Male contraceptive use
Coital Debut
At first intercourse, between 17-22% of men did not use any form of contraception [2]. The single greatest predictor of condom use was whether or not it was discussed prior to intercourse taking place (those who discussed it were more likely to use it). This was followed by perceived intimacy of intercourse, and by positive role-modelling of sexuality by parents [3].
51.7% of those who had just met their sexual partner did not use contraception, whereas only 23.6% of those going steady did not. [4]
Recent Intercourse
Among sexually-active adolescent males in the US, 20.3% have never used contraception, compared to 61.8% who always use contraception. [5]
The variables that affect first intercourse contraceptive use appear to remain important factors in ongoing contraceptive use. Relationship stability, communication, and desire to prevent pregnancy all are directly linked to contraceptive use [5]. Men who feel they should share responsibility for contraception are more likely to use contraceptives than are men who consider it to be their partner’s responsibility [6].
Condom Errors and Unintended Pregnancy
In a study of college men, when reviewing condom practices, respondents made an average of 4.2 errors, with the most common being not checking condom for defects, placing condom after beginning of intercourse, not having condoms on hand when sex was initiated, flipping condom over when placed incorrectly, and not leaving space at the tip. In that three month period, 32% had one or more episodes where the condom broke or slipped off. 60% did not discuss condom use before intercourse. [7]
12.7% of college men reported knowing that they caused an unintended pregnancy [7].
Satisfaction
In the Canadian Contraceptive Study, it was noted that, among women using dual forms of contraception (i.e. OCP and condoms), both they and their partners reported equal rates of satisfaction to those using OCP’s alone, while conferring a greater degree of contraceptive effectiveness, as well as protection from STI’s [9].
Take Home Message
Many men do feel that they have a role to play in preventing unintended pregnancy, and men who do so are more likely to communicate this to their partners, and initiate condom use. Proactive measures do support future condom use, thus demonstrating a need for adequate counselling by physicians to engage men in wanting to prevent unintended pregnancy.
Condom errors are very common, and are probably under-reported. Physicians must know the proper technique for condom use, and should take time to address questions that patients may have.
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2. Coleman L and Ingham R, “Attenders at young people’s clinics in Southampton: variations in contraceptive use” British Journal of Family Planning, 1998, 24(3):101–104
3. Stone N, Ingham R “Factors Affecting British Teenagers’ Contraceptive Use at First Intercourse: The Importance of Partner Communication” Perspectives on Sexual and Reproductive Health, 2002, 34(4):191–197
4. Manning, WD, Longmore MA, Giordano PC. “The Relationship Context of Contraceptive Use At First Intercourse”Family Planning Perspectives, 2000, 32(3):104–110
5. Manlove J, Ryan S, Franzetta K. “Contraceptive use and consistency in US teenagers’ more recent sexual relationships” Perspectives on sexual and reproductive health 2004 36:265-275
6. Marsiglio W, Adolescent males‘ orientation toward paternity and contraception, Family Planning Perspectives, 1993, 25(1):22–31
7. Crosby RA, Sanders SA, Yarber WL, Graham CA, Dodge, B. “Condom use errors and problems among college men” Sexually Transmitted Diseases (2002) 29:552-7
9. Fisher W, Boroditsky R, Morris B. "The 2002 Canadian Contraception Study: part 1" JOGC Jun 2004 26:580-90
