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Condom failure


Male latex condoms are used both to protect against pregnancy and against sexually transmitted infections. How effective they are depends upon proper use. Breakage during intercourse, or slippage, will render the condom ineffective. How often does this happen? A number of studies have been conducted (we found no systematic reviews); three examples illustrate the size of the problem.

Studies and results


Ninety-two monogamous heterosexual couples (aged 18 to 40 for women, 18-50 for men) were enrolled in a prospective study of Durex Ramses condoms [1]. At each sexual encounter a diary was completed which included information on condom use, and breaks and slips.

There were 4,637 attempts to use condoms. On six occasions the condoms broke before intercourse, leaving 4,631 condoms used for intercourse. Thirteen breaks occurred during intercourse (0.28%), and the total breakage rate was 0.41%. Complete slips were recorded on 29 occasions (0.63%) and 21 of these were recorded by the same couple. The overall failure rate of 0.91%, or an effectiveness rate of 99.1%. The total failure rate was 1.04%.


In France a random telephone survey [2] of 20,000 individuals drew on 4,500 sexually active people, of whom 731 had used a condom in the previous year and 707 provided information on difficulties of use.

The rate of breakage at last use in heterosexual intercourse was 3.4% and the rate of slippage was 1.1%, for a total failure rate of 4.5%, or an effectiveness rate of 95.5%.


In Australia 3658 condoms were used by 184 men in a study [3] which looked, inter alia, at penis size as a factor for breakage or slippage.

The rate of breakage was 1.34% and of slippage 2.05%, with a total failure rate of 3.39%. Penis size was not related to slippage, but penis circumference was strongly associated with breakage.


Comment


It seems that the reported rate of condom failure through slippage and breakage is significant. While 95% effectiveness of a contraceptive method sounds good, actually it leaves a woman with a chance of pregnancy which may be considered unacceptable. At 95% it is 7:1 against in any one year, rising to 33:1 against at 99%. As any follower of the turf could tell us, outsiders at 33:1 win races every day.

References:

  1. MJ Rosenberg, MS Waugh. Latex condom breakage and slippage in a controlled clinical trial. Contraception 1997 56: 17-21.
  2. A Messiah et al. Condom breakage and slippage during heterosexual intercourse: a French national survey. American Journal of Public Health 1997 87: 421-424.
  3. AM Smith et al. Does penis size influence condom slippage and breakage? Int Journal of STD & AIDS 1998 9: 444-447.



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