The Latex Condom: Recent Advances, Future Directions

Chapter 6 sidebar: Methodological Challenges in Studying Condoms

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Studies of condom use have several major methodological challenges.These are particularly evident when trying to correlate actual condom use with laboratory tests. Such studies examine human behavior of an inherently private nature. Both user characteristics and types of sexual practices can affect condom failure.

Also, relating human behavior to laboratory tests involves evaluating the material integrity of the condom as it changes over time. Thus, studies comparing human use to laboratory tests involve people using condoms that could be of compromised quality, either from being artificially aged or from prolonged storage in poor field environments. In order to protect participants, the studies must be conducted among populations not at risk of STDs. Also, the couples who need protection against pregnancy must be using an effective non-barrier contraceptive method.

Couples participating in these studies usually receive some financial incentives. Since motivation to use condoms in the studies is partly financial, research designs have each couple use an equal number of condoms from each lot to help control for valid responses regarding use.

Having each couple use an equal number of condoms from each lot also helps to control for the variation of sexual practices and user characteristics (such as penis size and vaginal dimensions) among different couples. Research has shown that some couples are more likely than others to experience condom breakage and slippage (see Chapter 3).

Controlling for variations of sexual practices within a single couple is virtually impossible, however. Even with the same partner, sexual acts may vary greatly from one episode to another. In order to assess the impact of variation in the sexual act on condom breakage rates, researchers have collected information on the intensity and duration of intercourse, and on sexual positions, through self-administered questionnaires. As with most self-reported information of a very private nature, this type of information cannot be verified objectively, making analysis problematic. Even so, such information is still valuable in attempting to shed some light on these factors.

by Markus J. Steiner

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