Sexually Transmitted Diseases

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Sexually Transmitted Diseases:
doi: 10.1097/01.olq.0000258487.38309.b9
Article

Self-Reported Mechanical Problems During Condom Use and Semen Exposure: Comparison of Two Randomized Trials in the United States of America and Brazil

Chen, Michael P.*; Macaluso, Maurizio*; Blackwell, Richard†; Galvao, Loren†§; Kulczycki, Andrzej†; Diaz, Juan¶; Jamieson, Denise J.*; Duerr, Ann∥

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Abstract

Objectives/Goal: To compare self-reported condom use problems and objectively determined semen exposure in 2 populations.

Study Design: Two randomized crossover trials in the United States and Brazil compared the failure rates of the female condom (FC) and male condom (MC). Participants used both condom types, completed condom-specific questionnaires to report problems, and collected precoital and postcoital samples of vaginal fluid. Prostate-specific antigen (PSA) was detected by immunoassay.

Results: Problems with condom use were reported less frequently in the Brazilian study (rate difference: FC = 24%, P <0.0001, MC = 5%, P = 0.003). By contrast, the PSA detection rates were similar for both the FC and the MC (rate difference: FC = 2%, MC = 1%, not significant). These results suggest that the PSA detection rate was similar in the 2 study groups and that self-reported problems may be a less reliable measure of condom failure.

Conclusions: Use of biomarkers of condom failure like PSA may help to strengthen the validity of studies promoting behavior change for the prevention of sexually transmitted diseases.

© Copyright 2007 American Sexually Transmitted Diseases Association

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