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Condom Failure or User Error: Explaining Discrepancies in Self-Reported Condom Use

Source: Eve Rose et al., “The Validity of Teens’ and Young Adults’ Self-reported Condom Use.” Archives of Pediatric and Adolescent Medicine 163 (January 2009): 61-63.  

Description:
 
This study, conducted in Athens, Georgia, examines the validity of self-reported condom use among young people. Study participants were a random sample of 715 young African-American women ages 15–25 who were part of an HIV-prevention program in STD and family planning clinics. The young women were asked whether they practiced 100% consistent condom use or inconsistent condom use, which was defined as any condom use less than 100% of the time. By utilizing a vaginal swab to check for sperm, researchers then determined whether a condom was used properly. Of those 715 participants, 484 women had usable tests. The findings were used to question the validity of self-reported condom use.
 
Key Findings:
 
  • 186 of 484 teens and young adults reported consistent condom use.
  • Of the 186 teens and young adults who reported consistent condom use, 63 (33.9%) had sperm present in their vaginal fluid.
  
SIECUS Analysis:
 
Sexual and reproductive health research relies heavily on self-reported behavior. This study was designed to question this reliance and assess the accuracy of self-reporting. By comparing self-reported condom use with actual presence of sperm in a woman’s vaginal fluid, the authors concluded that there is a significant difference between self-reports of consistent condom use and actual correct and consistent condom use.  
 
The findings suggest young women were either over-reporting their condom use or were using condoms incorrectly. The authors of the study believe that user error was more likely the driver of the discrepancy, as research has shown that teen and young adult error in condom use can be as high as 38 percent. The study did not ask young people about their knowledge of correct condom use, or how confident they were that they were using this method correctly. 
 
Some proponents of abstinence-only-until-marriage programs, which often discredit condoms, have used this study to suggest that condoms fail one-third of the time.[i] Others have suggested that it is proof that teens are not a reliable source of information on their own behavior. SIECUS does not believe that either of these are the take away message of this study. In fact, this study was not designed to assess the effectiveness of condoms and previous research that has shown condoms to be a highly effective method of preventing pregnancy and reducing the risk of STD transmission. 
 
Instead, we think it is important to focus on the fact that the overwhelming majority of young women in the study—those that admitted inconsistent condom use and those that reported using condoms consistently—were submitting accurate information. The tests also proved that a majority of those teens who reported using condoms consistently were doing so. The young people who reported using condoms consistently but were found to have sperm in their vaginal fluid, should teach us that there are many youth who still need to learn how to prevent errors in use. Equally important, however, is to focus on those young people who admitted that they were not using condoms consistently—these young people need additional information about the importance of using condoms to prevent both pregnancy and sexually transmitted diseases
 
 


[i] Roger Greer, “Abstinence-Based Sex Education under Attack, even as Study Suggests Condom Failure,” Focus on the Family Action, Inc., 20 January 2009, accessed 17 February 2009 <http://www.citizenlink.org/CLNews/A000009131.cfm>.
 
 

 

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