College males need education on condoms

If proper condom use were on a final exam, many college students apparently would flunk the test.

A study published this month found that an alarming number of male college students use condoms incorrectly, raising the risk of exposure to sexually transmitted diseases and the likelihood of unintended pregnancy.

Forty-three percent of study participants reported that in the preceding three months, they had put on a condom only after sex had begun, 15 percent said they removed the condom before sex was over, and 40 percent reported not leaving enough reservoir space at the condom’s tip, among other errors. The study was published in the journal Sexually Transmitted Diseases.

“In all, at least half of the men in our survey made at least one mistake, some more serious than others,” said Richard A. Crosby, an assistant professor at Emory University’s school of public health. “We saw more errors than even we anticipated.”

The study’s results dismayed public health experts, but did not surprise college students.

The study involved 158 male, heterosexual, unmarried, sexually active condom users enrolled as undergraduates at Indiana University. Their average age was 20. Crosby speculates that male students at other universities probably have similar rates of error, and suggests more research be done. Another question for further study, he says, is what sort of sex education the men received in high school.

Of the men in his study, three in 10 reported putting on the condom upside down in the preceding three months at least once, then flipping it over and unrolling it properly. The problem is that semen or germs that touch the condom’s outer surface will then be introduced into his partner’s body.

Sixty percent of the study participants said they had not discussed condom use with their partners before sex.

One-third of the men in the study reported losing erections from condom use, and nearly one-third reported condom breakage or slippage during sex.

Sex educators worry that the details of proper use will become even more lost with the rise of abstinence-only sex education programs. Since 1996, the federal government has committed nearly half a billion dollars to programs that promote abstinence and avoid mentioning any benefit of contraceptive use.

For their part, abstinence advocates say the study underscores how uncertain condom use can be.

“Besides, even if people do put it on correctly, they still can get someone pregnant or pass on disease,” said Richard Panzer, director of Free Teens USA, an abstinence group in Paterson. “To hang your faith and entire future on a piece of wafer-thin latex does not seem wise.”

The head of health education at Rutgers University, however, believes education needs to be more detailed, not less. Fern Walter Goodhart sends peer educators into dorms, sororities, and fraternities, armed with condoms and anatomically correct models for practicing. The educators even encourage students to practice blind-folded or with the lights out, to be sure they’ll know what they’re doing when they’re fumbling in the dark.

“You want them to replicate the skill in the environment in which it’s going to be used,” Goodhart said. “And you pray that they’ll be sober when they’re doing it.”

Ever since AIDS gripped the nation, health experts have called for consistent and correct condom use. The American public has clearly heard the first part of that message; condom use has skyrocketed. But the public health campaign has not included details on how exactly to use them.

That knowledge gap accounts for the chasm between the theoretical efficacy of condoms and their actual success. When used correctly, condoms are 98 percent effective in preventing pregnancy. But, given user errors, the pregnancy failure rate among typical condom users falls between 12 percent and 14 percent.

“I rarely run into a teenager who uses condoms correctly,” said Dr. Robert Johnson, head of the adolescent and young adult division at the University of Medicine and Dentistry of New Jersey in Newark. “Just last night, one youngster in my office told me, ‘Oh, I’m safe because I always put it on just before I (ejaculate).’ By the way, he was there to be treated for chlamydia. They don’t realize you can get someone pregnant with preejaculate fluid, and that they can contract or transmit disease by simple contact.”