Condoms are more effective when applied by males: a study of young black males in the United States.

PURPOSE To determine, among a sample of young black male (YBM), whether female application of male condoms for penile-vaginal intercourse would be associated with higher or lower rates of breakage or slippage. A secondary aim was to investigate if higher rates of breakage or slippage were associated with increased odds of acquiring chlamydia and/or gonorrhea. METHODS A cross-sectional study of 412 YBM, aged 15 to 23 years, was conducted in three US cities located in the Southern United States. RESULTS Among YBM reporting frequent female application of condoms, 43.5% reported one or more instance of breakage or slippage, compared with those reporting less frequent female application (27.2%, P = .003). Among YBM reporting one or more event of breakage or slippage, 25.4% tested positive for chlamydia and/or gonorrhea. In contrast, among those not reporting breakage or slippage, 17.2% tested positive (P = .047). CONCLUSIONS Findings suggest that educational and behavioral interventions should seek to improve young women's skills relative to condom application and use. Further studies could also investigate whether intervention efforts should encourage some YBM to be responsible for their own condom application.