An evaluation of a thicker versus a standard condom with gay men

Objectives: Although thicker (stronger) condoms are advocated in western Eu rope for anal intercourse between men, empirical evidence supporting their greater efficacy is lacking. The present study aimed to determine whether a thicker condom is less likely to fail (break or slip off) than a standard (regular thickness) condom, and to establish factors associated with condom failure among gay men. Design: A total of 283 homosexual couples participated in a double-blind, r andomized, controlled trial of a standard and a thicker condom. Methods: Each couple was allocated nine of either condom type. Data were co llected on user characteristics, and a questionnaire completed immediately after the use of each condom. The thicker and the standard condoms were use d by 142 and 141 couples, respectively. Results: No significant differences were found between the two condom types with respect to either clinical or non-clinical definitions of failure (br eakage and slippage). With instances of inappropriate use removed, failure rates for the standard and the thicker condom were low at 2.5 and 2.3%, res pectively. User characteristics associated with breakage were lower educati onal achievement, lack of confidence in condom use, and a history of condom breakage. Behaviours associated with breakage were unrolling the condom be fore fitting to the penis, longer penis length, absence of additional lubri cant, the use of inappropriate lubricant, and longer duration of intercours e. Conclusion: Breakage and slippage rates were low for both condom types. The re is no evidence from the present investigation to support the use of stro nger (thicker) condoms over standard strength condoms among gay men. The ap propriate use of additional lubricant should be encouraged. (C) 2001 Lippin cott Williams & Wilkins.