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Whether heterosexual couples decide to use condoms during sex may be determined more by the nature of the relationship than by aspects of the individual men or women involved, according to a new Dutch study.
When researchers looked at who used condoms regularly versus inconsistently, they found couple-related factors like age difference and how steady or casual the relationship was explained more than half of the variation in condom use. Traits of the individuals accounted for 15 percent or less of the variation.
The results suggest a need for a shift in the way individuals are counseled about condom use, according to Dr. Luu Ireland, from the department of obstetrics and gynecology at the University of California, Los Angeles.
"As physicians we focus more on the individual . . . (but based on the study findings) we probably should address more the type of relationship our patients are going to be involved in," Ireland, who was not involved in the study, said in an email to Reuters Health.
Previous research has focused on either the individual factors associated with condom use, such as gender, age and ethnicity, or on partnership factors, such as the duration and exclusivity of the relationship.
In the current study, Amy Matser, of the Public Health Service of Amsterdam, and her team looked at both sets of factors to determine which were most important in predicting who would use condoms regularly.
They surveyed a total 2,144 men and women who visited a sexually transmitted infections (STI) clinic in Amsterdam from May to August 2010. Participants were asked about their sexual behaviors with up to four of their most recent sexual partners - 6,401 partnerships in all - during the previous year.
Half of the study participants were under age 25 and just over half were women, the researchers note in the journal Sexually Transmitted Infections.
They found condoms were used regularly in just 33.5 percent of the 4,014 casual partnerships and 14 percent of the steady partnerships, according to Matser.
Specific characteristics of these couples were most commonly associated with irregular condom use, for example, it became more likely with the increasing duration of relationships, particularly in steady relationships.
Inconsistent condom use was also more frequent when both partners in a couple were the same ethnicity and in couples with increasing number of sex acts, participation in anal sex and sex-related drug use. This was true of both steady and casual sex relationships.
"We found that when