Black men who have sex with men report higher rates of condom breakage and slippage as well as incomplete use of condoms compared with white MSM. Publishing their findings in Sexually Transmitted Infections, researchers studied cross-sectional data of 475 MSM who were members of a cohort study in Atlanta and who said they’d used a condom for insertive sex (being the top) during the previous six months.

Black MSM were twice as likely as white MSM to report both breakage of condoms and slippage when pulling out. Nearly 40 percent of black MSM reported using a condom incompletely, meaning they put it on after already engaging in intercourse for a time or took it off before finishing intercourse; black MSM were significantly more likely than white MSM to report this.

Thirty-one percent of the MSM reported using a condom correctly, with most error rates similar between the races. However, fifty-three percent of black MSM reported using oil-based lubricants, which can weaken condoms, compared with 21 percent of white MSM. Also, black MSM were more likely than white MSM to unroll a condom completely before putting it on the penis. (The correct way to apply a condom is to roll it down over an erect penis, making sure that what will become the inside of the condom is facing down before allowing the latex to touch the tip of the penis.) MSM between the ages of 18 and 24 were 40 percent less likely to use a condom correctly compared with those 25 to 29 years of age. When factoring out race, younger men and those with less education were more likely to use oil-based lubricants.

Fifty-four percent of the participants said that standard condoms did not feel or fit optimally. White MSM were more likely than black MSM to report fit or feel problems or issues with maintaining an erection while using a condom.

The researchers concluded that their findings suggest that oil-based lubricant use, as well fit and feel problems, may account for a considerable percentage of condom breaks among MSM. They called for the condom industry to design better fitting condoms to address this problem. Better feeling and fitting condoms might not only increase the use of condoms in this population and but also decrease the likelihood of incomplete use.
To read the study abstract, click here.