. (2006). Application of a computational decision model to examine acute drug effects on human risk taking. Experimental and Clinical Psychopharmacology, 14, 254–264.
Leigh, B. C. (2002). Alcohol and condom use: A meta-analysis of event-level studies. Sexually Transmitted Diseases, 29, 476–482.
Lindberg, L. D., Sonenstein, F. L., Ku, L., & Levine, G. (1997). Young men’s experience with condom breakage. Family Planning Perspectives, 29, 128–131, 140.
Maisto, S. A., Carey, M. P., Carey, K. B., Gordon, C. M., Schum, J. L., & Lynch, K. G. (2004). The relationship between alcohol and individual differences variables on attitudes and behavioral skills relevant to sexual health among heterosexual young adult men. Archives of Sexual Behavior, 33, 571–584.
Petersen, J. L., & Hyde, J. S. (2010). A meta-analytic review of research on gender differences in sexuality, 1993–2007. Psychological Bulletin, 136, 21–38.
Pinkerton, S. D., & Abramson, P. R. (1997). Effectiveness of condoms in preventing HIV transmission. Social Science and Medicine, 44, 1303–1312.
Rashad, I., & Kaestner, R. (2004). Teenage sex, drugs and alcohol use: Problems identifying the cause of risky behaviors. Journal of Health Economics, 23, 493–503.
Sanders, S. A., Graham, C. A., Yarber, W. L., & Crosby, R. A. (2003). Condom use errors and problems among young women who put condoms on their male partners. Journal of the American Medical Women’s Association, 58, 95–98.
Sanders, S. A., Graham, C. A., Yarber, W. L., & Crosby, R. A. (2008). Starting late, ending early: Correlates of incomplete condom use among young adults. Health Education Monograph, 25, 45–50.
Shafii, T., Stovel, K., Davis, R., & Holmes, K. (2004). Is condom use habit forming? Condom use at sexual debut and subsequent condom use. Sexually Transmitted Diseases, 31, 366–372.
Shafii, T., Stovel, K., & Holmes, K. (2007). Association between condom use at sexual debut and subsequent sexual trajectories: A longitudinal study using biomarkers. American Journal of Public Health, 97, 1090–1095.
Spruyt, A., Steiner, M. J., Joanis, C., Glover, L. H., Piedrahita, C., Alvarado, G., … Cordero, M. (1998). Identifying condom users at risk for breakage and slippage: Findings from three international sites. American Journal of Public Health, 88, 239–244.
Štulhofer, A., Baćak, V., Ajduković, D., & Graham, C. (2010). Understanding the association between condom use at first and most recent sexual intercourse: An assessment of normative, calculative, and habitual explanations. Social Science and Medicine, 70, 2080–2084.
Štulhofer, A., Graham, C., Božičević, I., Kufrin, K., & Ajduković, D. (2007). HIV/AIDS-related knowledge, attitudes and sexual behaviors as predictors of condom use among young adults in Croatia. International Family Planning Perspectives, 33, 58–65.
Štulhofer, A., Graham, C., Božičević, I., Kufrin, K., & Ajduković, D. (2009). An assessment of HIV/STI vulnerability and related sexual risk-taking in a nationally representative sample of young Croatian adults. Archives of Sexual Behavior, 38, 209–225.
Warner, L., Newman, D. R., Kamb, M. L., Fishbein, M., Douglas, J. M., Zenilman, J., … Peterman, T. (2008). Problems with condom use among patients attending sexually transmitted disease clinics: Prevalence, predictors, and relation to incident gonorrhea and chlamydia. American Journal of Epidemiology, 167, 341–349.
Weller, S. C., Davis-Beaty, K. (2002). Condom effectiveness in reducing heterosexual HIV transmission. Cochrane Database of Systematic Reviews, (1), CD003255. doi:10.1002/14651858.CD003255.
Wiederman, M. W. (1999). Volunteer bias in sexuality research using college student participants. Journal of Sex Research, 36, 59–66.
Yarber, W. L., Crosby, R. A., Graham, C. A., Sanders, S. A., Arno, J., Hartzell, R. M., … Rothring, A. (2007). Correlates of putting condoms on after sex has begun and of removing them before sex ends: A study of men attending an urban public STD clinic. American Journal of Men’s Health, 1, 190–196.
Acknowledgment
This study was part of the research project “Behavioral HIV Surveillance” funded by the Croatian Ministry of Science, Education, and Sports.
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Baćak, V., Štulhofer, A. Condom Use Errors and Problems in a National Sample of Young Croatian Adults. Arch Sex Behav 41, 995–1003 (2012). https://doi.org/10.1007/s10508-011-9838-x
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DOI: https://doi.org/10.1007/s10508-011-9838-x