Date of Award


Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Dr. Laura Salazar

Second Advisor

Dr. Aaron Siegler


Introduction There are many personal and behavioral factors that can decrease the effectiveness of condoms, even when one is used every time. Clinical condom failure (the condom breaking, tearing, or completely slipping off the penis) contributes to less than perfect effectiveness rates and can be at least partially attributed to these personal and behavioral factors. Although specific use and storage behaviors can be reasons for a condom to break or slip, there are often other factors at play. Negative perceptions of condoms, self-efficacy when using condoms, type of sex act, and history of STI’s can all impact clinical failure rates.

Objective The purpose of this study was to assess four major factors: negative perceptions of condoms, self-efficacy, history of STI’s, and type of sex act, and their relationship to condom breakage and slippage in a sample of 381 condom users in Atlanta, GA.

Methods Data were drawn from the baseline survey of the C-PLEASURE Study. Bivariate analyses were conducted to determine the relationship between each independent variable and the two outcome variables: experiencing condom breakage in the last 6 months and experiencing condom slippage in the last 6 months. Then two logistic regression models, one for experience of any condom breaks in the last six months and one for experience of any condom slips in the last six months, were used to further determine these relationships.

Results The only significant relationship that was found was between negative perceptions of condoms and condom slips (AOR=1.08 95% CI= [1.02, 1.14], p=0.01). History of STI’s, type of sex act, lubricant use, lubricant type, consistent condom use, and self-efficacy did not return any significant relationships with experience of condom breaks or slips in the last 6 months, although self-efficacy did approach a significant relationship with condom slips (p=.07).

Conclusions Since negative perceptions are correlated with condom failure, attitudes and perceptions of condoms need to be addressed for greater efficacy. Further studies on self-efficacy and condom failure should be pursued to determine how strong the protective qualities of self-efficacy can be when it comes to effective use of condoms and prevention of condom failure.