A new and successful strategy for combating the spread of sexually transmitted diseases such as HIV draws from an old idea: Practice is fundamental to learning, even when it involves using condoms correctly.
The Kinsey Institute Homework Intervention Strategy gives men a "ditty bag" full of condoms and lubricants, makes sure the men understand how to apply condoms correctly, and then assigns homework. The men are expected to try out at least six condoms solo, paying particular attention to their own pleasure and which condoms they like best.
"It's such a simple idea, but nobody has every structured an approach like this," said William L. Yarber, professor in the Indiana University School of Public-Health-Bloomington. Yarber is co-author of the study, "A novel, self-guided, home-based intervention to improve condom use among young men who have sex with men," which was discussed at the American Public Health Association's annual meeting. "These are pilot studies. But even with small samples, the results are really good. Men become more motivated to use condoms; they use them more correctly and consistently. They also appreciate learning that there are different condoms available."
The first pilot study, published in the Journal of Men's Health in 2011, focused on heterosexual men. The APHA study, which will be published in the Journal of American College Health, focuses on young men who have sex with men, or MSM. This is an important group of men to reach, said Roberta Emetu, who coordinated the research project. MSM ages 18 to 29 are disproportionately diagnosed with HIV, according to the Centers for Disease Control and Prevention.
"The men who experienced this intervention became better in their condom use," said Emetu, a doctoral student at the IU School of Public Health-Bloomington. "They not only used them more often but used them correctly. We saw an increase in motivation to use them."
Yarber and his colleague Stephanie A. Sanders, along with the rest of the Kinsey Institute Condom Use Research Team have documented for more than 10 years how merely wearing a condom is not enough to provide effective protection against STDs and unwanted pregnancies. Condoms need to be used correctly, yet fit-and-feel issues can result in erection difficulty, loss of sensation, removal of condoms before the intercourse episode ends, and other problems that can interfere with their correct use.
"This homework strategy combines common sense, in that practice is important; the science of how the fit and feel of condoms may affect sexual arousal, and advances in technology - the new shapes, sizes and textures of condoms coming into the marketplace," said Sanders, associate director of The Kinsey Institute.
Not all condoms fit the same, and the use of lubricant also can be helpful.
"Most men do not experiment with different kinds of condoms," Yarber said. "They get what's available or what the other guys talk about. The kits for this study included eight different kinds of condoms and five kinds of lubricant."