Perceived versus actual condom skills among clients at sexually transmitted disease clinics

The primary aim of this study was to investigate whether individual self-reports of perceived ability to use a condom correctly correlated with the actual ability to do so. Participants in the study were 3,059 clients of a sexually transmitted disease clinic. The findings revealed that the participants' perceived self-efficacy with regard to using a condom effectively was a poor indicator of their clinically demonstrated skills using a penile model as scored on the 6-point Condom Skills Index. Condom skills, in general, were found to be at a moderate level only. Even though 89 percent of the sample were persons who said they were somewhat or very sure that they could put a condom on and take it off correctly, the sample mean score on the Condom Skills Index was only 3.6, or 60 percent correct. Perceived versus demonstrated condom skills showed poor correlations for both the relatively lower-risk group (r = .09; P < .001 and the pooled higher risk groups (r = .12; P < .001). Although men were significantly more likely than women to believe they had adequate condom skills, no significant differences were found between the clinically demonstrated condom skills of males and females. Although condom promotion has included issues of product quality and consistent use, little attention has focused on correct use. Hence, when interventions aimed at reducing risk for HIV focus on developing communication-negotiation skills regarding the consistent use of condoms, attention also should be directed toward developing skills for using condoms effectively.