2020 Theses Master's

Condom Size Matters: The Importance of Condom Fit in Safe and Pleasurable Penetrative Sex

Chadbourne, Elizabeth

The external condom has a high degree of utility in sexual health promotion, yet problems with nonuse and incorrect use of condoms among populations vulnerable to unintended pregnancy and sexually transmitted infections (STIs) persist. This paper uses critical interpretive synthesis (CIS) as a methodology to review the evidence that condom fit is predictive of sexual pleasure, product acceptability, and correct and consistent condom use behavior. The available literature assessing the relationships among condom use, sexual pleasure, and condom fit indicates the perception of poor condom fit is associated with reduced acceptability and pleasure ratings, lowered rates of correct and consistent condom use, and increased risk of condom failure. Existing theoretical work is built upon to propose a more comprehensive theoretical framework conceptualizing the mechanisms underlying these relationships, including penile and condom dimensions and contextual factors. Web search results and condom brand websites are subsequently analyzed regarding the amount and quality of size information provided suggesting that accessing reliable information about condom sizing can be difficult. Findings are integrated to provide recommendations for the condom industry and those working in the field of sexual health promotion, intended to aid these sectors in improving condom users’ knowledge about and access to appropriately sized condoms, for example, by conducting more collaborative cross-sector work regarding condom fit, in order to increase adherence to correct and consistent condom use as a preventive health behavior.