||Adeyemo Gabriel [ profile ]
Not everyone can use the male condom - Erectile Dysfunctionassociated with condom use
Apr 6th, 2011 - 06:15:23
My Fellow Advocate, I think this is an epistle and you should take some
little time to read it.
Not everyone can use the male condom - erectile dysfunction associated with
The studies reported below provides evidence for reasons for non use of
condom by gay men. It shows erectile dysfunction as a reason for gay men
engaging in unprotected sex, multiple sex partnering and possible increased
risk for HIV infection. There are evidence to suggest that for some gay
men, Erectile Dysfunction do happen when condom is use. The question is: is
Erectile Dysfunction [ED] a possible side effect of condom use?
It may be important to answer this question as the answer will hellp us to
plan effectively for persons who have ED with condom use - how large is this
population and how can this subpopulation of men protect themselves from the
risk of HIV infection and STI? These are important questions that helps us
design sensitive and effective HIV prevention programmes that identify
appropriate HIV prevention technologies for subpopulations.
*Condoms and erectile dysfunction*
A 2004 study of 78 HIV-positive gay men in
that while 38% of the men reported some degree of erectile dysfunction
[ix], this went up to 51% in the context of trying to use condoms. In other
words, more than half of the men experienced difficulty in getting or
sustaining an erection when trying to put a condom on. Furthermore 90% of
the 37 men whose erectile dysfunction was associated with condom use
reported inconsistent condom use during insertive sex, compared with 28% of
those who did not report condom-related erectile dysfunction.
Subsequent studies have strengthened the evidence that performance anxiety
and fear of impotence may be important drivers of mens reluctance to use
A US-study of 278 young (average age 23.7) heterosexual men attending an STI
clinic, for example,found
that men who reported at least one erection loss, either while putting
on condoms or during sex with a condom, in the previous three months had 50%
more episodes of unprotected sex during that period (an average of 10.6
episodes versus 7.0 in men with no erection difficulties). Forty point eight
per cent of men whod experienced erection failure also reported removing
condoms before sex was over twice as many as the 21.3% of men with no
erection problems. Erection loss, even in this young group, was common, with
28.1% reporting one experience of erection failure in the three most recent
episodes of sex.
One of the other predictors of erection loss was, importantly, having
multiple partners. Forty-five per cent of men reporting sex with three or
more partners during the previous three months reported erection loss
compared with 30% of those with one or two partners. This suggests a synergy
between multiple partners, erectile dysfunction and unprotected sex: author
Cynthia Graham suggested that men were more likely to be nervous with new
partners, which would make them reluctant to use condoms, even though they
were the very people who should be using them.
Once bitten twice shy also seemed to apply to gay men when it came to
experiencing erection loss during condom use, according to a study presented
to the Mexico World AIDS Conference in
gay men experience erection loss when they use condoms for insertive
sex, they are both less likely to use condoms over the following six months,
and less likely to *intend* to use condoms, Dutch researchers found.
So called COINED - COndom INduced Erectile Dysfunction was such a strong
independent predictor of subsequent premeditated, as opposed to
unpremeditated, unprotected sex, the researchers found, that it could be
used as a surrogate marker for it.
The researchers looked at the relationship between COINED and deliberately
risky sexual behaviour in 435 men, 6% of them HIV-positive, taking part in
the Amsterdam Cohort Studies of Homosexual Men.
Deliberate risk was defined as unprotected insertive anal intercourse (UIAI)
that was planned in advance, while COINED was defined as loss of erection
because of condom use. The data from the questionnaires suggested rates of
UIAI reached 18% (55/306) with casual partners and 17% (46/272) with steady
partners of discordant or unknown HIV status.
COINED was not associated with UIAI with steady partners. But among casual
partners, COINED was significantly associated with deliberate UIAI (odds
ratio of 6.57) but not with non-deliberate UIAI. The researchers conclude
that COINED is a unique predictor of deliberate UAI between casual partners.
If men experienced COINED they were 2.71 times more likely, six months
later, to have risky UIAI (p =