Health Kenya

Condoms are most effective when applied by men……….hmmmm

It’s been two and a half weeks since I wrote on this blog- I have missed my weekly therapy of reading then writing for you. Life sometimes gets in the way …. I will at some point explain my silence, not now though.
I am not in the mood for anything serious.
I choose an article published in 2014 in a scientific journal and i thought the article was a bit you know, hmmm…Odd. On the other hand, I may have got the wrong end of the stick and all you HIV scientists will come out at me with guns blazing – I haven’t had a fight for a long time – I might just enjoy it.
So let’s take a glance at an article that was published in the Annals of Epidemiology Journal in August 2014 whose title read ‘Condoms are more effective when applied by males: a study of young black males in the United States’.

 

 

paper title

 

Like some of you- I thought ‘Ati?’ (what?)
Anyways, in short the study says – ‘Are you a young sexually African – American young man – please put the condom on yourself – do not let the woman do it’.

 
So what was the evidence?
The study group was 702 young African-American men who were on average 19 years of age. Only half were in high school or college, more than 90% were receiving a form of public financial assistance and ALL of them had a history of a Sexually Transmitted infection (STI) and were attending an STI clinic. Generally, young African-American men from mainly the poor South who were already engaging in unprotected sex.

 
So how was the study done?

 

These young men used a computer assisted self-interview that lasted 30 minutes and then provided a urine sample that was tested for Chlamydia and Gonorrhoea.
So one of the questions were ‘In the past 2 months, how often did your partner put the condom on you?’ the answer could be ‘never’, ‘some of the time’, ‘half the time’, ‘almost every time’ or ‘every time’
They were then asked if the condom broke, slipped off during sex or during withdrawal …… any one of these was categorized as condom failure.
The events to be recalled were only those that occurred within the last 2 months – these were guys were who clearly a bit busy for their age.

 
And the results?
Only 2 in 10 had frequent female application of condom and of these 4 out of 10 reported condom breakage or slippage.
In contrast men who did not report frequent condom application by female had spillage or breakage in 3 out of 10 episodes.
Of those that reported spillage or breakage, about 3 out of 10 had a venereal disease whereas only about 2 out of 10 had a venereal disease among those that had no condom failure.
And oh yes – the urine sample showed that about 1 in 5 currently had an STI.

 
Conclusions of the study?
The first line of the discussion is a bit odd – I quote per verbatim from the paper……
Findings suggest that, among YBM (which stands for Young Black Men) from the Southern United States, the practice of having a female partner frequently apply condoms for PVI (Penile-Vaginal Intercourse) may heighten the risk of condom failure; as a result, this population may be more likely to acquire an STI.

 

never mind the acronyms……

 

Why do the researchers think they got these results – and again I quote the paper where they presented the reasons why the researchers thought the females weren’t that great at putting condoms on their partners……
……it’s quite possible, the female partners simply have never learned the basic application skills. It is also possible that they allow the condom to come into contact with sharp jewelry, fingernails, or teeth.

 

So girls – please remove all jewelry, sharp objects (wonder what those would include) and do not use your teeth! – tell that to a 19 year old …….can you picture that?
‘…..let’s eh, ngoja, I need to open this condom properly…’
‘Bring that thing, I will tear it like we always have………’
‘eeei wait, the study said no teeth! And I need to remove my jewelry’

 

Anyways, let me not bash this paper so much, the researchers provided another explanation as to why condoms that the women put on their partners (I almost said, condoms that women wore…. How does one best say this?) didn’t do the job well, again I quote the paper….
Female application may also imply a lack of desire for condom use by the male partner, thus lack of mutual desire to use condoms correctly may translate into other errors or problems such as adding oil-based lubricants.

 

I think it may also just mean that there is another factor in play here….. perhaps coercion, drugs, booze, 19-year old heat and impatience? Perhaps something a lot more complicated than what a character in Bondoks(the cartoon) would say– this *^!*ing girlfriend don’t know how to put that damn rubber thingie on me, right! It’s her fault!
I guess this is the vagary of using secondary data – remnants of data collected for a completely different purpose to attempt to offer predictions for a completely different problem.

 

OR what do you think?