Condoms used in one-in-four heterosexual encounters in the US

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A quarter of heterosexual adults in the United States used a condom the last time they had vaginal sex, researchers from Indiana University have found.

Respondents generally reported that condom use made no difference to sexual pleasure, to orgasm, or to maintaining an erection in men.

However, men reported a small but statistically significant diminution in sexual pleasure when they used condoms without also using an extra lubricant, and women reported more difficulty in achieving vaginal wetness.

Glossary

statistical significance

Statistical tests are used to judge whether the results of a study could be due to chance and would not be confirmed if the study was repeated. If result is probably not due to chance, the results are ‘statistically significant’. 

matched

In a case-control study, a process to make the cases and the controls comparable with respect to extraneous factors. For example, each case is matched individually with a control subject on variables such as age, sex and HIV status. 

Women were less likely to know than men whether condoms were pre-lubricated or what they were made of, though very few reported using an oil-based lubricant with a condom.

The survey and its participants

The study is part of the US National Survey of Sexual Health and Behaviour; HIV treatment update reported last year on the survey’s findings in gay men, which were co-sponsored by the Online Buddies gay dating company and published on the Manhunt website.

In the present study, 1645 heterosexual adults aged 18 to 59 who reported vaginal intercourse (14 of whom defined as bisexual and one as lesbian) were interviewed during 2009.

Fifty-two per cent were male and two-thirds were of white ethnicity, with 16% Hispanic and 10% African-American. There was an even spread of ages. Forty-eight per cent were married, 27% single, and 10% divorced or separated. A third had children living with them.

The researchers asked about participants’ most recent partner, and these roughly reflected the proportions of married and single people in the survey: 55% said their most recent partner was their regular partner, 12% said a ‘friend’, and 30% of men and 34% of women said their most recent partner was either a ‘new acquaintance’, a date, or a casual partner. Only 3% or men and 1% of women reported their most recent partner was a transactional (paid or paying) partner.

Condom and lubricant use

Condoms were used by 27.5% of men and 22% of women the last time they had sex and of those who did not use a condom, 25% of men (18% of all men) and 29% of women (22.5% of all women) used a sexual lubricant, while only 5% of men and women reported using both a condom and extra lubricant. This left 61% of men and women who used neither condom nor lubricant. Eighty-two per cent of men and 66% of women reported that the condom they used was pre-lubricated.

Women were more likely not to know what type of condom was used, what kind of lubricant was used, and whether the condom was pre-lubricated.

What counted as lubricant? Fifty per cent of the men and 58% of the women who used lubricant without a condom reported it was water- or silicone-based and 70% of both men and women who used it with a condom. Twenty-two per cent of men and 28% of women who did not use a condom reported just using saliva, and 14.5% of men and women who did use a condom. There was a discrepancy between men and women when it came to oil-based products; nearly 19% of men (29 individuals) who used lubricant without a condom reported using an oil-containing product such as Vaseline, baby oil or body lotion but only 4% of the women (seven individuals). Only four men and two women reported using oil-based products with condoms; in all cases these were latex condoms, which would be weakened by the lubricant.

There was also a discrepancy when it came to reporting who had applied the condom: while the majority of both sexes reported that the man generally put it on himself, 21% of men and 11% of women reported that the woman put it on – though women were more likely to report that she and her partner did it together.

Effect of condoms and lubricant on sex

In general, neither men nor women reported that using a condom, with or without extra lubricant, had any effect on sexual pleasure or ability for the man to achieve erection. Men who used a condom but no extra lubricant rated their sexual arousal levels somewhat lower than non-condom users or men who used a condom and lubricant, but although this difference was statistically significant, it was slight, and men rated their arousal levels as consistently high. Women who used a condom without lubricant reported more difficulty in achieving vaginal wetness, though they did not report lower rates of arousal. Although few women reported pain, they were more likely to do so without lubricant.

As for orgasm, neither condom use nor lubricant affected whether partners had an orgasm, or whether they perceived that their partner did. There were some interesting gender differences, though: while 95% of men had an orgasm and 94% of women perceived that they did, only 66% of women had an orgasm – although men thought they did 90% of the time.

Conclusions

This was not a study of couples, but individual men and women, so some of the discrepancies between sexes might be due to individual differences. Also condom use cannot be related to what kind of partner participants were having sex with, although it approximately matches the proportion of casual or new partners. It is noteworthy that, while almost exactly a quarter of heterosexuals used condoms last time they had vaginal sex, in the matching gay men’s survey, 45.5% of gay men reported using a condom last time they had anal sex. It is encouraging to note that, in this survey at least, condoms were reported as only very slightly affecting sexual pleasure and that using oil-based lubricants with them was rare.

References

Herbenick D et al. Characteristics of condom and lubricant use among a nationally representative probability sample of adults ages 18-59 in the United States. Journal of Sexual Medicine 10:474-483, DOI: 10.1111/jsm.12021, 2013.