EXECUTIVE SUMMARY

A recent analysis of national data indicates that from 2011-2015, 23.8% of women and 33.7% of men ages 15-44 used a condom at last sexual intercourse. Of those who used condoms, about 60% of men and 56% of women relied on condoms alone for pregnancy prevention.

  • About 7% of women ages 15-44 who used a condom during the past four weeks reported the condom broke or completely fell off during intercourse or withdrawal, while 25.8% said the condom was used for only part of the time during intercourse.
  • Among teens ages 15-19, 36% of women and 53% of men said they used condoms each time they had sex over the past year, compared to 11% of men and 9% of women ages 35-44.

A recent analysis of national data indicates that from 2011-2015, 23.8% of women and 33.7% of men ages 15-44 used a condom at last sexual intercourse. Of those who used condoms, about 60% of men and 56% of women relied on condoms alone for pregnancy prevention.1

At the present time, condoms are the only contraceptive
method that provides protection against pregnancy and most sexually transmitted infections (STIs), including the human immunodeficiency virus. The analysis was designed to examine recent trends in condom use during vaginal intercourse and measure the prevalence of condom use, alone or in combination with another contraceptive method.

Data from the analysis indicate the percentages of female and male condom users who used condoms only at last intercourse in the past 12 months decreased from 67.9% of women and 63.0% of men in 2002 to 65.6% and 57.6% for 2006-2010 and 59.9% and 56.4% for 2011-2015. Coupled with this decline, the percentages of female condom users who used condoms plus nonhormonal methods at last intercourse grew from 11.9% in 2006-2010 to 15.1% for 2011-2015.1

Data for the new analysis came from the National Survey of Family Growth (NSFG). The purpose of the NSFG is to provide nationally representative, scientifically credible data on factors related to birth and pregnancy rates, family formation and dissolution patterns, and reproductive health for use by various Department of Health and Human Services programs, as well as for research, explains the paper’s author, Casey Copen, MPH, PhD, a statistician with the National Center for Health Statistics. The survey has collected data on condom use in women since 1973, and men since 2002. Questions were added in 2013 to query women ages 15-44 about condom problems during the past four weeks of use.

Other findings from the analysis indicate that 25.0% of women and 33.2% of men used condoms plus hormonal methods at last sexual intercourse, while 15.1% of women and 10.5% of men used condoms plus nonhormonal methods. About 7% of women ages 15-44 who used a condom during the past four weeks reported the condom broke or completely fell off during intercourse or withdrawal, while 25.8% said the condom was used for only part of the time during intercourse.1

Condoms Are ‘Accessible Option’

The overall proportion of condom use is stable in recent years, with no large changes across the U.S. population, said Dennis Fortenberry, MD, MS, professor of pediatrics at the Indiana University School of Medicine and a member of the board of directors for the American Social Health Association.

“Although condoms will never solve all of the STI and pregnancy prevention needs of a diverse population, they remain an accessible and low-cost technology necessary for comprehensive public health prevention approaches,” Fortenberry noted in a press statement.

Condom use is “quite high among younger sexually active populations where STI and pregnancy are important and access to other means of prevention may be limited,” said Fortenberry. The new report confirms this increased use: Among teens ages 15-19, 36% of women and 53% of men said they used condoms each time they had sex during the past year, compared to 11% of men and 9% of women ages 35-44.1

Consistent, Correct Use Is Key

Providers can do more to teach people how to use condoms correctly, Fortenberry said. “The relatively high frequency of condom use problems suggests the need for continued public health education and training, since other research suggests that problems are less frequent among more experienced users,” he said.

According to Contraceptive Technology, healthcare providers should encourage patients to practice using condoms; when providing instruction on how to use condoms, they should have patients unroll a condom onto a model of a penis or a banana, both with eyes open and then again in the dark. They should offer to help patients select a condom that is most suitable to their needs, which may include the female condom. Many clinics now provide a variety of condoms in different sizes and textures to help patients find what works best for them.

Use the Centers for Disease Control’s fact sheet with a section on “Know Your Condom Dos and Don’ts,” to help men and women understand how to use a condom the right way every time. (Access the free fact sheet at http://bit.ly/2bNyguF.) Remind patients that a new condom must be used with every act of intercourse if any risk of pregnancy or sexually transmitted infection exists. Also, condoms should be donned before any genital contact, with the condom unrolled all the way to the base of erect penis. Immediately after ejaculation, the rim of the condom should be held while the penis is withdrawn, with the used condom disposed of safely.2

REFERENCES

  1. Copen CE. Condom use during sexual intercourse among women and men aged 15-44 in the United States: 2011-2015 National Survey of Family Growth. Natl Health Stat Report 2017;105:1-17.
  2. Warner L, Steiner MJ. Male condoms. In: Hatcher RA, Trussell J, Nelson AL, et al. Contraceptive Technology: 20th revised edition. New York: Ardent Media; 2011.