Advancing Sexual and Reproductive Health and Rights
 
Perspectives on Sexual and Reproductive Health
Volume 36, Number 3, May/June 2004

The Acceptability of the Female and Male Condom: A Randomized Crossover Trial

By Andrzej Kulczycki, Dhong-Jin Kim, Ann Duerr, Denise J. Jamieson and Maurizio Macaluso

CONTEXT: Although studies have assessed the acceptability of male and female condoms, comparative trial data are lacking.

METHODS: A sample of 108 women in stable relationships recruited from an urban, reproductive health clinic were randomly assigned to use 10 male or female condoms, followed by use of 10 of the other type. A nurse provided instruction in correct method use. Demographic information was collected in a baseline questionnaire; acceptability data were collected in follow-up and exit questionnaires and coital logs. Nonparametric and chi-square statistics were used to analyze measures of the methods' relative acceptability. Bowker's test of symmetry was adapted to test the null hypothesis of no difference in acceptability between condom types.

RESULTS: Participants used 678 female and 700 male condoms. Although neither method scored high on user satisfaction measures, the 63 women completing the study protocol preferred the male condom to the female condom for ease of application or insertion, ease of removal, general fit, feel of the condom during intercourse and ease of penetration. Participants reported that their partner also favored the male condom, although women generally appeared to like this method more than their partner did. In a direct comparison between the methods at the end of the study, women generally judged male condoms superior on specified preference criteria.

CONCLUSIONS: Across a range of criteria, the female condom was less acceptable than the male condom to most women and their partners. Although both types had low acceptability, they are needed and valid methods of pregnancy and disease prevention. That neither rated high on user satisfaction measures underscores the need for more barrier methods that women and men can use.

Perspectives on Sexual and Reproductive Health, 2004, 36(3):114-119

DOI:10.1363/3611404







 

 
 

Andrzej Kulczycki is assistant professor of maternal and child health, School of Public Health, and Dhong-Jin Kim is database analyst, Center for Research in Women's Health, both at the University of Alabama at Birmingham. Ann Duerr is associate director for scientific support, HIV Vaccine Trials Network, Fred Hutchinson Cancer Research Center, Seattle. Denise J. Jamieson is HIV epidemiology team leader, and Maurizio Macaluso is senior scientist and chief, Women's Health and Fertility Branch, both at the Division of Reproductive Health, U.S. Centers for Disease Control and Prevention, Atlanta.