Background: Adolescent women are disproportionately impacted by the adverse outcomes associated with sexual activity, including sexually transmitted infections (STI). Condoms as a means of prevention relies on use that is free of usage failure, including breakage and/or slippage. This study examined the daily prevalence of and predictors of condom breakage and/or slippage during vaginal sex and during anal sex among adolescent women.
Methods: Adolescent women (N = 387; 14 to 17 years) were recruited from primary care clinics for a longitudinal cohort study of STIs and sexual behavior. Data were daily partner-specific sexual diaries. Random intercept mixed-effects logistic regression was used to estimate the fixed effect of each predictor on condom breakage/slippage during vaginal or during anal sex (Stata, 13.0), adjusting model coefficients for the correlation between repeated within-participant diary entries.
Results: Condom slippage and/or breakage varied across sexual behaviors and was associated with individual-specific (eg, age and sexual interest) and partner-specific factors (eg, negativity). Recent behavioral factors (eg, experiencing slippage and/or breakage in the past week) were the strongest predictors of current condom slippage and/or breakage during vaginal or anal sex.
Conclusions: Factors associated with young women's condom breakage/slippage during vaginal or during anal sex should be integrated as part of STI prevention efforts and should be assessed as part of ongoing routine clinical care.
A diary study of adolescent women found that condom breakage/slippage was more frequent during vaginal than during anal sex; breakage/slippage overall was more likely if it had occurred in the past week.
From the *Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine; †Department of Sociology, Indiana University Purdue University-Indianapolis, Indianapolis, IN; and ‡Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC
Sources of Support: Data were drawn from a study supported by grants NIH U19AI43924-06, R01HD044387-03 from Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The content of this paper reflects solely the opinion of the authors.
Conflict of interest: None declared.
Correspondence: Devon J. Hensel, PhD, Section of Adolescent Medicine, Indiana University School of Medicine, 410 West 10th Street, Room 1001, Indianapolis, IN 46202. E-mail: djhensel@iupui.edu.
Received for publication November 6, 2015, and accepted June 2, 2016.
