How often do condoms fail? A cross-sectional study exploring incomplete use of condoms, condom failures and other condom problems among black and white MSM in southern USA

Objectives To compare the occurrence of risk-inducing condom events (condom failures and incomplete use) and the frequency of their antecedents (condom errors, fit/feel problems and erection problems) between black and white men who have sex with men (MSM), and determine the associations between risk-inducing condom events and their antecedents. Methods We studied cross-sectional data of 475 MSM who indicated using a condom as an insertive partner in the previous 6 months enrolled in a cohort study in Atlanta, Georgia, USA. Results Nearly 40% of black MSM reported breakage or incomplete use, and they were more likely to report breakage, early removal and delayed application of a condom than white MSM. Only 31% and 54% of MSM reported correct condom use and suboptimal fit/feel of a condom, respectively. The use of oil-based lubricants and suboptimal fit/feel were associated with higher odds of reporting breakage (p=0.009). Suboptimal fit/feel was also associated with higher odds of incomplete use of condoms (p