Am J Epidemiol 2003; 157:282-288.
Copyright © 2003 by Johns
Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Partner Characteristics, Intensity of the Intercourse, and Semen Exposure During Use of the Female Condom
1 Department of Epidemiology and International Health, School of Public Health, University of Alabama at Birmingham, Birmingham, AL.
2 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA.
3 Department of Pathology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL.
4 Department of Obstetrics and Gynecology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL.
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.
biological markers; coitus; condoms, female; contraception behavior; prostate-specific antigen; semen; sex behavior; sexually transmitted diseases
Abbreviations: Abbreviations: PSA, prostate-specific antigen; STD, sexually transmitted disease.
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