FHI - Increasing Choice of Male Condoms Does Not Increase Their Use, Study Shows -- December 30, 2005

Research Triangle Park, NC — Providing men with a choice of condoms — including ribbed, studded or loose-fitting "novelty" condoms associated with enhancement of sexual pleasure — does not necessarily mean men will use condoms more often, according to research conducted by Family Health International (FHI) in collaboration with the Jamaican Ministry of Health.

Rather than using more condoms overall, men in the FHI study tended to simply substitute condoms that they liked for ones they found less acceptable.

The study, appearing in the January issue of Sexually Transmitted Diseases, was conducted by FHI to see if the relatively simple measure of increasing condom choice might substantially reduce acquisition of sexually transmitted infections (STIs) by increasing overall condom use. The STI of greatest public health concern worldwide is human immunodeficiency virus (HIV), which causes AIDS. Despite an ever-growing HIV/AIDS pandemic and the fact that consistent and correct condom use is an effective means of preventing HIV infection, condoms often are not used by sexually active men at risk of infection.

The study was conducted in Kingston, Jamaica, at the capital's largest STI clinic among 414 men seeking treatment for urethral discharge, a common STI symptom. At enrollment, all of the men received single-dose treatment for gonorrhea, trichomoniasis, and chlamydia. Half of the men were assigned to receive only the standard low-cost clinic condom; half were given a choice of four types of condoms. Then, they were followed for up to six months. The objective was to compare the time to STI reinfection among men in the choice group to that among men receiving only the standard condom. Researchers also measured condom acceptability and self-reported condom use.

"At baseline, most study participants thought that a choice of condoms would lead them to use more condoms, but a choice of condoms did not increase condom use or subsequently lower STI rates," says Dr. Markus Steiner, an FHI senior epidemiologist and the study's principal investigator. "For public sector programs in which resources are often limited, our study supports the current general practice of providing a low-cost male condom. Such programs should not spend resources to provide more expensive condoms with fancy packaging or features to enhance sexual pleasure, when basic access to condoms is lacking in many settings. Globally, ensuring that all current demand for condoms is met must be the highest public health priority."

Family Health International is dedicated to improving lives, knowledge, and understanding worldwide through a highly diversified program of research, education, and services in family health and HIV/AIDS prevention and care. Since its inception in 1971, FHI has formed partnerships with national governments and local communities in countries throughout the developing world to support lasting improvements in the health of individuals and the effectiveness of entire health systems.