Condom Use During Sexual Intercourse Among Women and Men Aged 15-44 in the United States: 2011-2015 National Survey of Family Growth

Questions for Casey Copen, Ph.D., M.P.H., Statistician and Author of “Condom use during sexual intercourse among women and men aged 15-44 in the United States: 2011-2015 National Survey of Family Growth”

Q: Why did you decide to examine condom use in this report?

CC: There are about 20 million new sexually transmitted infections (STI) in the United States each year. These infections can lead to long-term health consequences, such as infertility. Condoms can provide protection against most STIs but are often used incorrectly and inconsistently. Similarly, condoms can reduce the risk of pregnancy but have one of the highest rates of contraceptive failure of any contraceptive method.

The purpose of this report was to examine recent trends in condom use during vaginal (sexual) intercourse and measure the prevalence of condom use, alone or in combination with another contraceptive method. This information can be used to plan health services and educational programs in the U.S.

Q: Has the data in this report been previously published?

CC: Data on condom use has been collected for women since 1973 and for men, since 2002. Starting in 2013, questions on problems with condom use were asked of women aged 15-44 who used a condom during intercourse in the past 4 weeks. Periodically, the National Survey of Family Growth (NSFG) publishes reports on current contraceptive use, which includes condoms, to measure how contraceptive use among women has changed over time.

Last month, NSFG released a report on contraceptive use among female and male teens aged 15-19 that included information on condom use at first and most recent intercourse (https://www.cdc.gov/nchs/data/nhsr/nhsr104.pdf). However, the data on condom use problems have not been previously published.

Q: What do you think were the main findings of your report?

CC: In 2011-2015, 23.8% of women and 33.7% of men aged 15–44 used a condom at last sexual intercourse in the past 12 months. Among condom users aged 15-44, the majority of women and men used only a condom and no other method during last intercourse in the past 12 months (59.9% of women and 56.4% of men); another 25.0% of women and 33.2% of men used condoms plus hormonal methods; and 15.1% of women and 10.5% of men used condoms plus non-hormonal methods. Almost 7% of women aged 15–44 who used a condom in the past four weeks said the condom broke or completely fell off during intercourse or withdrawal and 25.8% said the condom was used for only part of the time during intercourse.

Q: How has the percentage of condom use in the U.S. during sexual intercourse changed since 2002?

CC: The percentages of women aged 15-44 who used condoms at last sexual intercourse in the past 12 months were similar from 2002 to 2011-2015, but for men aged 15–44, the percentages increased from 29.5% in 2002 to 33.7% in 2011–2015. Percentages of female and male condom users aged 15–44 who used condoms only at last intercourse in the past 12 months decreased from 67.9% of women and 63.0% of men in 2002 to 59.9% and 56.4% in 2011-2015. Alongside this decline, percentages of female condom users aged 15–44 who used condoms plus non-hormonal methods at last intercourse increased from 11.9% in 2006–2010 to 15.1% in 2011–2015.

Q: What is the take-home message of your report?

CC: This report showed that the majority of women and men aged 15-44 in each NSFG survey period did not use a condom at all during last sexual intercourse. It is important to note that there are many factors associated with condom nonuse, such as being in a monogamous relationship, using hormonal or other methods to prevent pregnancy or trying to get pregnant. Although this report could not address each of these factors directly, these findings indicate there are differences in condom use by age, education, Hispanic origin and race, relationship at last sexual intercourse and number of sexual partners in the past 12 months. About one-quarter of women aged 15-44 who used a condom during intercourse in the past 4 weeks reported that the condom was used for only part of the time during intercourse (25.8%), suggesting that condoms are often used inconsistently.