We appreciate Dr Adam raising the issue of possible limitations in the definition of correct condom use described in our article. We included in our definition of correct condom use both episodes of user and method failure. Although we agree that method failure such as breakage or slippage cannot always be controlled by the user, it is likely that incorrect use can lead to these events and its frequency could be reduced through patient education.
Paz-Bailey G, Koumans E, Markowitz LE. Perfect Condom Use in a Less Than Perfect World—Reply. Arch Pediatr Adolesc Med. 2006;160(3):321-322. doi:10.1001/archpedi.160.3.322