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Associations of Sexually Transmitted Infections With Condom Problems Among Young Men Who Have Sex With Men

Mustanski, Brian PhD*; Ryan, Daniel T. MS*; Garofalo, Robert MD*†

Sexually Transmitted Diseases: July 2014 - Volume 41 - Issue 7 - p 427–432
doi: 10.1097/OLQ.0000000000000150
Original Study

Background Young men who have sex with men (YMSM) are disproportionately infected with sexually transmitted infections (STIs). Condom use is the most widely available means of preventing the transmission of STIs, but effectiveness depends on correct use. Condom errors such as using an oil-based lubricant have been associated with condom failures such as breakage. Little research has been done on the impact of condom problems on the likelihood of contracting an STI.

Methods Data came from Crew 450, a longitudinal study of HIV risk among YMSM (N = 450). All self-report data were collected using computer-assisted self-interview technology, and clinical testing was done for gonorrhea, chlamydia, and HIV.

Results Nearly all participants made at least 1 error, with high rates of using oil-based lubricant and incomplete use. No differences were found in rates of condom problems during anal sex with a man versus vaginal sex with a woman. Black YMSM reported significantly higher use of oil-based lubricants than white and Hispanic YMSM, an error significantly associated with HIV status (adjusted odds ratio, 2.60; 95% confidence interval, 1.04–6.51). Participants who reported a condom failure were significantly more likely to have an STI (adjusted odds ratio, 3.27; 95% confidence interval, 1.31–8.12).

Conclusions Young men who have sex with men report high rates of condom problems, and condom failures were significantly associated with STIs after controlling for unprotected sex. Educational programs are needed to enhance correct condom use among YMSM. Further research is needed on the role of oil-based lubricants in explaining racial disparities in STIs and HIV.

A study of young men who have sex with men found that condom failures were associated with laboratory diagnoses of sexually transmitted infections including HIV. Some errors such as use of oil-based lubricants with condoms were more common among black participants.

From the *Northwestern University Feinberg School of Medicine, Chicago, IL; and †Anne and Robert Lurie Children’s Hospital, Chicago, IL

Conflicts of interest: The authors have no conflicts of interest to disclose.

Support: This study was supported by a grant from the National Institute on Drug Abuse (R01DA025548). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health.

Correspondence: Brian Mustanski, PhD, Department of Medical Social Science, Northwestern University, 625 N. Michigan Ave, Suite 2700, Chicago, IL 60611. E-mail:

Received for publication November 21, 2013, and accepted May 13, 2014.

© Copyright 2014 American Sexually Transmitted Diseases Association