Partner Characteristics, Intensity of the Intercourse, and Semen Exposure During Use of the Female Condom

• Published in: American journal of epidemiology 2003-02, Vol.157 (4), p.282-288
• Main Authors: Lawson, M. Louise, Macaluso, Maurizio, Duerr, Ann, Hortin, Glen, Hammond, Karen R., Blackwell, Richard, Artz, Lynn, Bloom, Amy
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; biological markers; Biomarkers - analysis; Birth control; Coitus; condoms; Condoms, Female; Contraception Behavior; Equipment Failure; Female; Gynecology. Andrology. Obstetrics; Humans; Logistic Models; Male; Medical sciences; Middle Aged; Other methods of contraception. Sterilization; Penis - anatomy & histology; Prospective Studies; prostate-specific antigen; Prostate-Specific Antigen - analysis; PSA; Risk Factors; semen; Semen - chemistry; sex behavior; Sexual Partners; sexually transmitted disease; sexually transmitted diseases; Sexually Transmitted Diseases - prevention & control; STD; Vagina - anatomy & histology; Vagina - chemistry
• ISSN: 0002-9262; 1476-6256; 0002-9262
• DOI: 10.1093/aje/kwf211

The objective of this study was to assess how characteristics of the intercourse and the couple relate to semen exposure during use of the female condom. From 1996 to 1998, 210 women in Birmingham, Alabama, were trained to use the female condom and follow study procedures during a group session and individually practiced inserting the device. The outcome was semen exposure as defined by comparing pre- and postcoital prostate-specific antigen levels in vaginal fluid. Women who had high income levels had lower rates of semen exposure (odds ratio (OR) = 0.3, 95% confidence interval (CI): 0.2, 0.7), while those in a relationship of less than 2 years were at greater risk (OR = 2.4, 95% CI: 1.3, 4.1). Couples with a large disparity in vaginal fundus size and penis size were at increased risk of semen exposure (OR = 2.7, 95% CI: 1.2, 6.0). Engaging in very active intercourse also increased the risk (OR = 1.7, 95% CI: 1.1, 2.6). Thus, the protective effect of the female condom appears to be a function of user- and intercourse-specific characteristics. Future studies of male condom efficacy should focus on collecting detailed data about the users and characteristics of intercourse to predict failure accurately.