The clinical study will compare two lubricated polyurethane male condoms of different thickness with a marketed lubricated control male condom made of natural rubber latex. This crossover study will randomize 300 heterosexual couples to the sequence in which they use five condoms of each of the three study condom types. The clinical failure (breakage and slippage) rates of the two polyurethane condoms will be compared to the clinical failure (breakage and slippage) rate of commercial natural rubber latex control condom using a statistical test of non-inferiority. The study will also compare the acceptability of the two polyurethane condom different thickness with that of the natural rubber latex control condom obtained from interviews and questionnaires with subject couples.

The clinical study will compare two lubricated polyurethane male condoms of different thickness and different sizes with a marketed lubricated control male condom made of natural rubber latex.

Couples entering the study will be expected to use 5 of each type of the 3 condoms in a randomised order. The identity of the condoms will be masked to both the couples and the investigators. The aim will be to recruit 300 heterosexual with the intent of achieving a minimum 1,000 uses of each condom type. Couples will report condom use events using a condom report form. The primary information collected will relate to condom breakage and slippage of the penis during use.

The total clinical failure rates (breakage and slippage) of the two polyurethane condoms will be compared to the clinical failure (breakage and slippage) rate of commercial natural rubber latex control condom using a statistical test of non-inferiority. The study will also compare the acceptability of the two polyurethane condom different thickness with that of the natural rubber latex control condom obtained from interviews and questionnaires with subject couples.

Inclusion Criteria:

1. Between the ages of 18 and 45 (inclusive)
2. Protected against pregnancy by oral contraceptives, an IUD, an implant, contraceptive injections, contraceptive patch, or sterilization (tubal ligation or vasectomy)
3. Have home internet access, a valid personal email for each partner, ability to videoconference and use electronic signature technology
4. Willing and able to give electronic informed consent
5. Willing to respond to questions concerning their reproductive and contraceptive history and use of condoms via interview or self-administered questionnaires
6. Have vaginal intercourse at least once weekly
7. Willing to use the study products for fifteen acts of vaginal intercourse within nine weeks of study entry
8. In a mutually exclusive monogamous relationship with their study partner for at least 6 months and be willing to remain mutually monogamous throughout study participation
9. Both study partners have previous experience using male condoms
10. Agree not to use any additional vaginal or sexual lubricant except the AstroglideTM product provided, if desired, supplied by the study
11. Agree not to expose the study condoms to jewelry (hand, facial, or genital) or piercings (facial or genital) that could damage the study condoms.
12. Agree not to use sex toys or drugs intended to enhance or diminish sexual response when using study condoms
13. Male partner agrees to ejaculate during vaginal intercourse
14. Agree to (or partner) hold the condom at the base of the erect penis during withdrawal
15. Agree to return any condoms that break during use
16. Agree to return any unopened condoms
17. Reachable by telephone

Exclusion Criteria:

1. Currently participating in another similar clinical study
2. Female partner self-reported as pregnant
3. Allergic to natural rubber latex or polyurethane, or has a history of recurrent adverse events following use of latex or polyurethane products
4. Unable to follow study requirements, use instructions or attend study visits or exchanges
5. Have a significant (high) risk of STIs, including HIV infection, or having a medical history of recurrent, uncontrolled STIs (e.g. gonorrhoea, syphilis, Chlamydia, etc.)
6. Currently using condoms for protection against a known STI
7. Taking any internally applied medication to treat a genital condition that could interact with the study condom
8. Male partner has used medication that has caused erectile dysfunction, or had difficulty achieving/maintaining an erection, or achieving ejaculation in the last month under typical circumstances/conditions
9. Male has had a prostatectomy
10. Any self-reported genitourinary condition (e.g. itching, burning, irritation, etc.) which, in the opinion of the investigator, could affect use of the study condoms or the ability to interpret study data
11. Employee or affiliate of Essential Access Health or Sagami Rubber Industries Co., Ltd.

The baseline analysis population is the number of couples who were consented to join the study

Participants completed report forms after each condom use. Each condom report elicited information about specific adverse event usually experienced when using condoms including discomfort caused by burning, irritation and itching sensations, rashes, constriction, decreased sensitivity and dryness. Participants were expected to use all 15 condoms within 9 weeks, which can therefore be regarded as the monitoring period for adverse event.

All adverse events were rated by severity (mild, moderate, severe), duration (only while wearing condom, 1 to 10 minutes after condom removed, 11 to 59 minutes after condom removed and more than 59 minutes after condom removed.

All condom use events were self reported. There is a potential for misreporting the number of events.

Since the trial was masked it was not feasible to preselect men with smaller penises to use the smaller Condom B. Instead, a post hoc analysis of the association between penis size and clinical failure rates was conducted followed by a further non-inferiority analysis after excluding men with penis lengths exceeding the specified nominal length of Condom B (170 mm).