Early versions of a female condom were available in the 1920s and 1960s, but they were little used and soon forgotten. It took the arrival of AIDS, and the urgent need for a wider range of female-controlled barrier techniques, to rekindle scientific interest in this method. In the 1980s, three groups in Europe and the USA began development of new female condom designs, comprising 'Femidom (Reality)', the 'Bikini Condom', and 'Women's Choice'. Apart from differences in their physical design, Femidom differs from the others in that it is made of a polyurethane membrane, which has several advantages over latex. Of the three, Femidom is the most advanced in terms of development and clinical testing, and it is the only one to have reached the marketing stage. Laboratory studies and clinical trials suggest that its contraceptive efficacy is similar to that documented for the male condom, though a direct comparison is not possible because no comparative clinical trials have, as yet, been undertaken. Reported 'typical-use' pregnancy rates range from 12.4 to 22.2% at 6 months of use in the USA and Latin America, respectively, while a study in the UK observed a rate of 15% at 12 months. As with all barrier methods, most failures appear to be associated with poor compliance or incorrect use. 'Perfect-use' pregnancy rates were substantially lower, indicating that Femidom can be very effective, if used consistently and correctly. Evidence for Femidom's effectiveness to protect against transmission of sexual disease-causing organisms, including HIV, is still very limited and based largely on laboratory studies. Whilst, in theory, the condom should confer reliable protection, its efficacy in clinical use will depend upon correct and consistent use and upon the product's ability to maintain an effective physical barrier throughout penetrative intercourse. In this respect, the results of recent and ongoing clinical studies are expected with much interest. How valuable Femidom will
The polyurethane female condom is stronger than the latex male condom. Thus, the single-use female condom is less likely to break and has a longer shelf life than the single-use male condom. The ring at the closed end of the condom helps women insert the condom and secures the condom inside the vagina. The outer ring remains outside the vagina and protects the labia and the base of the penis. Female condom use reduces the likelihood of transmission of infectious diseases. The female condom is as effective at preventing pregnancy as the male condom and the diaphragm. Its life-table pregnancy rate in a multicenter clinical trial in the US and Latin America was 15.1% (12.4% in US and 22.% in Latin America). The 6-month failure rate during perfect use was 4.3%. In laboratory studies, no sexually transmitted organism, including HIV, penetrated the female condom. In a human use study, 14% of controls and 14.7% of non-perfect users were reinfected with trichomonas while none of the perfect users were reinfected. Advantages of the female condom follow: allows for greater sensitivity and greater protection than the male condom, is controlled by the female, can be used with any lubricant (even oil-based lubricants), and can be inserted well before intercourse. Disadvantages include cost (5 times costlier than the male condom), unsightly coverage of female genitalia, noisy during use, and breakage (although breakage rates were lower than for latex condoms: 1% vs. 2-5%). Method acceptability studies among various populations show that the inner rings and movement of the female condom during use were the most common complaints. Many women liked the female condom and would recommend it to others. Only a few women complained about insertion problems, yet it took some women at least two tries to insert the female condom.
Full Text Available UNHCR and its partners have been providing male condoms since the late 1990s. However, uptake remains alarmingly low. Will the agency be more successful in promoting the female condom, a female-initiated barrier method of contraception and disease prevention?
Seal, D W; Ehrhardt, A A
This article addresses heterosexual men's familiarity with the female condom and their attitudes toward this barrier method. Qualitative interviews were conducted with 71 ethnically diverse and heterosexually active men who were recruited in sexually transmitted disease (STD) clinics or through word of mouth in communities with high HIV/STD seroprevalence in New York City during fall 1994 to fall 1995. Only one man reported previous experience with the female condom. The large majority of men had no or limited knowledge of the female condom. Men's reactions to learning about this method ranged from positive to negative, although most men reported willingness to have sex with a partner who wanted to use the female condom. Positive reactions included: endorsement of a woman-controlled condom and her right to use it, the potential for enhancing one's sexual pleasure, and an eagerness to have a new sexual experience. Negative reactions centered on the "strangeness" and "bigness" of the female condom, concerns about prevention efficacy, and concerns about reductions in sexual pleasure. Our findings highlight the need for HIV prevention programs that target heterosexual men and promote the use of the female condom.
Evaluated a female condom promotion intervention for socioeconomically disadvantaged women at high risk for sexually transmitted diseases and HIV who had never used female condoms. Pre- and postintervention surveys indicated that providing education and counseling, along with unlimited quantities of male condoms, female condoms, and water-based…
Chatterjee, Karishma; Markham Shaw, Charla
This study examines newspaper and broadcast news depictions of the female condom from 1993 to 2009 in the three major television networks (ABC, CBS, and NBC), and in 8 of 10 top daily newspapers and 3 of 4 national newspapers published in the United States, according to circulation figures as of September 30, 2008. Given the high rates of sexually transmitted infections in the United States and their effect on women, particularly those between 15 and 24 years of age, it is important to examine media sources and the health information that the public is or is not receiving through these sources. This study (a) examines whether the female condom was depicted positively or negatively in broadcast and newspaper coverage, (b) determines the ways in which the female condom was compared with the male condom and with other contraceptives, and (c) identifies the sources used by journalists in female condom portrayals. The authors discuss the implications of the coverage of the female condom by broadcast and print news.
Okunlola, M A; Morhason-Bello, I O; Owonikoko, K M; Adekunle, A O
A cross-sectional study of female condom awareness, usage and concerns among the female undergraduates of the University of Ibadan was conducted in September 2004. The results of 850 out of the 879 female students interviewed were used for analysis (96.6%). Over 80% had knowledge of the female condom as a form of modern contraception and the majority of them learnt about it through the mass media (39.9%) and health workers (34.4%). However, only 11.3% had ever used the female condom, with most (40%) using it to prevent both unwanted pregnancy and sexually transmitted infections including HIV (STI/HIV). The sexual partners' approval was appreciable, accounting for about 42.7% among those that had experience of the female condom usage. Major concerns mentioned such as difficulty of inserting it into the vagina and lack of sexual satisfaction, were not different from those in earlier studies. The result of this study looks promising judging from a high awareness level of the female condom, even though its usage is low. The female condom may be an alternative strategy to combat unsafe sexual practises and its sequelae in a country like Nigeria that is male dominated.
Grayce Alencar Albuquerque
Full Text Available The objective was to learn about the experiences of women from a Health Strategy in view of the experience of sexual autonomy in the face of the female condom. It is an exploratory and qualitative study, completed in April 2010, which used semi-structured interview as data collection technique and the theory of social constructionism to aid in data analysis. Of the total of 25 women participants, after six months, only 12 were still in continuous use of the female condom. They pointed out the female condom as able to provide them with bargaining power, since it is inserted into their bodies. For some, the difficulty of trading remained for failure partner's approval. It is observed that in practice, the female condom becomes hostage of gender relations.
People who indulge in unsafe sex, such as female sex workers are the most at risk population groups due to multiple sexual partners and inconsistent condom use. The aim of this study was to assess condom utilization and sexual behavior of female sex workers in Gondar town, Northwest Ethiopia. Methods: A quantitative ...
Hogben, Matthew; Liddon, Nicole; Pierce, Antonya; Sawyer, Mary; Papp, John R; Black, Carolyn M; Koumans, Emilia H
The highest rates of sexually transmitted infections in the U.S. occur among adolescent females. One prevention strategy promoted for sexually active adolescents is condom use: therefore, influences on correct and consistent condom use are worth examining. Because interventions and observational research into predicting and increasing condom use have yielded mixed results, we hypothesized that a theoretically driven model incorporating female adolescents' perceptions about partner sentiments along with their own perceptions, intentions, and behaviours would improve condom use predictions. We also measured condom use errors and consistency for a more precise estimate of effective use than is common in the literature. In three structural equation models tested on a sample of 519 female adolescents, we found that intentions were associated with both correct and consistent condom use; that females' expectancy beliefs about condom use were associated with intentions; and that females' expectancy beliefs about partners' sentiments reduced the impact of their expectancy beliefs about condom use. The implications of these relations upon condom use correctness and consistency are discussed with respect to informing interventions, among other future research.
The "female condom," a new contraceptive which may offer women protection against STDs, could soon be out in the market. Currently being developed, the female condom is a disposable sheath made of latex or plastic which is worn inside the vagina. One such prototype, made of polyurethane plastic, has already undergone extensive testing and is expected to be on the market in Europe in the fall and worldwide in 1992. At 17 cm in length, this female contraceptive resembles a large male condom with a ring at both ends. One ring is placed outside the vulva, while the other ring is positioned inside the vagina. This design prevents contract between the vagina and the penis, theoretically protecting against STDs. Researchers worldwide are presently conducting clinical trials as to the efficacy and acceptability of the female condom. Although data on the efficacy of the new contraceptive is not yet available, some preliminary reports on its acceptability suggest that women seeking protection from STDs and AIDS -- especially high risk women -- will likely use the device if it becomes available. In a study in Cameroon, 36 out of 38 prostitutes said they liked the female condom, and 33 said that they would use it in the future. While both men and women in Thailand preferred the male condoms, women preferred using the female condom than having unprotected sex. Some believe that the new contraceptive will provide the means for a woman to protect herself when her partner is not being cooperative. The female condoms, however, has its drawback. Foremost among then is its price, which could be as high as $2 (8-20 times the price of a male condoms). Other reported disadvantages with the female condom include reduction of pleasure of spontaneity, and its appearance.
ones were higher and use of female condom was very low. Key words: ...  Besides, mass media campaigns are likely to contribute to the ... cess, continuous supply, free distribution and social marketing of .... Muslims and other religions.
Preliminary research findings from Brazil and Kenya indicate that, when women are provided with female condoms and peer group support, traditional obstacles to safe sex practices can be overcome. In these countries, as well as many others, women face cultural barriers to negotiating condom use with male partners. The study, conducted by the Women's Health Initiative of Family Health International's AIDS Control and Prevention Project, involved 106 Kenyan and 103 Brazilian women. A female focus group was held at the beginning of the study, followed by two peer support group meetings, with another focus group at the end of the study. Group support was an essential element in the acceptance process. Women who were afraid or unsuccessful with initial use were encouraged by other group members to try different, non-threatening approaches to the negotiation of female condom use and given suggestions for overcoming difficulties with insertion and lubrication. Some of these strategies included laying the female condom on the bed so the male partner raises the subject of its use and telling the partner the doctor had recommended the method to avoid the negative side effects associated with the pill. When female condom use is presented as a form of pregnancy prevention, the association of condoms with infidelity is overcome.
Mantell, Joanne E.; Smit, Jennifer A.; Beksinska, Mags; Scorgie, Fiona; Milford, Cecilia; Balch, Erin; Mabude, Zonke; Smith, Emily; Adams-Skinner, Jessica; Exner, Theresa M.; Hoffman, Susie; Stein, Zena A.
Young men in South Africa can play a critical role in preventing new human immunodeficiency virus (HIV) infections, yet are seldom targeted for HIV prevention. While reported condom use at last sex has increased considerably among young people, consistent condom use remains a challenge. In this study, 74 male higher education students gave their perspectives on male and female condoms in 10 focus group discussions. All believed that condoms should be used when wanting to prevent conception an...
The non-intervention studies which were not linked to specific interventions, operationalized acceptability in terms of women who liked the female condom, not necessarily based on practical experience or use. Intervention studies led to a high proportion of women using the technology, rating the experiences as satisfactory, ...
Objectives: To assess the knowledge, attitudes and use of the female condom among undergraduates of Kigali Health Institute. Methods: A descriptive study was carried out between May and June 2010. The sample was randomly selected from the students of Kigali Health Institute. A questionnaire based study was ...
Tarkang, Elvis E
HIV/AIDS prevention programs rooted in the social cognitive models are based on the theoretical assumptions that adoption of preventive behaviour (condom use) depends on the individual's perceptions of their susceptibility to HIV/AIDS and the benefits of condom use. However some studies contend that applying such models in the African setting may not be that simple considering that in many societies, people's capacity to initiate health enhancing behaviour are mediated by power relations (parents/guardians) and socialisation processes that are beyond the control of individuals. The relative influence of these family forces on condom use is however unknown in Cameroon. In this study it is hypothesized that adolescents' perceptions of family support for condom use, would encourage condom use among female students in Limbe urban city of Cameroon. A cross-sectional study of a probability sample of 210 female students selected from three participating secondary school was adopted, using a self-administered questionnaire to collect data. Pearson Chi-square statistics was used to test association between perceived family support for condom use and condom use. Statistics were calculated using SPSS version 20 software program. Of the respondents, 56.2% reported being sexually active. Of these, 27.4% reported using condoms consistently; 39.1% reported having used condoms during their first sexual intercourse, while 48.7% reported having used condoms during their last sexual intercourse. Majority of the female students exhibited positive perceptions regarding family support for condom use. Respondents who agreed that they feel themselves free to discuss condom use with their parents or any adult member of the family, reported more condom use during first sex than those who disagreed (X2 = 13.021; df = 6; p = 0.043). Likewise respondents who agreed that they feel themselves free to discuss condom use with their parents or any adult member of the family, reported
Andrews, Carin Hillerdal; Faxelid, Elisabeth; Sychaerun, Vanphanom; Phrasisombath, Ketkesone
Female sex workers (FSWs) are a high-risk population for HIV. Correct and consistent use of condoms is the most effective measure for reducing transmission of HIV. Lao PDR is a low HIV-prevalence country, but FSWs have a relatively high HIV prevalence. To be able to make recommendations for condom promotion interventions in Lao PDR it is important to know more about the context specific situation. This study looked at reasons for and associated factors of consistent condom use among FSWs. A cross-sectional survey among 258 FSWs in Kaysone Phomvihan district in Savannakhet province was performed. Almost all FSWs had enough condoms (94%), condoms always available (100%) and could always afford condoms (92%). Consistent condom use was 97% with non-regular partners and 60% with regular partners. Almost all respondents (95%) had received information about condoms from the drop-in centre. Stated reasons for consistent condom use were prevention of HIV (94%), STIs (88%) and pregnancy (87%). Most reasons for inconsistent condom use were related to partners not wanting to use condoms because of reduced sexual pleasure. Some FSWs reported that they were physically abused and forced not to use condoms. Shorter time in sex work, higher education and FSW not having regular partners were significantly associated with consistent condom use. Consistent condom use was very high with non-regular partners, but less frequent with regular partners. The main reason for inconsistent condom use was that the partner did not want to use a condom. Associated factors for consistent condom use were not having regular partners, higher education and shorter time in sex work. Condom promotion programs should include both FSWs and their partners and female condoms should be included in condom intervention efforts. Future studies should investigate the validity of self-reported sexual practices, partners' reasons for inconsistent condom use, risk of violence in sex work and why shorter time in sex
Basuki, E.; Wolffers, I.; Devillé, W.; Erlaini, N.; Luhpuri, D.; Hargono, R.; Maskuri, N.; Suesen, N.; Beelen, N. van
The aim of this study was to gather data on condom use among brothel-based female sex workers in Indonesia and to study the reasons for not using condoms in order to provide new and existing condom promotion programs with information to improve their performance. Quantitative data were gathered by
Yang, Hongmei; Li, Xiaoming; Stanton, Bonita; Fang, Xiaoyi; Zhao, Ran; Dong, Baiqing; Liu, Wei; Liang, Shaoling; Zhou, Yuejiao; Hong, Yan
The objective of this study was to assess the potential role of gatekeepers of establishments in promoting condom use among female sex workers (FSWs) in China. The goals of this study were to explore FSWs' perceptions of gatekeeper attitudes and support for condom use, and to assess their association with FSWs' practice, communication, intention, proper use, knowledge of correct use, and perceptions related to condom use. The authors conducted a cross-sectional study among 454 establishment-based FSWs in one Chinese county. Perceived gatekeeper support for condom use was low among FSWs. Perceived support was positively associated with condom use communication with sexual partners, condom use frequency and intention, but not associated with proper condom use among FSWs. Perceived support was significantly associated with most condom use-related perceptions (e.g., self-efficacy of condom use, barriers to condom use, and perceived peer condom use) among FSWs. Healthcare professionals should work with gatekeepers to create a supportive local environment for condom use in sex work establishments. Gatekeepers need to clearly articulate their support for condom use to the FSWs. Training and skill acquisition regarding correct use of condoms among FSWs will be necessary.
Witte, Susan S; Stefano, Kyle; Hawkins, Courtney
The female condom is the only other barrier contraception method besides the male condom, and it is the only "woman-initiated" device for prevention of sexually transmitted infections. Although studies demonstrate high acceptability and effectiveness for this device, overall use in the United States remains low. The female condom has been available through Medicaid in many states since 1994. We provide the first published summary of data on Medicaid reimbursement for the female condom. Our findings demonstrate low rates of claims for female condoms but high rates of reimbursement. In light of the 2009 approval of a new, cheaper female condom and the recent passage of comprehensive health care reform, we call for research examining how health care providers can best promote consumer use of Medicaid reimbursement to obtain this important infection-prevention device.
Yam, Eileen A; Okal, Jerry; Musyoki, Helgar; Muraguri, Nicholas; Tun, Waimar; Sheehy, Meredith; Geibel, Scott
To examine whether nonbarrier modern contraceptive use is associated with less consistent condom use among Kenyan female sex workers (FSWs). Researchers recruited 579 FSWs using respondent-driven sampling. We conducted multivariate logistic regression to examine the association between consistent condom use and female-controlled nonbarrier modern contraceptive use. A total of 98.8% reported using male condoms in the past month, and 64.6% reported using female-controlled nonbarrier modern contraception. In multivariate analysis, female-controlled nonbarrier modern contraceptive use was not associated with decreased condom use with clients or nonpaying partners. Consistency of condom use is not compromised when FSWs use available female-controlled nonbarrier modern contraception. FSWs should be encouraged to use condoms consistently, whether or not other methods are used simultaneously. Copyright © 2016 Elsevier Inc. All rights reserved.
Alam, Nazmul; Chowdhury, Mahbub Elahi; Mridha, Malay K; Ahmed, Anisuddin; Reichenbach, Laura J; Streatfield, Peter Kim; Azim, Tasnim
Negotiation for condom use by female sex workers with their male clients can enhance condom use. A cross-sectional study was conducted among 1395 female sex workers; 439 from two brothels, 442 from 30 hotels, and 514 from streets of two cities in Bangladesh to determine the predictors of condom use negotiation. Consistent condom use rates in the 7 days prior to interview were reported to be 16.2%, 21.7%, and 4.5% among the brothel, hotel, and street-based female sex workers, respectively. Overall, 28.1% of female sex workers negotiated for condom use with their clients. Participation in behaviour change communication (BCC) programmes (AOR, 1.5; 95% CI, 1.2-2.0) and self-perceived risk of human immunodeficiency virus infection (AOR, 1.8 95% CI, 1.6-2.1) were positive predictors for condom negotiation. Compared to the hotel-based female sex workers, street (AOR, 0.6; 95% CI, 0.4-0.9) and brothel-based female sex workers (AOR, 0.7; 95% CI, 0.5-0.9) were less likely to negotiate for condom use. Female sex workers in Bangladesh are at high risk for sexually transmitted infection / human immunodeficiency virus infection because of low overall negotiation for condom use. Participation in BCC programmes had positive effect on condom negotiation by female sex workers, and should be strengthened in commercial sex venues.
Five studies measuring condom use with regular non-paying partners recorded less consistent condom use with these partners. This review illustrates the existence of sufficient evidence showing the effectiveness of behavioural interventions targeting correct and consistent condom use by FSWs. Keywords: commercial sex ...
Latka, Mary H.; Kapadia, Farzana; Fortin, Princess
Data on adolescents' views regarding the female condom are limited. We conducted seven single-gender focus groups with 47 New York City boys and girls aged 15-20 years (72% African American; 43% ever on public assistance; 72% sexually active; 25% had either been pregnant or fathered a pregnancy). Conceptual mapping was performed by participants to…
Mukenge-Tshibaka, Léonard; Alary, Michel; Geraldo, Nassirou; Lowndes, Catherine M
Our objective was to assess if female sex workers (FSWs) and their potential male clients in Cotonou, Benin, know how to use male condoms correctly. From April to June 2000, 314 FSWs and 208 men were interviewed, and asked to demonstrate on a wooden penis how they usually use male condoms. In all, 27.6% of both women and men tore the condom envelope on the notch; 89.3% of the women versus 75.4% of the men easily found the correct side; 17.3% of the women versus 28.3% of the men held the top of the condom to avoid air entering; 91.4% of the women versus 75.6% of the men correctly unrolled the condom. Taking all the four criteria together, only approximately 11% of participants performed a correct condom use demonstration. FSWs frequently reported condom breakage, which was significantly associated with incorrect condom demonstration (P = 0.04). Correct condom use is suboptimal in these heavy consumers of male condoms in Benin. Condom breakage is frequent and is associated with incorrect use.
Sanou Sobze, Martin; Fokam, Joseph; Onohiol, James-Francis; Soung Iballa, Brice; Djeunang, Bruna; Azeufack Ngueko, Yannick; Mbida, Mpoame; Ercoli, Lucia; Colizzi, Vittorio; Russo, Gianluca
An important component of the response to the AIDS epidemic is the prevention of HIV infection and other sexually transmitted diseases through the use of condoms. In order to enhance HIV prevention programs and minimize the occurrence of unwanted pregnancies, female condoms have been introduced within the community, with the ultimate goal of reducing vulnerability of women. The success of such a program depends on its acceptance by the target population. A survey was conducted among 426 respondents from different regions of Cameroon, to evaluate their perception of HIV/AIDS and their level of acceptance of condom usage in general, and female condom use in particular. Respondents were young adults residing in seven regions of Cameroon (86.4% west, 6.5% Littoral, 3% Centre and 4.1% Adamawa, East, Far-North and North-West). Mean age was 22.6 years; 57% were male, 95% were single, and 77% were university educated. Overall, 76% of participants reported using condoms, though 48% complained of decreased sexual satisfaction. Interestingly, awareness regarding female condoms was 74.5% and 88.5% in men and women respectively, however only 8% and 9.9% respectively reported having ever used them. Respondents generally learnt about sexual education through broadcasting media (~90%). In this sexually active Cameroonian population, the rate of acceptance or use of female condom remains very low, even among women. Strategies to increase awareness of female condoms among young women, their benefits and correct use, are needed.
Smalyanna Sgren da Costa Andrade
Full Text Available Objective.Evaluate the knowledge about male and female condoms among women living in subnormal agglomerate and identify sources of information and appropriate care to use. Methods. Household survey, descriptive, transversal and quantitative study with 300 women over 18 of João Pessoa, Paraíba, Brasil, who began their sexual life. The systematic sampling plan for data collection was used. The interview form included sociodemographic questions and gazed relevant aspects of the use of condoms as a preventive measure of sexually transmitted infections and AIDS. Results. TV and healthcare professionals were the main sources of information. The participants knew more often the male condom features compared to women. The care most often mentioned by women as the use of male and female condoms were related to the validity, form of openness and conditions of packaging and storage of condoms. The largest number of care focused on measures taken in the pre-sexual moment. Moreover, care was nonspecific on the female condom. Conclusion: The participating women have inadequate knowledge on female and male condoms. It is necessary that the nursing seek health education strategies for improving knowledge about relevant information about male and female condoms.
Sgren da Costa Andrade, Smalyanna; Lacet Zaccara, Ana Aline; Souza Leite, Kamila Nethielly; de Almeida Nunes, Maria Luísa; Campos Coêlho, Hemílio Fernandes; Dos Santos Oliveira, Simone Helena
Evaluate the knowledge about male and female condoms among women living in subnormal agglomerate and identify sources of information and appropriate care to use. Household survey, descriptive, transversal and quantitative study with 300 women over 18 of João Pessoa, Paraíba, Brasil, who began their sexual life. The systematic sampling plan for data collection was used. The interview form included sociodemographic questions and gazed relevant aspects of the use of condoms as a preventive measure of sexually transmitted infections and AIDS. TV and healthcare professionals were the main sources of information. The participants knew more often the male condom features compared to women. The care most often mentioned by women as the use of male and female condoms were related to the validity, form of openness and conditions of packaging and storage of condoms. The largest number of care focused on measures taken in the pre-sexual moment. Moreover, care was nonspecific on the female condom. The participating women have inadequate knowledge on female and male condoms. It is necessary that the nursing seek health education strategies for improving knowledge about relevant information about male and female condoms.
Kulczycki, Andrzej; Kim, Dhong-Jin; Duerr, Ann; Jamieson, Denise J; Macaluso, Maurizio
Although studies have assessed the acceptability of male and female condoms, comparative trial data are lacking. A sample of 108 women in stable relationships recruited from an urban, reproductive health clinic were randomly assigned to use 10 male or female condoms, followed by use of 10 of the other type. A nurse provided instruction in correct method use. Demographic information was collected in a baseline questionnaire; acceptability data were collected in follow-up and exit questionnaires and coital logs. Nonparametric and chi-square statistics were used to analyze measures of the methods' relative acceptability. Bowker's test of symmetry was adapted to test the null hypothesis of no difference in acceptability between condom types. Participants used 678 female and 700 male condoms. Although neither method scored high on user satisfaction measures, the 63 women completing the study protocol preferred the male condom to the female condom for ease of application or insertion, ease of removal, general fit, feel of the condom during intercourse and ease of penetration. Participants reported that their partner also favored the male condom, although women generally appeared to like this method more than their partner did. In a direct comparison between the methods at the end of the study, women generally judged male condoms superior on specified preference criteria. Across a range of criteria, the female condom was less acceptable than the male condom to most women and their partners. Although both types had low acceptability, they are needed and valid methods of pregnancy and disease prevention. That neither rated high on user satisfaction measures underscores the need for more barrier methods that women and men can use.
Grimley, Diane M.; Lee, Patricia A.
Examines the sexual practices of 235 females aged 15 to 19 years and their readiness to use specific contraceptive methods. Results indicate that, despite the availability of newer contraceptive methods, most sexually active adolescents were least resistant to using condoms, perceiving the male condom as an acceptable preventative both for…
Albert, A E; Warner, D L; Hatcher, R A; Trussell, J; Bennett, C
OBJECTIVES. The purpose of this study was to evaluate condom use and the incidence of breakage and slippage during vaginal intercourse among female prostitutes in legal Nevada brothels, where use of condoms is required by law. METHODS. Forty-one licensed prostitutes in three brothels were enrolled in a prospective trial in August 1993. Used condoms were collected to verify reported breaks visually. Retrospective breakage and slippage rates were obtained in a standardized interview. RESULTS. Condoms were used for every act of vaginal intercourse with a brothel client during the study period, as well as in the previous year. In the prospective study phase, condoms were used in 353 acts of vaginal intercourse with clients. No condoms broke, and none fell off the penis during intercourse. Only twice (0.6%) did condoms completely fall off during withdrawal. Twelve times (3.4%) during intercourse and 15 times (4.3%) during withdrawal, condoms slipped down the penis but did not fall off. CONCLUSIONS. These findings, among the lowest breakage and slippage rates published, suggest that regular condom use may lead to condom mastery and the development of techniques to reduce the likelihood of breakage and slippage. PMID:7485663
Terris-Prestholt, Fern; Windmeijer, Frank
Despite condoms being cheap and effective in preventing HIV, there remains an 8billion shortfall in condom use in risky sex-acts. Social marketing organisations apply private sector marketing approaches to sell public health products. This paper investigates the impact of marketing tools, including promotion and pricing, on demand for male and female condoms in 52 countries between 1997 and 2009. A static model differentiates drivers of demand between products, while a dynamic panel data estimator estimates their short- and long-run impacts. Products are not equally affected: female condoms are not affected by advertising, but highly affected by interpersonal communication and HIV prevalence. Price and promotion have significant short- and long-run effects, with female condoms far more sensitive to price than male condoms. The design of optimal distribution strategies for new and existing HIV prevention technologies must consider both product and target population characteristics. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.
Gurav, Kaveri; Bradley, Janet; Chandrashekhar Gowda, G; Alary, Michel
A qualitative study was conducted to obtain a detailed understanding of two key determinants of condom breakage - 'rough sex' and poor condom fit - identified in a recent telephone survey of female sex workers, in Bangalore, India. Transcripts from six focus-group discussions involving 35 female sex workers who reported condom breakage during the telephone survey were analysed. Rough sex in different forms, from over-exuberance to violence, was often described by sex workers as a result of clients' inebriation and use of sexual stimulants, which, they report, cause tumescence, excessive thrusting and sex that lasts longer than usual, thereby increasing the risk of condom breakage. Condom breakage in this setting is the result of a complex set of social situations involving client behaviours and power dynamics that has the potential to put the health and personal lives of sex workers at risk. These findings and their implications for programme development are discussed.
Bradley, Janet; Rajaram, S; Alary, Michel; Isac, Shajy; Washington, Reynold; Moses, Stephen; Ramesh, B M
Condoms are effective in preventing the transmission of HIV and other sexually transmitted infections, when properly used. However, recent data from surveys of female sex workers (FSWs) in Karnataka in south India, suggest that condom breakage rates may be quite high. It is important therefore to quantify condom breakage rates, and examine what factors might precipitate condom breakage, so that programmers can identify those at risk, and develop appropriate interventions. We explored determinants of reported condom breakage in the previous month among 1,928 female sex workers in four districts of Karnataka using data from cross-sectional surveys undertaken from July 2008 to February 2009. Using stepwise multivariate logistic regression, we examined the possible determinants of condom breakage, controlling for several independent variables including the district and client load. Overall, 11.4% of FSWs reported at least one condom break in the previous month. FSWs were much more likely to report breakage if under 20 years of age (AOR 3.43, p = 0.005); if divorced/ separated/widowed (AOR 1.52, p = 0.012); if they were regular alcohol users (AOR 1.63, p = 0.005); if they mostly entertained clients in lodges/rented rooms (AOR 2.99, p = 0.029) or brothels (AOR 4.77, p = 0.003), compared to street based sex workers; if they had ever had anal sex (AOR 2.03, p = 0.006); if the sex worker herself (as opposed to the client) applied the condom at last use (AOR 1.90, p < 0.001); if they were inconsistent condom users (AOR 2.77, p < 0.001); and if they had never seen a condom demonstration (AOR 2.37, p < 0.001). The reported incidence of condom breakage was high in this study, and this is a major concern for HIV/STI prevention programs, for which condom use is a key prevention tool. Younger and more marginalized female sex workers were most vulnerable to condom breakage. Special effort is therefore required to seek out such women and to provide information and skills on correct
Bowling, Jessamyn; Dodge, Brian; Bindra, Nyamat; Dave, Bhaktiben; Sharma, Ritika; Sundarraman, Vikram; Thirupathur Dharuman, Sivakumar; Herbenick, Debby
This qualitative study examined the acceptability of female condoms in urban India, with a focus on sexual pleasure. We conducted focus group discussions with 50 women and 19 men, as well as a small number of individual interviews with women (n = 3), in Chennai and New Delhi. Perceived benefits of female condoms included protection against unintended pregnancy and sexually transmitted infections, increased sense of empowerment for women, and simple clean up. The most common drawback was reduc...
Barrientos, Jaime E; Bozon, Michel; Ortiz, Edith; Arredondo, Anabella
This paper describes HIV seroprevalence, knowledge of HIV transmission, and condom use among female sex workers (FSW) attending five specialized sexually transmitted disease (STD) clinics in Santiago, Chile. A short questionnaire with socio-demographic, AIDS knowledge, and condom-use variables was administered to 626 FSW. HIV seroprevalence was estimated with a blood test sent to the Chilean Public Health Institute. ELISA was used to confirm HIV in suspected cases. HIV prevalence was 0%. FSW showed adequate overall knowledge of HIV, even better than reported for the Chilean general population on some items. Condom use with clients was high ("always" = 93.4%), although regular use with steady partners was low ("always" = 9.9%). The zero HIV seroprevalence and consistent condom use with clients confirms the positive impact of intervention strategies for FSW, increasing both correct knowledge of AIDS and condom use with clients and helping decrease these women's HIV/AIDS vulnerability.
Full Text Available Abstract Background Condoms are effective in preventing the transmission of HIV and other sexually transmitted infections, when properly used. However, recent data from surveys of female sex workers (FSWs in Karnataka in south India, suggest that condom breakage rates may be quite high. It is important therefore to quantify condom breakage rates, and examine what factors might precipitate condom breakage, so that programmers can identify those at risk, and develop appropriate interventions. Methods We explored determinants of reported condom breakage in the previous month among 1,928 female sex workers in four districts of Karnataka using data from cross-sectional surveys undertaken from July 2008 to February 2009. Using stepwise multivariate logistic regression, we examined the possible determinants of condom breakage, controlling for several independent variables including the district and client load. Results Overall, 11.4% of FSWs reported at least one condom break in the previous month. FSWs were much more likely to report breakage if under 20 years of age (AOR 3.43, p = 0.005; if divorced/ separated/widowed (AOR 1.52, p = 0.012; if they were regular alcohol users (AOR 1.63, p = 0.005; if they mostly entertained clients in lodges/rented rooms (AOR 2.99, p = 0.029 or brothels (AOR 4.77, p = 0.003, compared to street based sex workers; if they had ever had anal sex (AOR 2.03, p = 0.006; if the sex worker herself (as opposed to the client applied the condom at last use (AOR 1.90, p Conclusions The reported incidence of condom breakage was high in this study, and this is a major concern for HIV/STI prevention programs, for which condom use is a key prevention tool. Younger and more marginalized female sex workers were most vulnerable to condom breakage. Special effort is therefore required to seek out such women and to provide information and skills on correct condom use. More research is also needed on what specific situational parameters
Zabrocki, Christopher; Polutnik, Chloe; Jonbekov, Jonbek; Shoakova, Farzona; Bahromov, Mahbat; Weine, Stevan
This study examined condom use and intimacy among Tajik male migrants and their regular female partners in Moscow, Russia. This study included a survey of 400 Tajik male labour migrants and longitudinal ethnographic interviews with 30 of the surveyed male migrants and 30 of their regular female partners. of the surveyed male migrants, 351 (88%) reported having a regular female partner in Moscow. Findings demonstrated that the migrants' and regular partners' intentions to use condoms diminished with increased intimacy, yet each party perceived intimacy differently. Migrants' intimacy with regular partners was determined by their familiarity and the perceived sexual cleanliness of their partner. Migrants believed that Muslim women were cleaner than Orthodox Christian women and reported using condoms more frequently with Orthodox Christian regular partners. Regular partners reported determining intimacy based on the perceived commitment of the male migrant. When perceived commitment faced a crisis, intimacy declined and regular partners renegotiated condom use. The association between intimacy and condom use suggests that HIV-prevention programmes should aim to help male migrants and female regular partners to dissociate their approaches to condom use from their perceptions of intimacy.
Andrews, Carin Hillerdal; Faxelid, Elisabeth; Sychaerun, Vanphanom; Phrasisombath, Ketkesone
Background Female sex workers (FSWs) are a high-risk population for HIV. Correct and consistent use of condoms is the most effective measure for reducing transmission of HIV. Lao PDR is a low HIV-prevalence country, but FSWs have a relatively high HIV prevalence. To be able to make recommendations for condom promotion interventions in Lao PDR it is important to know more about the context specific situation. This study looked at reasons for and associated factors of consistent condom use amon...
Grimley, D M; Lee, P A
This study examined the sexual practices of 235 females aged 15 to 19 years and their readiness to use specific contraceptive methods for birth control and sexually transmitted disease (STD) prevention. The investigation was based on the stages-of-change construct from the Transtheoretical Model (Prochaska & DiClemente, 1983, 1984). Results demonstrated that despite the availability of newer contraceptive methods (e.g., Depo-Provera), most sexually active adolescents were least resistant to using condoms and were further along in the stages of change for condom use as compared with other contraceptive methods. Moreover, the females perceived the male condom as an acceptable method for prevention of both pregnancy and STDs. These findings suggest that interventions designed to target consistent and correct condom use may result in better compliance, reducing the number of unintended pregnancies and STD cases among this populations.
Full Text Available Introduction. Female sex workers (FSWs are a group at increased risk for human immunodeficiency virus (HIV infection, and inconsistent condom use with clients is a known risk factor for infection in this group. Objective. The aim of the study was to determine factors associated with inconsistent condom use with clients among female sex workers in Podgorica, Montenegro. Methods. We conducted an HIV bio-behavioral cross-sectional study in a sample of female sex workers recruited by snowball sampling. Results. A total of 142 FSWs were recruited. Eighty-one (57.0% of them used condoms consistently with clients. HIV prevalence was 0.0%. In the multivariate analysis inconsistent condom use with clients in the previous month was associated with clients’ negative personal attitude [age-adjusted odds ratio (AOR = 22.7, 95% confidence interval (CI = 2.3-228.0] or client’s indifference (AOR = 13.0, 95% CI = 1.4-118.9 towards using condom during sex with sexual workers, decision making by clients or by mutual agreement with client about using a condom (AOR = 10.2, 95% CI = 3.7-28.0, and early age of first sex (AOR = 5.4, 95% CI = 1.6-18.5. Conclusion. Our results suggest not only the need for further promotion of condom use, information and education for FSW but also the need to strengthen negotiation skills of FSWs with clients on regular use of condoms, as well as the need to extend prevention programs to clients of FSWs.
Bui, Thanh Cong; Markham, Christine M; Tran, Ly T H; Beasley, R Palmer; Ross, Michael W
We examined condom-use negotiation strategies and condom use among 81 female sex workers (FSWs) in Phnom Penh, Cambodia. Percentages of FSWs who did not negotiate condom use or could not describe a negotiation strategy with native clients, foreign clients, and non-paying partners were 15.0, 29.0 and 67.6 %, respectively. The most common negotiation strategy used was "provision of risk information" for native clients (43.8 %) and non-paying partners (26.5 %), and "direct request" for foreign clients (39.5 %). About half could not describe more than one negotiation strategy. Consistent condom use was high with native clients (98.8 %), yet comparatively lower with foreign clients (86.9 %) and non-paying partners (26.5 %). FSWs who did not negotiate or did not know how to negotiate condom use were less likely to report condom use with non-paying regular partners. Future interventions should enhance condom negotiation strategies between FSWs and all partner types.
Peters, J.T.P.; Driel, F.T.M. van; Jansen, W.H.M.
Introduction: The female condom is the only evidence-based AIDS prevention technology that has been designed for the female body; yet, most women do not have access to it. This is remarkable since women constitute the majority of all HIV-positive people living in sub-Saharan Africa, and gender
Iakunchykova, Olena P; Burlaka, Viktor
While female sex workers (FSWs) carry one of the highest risks of HIV transmission, little is known about predictors of HIV and risky behavior of FSWs in Ukraine. In this study of 4806 Ukrainian FSWs, the prevalence of HIV was 5.6 %. FSWs had higher odds to be HIV infected if they had lower income, were older, injected drugs, experienced violence, and solicited clients on highways. Inconsistent condom use with clients was reported by 34.5 % of FSWs. FSWs who solicited clients at railway stations, via media, through previous clients and other FSWs, and on highways reported lower consistency of condom use. Furthermore, inconsistent condom use was related to younger age, alcohol use, having fewer clients, not being covered with HIV prevention, and experiences of violence. The present study expands on the rather limited knowledge of correlates of the HIV and inconsistent condom use among FSWs in Ukraine.
Full Text Available This study aimed to assess the prevalence and correlates of condom use at last sexual intercourse among people aged 15–49 years in Nepal. Secondary data analysis was performed using the Nepal Demographic and Health Survey 2011. The study was restricted to the respondents who reported ever having had sexual intercourse; 9843 females and 3017 males were included. Condom use was assessed by asking if respondents used condoms in their most recent sexual intercourse. Chi-square test and multivariate logistic regression analysis were performed using Complex Sample Analysis Procedure to adjust for sample weight and multistage sampling design. Overall, 7.6% of total, and 16.3% of males and 6.2% of females reported using condoms in their last sexual intercourse. Living in Far-Western region, age and wealth quintile were positively associated with condom use in both males and females. Being unmarried was the most important predictor of condom use among males. Higher education was associated with increased likelihood of condom use in females. However, mobility, having multiple sexual partners, and HIV knowledge were not significant correlates of condom use in both sexes. A big difference was observed in the variance accounted for males and females; indicating use of condoms is poorly predicted by the variables included in the study among females. Condom use was more associated with sociodemographic factors than with sexual behavior and HIV knowledge.
Mantell, Joanne E; West, Brooke S; Sue, Kimberly; Hoffman, Susie; Exner, Theresa M; Kelvin, Elizabeth; Stein, Zena A
Health care providers can play a key role in influencing clients to initiate and maintain use of the female condom, an underused method for HIV/STI and pregnancy prevention. In 2001-2002, based on semistructured interviews with 78 health care providers from four types of settings in New York City, we found that most providers had seen the female condom, but they had not used it and did not propose the method to clients. They lacked details about the method-when to insert it, where it can be obtained, and its cost. Gender of provider, provider level of training, and setting appeared to influence their attitudes. Unless and until provider training on the female condom is greatly improved, broader acceptance of this significant public health contribution to preventing HIV/AIDS and unwanted pregnancy will not be achieved.
Rasch, Vibeke; Yambesi, Fortunata; Kipingili, Rose
BACKGROUND: This study describes the outcome of a postabortion care intervention aimed at introducing the female condom as a means of preventing women from having unwanted pregnancies and sexually transmitted infections (STIs)/HIV. METHODS: Postabortion contraceptive counseling and services were...... intended to use it again. CONCLUSION: Postabortion care programs provide an excellent entry point for introducing the female condom as a contraceptive method for the prevention of both repeat unwanted pregnancies and STI/HIV infection....... offered to 548 women admitted to the Kagera Regional Hospital for incomplete abortion. The counseling included information about STI/HIV and the use male or female condom. In total, 521 (95%) women accepted contraception. RESULTS: Contraceptive use was assessed 3 months after abortion among 475 (91...
Stockman, Jamila K.; Morris, Meghan D.; Martinez, Gustavo; Lozada, Remedios; Patterson, Thomas L.; Ulibarri, Monica D.; Vera, Alicia; Strathdee, Steffanie A.
Little is known about female condom use among female sex workers who inject drugs (FSW-IDUs) in Northern Mexico, where HIV/STI prevalence is high. We examined the prevalence and correlates of female condom use and interest in female condom use among FSW-IDUs aged ≥18 years in Tijuana and Ciudad Juárez, Mexico enrolled in a behavioral intervention designed to reduce high-risk sexual and injection behaviors. Of 621 FSW-IDUs, 8 % reported ever using female condoms, and 67.2 % expressed interest ...
Porche, D J
People who choose not to abstain from sexual intercourse can use barrier contraceptive methods, such as condoms, to reduce their risk of contracting HIV and other sexually transmitted diseases (STDs). Health care providers who provide safer sex education and counseling should provide information on condoms as a way of reducing the risk of HIV/STD transmission. Since latex condoms are regulated by the US Food and Drug Administration (FDA) as medical devices, FDA regulations govern latex condom manufacturing and testing in accordance with stringent national standards. The FDA randomly tests imported condoms according to the same stringent quality control standards as US-produced condoms. Condom effectiveness, however, depends upon their correct and consistent use during every sexual act. Relevant data and guidelines are presented on the correct use of male latex and female polyurethane condoms. Both male latex and female polyurethane condoms can prevent the transmission of HIV and other STDs.
Lianne A Urada
Full Text Available Social and structural influences of condom negotiation among female sex workers (FSWs remain understudied. This study assesses environmental and individual factors associated with condom negotiation among FSWs at high risk for acquiring HIV in a large urban setting of Metro Manila, Philippines.Female bar/spa workers (N = 498, aged 18 and over, underwent interview-led surveys examining their sexual health practices in the context of their risk environments. Data were collected from April 2009-January 2010 from 54 venues. Multiple logistic regressions were conducted to assess socio-behavioral factors (e.g., age, education, length of time employed as an entertainer, and alcohol/drug use and socio-structural factors (e.g., venue-level peer/manager support, condom rule/availability, and sex trafficking associated with condom negotiation, adjusting for individuals nested within venues.Of 142 FSWs who traded sex in the previous 6 months (included in the analysis, 24% did not typically negotiate condom use with venue patrons. Factors in the physical environment--trafficked/coerced into work (AOR = 12.92, 95% CI = 3.34-49.90, economic environment--sex without a condom to make more money (AOR = 1.52, 95% CI 1.01-2.30, policy environment--sex without a condom because none was available (AOR = 2.58, 95% CI = 1.49-4.48, and individual risk--substance use (AOR = 2.36, 95% CI = 1.28-4.35 were independently associated with FSWs' lack of condom negotiation with venue patrons.Factors in the physical, economic, and policy environments, over individual (excepting substance use and social level factors, were significantly associated with these FSWs' condom negotiations in the Philippines. Drawing upon Rhodes' risk environment framework, these results highlight the need for policies that support safer sex negotiations among sex workers in the context of their risk environments. Interventions should reduce barriers to condom negotiation
Zhang, Liying; Li, Xiaoming; Zhou, Yuejiao; Lin, Danhua; Su, Shaobing; Zhang, Chen; Stanton, Bonita
We utilized Protection Motivation Theory to assess predictors of intention and behavior of consistent condom use among Chinese female sex workers (FSWs). A self-administered questionnaire was used in a cross-sectional survey among 700 FSWs in Guangxi, China. Multivariate logistic regression analysis indicated that extrinsic and intrinsic rewards, self-efficacy, and response costs predicted consistent condom use intention and behavior among FSWs. Sexually transmitted infection/ HIV prevention programs need to reduce FSWs' perceptions of positive extrinsic rewards and intrinsic rewards for engaging in consistent condom use, reduce FSWs' perception of response costs for using a condom, and increase condom use self-efficacy among FSWs.
Todd, Catherine S; Nasir, Abdul; Stanekzai, Mohammad R; Scott, Paul T; Close, Nicole C; Botros, Boulos A; Strathdee, Steffanie A; Tjaden, Jeffrey
There is little information about HIV awareness or condom use among female sex workers (FSWs) in Afghanistan. The purpose of this cross-sectional study was to assess HIV awareness, knowledge, and condom use among FSWs in three Afghan cities. FSWs residing in Jalalabad, Kabul, and Mazar-i-Sharif were recruited through outreach programs and completed an interviewer-administered questionnaire and rapid tests for hepatitis B surface antigen, HIV, syphilis, and hepatitis C virus. Logistic regression identified factors associated with HIV awareness, comprehensive HIV knowledge (knowledge that HIV cannot be detected by sight, that condoms prevent HIV, and rejection of local misconceptions about HIV transmission), and consistent condom use (use with every sex act) with clients in the last six months. Of 520 participants, 76.9% had no formal education and 37.7% lived outside Afghanistan in the last five years. Nearly half (44.2%) were aware of HIV but, of these, only 17.4% (N = 40) had comprehensive HIV knowledge. There were significant differences by site; FSWs in Jalalabad were more likely to be aware of HIV but FSWs in Kabul were more likely to have correct HIV knowledge and use condoms consistently with clients. Consistent client condom use was reported by 11.5% (N = 60) and was independently associated with having more clients per month (AOR = 1.99, 95% CI: 1.04-3.81). In conclusion, comprehensive HIV knowledge and consistent condom use with clients are low among Afghan FSWs in these cities. Efforts to reach this population should focus on relaying accurate information and expanding condom use with clients.
Bull, Sheana S; Posner, Samuel F; Ortiz, Charlene; Beaty, Brenda; Benton, Kathryn; Lin, Lillian; Pals, Sherri L; Evans, Tom
To evaluate effects of a 6-month social marketing campaign on awareness of, attitudes toward and use of female as well as male condoms for 15-25 year-old-women. Using a time-space sampling methodology, we conducted a cross-sectional survey of 3407 women at pre-campaign in 12 western U.S. neighborhoods on female and male condom awareness, attitudes, and use. Six of the 12 study neighborhoods were randomly selected to receive the POWER social marketing campaign designed to impact condom knowledge, attitudes, and use. The campaign was followed with another cross-sectional survey of 3,003 women in all 12 study neighborhoods on condom knowledge, attitudes, use and awareness of POWER materials. We compared pre-and post-campaign surveys to determine the efficacy of POWER and conducted post hoc analyses on post-campaign data to determine if exposure to POWER was related to higher levels of positive condom attitudes and norms and condom use. We found no differences between neighborhoods with and without the POWER campaign with regard to our primary outcomes. To diagnose reasons for this null effect, we examined outcomes post hoc examining the influence of POWER exposure. Post hoc analyses show some evidence that exposure to POWER was associated with condom use. In the context of the nested trial, this raises concerns that post test only evaluations are limited. Establishing the efficacy of a social marketing campaign is challenging. This group randomized trial showed a null effect. Social marketing campaigns may need to have more media channels and saturation before they can show behavioral effects. Using a nested design with randomization at the community level and probability sampling introduces rigor not commonly seen in evaluations of social marketing campaigns.
Peters, Anny JTP; van Driel, Francien TM; Jansen, Willy HM
Introduction The female condom is the only evidence-based AIDS prevention technology that has been designed for the female body; yet, most women do not have access to it. This is remarkable since women constitute the majority of all HIV-positive people living in sub-Saharan Africa, and gender inequality is seen as a driving force of the AIDS epidemic. In this study, we analyze how major actors in the AIDS prevention field frame the AIDS problem, in particular the female condom in comparison to other prevention technologies, in their discourse and policy formulations. Our aim is to gain insight into the discursive power mechanisms that underlie the thinking about AIDS prevention and women’s sexual agency. Methods We analyze the AIDS policies of 16 agencies that constitute the most influential actors in the global response to AIDS. Our study unravels the discursive power of these global AIDS policy actors, when promoting and making choices between AIDS prevention technologies. We conducted both a quantitative and qualitative analysis of how the global AIDS epidemic is being addressed by them, in framing the AIDS problem, labelling of different categories of people for targeting AIDS prevention programmes and in gender marking of AIDS prevention technologies. Results We found that global AIDS policy actors frame the AIDS problem predominantly in the context of gender and reproductive health, rather than that of sexuality and sexual rights. Men’s sexual agency is treated differently from women’s sexual agency. An example of such differentiation and of gender marking is shown by contrasting the framing and labelling of male circumcision as an intervention aimed at the prevention of HIV with that of the female condom. Conclusions The gender-stereotyped global AIDS policy discourse negates women’s agency in sexuality and their sexual rights. This could be an important factor in limiting the scale-up of female condom programmes and hampering universal access to
Peters, J.T.P.; Driel, F.T.M. van; Jansen, W.H.M.
Sub-Saharan African women are affected disproportionately highly by AIDS, while experiencing lack of choice for devices which protect them against sexual transmitted diseases, including HIV. One should expect that global policy makers react positive to the female condom, a contraceptive device which
Bailey, Althea E; Figueroa, John Peter
This paper explores barriers to consistent condom use among female sex workers in Jamaica in a qualitative study using grounded theory. Multiple perspectives were sought through 44 in-depth interviews conducted with female sex workers, clients, the partners of sex workers and facilitators of sex work. Poverty and lack of education or skills, severely limited support systems as well as childhood abuse served to push the majority of participants into sex work and created vulnerability to HIV and other STIs. Despite these constraints, women found ways to exercise agency, ensure condom use, adopt protective measures and gain economic advantage in various aspects of the Jamaican sex trade. Perceived relationship intimacy between sex workers and their clients and/or their main partners emerged as the main factor contributing to reduced risk perception and inconsistent condom use. Relationship intimacy, with associated trust and affirmation of self, is the most important factor influencing sexual decision-making with respect to lapse in condom use among female sex workers in Jamaica. Study findings provide important insights that can enhance individual psychosocial, interpersonal and community-based interventions as well as inform environmental, structural and policy interventions to reduce risk and vulnerability among female sex workers.
Correlates of Condom Use among Male and Female aged 18-24 Years in ... used in the analysis for this paper only includes sexually active youth (18-24 years). ... in past 12 months, having had two or more sexual partners in the past year and ...
Mathenjwa, Thulile; Maharaj, Pranitha
To explore commercial sex workers' experiences with the female condom in Swaziland. This is a qualitative study that draws on two focus group discussions and ten individual in-depth interviews with female commercial sex workers in Lavumisa, Swaziland. The findings suggest that the majority of female sex workers prefer to use the female condom with their clients because it offers them greater control over the sexual encounter. Other factors that facilitate its use include the absence of side effects, the enhancement of sexual pleasure and protection against the risk of STIs (including HIV). In addition, the women reported that the female condom is stronger and more resistant to breakage than the male condom. Moreover, the female condoms can be inserted well in advance of sexual intercourse. Difficulties of insertion, partner objection and limited product availability were some of the barriers to the use of the device. There was also a tendency to reuse the female condoms because of lack of product availability and privacy to insert it. Although female condom use involves negotiation with clients, the fact that it offers sex workers an independent method of protection gives them more power and also, increases their ability to control their sexual and reproductive health.
Ashley L. Grosso
Full Text Available Objectives. This study examined correlates of condom use among 248 female sex workers (FSW in The Gambia.Methods. Between July and August 2011, FSW in The Gambia who were older than 16 years of age, the age of consent in The Gambia, were recruited for the study using venue-based sampling and snowball sampling, beginning with seeds who were established clients with the Network of AIDS Services Organizations. To be eligible, FSW must have reported selling sex for money, favors, or goods in the past 12 months. Bivariate and multivariate logistic regressions were used to determine associations and the relative odds of the independent variables with condom use. Four different condom use dependent variables were used: consistent condom use in the past six months during vaginal or anal sex with all clients and partners; consistent condom use in the past month during vaginal sex with new clients; consistent condom use in the past month during vaginal sex with nonpaying partners (including boyfriends, husbands, or casual sexual partners; and condom use at last vaginal or anal sex with a nonpaying partner.Results. Many FSW (67.34%, n = 167 reported it was not at all difficult to negotiate condom use with clients in all applicable situations, and these FSW were more likely to report consistent condom use with all clients and partners in the past 6 months (aOR 3.47, 95% CI [1.70–7.07] compared to those perceiving any difficulty in condom negotiation. In addition, FSW were more likely to report using condoms in the past month with new clients (aOR 8.04, 95% CI [2.11–30.65] and in the past month with nonpaying partners (aOR 2.93, 95% CI [1.09–7.89] if they had been tested for HIV in the past year. Women who bought all their condoms were less likely than those who received all of their condoms for free (aOR 0.38, 95% CI [0.15–0.97] to have used a condom at last vaginal or anal sex with a nonpaying partner.Conclusions. HIV and sexually transmitted
Mantell, J E; Scheepers, E; Karim, Q A
The successful implementation of new public health policy is influenced by provider preparedness and user acceptability of the new intervention. This paper describes the development and implementation of a participatory Training of Trainers (TOT) programme as a precursor to launch the South African government's female-initiated HIV prevention strategies in public health clinics. Three hundred peer-trainees from throughout South Africa were trained through a comprehensive, modular and interactive three-day workshop. The workshop content included: HIV/AIDS knowledge, beliefs and attitudes; values clarification regarding HIV infection and sexuality; sexual desensitization; 'hands-on' training in the use of and introduction of the female condom; and counselling, communication and programme planning skills. The TOT generated a cadre of knowledgeable health care workers for training others and provided a support structure at the service delivery level for ensuring potential users' access to the female condom within each province. Qualitative assessments of the training and trainer debriefing sessions suggest that the training was successful in increasing knowledge and promoting positive attitudes about female condoms. In addition, the expanded repertoire of problem-solving approaches left providers feeling confident about recommending this method to clients.
Yang, Yi; Yang, Cui; Latkin, Carl A; Luan, Rongsheng; Nelson, Kenrad E
There has been little theory-based research focusing on condom use among male clients of female sex workers (CFSW) in China. The current study applied social cognitive theory to condom use behaviors of CFSW in China. Face-to-face structured interviews were conducted among 584 CFSW recruited through snowball sampling. Bivariate and multivariate logistic regression models were applied to examine factors associated with consistent condom use. A minority (30.65 %) of respondents reported using condoms consistently with FSW, and 7 of 12 social cognitive dimensions/subdimensions were found to be significantly influential. The most significant factors were self-efficacy [adjusted prevalence ratio (APR) = 2.11, 95 %, CI = 1.74-2.43] and personal pleasure reduction (APR = 0.3, 95 % CI = 0.15-0.6). HIV-related knowledge, perceived HIV susceptibility, condom cost, condom efficacy, and embarrassment of carrying condoms were not associated with consistent condom uses with FSW. Findings from the current study suggest future prevention programs should target sex venues, and condom access should ensure both quantity and quality. Peer education should focus on knowledge education and peer norms, and knowledge education should include information on HIV infection severity and how to increase pleasure with condom use.
Mantell, Joanne E.; Smit, Jennifer A.; Beksinska, Mags; Scorgie, Fiona; Milford, Cecilia; Balch, Erin; Mabude, Zonke; Smith, Emily; Adams-Skinner, Jessica; Exner, Theresa M.; Hoffman, Susie; Stein, Zena A.
Young men in South Africa can play a critical role in preventing new human immunodeficiency virus (HIV) infections, yet are seldom targeted for HIV prevention. While reported condom use at last sex has increased considerably among young people, consistent condom use remains a challenge. In this study, 74 male higher education students gave their…
Full Text Available This study investigated the impact of self-efficacy in relation to condom use. A sample of 87 female college students completed self-report measures related to their sexual history, attitudes towards condoms and past condom use, as well as their outcome expectancy and intention to use condoms in the future. The results showed a positive correlation between self-efficacy and positive attitudes towards condom use, as well as correlations between past behavior, self-efficacy and intention to use condoms in the future. Multiple linear regression models were used to further explore the relationship between self-efficacy, past condom use, outcome expectancy and attitudes toward condoms, with the intention to use condoms in the future. The results demonstrated that both self-efficacy and past condom use are significant predictors of an individual’s intention to use condoms in the future.
Luana Duarte Wanderley Cavalcante
Full Text Available OBJECTIVE To validate assistive technology for visually impaired women to learn how to use the female condom. METHOD a methodological development study conducted on a web page, with data collection between May and October 2012. Participants were 14 judges; seven judges in sexual and reproductive health (1st stage and seven in special education (2nd stage. RESULTS All items have reached the adopted parameter of 70% agreement. In Stage 1 new materials were added to represent the cervix, and instructions that must be heard twice were included in the 2nd stage. CONCLUSION The technology has been validated and is appropriate for its objectives, structure / presentation and relevance. It is an innovative, low cost and valid instrument for promoting health and one which may help women with visual disabilities to use the female condom.
Full Text Available OBJETIVO: avaliar a aceitabilidade, a adesão e a experiência com o uso de condom feminino (CF entre mulheres infectadas pelo HIV. MÉTODO: estudo descritivo prospectivo com 76 mulheres infectadas pelo HIV atendidas no CAISM/UNICAMP e no Centro Corsini de Campinas. Após entrevista de triagem e concordando em participar, as voluntárias receberam calendário para registro das relações sexuais e uso de condom masculino (CM. Após 30 dias, compareceram à visita de treinamento com colocação do CF em modelo pélvico, trazendo o diário do ciclo anterior, considerado controle. Aplicou-se questionário estruturado após 30, 60 e 90 dias, recolhendo-se sempre o diário de registro das relações sexuais e uso de CF ou CM. Usaram-se os testes de c², exato de Fisher, McNemar e Friedman para amostras emparelhadas na análise estatística. RESULTADOS: predominaram as mulheres jovens, de baixa escolaridade, que moravam com o parceiro. Observou-se taxa de continuidade de uso de 52%, ao longo de 90 dias. O uso de CF, em metade das relações sexuais em cada período de estudo, permaneceu estável nos 90 dias. Houve significativa diminuição da proporção média das relações sexuais desprotegidas (de 14% para 6%, sem uso de CM ou CF, aos 90 dias. As dificuldades iniciais no manuseio do CF foram superadas com o tempo. Os casais sorodiscordantes tiveram maior proporção de relações protegidas que os casais soroconcordantes, porém a diferença não foi significativa. As mulheres que relataram uso prévio consistente de CM apresentaram número significantemente maior de relações protegidas com CF. CONCLUSÕES: a oferta do CF foi capaz de reduzir as relações sexuais desprotegidas entre mulheres infectadas pelo HIV, que se mostraram motivadas e receptivas a este método.PURPOSE: to evaluate acceptability, adhesion and experience with the use of female condom (FC among HIV-infected women. METHODS: prospective descriptive study with 76 HIV
Hasbun, Julia; Charow, Rebecca; Rosario, Santo; Tillotson, Louise; McGlaughlin, Elaine; Waters, John
Introduction Not only do transgender female sex workers have some of the highest rates of sexually transmitted infections (STI), human immunodeficiency virus (HIV), and experienced stigma, they also have higher likelihood of early sexual debut and some of the lowest levels of educational attainment compared to other stigmatized populations. Some of the most common interventions designed to reduce transmission of HIV and STIs seek to educate high-risk groups on sexual health and encourage condom use across all partner types; however, reaching stigmatized populations, particularly those in resource-limited settings, is particularly challenging. Considering the importance of condom use in stopping the spread of HIV, the aim of this study was two-fold; first to characterize this hard-to-reach population of transgender female sex workers in the Dominican Republic, and second, to assess associations between their HIV knowledge, experienced stigma, and condom use across three partner types. Methods We analyzed self-reported data from the Questionnaire for Transgender Sex Workers (N = 78). Respondents were interviewed at their workplaces. Univariate and bivariate analyses were employed. Fisher Chi-square tests assessed differences in HIV knowledge and experienced stigma by condom use across partner types. Results HIV knowledge was alarmingly low, condom use varied across partner type, and the respondents in our sample had high levels of experienced stigma. Average age of first sexual experience was 13.12 years with a youngest age reported of 7. Dominican Republic statutory rape laws indicate 18 years is the age of consent; thus, many of these transgender women’s first sexual encounters would be considered forcible (rape) and constitute a prosecutable crime. On average, respondents reported 8.45 sexual partners in the prior month, with a maximum of 49 partners. Approximately two thirds of respondents used a condom the last time they had sex with a regular partner. This
Budhwani, Henna; Hearld, Kristine R; Hasbun, Julia; Charow, Rebecca; Rosario, Santo; Tillotson, Louise; McGlaughlin, Elaine; Waters, John
Not only do transgender female sex workers have some of the highest rates of sexually transmitted infections (STI), human immunodeficiency virus (HIV), and experienced stigma, they also have higher likelihood of early sexual debut and some of the lowest levels of educational attainment compared to other stigmatized populations. Some of the most common interventions designed to reduce transmission of HIV and STIs seek to educate high-risk groups on sexual health and encourage condom use across all partner types; however, reaching stigmatized populations, particularly those in resource-limited settings, is particularly challenging. Considering the importance of condom use in stopping the spread of HIV, the aim of this study was two-fold; first to characterize this hard-to-reach population of transgender female sex workers in the Dominican Republic, and second, to assess associations between their HIV knowledge, experienced stigma, and condom use across three partner types. We analyzed self-reported data from the Questionnaire for Transgender Sex Workers (N = 78). Respondents were interviewed at their workplaces. Univariate and bivariate analyses were employed. Fisher Chi-square tests assessed differences in HIV knowledge and experienced stigma by condom use across partner types. HIV knowledge was alarmingly low, condom use varied across partner type, and the respondents in our sample had high levels of experienced stigma. Average age of first sexual experience was 13.12 years with a youngest age reported of 7. Dominican Republic statutory rape laws indicate 18 years is the age of consent; thus, many of these transgender women's first sexual encounters would be considered forcible (rape) and constitute a prosecutable crime. On average, respondents reported 8.45 sexual partners in the prior month, with a maximum of 49 partners. Approximately two thirds of respondents used a condom the last time they had sex with a regular partner. This was considerably lower than
Masvawure, Tsitsi B.; Mantell, Joanne E.; Mabude, Zonke; Ngoloyi, Claudia; Milford, Cecilia; Beksinska, Mags; Smit, Jennifer A.
Although male partner cooperation is often essential for successful use of the female condom, only a few studies have directly assessed men’s experiences of using the device. We examined barriers to and facilitators of female condom use via qualitative in-depth interviews with 38 young men (18 to 28 years) in South Africa whose partners, all university students, were enrolled in a female condom intervention trial. In all, 21 men used the female condom; the remaining 17 did not attempt use. Th...
Richard, A J; Bell, D C; Montoya, I D
Attitudes-norms research (the theories of planned behavior and reasoned action) has been successful in accounting for many types of behavior change. One of the strengths of this approach has been to combine individual beliefs and normative influences in the explanation of behavior change. However, the conceptualization of normative influence in these theories makes very strong assumptions about self-awareness in the selection of normative referents. These assumptions are particularly problematic when applied to female cocaine smokers, who report frequent sex while under duress or while cognitively impaired. In this study the original conceptualization of normative influence and two alternatives (assuming emotion-based and interaction-based selection of normative referents) are operationalized to evaluate stage of change for condom use among women who are heavy crack cocaine users with multiple sex partners. Results show that stage of change for use of condoms with nonmain partners is best accounted for by interaction-based selection of normative referents.
... of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Birth Control Read more NIH MedlinePlus Magazine Read more Health ...
Nie, Li; Liao, Susu; Weeks, Margaret R; Wang, Yanhong; Jiang, Jingmei; Zhang, Qingning; Zhou, Yuejiao; He, Bin; Li, Jianghong; Dunn, Jennifer
The female condom (FC) is an effective tool for dual protection, but it remains underused. Individual and contextual reasons need to be explored. The aim of this study was to compare individual and contextual characteristics of FC multitime users, 1-time users, and nonusers among women in the sex industry of 4 study sites in China. A standardized 1-year FC intervention along with male condoms was implemented through outreach to sex establishments. Three serial cross-sectional surveys were conducted at baseline and after each of two 6-month intervention phases. A total of 445, 437, and 290 eligible women were interviewed at 3 cross-sectional surveys, respectively. At the first and second postintervention surveys, 83.3% and 81.7% of women reported knowing about FC, and 28.8% and 36.6% had used FC at least once. Women who used FC multiple times reported less unprotected sex than nonusers in the last 30 days (3.0% vs. 17.2% at first and 3.2% vs. 16.8% at second postintervention survey, P 4.0) and working in boarding houses (adjusted odds ratio, 3.4) were associated with FC use. Adding FC into male-condom-only intervention may reduce unprotected sex among women in sex establishments in rural and small urban areas of China. Adoption of FC may be related not only to intervention exposure but also to contextual factors associated with study site and type of sex establishments.
Wang, Bo; Li, Xiaoming; Stanton, Bonita; Yang, Hongmei; Fang, Xiaoyi; Zhao, Ran; Dong, Baiqing; Zhou, Yuejiao; Liu, Wei; Liang, Shaoling
Vaginal douching has been hypothesized to increase a woman's risk for human immunodeficiency virus (HIV) infection. However, data on the prevalence of this practice and its association with condom use and sexually transmitted infections (STIs) are limited. A cross-sectional survey among 454 female sex workers (FSWs) in a Chinese county. Vaginal douching was reported by 64.7% of the women. The prevalence of self-reported history of STI and that of current STI was 19.4% and 41.5%, respectively. Fifteen percent of the women reported consistent use of condoms with their clients and 8.4% with their regular partners. Vaginal douching was significantly associated with decreased use of condoms (with clients: OR = 0.31; with regular partner(s): OR = 0.22) and increased rate of self-reported STI history (OR = 1.95). However, there was no direct relation between douching and current STI. Over one third of the women believed that douching can prevent STI/HIV. Vaginal douching exposes FSWs to a high risk of STI/HIV. Medical professional and public health workers should correct women's misconception about the effectiveness of douching and discourage women from douching through educational activities.
Morris, Chester N; Morris, Sheldon R; Ferguson, Alan G
Female sex workers and their clients remain a high risk core group for HIV in Africa. We measured sexual behavior of a snowball sample of female sex workers (FSW) along the Trans Africa highway from Mombasa, Kenya to Kampala, Uganda and surveyed the availability of male condoms at 1,007 bars and lodgings in Kenya along the highway trucking stops where transactional sex occurs. There were 578 FSW one month sex diaries analyzed, 403 from Kenya and 175 from Uganda. Kenyan FSW had a median of 45 sexual acts per 28 days compared to 39 sex acts per 28 days by Ugandan FSW (P lodges in Kenya compared to Uganda were more likely to: have condom dispensers, 25% versus 1%, respectively (P < 0.01); distribute or sell condoms, 73.9% versus 47.6% (P < 0.01); and have more weekly condom distribution, 4.92 versus 1.27 condoms per seating capacity (P < 0.01). Our data indicate that in both countries condom use for FSW is suboptimal, particularly with regular partners, and greater condom use by Trans African highway FSW in Kenya compared to Uganda may be related to availability. Targeted interventions are warranted for FSW and truck drivers to prevent transmission in this important core group.
Beksinska, Mags E; Piaggio, Gilda; Smit, Jennifer A; Wu, Junqing; Zhang, Yufeng; Pienaar, Jacqueline; Greener, Ross; Zhou, Ying; Joanis, Carol
New designs of female condom have been developed to reduce costs and improve acceptability. To secure regulatory approvals, clinical studies are needed to verify performance. We aimed to assess the functional performance and safety of three new condom types-the Woman's Condom, the VA worn-of-women (wow) Condom Feminine, and the Cupid female condom-against the existing second-generation female condom (FC2). We did a randomised controlled, non-inferiority, four-period crossover trial at three sites in Shanghai, China, and one site in Durban, South Africa, between May 1, 2011, and Jan 31, 2012. Participants aged 18-45 years who were sexually active, monogamous, not pregnant, and not sex workers, were eligible for inclusion if they were literate, had no known allergies to the study products; used a reliable, non-barrier method of contraception, and had no visible or reported sexually transmitted infections. We used a computer-generated randomisation sequence with a Williams square design of size four to assign patients (1:1:1:1) to the FC2 control device, or the Woman's, VA wow, or Cupid condoms, with 12 potential allocations. Randomisation was stratified by site. Participants were not masked to condom type, but allocation was concealed from study investigators. The primary non-inferiority endpoints were total clinical failure and total female condom failure, with a non-inferiority margin of 3%. Women were asked to use five of each condom type and were interviewed after use of each type. We also assessed safety data for each type. We did both per-protocol and intention-to-treat analyses. We calculated frequencies and percentages for each failure event and estimated differences in performance with a generalised estimating equation model. This study is registered, number DOH-27-0113-4271. 616 women were assessed for eligibility, of whom 600 were randomly assigned to condom-type order (30, 120, and 150 women in the three sites in China, and 300 women in the site in South
Full Text Available Lizzie Moore,1 Mags Beksinska,1,2 Alnecia Rumphs,3 Mario Festin,4 Erica L Gollub3 1MatCH Research (Maternal, Adolescent and Child Health Research, Department of Obstetrics and Gynaecology, University of the Witwatersrand, Westville, Durban, South Africa; 2Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK; 3Florida International University, Department of Epidemiology, Stempel College of Public Health and Social Work, Miami, FL, USA; 4World Health Organization, Special Program of Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland Abstract: Women in developing countries are at high risk of HIV, sexually transmitted infections, and unplanned pregnancy. The female condom (FC is an effective dual protective method regarded as a tool for woman's empowerment, yet supply and uptake are limited. Numerous individual, socioeconomic, and cultural factors influence uptake of new contraceptive methods. We reviewed studies of FC knowledge, attitudes, practices, and behaviors across developing countries, as well as available country-level survey data, in order to identify overarching trends and themes. High acceptability was documented in studies conducted in diverse settings among male and female FC users, with FCs frequently compared favorably to male condoms. Furthermore, FC introduction has been shown to increase the proportion of "protected" sex acts in study populations, by offering couples additional choice. However, available national survey data showed low uptake with no strong association with method awareness, as well as inconsistent patterns of use between countries. We identified a large number of method attributes and contextual factors influencing FC use/nonuse, most of which were perceived both positively and negatively by different groups and between settings. Male partner
Full Text Available BACKGROUND: Sex workers in China continue to engage in unprotected sex acts that put them at risk for contracting HIV (Human Immunodeficiency Virus and other STIs (Sexually Transmitted Infections. The purpose of this study was to explore women's work history, the context of sex work, condom use, HIV testing services, and potential barriers to condom use in a sample of FSWs (female sex workers in Guangzhou, China. METHODOLOGY/PRINCIPAL FINDINGS: In-depth, semi-structured, face-to-face interviews were conducted with 24 FSWs in Guangzhou, China. Informants were recruited using a purposive sampling technique. Qualitative data were coded and analyzed using NVivo 8.0. The majority of respondents were internal economic migrants who had entered the sex industry in pursuit of greater financial reward. Most women in the study were married or had steady boyfriends, and were young, with secondary education and limited knowledge about HIV and STIs. Most were not satisfied with their current living conditions and expressed a desire to leave the sex industry. Women reported that they were more likely to use condoms during sex acts with commercial partners than with non-commercial partners. The potential stigma of being seen as a sex worker prevented many from accessing HIV testing. Three key factors put these FSWs at risk for HIV and STIs: unreasonable trust toward clients, stereotypes and assumptions about customers, and financial incentives. CONCLUSIONS/SIGNIFICANCE: These findings suggest that social and economic factors play an important role in shaping sexual decision-making among female sex workers in Guangzhou. We argue that greater insight into and attention to these factors could enhance the success of HIV prevention efforts.
Tobin-West, Charles I; Maduka, Omosivie; Onyekwere, Victor N; Tella, Adedayo O
Most university students in Nigeria are sexually active and engage in high risk sexual behaviors. The aim of this study was to assess the acceptability and use of female condoms in the context of HIV prevention in order to provide basic information that can stimulate female condom programming to promote sexually transmitted infection and HIV prevention among youths in tertiary institutions. A descriptive, cross-sectional study was carried out among 810 undergraduate students of the University of Port Harcourt from October to November 2011, using a stratified sampling method and self-administered questionnaires. Most of the students, 589 (72.7%) were sexually active; 352 (59.7%) reported having just one sexual partner, while 237 (40.3%) had multiple partners. The mean number of sexual partners in the past six months was 2.2 ± 0. Consistent condom use was reported among 388 (79.2%) students, 102 (20.8%) reported occasional usage, while 99 (16.8%) did not use condoms at all. Only 384 (65.2%) of the students had ever been screened for HIV. Although 723 (89.3%) were aware of female condoms, only 64(8.9%) had ever used one due to unavailability, high cost, and difficulty with its insertion. Nevertheless, 389 (53.8%) of the students expressed willingness to use them if offered, while 502 (69.4%) would recommend it to friends/peers. This study highlights significant challenges in the use of female condoms among university students. These include unavailability, high cost, and difficulty with insertion. Therefore, deliberate efforts using social marketing strategies, appropriate youth-friendly publicity, and peer education must be exerted to provide affordable female condoms and promote usage; such efforts should target vulnerable youths in Nigerian tertiary institutions.
Choi, Susanne Y P; Holroyd, Eleanor
This paper analyses barriers to consistent condom use in the context of transactional sex among female sex workers in mainland China. It reveals how differences in socioeconomic profile and organisational hierarchies amongst different groups of sex workers create different barriers to condom use. Data was collected by means of field observation of entertainment venues and in-depth interviews. Findings suggest that, compared with other sex workers, street-walkers are less likely to use condoms with their clients, hold highly disadvantaged socioeconomic profiles and work in isolation. Major barriers to condom use link to economic deprivation and threats of violence from clients. For the women working in entertainment venues, drunkenness of clients, pricing mechanisms and familiarity with clients pose barriers to condom use. Yet within all these constraints women are not powerless and instead find ways to exercise agency and gain personal protection and economic advantage. In the newly emerging China, both structural hierarchies of work and individual agency inform condom use by female sex workers. Future HIV intervention programmes need to take these factors into account in order to meet the needs of different groups of women sex workers.
Yi, Siyan; Tuot, Sovannary; Chhoun, Pheak; Pal, Khuondyla; Ngin, Chanrith; Chhim, Kolab; Brody, Carinne
Despite the success in promoting condom use in commercial relationships, condom use with regular, noncommercial partners remains low among key populations in Cambodia. This study explores factors associated inconsistent condom use with sweethearts among unmarried sexually active female entertainment workers (FEWs). In 2014, the probability proportional to size sampling method was used to randomly select 204 FEWs from entertainment venues in Phnom Penh and Siem Reap for face-to-face interviews. Multivariate logistic regression analysis was conducted to examine independent determinants of inconsistent condom use. Of total, 31.4% of the respondents reported consistent condom use with sweethearts in the past three months. After adjustment, respondents who reported inconsistent condom use with sweethearts remained significantly less likely to report having received any form of sexual and reproductive health education (AOR = 0.49, 95% CI = 0.22-0.99), but more likely to report having been tested for HIV in the past six months (AOR = 2.19, 95% CI = 1.03-4.65). They were significantly more likely to report having used higher amount of alcohol in the past three months (AOR = 1.29, 95% CI = 1.01-1.99) and currently using a contraceptive method other than condoms such as pills (AOR = 4.46, 95% CI = 1.34-10.52) or other methods (AOR = 9.75, 95% CI = 2.07-9.86). The rate of consistent condom use in romantic relationships among unmarried FEWs in this study is considerably low. The importance of consistent condom use with regular, non-commercial partners should be emphasized in the education sessions and materials, particularly for FEWs who use non-barrier contraceptive methods.
Tamene, Masresha Molla; Tessema, Gizachew Assefa; Beyera, Getahun Kebede
Sexually transmitted infections are among the most important public health problems in the world. People who indulge in unsafe sex, such as female sex workers are the most at risk population groups due to multiple sexual partners and inconsistent condom use. The aim of this study was to assess condom utilization and sexual behavior of female sex workers in Gondar town, Northwest Ethiopia. A quantitative cross-sectional study triangulated with qualitative method was conducted from March 20 - April 10, 2014 in Gondar town. The quantitative data were collected through interviewing 488 female sex workers while in-depth interview was administered to collect qualitative data from 10 female sex workers. The collected data were entered into EPI-INFO version 3.5.3 and exported to SPSS version 20.0 software for analysis. Logistic regression analysis was done to determine the association between condom utilization and independent variables. This study revealed that less than half (47.7%) of the respondents utilized condom with any type of client. Secondary education or above, perceiving themselves at risk of HIV/AIDS infection, having awareness that sexually transmitted infections could increase HIV infection, being tested for HIV/AIDS in the last 12 months, and having lower number of clients in a month were positively associated with condom utilization. This finding depicted that condom utilization was low among female sex workers. Thus, developing and implementing target oriented behavioral change and communication strategies are needed to prevent the risk of acquiring HIV/AIDS and other sexually transmitted infections in female sex workers.
Seepaneng S. Phiri
Full Text Available Background: Despite the acceptability of the Female Condom2 (FC2 as a contraceptive method by some women, it remains inaccessible and unavailable to the majority of women because of affordability, training, distribution and marketing strategies. The FC2 affords women dual protection and the option to negotiate safe sex. Objective: This paper explores and describes the perspective of the healthcare providers regarding accessibility and availability of the FC2 as a contraceptive method in the Tshwane district. Method: The study used an explorative, descriptive, and qualitative design. Data were collected from 26 healthcare providers who were purposively selected. In-depth face-to-face interviews were conducted with these healthcare providers in the Tshwane district. Tesch’s method of open coding was used for data analysis. Results: Two main themes emerged, namely, the availability of the FC2 and the knowledge o fthe healthcare providers. The findings of this study indicated that the availability of the FC2 remains a challenge because of factors such as lack of affordability, inefficient procurement and lack of distribution measures. The condoms are also not available at strategic points so as to ensure accessibility. Insufficient knowledge amongst healthcare providers was described as a barrier which affects the quality of training of the service users. Conclusions: It is evident that the FC2 is not yet available in all healthcare settings, therefore strategies to safeguard accessibility and availability of the FC2 as a contraceptive method are recommended.
Nuken, Amenla; Kermode, Michelle; Saggurti, Niranjan; Armstrong, Greg; Medhi, Gajendra Kumar
This study examines the relationship between alcohol use, HIV status, and condom use among female sex workers in Nagaland, India. We analyzed data from a cross-sectional survey undertaken in 2009, using descriptive and multivariate statistics. Out of 417 female sex workers, one-fifth used alcohol daily and one-tenth were HIV-positive. HIV-positive female sex workers were more likely than HIV-negative female sex workers to consume alcohol daily (30.2% vs. 18.0%). HIV-positive daily alcohol users reported lower condom use at last sex with regular clients compared to HIV-positive non-daily alcohol users (46.2% vs. 79.3%), a relationship not evident among HIV-negative female sex workers. There is a need to promote awareness of synergies between alcohol use and HIV, and to screen for problematic alcohol use among female sex workers in order to reduce the spread of HIV.
Volkmann, Tyson; Wagner, Karla D; Strathdee, Steffanie A; Semple, Shirley J; Ompad, Danielle C; Chavarin, Claudia V; Patterson, Thomas L
Male clients of female sex workers (FSWs) in Tijuana, Mexico engage in high levels of unprotected sex. While behavioral change theories posit that self-efficacy predicts condom use, correlates of self-efficacy for condom use remain largely unstudied. We examined these correlates among male clients of FSWs in Tijuana. Eligible male clients were at least 18 years of age, HIV-negative, lived in Tijuana or San Diego, reported unprotected sex with a Tijuana FSW at least once in the past 4 months, and agreed to be treated for sexually transmitted infections (STIs). Participants completed an interviewer-administered questionnaire including demographics, substance use, psychosocial and psychosexual characteristics (e.g., outcome expectancies for negotiation of safer sex, social support, and sexual sensation seeking), and sexual behaviors. Participants also underwent HIV/STI testing. A stepwise hierarchical multiple regression analysis identified correlates of self-efficacy for condom use. Of 393 male clients, median age was 37 years. Participants were mostly Spanish-speaking and employed. Factors independently associated with higher self-efficacy for condom use were higher positive outcome expectancies for negotiation of safer sex, lower sexual sensation seeking scores, and higher social support scores. Both psychosocial and psychosexual factors may influence self-efficacy for condom use among male clients of FSWs. These factors represent central constructs in sociocognitive models that explain behavioral change and could be intervention targets for improving self-efficacy for condom use and, ultimately, safer sex behavior.
Redding, Colleen A.; Prochaska, James O.; Armstrong, Kay; Rossi, Joseph S.; Hoeppner, Bettina B.; Sun, Xiaowu; Kobayashi, Hisanori; Yin, Hui-Qing; Coviello, Donna; Evers, Kerry; Velicer, Wayne F.
Smoking and sexual risk behaviors in urban adolescent females are prevalent and problematic. Family planning clinics reach those who are at most risk. This randomized effectiveness trial evaluated a transtheoretical model (TTM)-tailored intervention to increase condom use and decrease smoking. At baseline, a total of 828 14- to 17-year-old females…
Full Text Available Abstract Background Heterosexual contact is the most common mode of transmission of sexually transmitted infections (STIs including Human Immunodeficiency Virus (HIV in Nepal and it is largely linked to sex work. We assessed the non-use of condoms in sex work with intimate sex partners by female sex workers (FSWs and the associated self-efficacy to inform the planning of STI/HIV prevention programmes in the general population. Methods This paper is based on a qualitative study of Female Sex Workers (FSWs in Nepal. In-depth interviews and extended field observation were conducted with 15 FSWs in order to explore issues of safe sex and risk management in relation to their work place, health and individual behaviours. Results The main risk factor identified for the non-use of condoms with intimate partners and regular clients was low self efficacy. Non-use of condoms with husband and boyfriends placed them at risk of STIs including HIV. In addition to intimidation and violence from the police, clients and intimate partners, clients' resistance and lack of negotiation capacity were identified as barriers in using condoms by the FSWs. Conclusion This study sheds light on the live and work of FSWs in Nepal. This information is relevant for both the Government of Nepal and Non Governmental Organisations (NGO to help improve the position of FSWs in the community, their general well-being and to reduce their risks at work.
Despite the significance for sexually transmitted diseases (STD) control in East Asia, few studies have examined the relationship between high-risk sexual behavior and condom use. We investigated how three sexually vulnerable groups for STDs show differences in condom use behaviors (CUBs) depending on their STD infection. The source of data came from the National Survey for STD Prevalence Rate and Sexual Behavior of the High-Risk Sexual Community. The effects of behavioral determinants on CUBs were estimated by using path analysis models. An 11-item questionnaire assessing subjects' health risk behaviors, sexual beliefs, sexual risk behaviors, and condom use. Condom use was higher for men who have sex with men (MSM; n = 108) when they were bisexuals and had high self-efficacy, for Johns (Johns; n = 118) when they had experience of STD infection, and for female sex workers (FSWs; n = 1,083) when they had high self-efficacy, did not engage in drunken sex, and were anxious about infection. Regardless of whether they were infected with STDs, FSWs always used condom when they had high sexual beliefs. On the contrary, Johns exhibited a negative relationship between sexual risk behavior and condom use when they had experience of STD infection. The variable commonly significant to all three groups was the number of sex partners; but it exhibited a positive relationship with MSMs and Johns, and a negative one with FSWs. CUBs were related to sexual beliefs as well as sexual risk behavior. At the same time, the experience of STD infection mediated the relationship between the two. Therefore, we need to draw social attention to promote safer sex among STD-vulnerable groups.
Full Text Available BACKGROUND: Despite the significance for sexually transmitted diseases (STD control in East Asia, few studies have examined the relationship between high-risk sexual behavior and condom use. We investigated how three sexually vulnerable groups for STDs show differences in condom use behaviors (CUBs depending on their STD infection. METHODS: The source of data came from the National Survey for STD Prevalence Rate and Sexual Behavior of the High-Risk Sexual Community. The effects of behavioral determinants on CUBs were estimated by using path analysis models. An 11-item questionnaire assessing subjects' health risk behaviors, sexual beliefs, sexual risk behaviors, and condom use. RESULTS: Condom use was higher for men who have sex with men (MSM; n = 108 when they were bisexuals and had high self-efficacy, for Johns (Johns; n = 118 when they had experience of STD infection, and for female sex workers (FSWs; n = 1,083 when they had high self-efficacy, did not engage in drunken sex, and were anxious about infection. Regardless of whether they were infected with STDs, FSWs always used condom when they had high sexual beliefs. On the contrary, Johns exhibited a negative relationship between sexual risk behavior and condom use when they had experience of STD infection. The variable commonly significant to all three groups was the number of sex partners; but it exhibited a positive relationship with MSMs and Johns, and a negative one with FSWs. CONCLUSIONS: CUBs were related to sexual beliefs as well as sexual risk behavior. At the same time, the experience of STD infection mediated the relationship between the two. Therefore, we need to draw social attention to promote safer sex among STD-vulnerable groups.
Prophylactics; Rubbers; Male condoms; Contraceptive - condom; Contraception - condom; Barrier method - condom ... your health care provider or pharmacy about emergency contraception ("morning-after pills"). PROBLEMS WITH CONDOM USE Some ...
Full Text Available In many settings, interventions targeting female sex workers (FSWs could significantly reduce the overall transmission of HIV. To understand the role HIV pre-exposure prophylaxis (PrEP could play in controlling HIV transmission amongst FSWs, it is important to understand how its impact compares with scaling-up condom use—one of the proven HIV prevention strategies for FSWs. It is important to remember that condoms also have other benefits such as reducing the incidence of sexually transmitted infections and preventing pregnancy. A dynamic deterministic model of HIV transmission amongst FSWs, their clients and other male partners (termed ‘pimps’ was used to compare the protection provided by PrEP for HIV-negative FSWs with FSWs increasing their condom use with clients and/or pimps. For different HIV prevalence scenarios, levels of pimp interaction, and baseline condom use, we estimated the coverage of PrEP that gives the same reduction in endemic FSW HIV prevalence or HIV infections averted as different increases in condom use. To achieve the same impact on FSW HIV prevalence as increasing condom use by 1%, the coverage of PrEP has to increase by >2%. The relative impact of PrEP increases for scenarios where pimps contribute to HIV transmission, but not greatly, and decreases with higher baseline condom use. In terms of HIV infections averted over 10 years, the relative impact of PrEP compared to condoms was reduced, with a >3% increase in PrEP coverage achieving the same impact as a 1% increase in condom use. Condom promotion interventions should remain the mainstay HIV prevention strategy for FSWs, with PrEP only being implemented once condom interventions have been maximised or to fill prevention gaps where condoms cannot be used.
Wu, J.; Zhou, X.; Lu, C.; Moyer, E.; Wang, H.; Hong, L.; Deng, X.
Background: Sex workers in China continue to engage in unprotected sex acts that put them at risk for contracting HIV (Human Immunodeficiency Virus) and other STIs (Sexually Transmitted Infections). The purpose of this study was to explore women’s work history, the context of sex work, condom use,
Ting,Rachel Sing-Kiat; Wong,Ee Lynn; Tnay,Jessie Koh-Sing
Rachel Sing-Kiat Ting,1 Ee-Lynn Wong,2 Jessie Koh-Sing Tnay3 1School of Sociology, China University of Political Sciences and Law, Beijing, China; 2InPsych Psychological and Counselling Services, Kuala Lumpur, 3Institute of Borneo Studies, Universiti Malaysia Sarawak, Sarawak, Malaysia Background: Female condom (FC) has been available for over 30 years, but it still lacks wide acceptability. To overcome misdirection and invagination occurring in FC and to provide a wider area of protection, W...
Background Condom failure has always been found to coexist with condom usage, especially among sex workers. Objective To describe the actions of female sex workers when they are faced with situations of condom failure. Methods Using the survey design, the participants were selected through the snowball sampling method. Their responses were obtained using a structured questionnaire. A total of 100 questionnaires were analysed. Results With respect to the immediate actions of sex workers after condom failure, 36% of the respondents continued with the sexual encounter after noticing that the condom was broken. Another 36% stopped immediately when they noticed that the condom had failed, but replaced the condom; 13% of the participants stopped the sexual encounter completely; 3% applied vaginal spermicidal foam; and 5% of the respondents stopped immediately and took a douche when they had the chance. For the actions within the next 24 hours of experiencing condom failure with a client, 53% of the participants did nothing; 4% sought counsel from a professional; 3% of the respondents took alcohol or drugs to forget the incident, 25% went to the clinic for assistance and 8% offered other responses. Conclusion While continuing the sexual encounter without replacing the condom, taking alcohol and drugs or doing nothing could increase the risk of contracting HIV; however, actions like stopping the sexual encounter completely and visiting a clinic or a professional could make a difference between staying HIV negative or seroconverting. There is a need for targeted intervention to address issues of inappropriate behaviours after experiencing condom failure. PMID:29568633
Dunn, Jennifer; Zhang, Qingning; Weeks, Margaret R; Li, Jianghong; Liao, Susu; Li, Fei
New interventions to reduce HIV and sexually transmitted infections (STI) among female sex workers are introduced into the context of women's existing prevention beliefs and practices. These indigenous practices affected implementation of our program to introduce female condoms to women in sex-work establishments in southern China. We used ethnographic field observations and in-depth interviews to document common prevention methods women reported using to protect themselves before and during intervention implementation. Individual, sex-work establishment, and other contextual factors, including sources of information and social and economic pressures to use or reject prevention options, shaped their perceptions and selection of these methods and affected adoption of female condoms as an additional tool. Efforts to improve uptake of effective prevention methods among low-income sex workers require attention to the context and spectrum of women's HIV/STI prevention practices when introducing innovations such as female condoms, microbicides, pre-exposure prophylaxis pills, and others, as they become available.
Crosby, R; DiClemente, R J; Wingood, G M; Sionean, C; Cobb, B K; Harrington, K; Davies, S; Hook, E W; Oh, M K
To assess condom application ability and the relationship between perceived ability and demonstrated ability. Also, to examine the association between high-demonstrated condom application ability and recent sexual risk behaviors and laboratory-diagnosed sexually transmitted diseases (STDs) among African-American adolescent females. A purposeful sample of sexually active African-American females (n = 522) completed a structured interview and provided vaginal swab specimens for STD testing. Subsequent to the interview, adolescents demonstrated their condom application skills using a penile model. A 9-item scale assessed adolescents' perceived self-efficacy to apply condoms. Sexual risk behaviors assessed by interview were noncondom use at last intercourse and the last five intercourse occasions for steady and casual sex partners as well as any unprotected vaginal sex in the past 30 days and the past 6 months. Approximately 28% of the sample tested positive for at least one STD and nearly 26% self-reported a history of STDs. Controlled analyses indicated that adolescents' self-efficacy for correct use was not related to demonstrated skill. Adolescents' demonstrated ability was not related to any of the sexual risk behaviors. Likewise, recent experience applying condoms to a partner's penis and demonstrated ability were not related to laboratory-diagnosed STDs or self-reported STD history. Adolescents may unknowingly be at risk for human immunodeficiency virus and STD infection owing to incorrect condom application. Further, high-demonstrated ability to apply condoms was not related to safer sex or STDs. Reducing sexual risk behaviors may require more than enhancing adolescent females' condom application skills and may require addressing other relational skills.
Marfatia, Y S; Pandya, Ipsa; Mehta, Kajal
Though many methods of prevention of STI/HIV are available, condoms remain of utmost importance. They have gone a long way from the oiled silk paper used by the Chinese and the hard sheaths made of tortoise- shell used by the Japanese to the latex condoms of today. The breakthrough came when the rubber vulcanization process was invented by Charles Goodyear and eventually the first rubber condom was made. The condom offers maximum protection( more than 90%) against HIV, Hepatitis B virus and N.Gonorrhoea. They also offer protection in scenarios when alternate sexual practices are adapted. The female condom in the only female driven contraceptive method available today. Graphene and Nano lubricated condoms are new in the market and others in futuristic approach may include wearable technology/Technology driven condom and invisible Condoms. Both Correct and Consistent use of condoms needs to be promoted for HIV/STI prevention.
Full Text Available Rachel Sing-Kiat Ting,1 Ee-Lynn Wong,2 Jessie Koh-Sing Tnay3 1School of Sociology, China University of Political Sciences and Law, Beijing, China; 2InPsych Psychological and Counselling Services, Kuala Lumpur, 3Institute of Borneo Studies, Universiti Malaysia Sarawak, Sarawak, Malaysia Background: Female condom (FC has been available for over 30 years, but it still lacks wide acceptability. To overcome misdirection and invagination occurring in FC and to provide a wider area of protection, Wondaleaf® (WL, a new-generation adhesive FC, was recently invented. This pioneering study sought to assess the acceptability and functional performance of WL among Malaysian women. Methods: A mixed method survey was conducted in three cities of Malaysia, recruiting sexually active heterosexual women, aged 18–50, by snowball sampling method. Participants were provided with WL and initially surveyed to rate its performance in five coital usages over 2 months. After that, the participants underwent a second survey to rate their satisfaction and acceptability toward WL. Descriptive statistics on clinical failure rates were tabulated with correlational analysis performed to identify major variables contributing to WL’s functional performance and acceptability. Results: Out of the 51 enrolled participants, 31 women completed the required surveys. WL’s total clinical failure rate was 2.60% (out of 155 condom uses with above-average ratings of functional performance. The ease of use significantly correlated with ratings of no slippage and no misdirection. The confidence in WL’s safety features significantly correlated with a sense of empowerment and protection. Conclusion: WL has a relatively low risk of clinical failures and an overall favorable acceptability among Malaysian women. However, this study also showed that its future usage largely depends on partner acceptability. It may have the potential of complementing the existing barrier toward
Okafor, Uchenna O.; Crutzen, Rik; Awo, Egbe A.; Van Den Borne, Bart
A qualitative study using in-depth interviews explored the perceptions and views of brothel leaders and HIV program experts on the acceptability and adoptability of using gatekeepers in interventions aimed at improving Female Sex Workers’ (FSWs) condom use in Nigeria. Brothel leaders are an
Prabawanti, Ciptasari; Dijkstra, Arie; Riono, Pandu; Tb, Gagan Hartana
Introduction: The male-to-female transgender (waria) is part of a key population at higher risk for HIV. This study aims to test whether psychosocial determinants as defined by the theory of planned behaviour (TPB) can explain behaviours related to condom use among waria. Three preparatory
Full Text Available Abstract Background The HIV prevalence among female populations involved in sex work in Nigeria has heightened interest in HIV prevention programming for this sub-population with brothel-based female sex workers (BB FSWs having a prevalence of 27.4%, six times higher than the prevalence in the general population. Methods/design The clusters in the randomized pilot trial will be brothels and female sex workers (FSWs residing in the brothels will be the participants of the study. The participants will receive free condom distribution as well as HIV prevention messages on condom use and negotiation skills to increase self-efficacy in handling social and gender power plays within their environment. Twelve brothels will be randomized into experimental and control conditions with a minimum total sample size of 200 participants. Recruitment of participants will be carried out from within the brothels. The control condition will receive a standard intervention consisting of a minimum of six interactive sessions with peer educators (PE engaging their peers through group discussions and one on one interaction using pre-designed HIV prevention messages. The experimental condition will receive the standard intervention as well as interactive sessions with the brothel leadership (chairladies and brothel managers to facilitate consistent condom use and appropriate condom use policies, conditions, and messaging. Both interventions will be delivered over a maximum period of 16 weeks, and male and female condoms will be distributed during the intervention. Quantitative assessments will be carried out at baseline and at 16 weeks follow-up, and the pilot findings will inform feasibility of and sample size estimation for a phase III trial. The primary outcomes measured are recruitment rate attrition rate and adherence to the intervention. Consistent condom use outcomes by FSWs within the brothel with all partner types and enhanced self-efficacy for condom
Okafor, Uchenna; Crutzen, Rik; Okekearu, Ifeanyi; Adebajo, Sylvia; Uzoh, Adaora; Awo, Egbe Aneotah; Chima, Chukwuemeka; Agwagwa, Ogechukwu; van den Borne, Bart
The HIV prevalence among female populations involved in sex work in Nigeria has heightened interest in HIV prevention programming for this sub-population with brothel-based female sex workers (BB FSWs) having a prevalence of 27.4%, six times higher than the prevalence in the general population. The clusters in the randomized pilot trial will be brothels and female sex workers (FSWs) residing in the brothels will be the participants of the study. The participants will receive free condom distribution as well as HIV prevention messages on condom use and negotiation skills to increase self-efficacy in handling social and gender power plays within their environment. Twelve brothels will be randomized into experimental and control conditions with a minimum total sample size of 200 participants. Recruitment of participants will be carried out from within the brothels. The control condition will receive a standard intervention consisting of a minimum of six interactive sessions with peer educators (PE) engaging their peers through group discussions and one on one interaction using pre-designed HIV prevention messages. The experimental condition will receive the standard intervention as well as interactive sessions with the brothel leadership (chairladies and brothel managers) to facilitate consistent condom use and appropriate condom use policies, conditions, and messaging. Both interventions will be delivered over a maximum period of 16 weeks, and male and female condoms will be distributed during the intervention. Quantitative assessments will be carried out at baseline and at 16 weeks follow-up, and the pilot findings will inform feasibility of and sample size estimation for a phase III trial. The primary outcomes measured are recruitment rate attrition rate and adherence to the intervention. Consistent condom use outcomes by FSWs within the brothel with all partner types and enhanced self-efficacy for condom negotiation with all partner types will be the primary
Wong, Ee-Lynn; Tnay, Jessie Koh-Sing
Background Female condom (FC) has been available for over 30 years, but it still lacks wide acceptability. To overcome misdirection and invagination occurring in FC and to provide a wider area of protection, Wondaleaf® (WL), a new-generation adhesive FC, was recently invented. This pioneering study sought to assess the acceptability and functional performance of WL among Malaysian women. Methods A mixed method survey was conducted in three cities of Malaysia, recruiting sexually active heterosexual women, aged 18–50, by snowball sampling method. Participants were provided with WL and initially surveyed to rate its performance in five coital usages over 2 months. After that, the participants underwent a second survey to rate their satisfaction and acceptability toward WL. Descriptive statistics on clinical failure rates were tabulated with correlational analysis performed to identify major variables contributing to WL’s functional performance and acceptability. Results Out of the 51 enrolled participants, 31 women completed the required surveys. WL’s total clinical failure rate was 2.60% (out of 155 condom uses) with above-average ratings of functional performance. The ease of use significantly correlated with ratings of no slippage and no misdirection. The confidence in WL’s safety features significantly correlated with a sense of empowerment and protection. Conclusion WL has a relatively low risk of clinical failures and an overall favorable acceptability among Malaysian women. However, this study also showed that its future usage largely depends on partner acceptability. It may have the potential of complementing the existing barrier toward contraceptive use. Further studies are needed to understand the global acceptability of WL. PMID:29440937
Ting, Rachel Sing-Kiat; Wong, Ee-Lynn; Tnay, Jessie Koh-Sing
Female condom (FC) has been available for over 30 years, but it still lacks wide acceptability. To overcome misdirection and invagination occurring in FC and to provide a wider area of protection, Wondaleaf ® (WL), a new-generation adhesive FC, was recently invented. This pioneering study sought to assess the acceptability and functional performance of WL among Malaysian women. A mixed method survey was conducted in three cities of Malaysia, recruiting sexually active heterosexual women, aged 18-50, by snowball sampling method. Participants were provided with WL and initially surveyed to rate its performance in five coital usages over 2 months. After that, the participants underwent a second survey to rate their satisfaction and acceptability toward WL. Descriptive statistics on clinical failure rates were tabulated with correlational analysis performed to identify major variables contributing to WL's functional performance and acceptability. Out of the 51 enrolled participants, 31 women completed the required surveys. WL's total clinical failure rate was 2.60% (out of 155 condom uses) with above-average ratings of functional performance. The ease of use significantly correlated with ratings of no slippage and no misdirection. The confidence in WL's safety features significantly correlated with a sense of empowerment and protection. WL has a relatively low risk of clinical failures and an overall favorable acceptability among Malaysian women. However, this study also showed that its future usage largely depends on partner acceptability. It may have the potential of complementing the existing barrier toward contraceptive use. Further studies are needed to understand the global acceptability of WL.
Vejella, Shanti; Patel, Sangram Kishor; Saggurti, Niranjan; Prabhakar, Parimi
Community collectivization is an integral part of condom use and HIV risk reduction interventions among key population. This study assesses community collectivization among female sex workers (FSWs), and explores its relationship with sex workers' consistent condom use (CCU) with different partners considering the interaction effect of time and collectivization. Data were drawn from two rounds of cross-sectional surveys collected during 2010 (N1 = 1986) and 2012 (N2 = 1973) among FSWs in Andhra Pradesh, India. Results of the multiple logistic regression analysis show that, CCU with regular and occasional clients increased over the inter-survey period among FSWs with a high collective efficacy (AOR 2.9 and 6.1) and collective agency (AOR 14.4 and 19.0) respectively. The association of high levels of collectivization with CCU and self-efficacy for condom use are central to improve the usefulness and sustainability of HIV prevention programs worldwide.
Navani-Vazirani, Sonia; Solomon, Davidson; Gopalakrishnan; Heylen, Elsa; Srikrishnan, Aylur Kailasom; Vasudevan, Canjeevaram K; Ekstrand, Maria L
The aim of this study was to examine female sex workers' solicitation of clients using mobile phones and the association between this and condom use with clients. Cross-sectional data were utilised to address the study's aim, drawing on data collected from female sex workers in Calicut, Kerala, and Chirala, Andhra Pradesh. Use of mobile phone solicitation was reported by 46.3% (n = 255) of Kerala participants and 78.7% (n = 464) of those in Andhra Pradesh. Kerala participants reporting exclusive solicitation using mobile phones demonstrated 1.67 times higher odds (95% CI: 1.01-2.79) of inconsistent condom use than those reporting non-use of mobile phones for solicitation. However, those reporting exclusive solicitation through mobile phones in Andhra Pradesh reported lower odds of inconsistent condom use (OR: 0.03; 95% CI: 0.01-0.26) than those not using mobile phones for solicitation. Findings indicate that solicitation of clients using mobile phones facilitates or hampers consistency in condom use with clients depending on the context, and how mobile phones are incorporated into solicitation practices. Variations in sex work environments, including economic dependence on sex work or lack thereof may partially account for the different effects found.
Navani-Vazirani, S; Solomon, D; Krishnan, G; Heylen, E; Srikrishnan, AK; Vasudevan, CK; Ekstrand, ML
The aim of this study was to examine female sex workers’ solicitation of clients using mobile phones and the association between this and condom use with clients. Cross-sectional data were utilised to address the study's aim, drawing on data collected from female sex workers in Calicut, Kerala and Chirala, Andhra Pradesh. Use of mobile phone solicitation was reported by 46.3% (n = 255) of Kerala participants and 78.7% (n = 464) of those in Andhra Pradesh. Kerala participants reporting exclusive solicitation using mobile phones demonstrated 1.67 times higher odds (95% CI: 1.01–2.79) of inconsistent condom use than those reporting non-use of mobile phones for solicitation. However, those reporting exclusive solicitation through mobile phones in Andhra Pradesh reported lower odds of inconsistent condom use (OR: 0.03; 95% CI: 0.01–0.26) than those not using mobile phones for solicitation. Findings indicate that solicitation of clients using mobile phones facilitates or hampers consistency in condom use with clients depending on the context, and how mobile phones are incorporated into solicitation practices. Variations in sex work environments, including economic dependence on sex work or lack thereof may partially account for the different effects found. PMID:25301669
Sales, Jessica M.; Lang, Delia L.; DiClemente, Ralph J.; Latham, Teaniese P; Wingood, Gina M.; Hardin, James W.; Rose, Eve S.
Objective Although effective HIV prevention interventions have been developed for adolescents, few interventions have explored whether components of the intervention are responsible for the observed changes in behaviors post-intervention. This study examined the mediating role of partner communication frequency on African-American adolescent females’ condom use post-participation in a demonstrated efficacious HIV risk-reduction intervention. Main Outcome Measures Percent condom use in the past 60 days and consistent condom use in the past 6o days across the 12-month follow-up period. Design As part of a randomized controlled trial of African-American adolescent females (N=715), 15-21 years, seeking sexual health services, completed a computerized interview at baseline (prior to intervention) and again 6- and 12-month follow-up post-intervention participation. The interview assessed adolescents’ sexual behavior and partner communication skills, among other variables, at each time point. Using generalized estimating equation (GEE) techniques, both logistic and linear regression models were employed to test mediation over the 12-month follow-up period. Additional tests were conducted to assess the significance of the mediated models. Results Mediation analyses observed that partner communication frequency was a significant partial mediator of both proportion condom-protected sex acts (p =.001) and consistent condom use (p = .001). Conclusion Partner communication frequency, an integral component of this HIV intervention, significantly increased as a function of participating in the intervention partially explaining the change in condom use observed 12-months post-intervention. Understanding what intervention components are associated with behavior change is important for future intervention development. PMID:21843001
Parcesepe, Angela M; L'Engle, Kelly L; Martin, Sandra L; Green, Sherri; Suchindran, Chirayath; Mwarogo, Peter
Early initiation of sex work is prevalent among female sex workers (FSWs) worldwide. The objectives of this study were to investigate if early initiation of sex work was associated with: (1) consistent condom use, (2) condom negotiation self-efficacy or (3) condom use norms among alcohol-using FSWs in Mombasa, Kenya. In-person interviews were conducted with 816 FSWs in Mombasa, Kenya. Sample participants were: recruited from HIV prevention drop-in centres, 18 years or older and moderate risk drinkers. Early initiation was defined as first engaging in sex work at 17 years or younger. Logistic regression modelled outcomes as a function of early initiation, adjusting for drop-in centre, years in sex work, supporting others and HIV status. FSWs who initiated sex work early were significantly less likely to report consistent condom use with paying sex partners compared with those who initiated sex work in adulthood. There was no significant difference between groups in consistent condom use with non-paying sex partners. FSWs who initiated sex work early endorsed less condom negotiation self-efficacy with paying sex partners compared with FSWs who did not initiate sex work early. Findings highlight a need for early intervention for at-risk youth and adolescent FSWs, particularly in relation to HIV sexual risk behaviours. Evidence-based interventions for adolescent FSWs or adult FSWs who began sex work in adolescence should be developed, implemented and evaluated. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Full Text Available Contact dermatitis from natural latex of condom has been reported and is attributed to latex sensitivity. Chemical leukoderma from rubber condom is probably not reported. Here we present a case of chemical leukoderma in a 32-year-old male who developed depigmentation around the shaft of the penis in a circumferential pattern. Since the lesion was solitary and the site corresponded to the point of maximum contact of the condom, a diagnosis of contact leukoderma due to latex condom was thought of. Patch testing was done with mercaptobenzothiazole (MBT, dusting powder present in the condom, and condom latex as such. The patient tested positive (3+ with mercaptobenzothiazole and the condom latex. On discontinuation of condom use and with UVB phototherapy, lesions repigmented in eight weeks.
Mooney, Alyssa; Kidanu, Aklilu; Bradley, Heather M; Kumoji, Evelyn Kuor; Kennedy, Caitlin E; Kerrigan, Deanna
Although reported condom use between female sex workers and their clients is high in Ethiopia, condom use with regular, non-paying partners remains low, posing a substantial risk of HIV infection to sex workers, their partners and the general population. Previous studies have identified the synergistic effects of substance abuse, violence and HIV risk, but few have examined these inter-relationships among female sex workers and their regular, non-paying partners. This study explored the associations between work-related violence, alcohol abuse and inconsistent condom use among establishment-based female sex workers and their regular, non-paying partners in Adama City, Ethiopia. A cross-sectional survey was conducted with 350 establishment-based female sex workers, aged 15-35, at 63 bars, hotels and nightclubs. Multivariate logistic regression analysis was conducted to test the association between work-related violence and condom use with regular, non-paying partners, controlling for age, overall income, education and sex workers' total number of sexual partners in the past week. Alcohol abuse was explored as an effect modifier. Respondents reported a high prevalence of work-related violence (59%) and alcohol abuse (51%). Work-related violence was statistically significantly associated with unprotected sex with regular, non-paying partners among those who abused alcohol (OR: 6.34, 95% CI: 2.43-16.56) and among those who did not (OR: 2.98, 95% CI: 1.36-6.54). Alcohol abuse was not associated with inconsistent condom use within these partnerships, though it may strengthen the effect of work-related violence on unprotected sex. Findings suggest violence against establishment-based female sex workers is associated with HIV risk within regular, non-paying partnerships. Qualitative work is needed to better understand the links between a violent work environment and condom use with regular, non-paying partners and how interventions can be implemented in this context to
Rosenthal, Lisa; Levy, Sheri R; Earnshaw, Valerie A
Gendered-based power affects heterosexual relationships, with beliefs in the U.S. prescribing that men dominate women sexually. We draw on social dominance theory to examine whether women's and men's level of support for group-based hierarchy (i.e., social dominance orientation; SDO) helps explain gender-based power beliefs and dynamics in heterosexual relationships. We conducted a laboratory study at a Northeastern U.S. university among 357 women and 126 men undergraduates who reported being heterosexual and sexually active, testing three sets of hypotheses. First, as hypothesized, women endorsed SDO and the belief that men should dominate sexually less than men did. Second, as hypothesized, among women and men, SDO was positively correlated with the belief that men should dominate sexually, and negatively correlated with sexual self-efficacy (confidence in sexual situations) and number of female condoms (a woman-controlled source of protection) taken. Third, structural equation modeling, controlling for age, family income, number of sexual partners in the past month, and perceived HIV/AIDS risk, supported the hypothesis that among women and men, the belief that men should dominate sexually mediates SDO's association with sexual self-efficacy. The hypothesis that the belief that men should dominate sexually mediates SDO's association with number of female condoms taken was supported for women only. The hypothesis that sexual self-efficacy mediates SDO's association with number of female condoms taken was not supported. Results suggest SDO influences power beliefs and dynamics in heterosexual relationships. Although female condoms are an important woman-controlled source of protection, power-related beliefs may pose a challenge to their use.
Fehrenbacher, Anne E; Chowdhury, Debasish; Ghose, Toorjo; Swendeman, Dallas
Consistent condom use (CCU) is the primary HIV/STI prevention option available to sex workers globally but may be undermined by economic insecurity, life-course vulnerabilities, behavioral factors, disempowerment, or lack of effective interventions. This study examines predictors of CCU in a random household survey of brothel-based female sex workers (n = 200) in two neighborhoods served by Durbar (the Sonagachi Project) in Kolkata, India. Multivariate logistic regression analyses indicated that CCU was significantly associated with perceived HIV risk, community mobilization participation, working more days in sex work, and higher proportion of occasional clients to regular clients. Exploratory analyses stratifying by economic insecurity indicators (i.e., debt, savings, income, housing security) indicate that perceived HIV risk and community mobilization were only associated with CCU for economically secure FSW. Interventions with FSW must prioritize economic security and access to social protections as economic insecurity may undermine the efficacy of more direct condom use intervention strategies.
HIV-AIDS and protective measures that can be used. Results. ... transmitted diseases (STDs) (and pregnancy) have to rely on .... it comes out of the vagina, so a barrier is still in place. ... workers, nurses, secretaries and doctors on the staff of.
Only simple equipment, simple technology and low initial capital investment are needed in their manufacture. The condoms can be made by people who were previously unskilled or only semi-skilled workers. Plastic condoms differ from those made of latex rubber in that the nature of the plastic film allows unlimited shelf-life. Also, the plastic has a higher degree of lubricity than latex rubber; if there is a demand for extra lubrication in a particular market, this can be provided. Because the plastic is inert, these condoms need not be packaged in hermetically sealed containers. All these attributes make it possible to put these condoms on the distributors' shelves in developing countries competitively with rubber condoms. The shape of the plastic condom is based on that of the lamb caecum, which has long been used as luxury-type condom. The plastic condom is made from plastic film (ethylene ethyl acrilate) of 0.001 inch (0.0254 mm.) thickness. In addition, a rubber ring is provided and sealed into the base of the condom for retention during coitus. The advantage of the plastic condom design and the equipment on which it is made is that production can be carried out either in labour-intensive economy or with varying degrees of mechanization and automation. The uniform, finished condom if made using previously untrained workers. Training of workers can be done in a matter of hours on the two machines which are needed to produce and test the condoms. The plastic film is provided on a double wound roll, and condom blanks are prepared by means of a heat-sealing die on the stamping machine. The rubber rings are united to the condom blanks on an assembly machine, which consists of a mandrel and heat-sealing equipment to seal the rubber ring to the base of the condom. Built into the assembly machine is a simple air-testing apparatus that can detect the smallest pinhole flaw in a condom. The manufacturing process is completed by unravelling the condom from the assembly
Charles, Bimal; Sam, Asirvatham Edwin
Clients of female sex workers (FSWs) possess a high potential of transmitting HIV and other sexually transmitted infections from high risk FSWs to the general population. Promotion of safer sex practices among the clients is essential to limit the spread of HIV/AIDS epidemic. The aim of this study is to estimate the prevalence of consistent condom use (CCU) among clients of FSWs and to assess the factors associated with CCU in Tamil Nadu. 146 male respondents were recruited from the hotspots who reportedly had sex with FSWs in exchange for cash at least once in the past one month. Data were analyzed using bivariate and multivariate methods. Overall, 48.6 and 0.8 percent clients consistently used condoms in the past 12 months with FSWs and regular partners, respectively. Logistic regression showed that factors such as education, peers' use of condoms, and alcohol consumption significantly influenced clients' CCU with FSWs. Strategies for safe sex-behaviour are needed among clients of FSWs in order to limit the spread of HIV/AIDS epidemic in the general population. The role of peer-educators in experience sharing and awareness generation must also be emphasized. PMID:26316978
Wood, V D; Buckle, R A
In the adolescent clinic of the Children's Center at the District of Columbia General Hospital, the proficiency of high-risk adolescents in condom usage was investigated. The majority of patients are served for sexually transmitted diseases (STDs), contraception, and the diagnosis of pregnancy. In December 1990 and March 1991, each teenager who visited the clinic was given a latex reservoir-tipped condom and the plastic cover of a 60 mL syringe and was instructed to place the condom on the plastic cover. Then each was asked if it is better to remove the condom while the penis is still hard (erect) or when it is soft (flaccid). A performance score was assigned to each subject based on the following variables: 1) pinch the reservoir tip, 2) orient the condom correctly (not inside out), 3) roll the condom down the shaft, and 4) know that condoms should be removed while the penis is still erect. The maximum performance score was 4 with 1 point awarded for each successfully completed component. 38 females and 19 males with an age range from 13 to 19 years were included in the study group. 3 males (15.8%) and 22 females (57.8%) were either treated or were receiving follow-up for an STD, for an overall STD rate of 43.9%. The mean performance score for the study population was 2.3. Females averaged a performance score of 2.34, versus 2.31 for males. Females with STDs averaged higher scores than females who were infection-free (2.4 versus 2.1). Conversely, males with STDs averaged lower scores than those without STDs (2.0 versus 2.4). The most common deficiency was the failure to pinch the reservoir tip (67%) followed by failure to remove the condom while the penis is erect (61%), incorrect (inside out) orientation (25%), and failure to roll the condom completely down the shaft (9%). Among adolescents, health-compromising sexual behavior continues. Health-care workers should provide information on sexuality issues such as genital tract infections and contraception.
McLaurin-Jones, TyWanda; Lashley, Maudry-Beverly; Marshall, Vanessa
This study utilized quantitative and qualitative methods to (1) investigate the relationship between frequency of condom use and negotiation strategies and (2) evaluate experiences with condom negotiations among sexually active, heterosexual, African American college women. One hundred female students from a Historically Black Colleges and Universities (HBCU) completed a questionnaire that included the Condom Influence Strategies Scale (CIS) and participated in a focus group. An ANOVA was conducted to compare differences between never, inconsistent, and consistent condom users. Consistent condom users scored higher than never users on the "withholding sex" subscale of the CIS (4.88 vs. 3.55; p negotiation included deciding the "right timing" of discussion and having a previous history of sexual intercourse without a condom with their partner. Other key concepts that contribute to condom negotiation are the views that condoms are a male's responsibility and stigma of women who carry condoms.
Full Text Available Abstract Background To determine potential social, psychological, and environmental-structural factors that may result in motivating female sex workers (FSWs, who are rural-to-urban migrants, and their paying partners in Shanghai, China to promote consistent condom use (CCU. Methods A cross-sectional study was conducted in five districts of Shanghai, including three suburbs and two downtown locales. We adopted a cluster randomized sampling method to obtain 20 geographic sites, which consisted of 1 or more communities/villages proximal to a location where FSWs were accessible. Five hundred four FSWs from 132 Xitou Fang (shampoo wash rooms, massage parlors, and hair salons who explicitly provided sexual services were enrolled in the study. Each participant completed a questionnaire survey and interview aimed to collect information on the perceptions and behaviors of individuals associated with a risk for human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS,self-efficacy at negotiating safe sex,and the physical, social, and policy environment of the establishments where they worked. Results The percentage of FSWs who reported consistent condom use with their paying partners was 63.3%. Controlling for socio-demographic characteristics in multivariate analyses, environmental-structural support (OR, 3.96; CI, 2.52–6.22 for condom use was the most significant positive predictor of CCU among FSWs and their regular paying partners. A high perception of susceptibility and risk of HIV/AIDS (OR, 1.96; CI, 1.25–3.01, a high perception of benefits on condom use to protect themselves (OR, 2.06; CI, 1.32–3.22, and high safe sex self-efficacy (OR, 2.52; CI, 1.64–3.85 also play important roles on CCU based on multivariate analyses. Conclusions Environmental-structural factor support for condom use, in addition to social, psychological, and individual cognitive factors are significant predictors of CCU among FSWs, which should be
Background Avahan, the India AIDS initiative began HIV prevention interventions in 2003 in Andhra Pradesh (AP) among high-risk groups including female sex workers (FSWs), to help contain the HIV epidemic. This manuscript describes an assessment of this intervention using the published Avahan evaluation framework and assesses the coverage, outcomes and changes in STI and HIV prevalence among FSWs. Methodology Multiple data sources were utilized including Avahan routine program monitoring data, two rounds of cross-sectional survey data (in 2006 and 2009) and STI clinical quality monitoring assessments. Bi-variate and multivariate analyses, Wald Chi-square tests and multivariate logistic regressions were used to measure changes in behavioural and biological outcomes over time and their association. Results Avahan scaled up in conjunction with the Government program to operate in all districts in AP by March 2009. By March 2009, 80% of the FSWs were being contacted monthly and 21% were coming to STI services monthly. Survey data confirmed an increase in peer educator contacts with the mean number increasing from 2.9 in 2006 to 5.3 in 2009. By 2008 free and Avahan-supported socially marketed condoms were adequate to cover the estimated number of commercial sex acts, at 45 condoms/FSW/month. Consistent condom use was reported to increase with regular (63.6% to 83.4%; AOR=2.98; p<0.001) and occasional clients (70.8% to 83.7%; AOR=2.20; p<0.001). The prevalence of lifetime syphilis decreased (10.8% to 6.1%; AOR=0.39; p<0.001) and HIV prevalence decreased in all districts combined (17.7% to 13.2%; AOR 0.68; p<0.01). Prevalence of HIV among younger FSWs (aged 18 to 20 years) decreased (17.7% to 8.2%, p=0.008). A significant increase in condom use at last sex with occasional and regular clients and consistent condom use with occasional clients was observed among FSWs exposed to the Avahan program. There was no association between exposure and HIV or STIs, although numbers
Rachakulla Hari Kumar
Full Text Available Abstract Background Avahan, the India AIDS initiative began HIV prevention interventions in 2003 in Andhra Pradesh (AP among high-risk groups including female sex workers (FSWs, to help contain the HIV epidemic. This manuscript describes an assessment of this intervention using the published Avahan evaluation framework and assesses the coverage, outcomes and changes in STI and HIV prevalence among FSWs. Methodology Multiple data sources were utilized including Avahan routine program monitoring data, two rounds of cross-sectional survey data (in 2006 and 2009 and STI clinical quality monitoring assessments. Bi-variate and multivariate analyses, Wald Chi-square tests and multivariate logistic regressions were used to measure changes in behavioural and biological outcomes over time and their association. Results Avahan scaled up in conjunction with the Government program to operate in all districts in AP by March 2009. By March 2009, 80% of the FSWs were being contacted monthly and 21% were coming to STI services monthly. Survey data confirmed an increase in peer educator contacts with the mean number increasing from 2.9 in 2006 to 5.3 in 2009. By 2008 free and Avahan-supported socially marketed condoms were adequate to cover the estimated number of commercial sex acts, at 45 condoms/FSW/month. Consistent condom use was reported to increase with regular (63.6% to 83.4%; AOR=2.98; p Conclusions The absence of control groups is a limitation of this study and does not allow attribution of changes in outcomes and declines in HIV and STI to the Avahan program. However, the large scale implementation, high coverage, intermediate outcomes and association of these outcomes to the Avahan program provide plausible evidence that the declines were likely associated with Avahan. Declining HIV prevalence among the general population in Andhra Pradesh points towards a combined impact of Avahan and government interventions.
Parks, Kathleen A.; Collins, R. Lorraine; Derrick, Jaye L.
Prevalence data indicate that alcohol and marijuana are frequently used intoxicants among young adults in the United States. In a number of studies, both alcohol use and marijuana use have been associated with failure to use condoms, a high risk sexual behavior. The purpose of the current study was to assess the individual and additive effects of alcohol and marijuana use on this risky sexual behavior among 251, young adult, female, bar drinkers. Multi-level modeling was used to assess the likelihood of condom use during sexual events that occurred as a function of substance use (none, only alcohol, only marijuana, or both) prior to and partner type during the event, as well as individual differences in sexual assertiveness. Initial model testing (level 1 and 2) revealed that there were significant main effects for partner type (known), substance use (alcohol and marijuana) and sexual assertiveness (refusal, pregnancy/STI prevention) on risky sex. Final model testing indicated that sexual assertiveness interacted with substance use to influence risky sex. Women who were low in sexual assertiveness refusal were more likely to engage in risky sex on days when they had consumed both alcohol and marijuana prior to the sexual activity. These findings highlight the complex nature of the relationship between substance use and risky sex. PMID:22612253
Legendre-Dugal, Marianne; Bradley, Janet; Rajaram, Subramanian Potty; Lowndes, Catherine M; Ramesh, Banadakoppa M; Washington, Reynold; Moses, Stephen; Blanchard, James; Alary, Michel
To assess whether having received grey packets containing treatment for gonorrhoea and chlamydia was associated with condom use among female sex workers (FSWs) in 5 districts of southern India covered by the Avahan programme where both periodic presumptive treatment (PPT) and syndromic management were used to control these sexually transmitted infections (STIs) among FSWs. Cross-sectional study of FSWs recruited in the field in 5 districts of southern India (Bangalore, Belgaum, Bellary, Guntur and Mumbai) in 2006-2007. 1378 self-identified FSWs out of 1442 were approached to participate in the study (participation rate: 95.6%). The only exclusion criterion was to be aged <18 years. Consistent condom use (CCU) with new or occasional clients, and with the most recent repeat client as assessed using a questionnaire administered through face-to-face interviews. Using the Poisson regression to model the association between the number of grey packets received in the past 3-12 months and reported CCU, adjusting for factors associated with condom use and other potential confounders in our data, CCU was lowest among FSWs who had received ≥3 grey packets in the past 3-12 months with their new or occasional clients (adjusted prevalence ratio (APR): 0.70, 95% CI 0.57 to 0.84, p<0.001) and with the most recent repeat client (APR 0.63, 95% CI 0.51 to 0.78, p<0.001). Tests for trends showed that CCU with both types of clients decreased with the number of grey packets received (p<0.001). Since we could not distinguish grey packets used for PPT from those given for syndromic management, these results could be either due to a perception of protection conferred by PPT or by the fact that inconsistent condom users are more at risk for STIs. Further research on the potential disinhibiting effect of PPT is warranted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Carrasco, Maria Augusta; Nguyen, Trang Q; Barrington, Clare; Perez, Martha; Donastorg, Yeycy; Kerrigan, Deanna
Evidence indicates that social cohesion is a successful strategy to improve consistent condom use (CCU) among female sex workers. However, the individual and layered or combined effect that various types of overlapping stigmas may have on CCU between female sex workers living with HIV and their clients and steady partners has not been analyzed. Drawing on the Abriendo Puertas cohort of female sex workers living with HIV in the Dominican Republic, we used structural equation modeling to test the hypothesis that both HIV stigma and sex work stigma mediate the association between social cohesion and CCU and that they have a layered effect. The results indicated that HIV stigma mediated the association between social cohesion and CCU with clients and partners, while sex work-related stigma did not. There was no evidence of a layered HIV stigma and sex work stigma effect, which may be due to methodological limitations to handle highly correlated latent variables. Findings highlight the need to address internalized HIV stigma within the context of community-based approaches to enhance their HIV prevention impact. This will help to reduce the risk of HIV re-infection with a new distinct HIV viral strain, STI infection, and onward HIV transmission among female sex workers living with HIV.
Many people in the US are infected with HIV. One can not tell whether someone has HIV simply by looking at them. As such, not using a condom when having sex with an individual outside of a mutually monogamous relationship in which both partners are not infected with HIV opens one to the potentially enormous risk of contracting HIV and other sexually transmitted diseases (STD). The risk of unwanted pregnancy also looms high when heterosexual intercourse is practiced without contraception. The high incidences of unwanted pregnancies and STDs in the US attest to the squeamishness of the American public about contraception in general and condoms in particular. Compared to other leading industrialized nations, the US has the highest birth rate with 40% of US births unintended; 75% of births to teenagers are unplanned, with 66% of such teens giving birth as unmarried mothers. Twelve million people in the US annually contract STDs, 66% of them under age 25 years, and an estimated one million people in the US are infected with HIV. This article reports the establishment by Zero Population Growth (ZPG) Seattle of a comfortable, nonprofit store in which patrons can learn about and buy condoms. Appropriate especially for young people, the store provides an alternative to the pharmacies and sex shops in which people are typically constrained to buy prophylactics. Launched in 1975, the Rubber Tree is a nonprofit store in which approximately sixty varieties of condoms, safer sex supplies, T-shirts, and books on sexuality, population growth, and the environment are sold. The Seattle Times recently noted that it is the only store of its kind in the nation. The store also provides fliers on STDs and other sex-related subjects, has a borrowing library, and displays ZPG literature. The laid back staff and volunteers tackle sexuality with a balance of humor and seriousness, yet are trained to answer questions about contraceptives without attempting to take the place of professionally
sexual partners without using condoms are at risk of HIV transmission. ... Key words: Cameroon, condom use, HIV/AIDS, multiple sexual partners, secondary school female students .... The number of sexual partners is an important indicator of.
Pinkerton, S D; Abramson, P R
The consistent use of latex condoms continues to be advocated for primary prevention of HIV infection despite limited quantitative evidence regarding the effectiveness of condoms in blocking the sexual transmission of HIV. Although recent meta-analyses of condom effectiveness suggest that condoms are 60 to 70% effective when used for HIV prophylaxis, these studies do not isolate consistent condom use, and therefore provide only a lower bound on the true effectiveness of correct and consistent condom use. A reexamination of HIV seroconversion studies suggests that condoms are 90 to 95% effective when used consistently, i.e. consistent condom users are 10 to 20 times less likely to become infected when exposed to the virus than are inconsistent or non-users. Similar results are obtained utilizing model-based estimation techniques, which indicate that condoms decrease the per-contact probability of male-to-female transmission of HIV by about 95%. Though imperfect, condoms provide substantial protection against HIV infection. Condom promotion therefore remains an important international priority in the fight against AIDS.
The aim of the study was to investigate factors affecting condom use among senior secondary school pupils in South Africa. Objectives were to identify the sociodemographic characteristics and sexual history, knowledge about correct condom use, source of condom information, AIDS health beliefs, self efficacy of condom use, correlates and predictors of condom use in Grade 12 students. Cross sectional survey. 460 Grade 12 secondary school pupils from three rural schools. The sample included 460 Grade 12 secondary school pupils, 170 (37%) males and 290 (63%) females in the age range of 16 to 30 years (mean age 19.7 yrs, SD = 2.5). Self reported sexual activity and condom use (12 items); source of 'condom' information (12 items); knowledge of correct condom use (10 items); a 16 item AIDS Health Belief Scale and a 28 item Condom Use Self-Efficacy Scale. About half of those sexually active (52.6% males and 40.5% females) reported never having used condoms. About 90% levels of correct answers on condom knowledge were found for the items of "protection against AIDS" and "expire date of condoms". Knowing someone with HIV/AIDS was related to current condom use and a history of STD with lifetime condom use. The four AIDS beliefs sub-scales were all related to self efficacy of condom use. Behavioural norm to use condoms, attitudes towards condom use, normative beliefs to use of condoms and subjective norm to use condoms were all related to condom use intention. Normative beliefs and subjective norms to use condoms were both negatively related with lifetime condom use, current condom use, and self efficacy in condom use. Normative beliefs, attitudes and subjective norms about condoms predicted condom use intention, AIDS susceptibility and AIDS benefits predicted condom use with last sexual partner, and AIDS benefits and AIDS barriers predicted condom use intention. Findings have relevant implications and are discussed in the context of developing an educational or intervention
Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua
Abstract Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs). We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40–49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time. By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P HIV prevalence increased for older age clients (1.3%–2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%–0.8%, P sex with men or intravenous drug use. Clients preferred LTFSWs, especially older clients (81.9%). Our results suggest that HIV and syphilis infections are increasing in older clients who prefer LTFSWs. HIV and syphilis are likely increasing in Guangxi Province through heterosexual transmission
Pitpitan, Eileen V; Wagner, Karla D; Goodman-Meza, David; Semple, Shirley J; Chavarin, Claudia; Strathdee, Steffanie A; Patterson, Thomas L
Tijuana is situated on Mexico's northern border with the U.S., where sex work is quasi-legal. Whereas previous work has focused on the risk behaviors of female sex workers (FSWs), less is known about the risk behaviors of their male clients. Further, research has not examined structural factors as moderators of the association between substance use and condom use, including the contexts in which sex takes place. The purpose of the current study is to examine whether having sex with FSWs in a bar moderates the link between alcohol intoxication during sex and condom use. We recruited 375 male clients of FSWs in Tijuana, Mexico from San Diego, California and Tijuana. Using computer assisted interviewing, we surveyed participants on their alcohol use, condom use, and physical contexts of sex with FSWs in the past 4 months. Results showed that more frequent intoxication during sex with FSWs is associated with more unprotected sex, but only among clients having sex with FSWs in a bar context. Results point to potential reasons for inconsistent condom use with FSWs in this context, including lower risk perceptions of sex with FSWs in bars. Future research should examine structural factors that underlie clients' risk behavior in bars in order to inform structural-level HIV prevention interventions.
Community-based prevention leads to an increase in condom use and a reduction in sexually transmitted infections (STIs among men who have sex with men (MSM and female sex workers (FSW: the Frontiers Prevention Project (FPP evaluation results
Full Text Available Abstract Background India has an estimated 2.0 million to 3.1 million people living with HIV; it has the highest number of HIV-positive people in Asia and ranks third in the world. The Frontiers Prevention Project (FPP was implemented in 2002 to conduct targeted prevention intervention geared towards female sex workers (FSW and men who have sex with men (MSM in the state of Andhra Pradesh (AP. This paper reports the overall changes in behaviour and STI outcomes between 2003/4 and 2007 and also describes the changes attributed to the FPP. Methods The evaluation used two cross-sectional surveys among MSM and FSW at 24 sites in AP. Surveys were implemented using a similar methodology. Univariate analyses were conducted by comparing means: baseline vs. four-year follow-up and FPP vs. non-FPP. For both MSM and FSW, random and fixed-effects logit regression models at the site level were estimated for condom use with last partner, syphilis sero-positivity and HSV 2 sero-positivity. In addition, for FSW we estimated models for condom use with regular partner, and for MSM we estimated models for condom use with last female partner. Results Among MSM, fixed-effects analysis revealed that FPP was positively correlated with the probability of condom use with last female sexual partner and negatively correlated with the individual probability of sero-positivity to syphilis and HSV 2. Among FSW, the FPP intervention was significantly correlated with increased condom use with regular partners and with lower probability of STI sero-positivity. Discussion Important changes in behaviours related to an increase in prevention activities translated to reductions in STI sero-prevalence in AP, India. In contrast with non-FPP sites, the FPP sites experienced an intense community approach as part of the FPP intervention, and the general increase in condom use and its effect on STI sero-prevalence reflected the efficacy of these intense prevention activities focused on
Elisabeth Meloni Vieira
Full Text Available OBJECTIVES: To study HIV-positive women and women at risk of becoming infected with HIV who attended HIV prevention education group sessions at a university hospital in Bra-zil and to compare the use of the female condom and the male condom by these two groups of women. METHODS: The study subjects were 165 women participating in HIV prevention education group sessions at the Medical School Hospital of Ribeirão Preto of the University of São Paulo, in the city of Ribeirão Preto, São Paulo, Brazil. Women could be enrolled in the study from August 2000 to June 2001, and the follow-up observation time period was from August 2000 to July 2001. Male condoms and female condoms were freely distributed to all the participants at the end of each educational session and also at the end of each follow-up visit that the participants made. Each woman took part in an initial interview and was asked to return monthly. At each follow-up visit an additional short interview was carried out in order to investigate use of the male condom and of the female condom. Variables that were examined for the study included age, education, ethnic group, marital or relationship status, number of children, the women's use of male condoms and female condoms, commercial sex (whether the women had ever had sex in exchange for money, gifts, or favors, and previous knowledge of the female condom. RESULTS: The 165 women studied fell into the following three categories: 132 of them (80.0% were HIV-positive, 26 of them (15.8% had a sexually transmitted disease (STD other than HIV and did not have an HIV-positive partner, and 7 of them (4.2% had an HIV-positive partner but did not have HIV or any other STD. The women ranged in age from 15 to 64 years, with a mean of 30.3 years. Of the women in the study, 69.7% of them were married or were cohabitating, and 90.9% of them had a sexual partner. Just over two-thirds of the women had seven years of formal schooling or less. Out of 163
Roberto, E L
A number of program strategies have been suggested to close the gap between knowledge and awareness of family planning, and its practice. Most focus on the interim between awareness and usage. This article presents data to support the argument that the problem lies in the awareness stage. Its assumption is that the quality of the awareness is important. As opposed to the survey method of determining awareness, the author proposes the "Focus Group Discussion." As illustration, he presents results of a study using this method, on awareness about condoms, undertaken as part of a Population Center Foundation Condom Distribution Project, in 1975. Its purpose was to identify the more important attitudes toward condoms among married couples, the factors which motivate the couples to use or reject them, and the meanings associated with condoms and how these influence the time, manner, and reasons for rejecting or accepting them. 4 group discussions were carried out, with 8 or 10 married male and female respondents, age 18-35, with at least 2 children, of middle and lower class, and all having at least heard of condoms. Discussions were taped and subjected to content analysis. The 7 major findings are: 1) Quality of awareness depends on experience with use. 2) Experience with use does not guarantee positive quality awareness -- some regular users were still ignorant of some aspects of condom use. 3) Respondents perceive positive aspects of condoms, which should be reinforced. 4) Most of the negative qualities perceived by respondents were imaginary, but can be combatted by the positive statements of users. 5) Filipino men respond to their wives' reactions and project an image of sexual prowess, both possibly damaging to the reputation of condoms; communicators and educators must address the wives equally with their husbands. 6) Buying condoms is embarrassing: studies are needed on how this can be overcome at the places of purchase. 7) Brand awareness is low: only 3 or 4 out
Crosby, R; Milhausen, R; Sanders, S A; Graham, C A; Yarber, W L
This exploratory study compared the frequency of condom use errors and problems between men reporting that condom use for penile-vaginal sex was a mutual decision compared with men making the decision unilaterally. Nearly 2000 people completed a web-based questionnaire. A sub-sample of 660 men reporting that they last used a condom for penile-vaginal sex (within the past three months) was analysed. Nine condom use errors/problems were assessed. Multivariate analyses controlled for men's age, marital status, and level of experience using condoms. Men's unilateral decision-making was associated with increased odds of removing condoms before sex ended (adjusted odds ratio (AOR) 2.51, p = 0.002), breakage (AOR 3.90, p = 0.037), and slippage during withdrawal (AOR 2.04, p = 0.019). Men's self-reported level of experience using condoms was significantly associated with seven out of nine errors/problems, with those indicating less experience consistently reporting more errors/problems. Findings suggest that female involvement in the decision to use condoms for penile-vaginal sex may be partly protective against some condom errors/problems. Men's self-reported level of experience using condoms may be a useful indicator of the need for education designed to promote the correct use of condoms. Education programmes may benefit men by urging them to involve their female partner in condom use decisions.
Wright, S S; Kyes, K B
Social learning theory predicts that reading non-erotic stories involving condom use will be as effective as reading erotic stories with condom use in producing positive attitudes toward condoms. Werner's orthogenetic principle, however, predicts that reading erotic condom stories will be most effective because of the link created between sexual arousal and cognitive information about condoms. 168 male and 149 female undergraduates enrolled in Introductory Psychology at a small, private, southern university participated in a study to test the validity of these two theories. The students read one of the following types of stories: erotic with condom placement described, erotic without condom use, or non-erotic with a model for discussing condoms. The men and women who read the non-erotic stories were most positive about condoms and reported the strongest intentions to use condoms in the future. These findings suggest that erotica is not necessary to produce positive attitudes toward condoms.
Treffke, H; Tiggemann, M; Ross, M W
The Australian study investigated condom-specific assertiveness and condom use as a means of prevention infection from sexually transmitted diseases. 211 men participated including 83 homosexual men (aged 19-62 years) and 128 heterosexual men (aged 17-49) who completed a questionnaire that comprised demographic details such as age, monogamy, and sexual activity as well as attitudinal and assertiveness measures. General assertiveness was measured by the Rathus Assertiveness Schedule (RAS) which had been widely used across a wide range of social situations. Assertiveness relating specifically to situations involving condoms was measured by the Condom Assertiveness Scale (CAS). Intention to use condoms was positively related to favorable attitudes, which were related to condom-specific assertiveness for both groups. For the heterosexual men only, general social assertiveness was negatively related to attitudes toward condoms. For both groups, the condom-specific measure of assertiveness was positively correlated with attitudes toward condoms. Condom-specific assertiveness was positively related to general social assertiveness as measured by the Rathus Assertiveness Schedule for the homosexual, but not for the heterosexual men. The negative relationship between general assertiveness and attitude to condoms among the heterosexual men implies that the risk reducing behavior of condom use did not seem to accord with the perceptions of masculinity and social assertiveness among heterosexual men. Thus, female partners of such heterosexual men exhibiting negative attitudes toward condom use combined with assertiveness would have to overcome resistance to insist on the use of condoms. Recently some advertising campaigns have been directed at women. The promotion of condom use among heterosexual men has to deal with the perceptions of condom use as unmasculine behavior.
Social marketing is a strategy which addresses a public health problem with private-sector marketing and sales techniques. In condom social marketing programs, condoms are often offered for sale to the public at low prices. 350 million condoms were sold to populations in developing countries through such programs in 1992, and another 650 million were distributed free through public clinics. The major donors of these condoms are the US Agency for International Development, the World Health Organization, the UN Population Fund, the International Planned Parenthood Federation, the World Bank, and the European Community. This marketing approach has promoted condom use as prevention against HIV transmission and has dramatically increased the number of condoms distributed and used throughout much of Africa, Latin America, and Asia. Donors are now concerned that they will not be able to provide condoms in sufficient quantities to keep pace with rapidly rising demand. Findings in selected countries, however, suggest that people seem willing to buy condoms which are well promoted and distributed. Increasing demand for condoms may therefore be readily met through greater dependence upon social marketing programs and condom sales. Researchers generally agree that a social marketing program must change for 100 condoms no more than 1% of a country's GNP in order to sell an amount of condoms equal to at least half of the adult male population. Higher prices may be charged for condoms in countries with relatively high per-capita incomes. Since prices charged tend to be too low to cover all promotional, packaging, distribution, and logistical management costs, most condom distribution programs will have to be subsidized on an ongoing basis.
HIV prevalence, AIDS knowledge, and condom use among female sex workers in Santiago, Chile Prevalencia del VIH, conocimientos sobre el SIDA, y uso del condón en trabajadoras sexuales de Santiago, Chile
Jaime E. Barrientos
Full Text Available This paper describes HIV seroprevalence, knowledge of HIV transmission, and condom use among female sex workers (FSW attending five specialized sexually transmitted disease (STD clinics in Santiago, Chile. A short questionnaire with socio-demographic, AIDS knowledge, and condom-use variables was administered to 626 FSW. HIV seroprevalence was estimated with a blood test sent to the Chilean Public Health Institute. ELISA was used to confirm HIV in suspected cases. HIV prevalence was 0%. FSW showed adequate overall knowledge of HIV, even better than reported for the Chilean general population on some items. Condom use with clients was high ("always" = 93.4%, although regular use with steady partners was low ("always" = 9.9%. The zero HIV seroprevalence and consistent condom use with clients confirms the positive impact of intervention strategies for FSW, increasing both correct knowledge of AIDS and condom use with clients and helping decrease these women's HIV/AIDS vulnerability.Este artículo examina la prevalencia del VIH, los conocimientos respecto a su infección y, además, describe el uso del condón en mujeres que ejercen el comercio sexual en Santiago de Chile y que son atendidas en cinco centros especializados de enfermedades de transmisión sexual. Se aplicó una encuesta que indagaba sobre las características sociodemográficas, el conocimiento sobre el VIH/SIDA y el uso del condón a 626 mujeres. La prevalencia del VIH fue evaluada mediante un examen de ELISA. La prevalencia del VIH fue 0. El conocimiento del VIH fue bueno e, incluso, mejor que en población general, en algunos indicadores. El uso del condón con los clientes fue alto, aunque su uso regular con las parejas estables fue bajo. La prevalencia cero del VIH y el uso consistente de condones con los clientes confirma el impacto positivo que han tenido las estrategias de intervención implementadas para estos grupos, incrementando el conocimiento adecuado sobre el SIDA y el
Evaluación del uso del preservativo femenino promovido desde un programa de educación para la salud: un enfoque cualitativo Evaluation of female condom use within a health education program: a qualitative approach
Full Text Available El trabajo aquí recogido se aborda desde un estudio de caso, a través del enfoque cualitativo, mediante la técnica del grupo de discusión con la participación de 9 grupos, conformados por un total de 83 estudiantes universitarios del noroeste de España, con edades entre 19 y 42 años. Los objetivos principales de este trabajo son conocer la satisfacción de los y las participantes con el uso del preservativo femenino, así como las ventajas y obstáculos encontrados en su utilización que ha sido promovida a través de un programa de promoción de la salud. Como resultados y conclusiones destacar que las mujeres enfatizan en mayor medida que los varones la satisfacción y ventajas obtenidas con la utilización del método. Como puntos fuertes sobre el uso del preservativo femenino los y las participantes destacan la alta resistencia a la rotura y entre las debilidades apuntan los problemas ligados a su colocación y estética. El estudio sobre el uso del preservativo femenino revela la necesidad de continuar desarrollando intervenciones de formación encaminadas a la promoción de este método, sin excluir el empleo de otros, así como de reforzar la incorporación de estrategias educativas que permitan avanzar en la eliminación de estereotipos de género.This study is concerned with the promotion of the female condom. It is a qualitative study that was carried out by means of discussion groups, with the participation of nine groups. The study's sample was formed by 83 university students aged 19-42 years, from Galicia (Spain. The main objective of this study is to know the degree of satisfaction of the participants, and the advantages/drawbacks of using the female condom, which was promoted by a health programme. With regard to the conclusions of the study, it should be pointed out that the female participants focused more on the advantages of using the female condom, whereas the male participants primaly emphasised its drawbacks. The
In Tanzania, the debate about whether condoms should be free is particularly significant because condoms were unheard of 5 years ago and are the least population form of contraception. A nongovernmental organization (NGO) is selling condoms which they promote as "fun." Sales blossomed after an advertising campaign was televised during the soccer World Cup. The new prevailing attitude seems to be that if a man can afford sex, he can afford to buy a condom. In fact, one NGO which distributed free condoms found that their supply at a local guest house was always depleted. Their pleasure with this success was diminished when they learned that people were selling their condoms across the border in Uganda.
Baele, J; Dusseldorp, E; Maes, S
To investigate aspects of adolescents' condom use self-efficacy that affect their intended and actual condom use. Four hundred twenty-four male and female sexually experienced and inexperienced adolescents with a mean age of 17.0 years filled out a questionnaire concerning condom use self-efficacy and intended and actual condom use. Specific condom use self-efficacy scales were constructed from 37 items on the basis of a principal component analysis. The effect of self-efficacy, both as a global measure and in terms of specific scales, on condom use intention and consistency was assessed using multiple hierarchic regression analyses. Six specific self-efficacy scales were constructed: Technical Skills, Image Confidence, Emotion Control, Purchase, Assertiveness, and Sexual Control. In sexually inexperienced adolescents, global self-efficacy explained 48%, the six self-efficacy scales 30%, and both together 51% of the variance in intention, after statistical control for gender, age, and education level. In the sexually experienced sample, this was 40%, 50%, and 57% for intention, and 23%, 29%, and 33% for consistency of condom use. Significant predictors of intention in the final model were gender, age, global self-efficacy and purchasing skills in the inexperienced sample, and global self-efficacy, emotion control, assertiveness, image confidence, and sexual control in the experienced sample, whereas gender, age, global self-efficacy, emotion control, assertiveness, and purchase predicted consistency of condom use in the experienced sample. Condom use self-efficacy is a multidimensional construct. Intended and actual condom use in adolescents are best predicted by self-efficacy measures that include both global and relevant specific aspects of condom use.
Piotrow, P T; Rinehart, W
A great deal of avoided if political and religious leaders, educators, health care providers and the mass media would band together in an effort to promote condom use. Condoms use protects against unwanted pregnancies, STDs and AIDS. Yet, public discussions on condom use are rate. In the US, political leaders avoid mentioning the topic, and television networks severely restrict the airing of public service announcements for condoms. Worldwide, an estimated 100 billion acts of sexual intercourse take place every year. A recent report indicates that it would take a modest 13 billion condoms a year to protect everyone who is at risk of contracting AIDS and other STDs, and risk of having an unwanted pregnancy. Currently, worldwide production of condoms stands at about 6 billion a year. Furthermore, condom makers have the capacity to increase production by some 2 billion, and could add new capacity in about 2 years. Many believe that marketing condoms is a difficult enterprise, since men often report that condoms reduce pleasure, cause embarrassment, or are not available when needed. The challenge for markets, then, is to create demand. This is especially true in the US, where prime-time advertising and the use of popular entertainment, such as soap operas, could promote condoms as both safe and satisfying. In the developing world, the challenge is to make condoms widely available and affordable. Some changes have taken place since 1981, when AIDS first came into the spotlight. In the US, people now discuss the topic of STDs more openly. But an all-out effort to promote condom use has not yet begun.
Hood, Kristina B; Shook, Natalie J
The Centers for Disease Control and Prevention (2011) estimated that women represent 24% of HIV diagnoses in the United States, with most infections resulting from heterosexual contact. However, consistent condom use is highly effective in preventing the spread of HIV. The current study examined women's attitudes toward condom use and potential inconsistencies related to the conceptualization and measurement of attitudes. Data were collected from October 2009 through March 2010. Researchers included 556 female undergraduate students from the Southeast region of the United States. Exploratory and confirmatory factor analyses were used to determine whether women's condom use attitudes were composed of an affective and a cognitive component. Evidence for a two-factor model of condom use attitudes consisting of an affective and cognitive component was found, with participants reporting slightly negative feelings toward condom use but favorable beliefs about using condoms. Affect accounted for more variance (42%) than cognition (8%) in condom use attitudes. Notably, affect and cognition were differentially associated with past behavior and intentions to use condoms. Understanding the structure of women's attitudes toward using condoms can aid in the creation of appropriate HIV prevention and condom use messaging targeted toward promoting positive attitudes and normative change. Changing women's attitudes in this manner could enhance the effectiveness of condom use interventions.
樋口, 匡貴; 中村, 菜々子
Properly using condoms is one of the most effective types of protection against HIV. To clarify the contents of normative beliefs regarding purchasing and using condoms, 390 undergraduate student volunteers were surveyed. The exploratory and confirmatory factor analyses revealed that both males and females held two types of normative beliefs, namely formal normative beliefs and informal normative beliefs, regarding purchasing and using condoms. Formal normative beliefs were concerned with the...
Malaysia, famous for its natural rubber, is also producing condoms made from local rubber. About 40,000 gross of condoms a month are being produced by a factory with about 30 female workers. 30-40% of the production is exported to Europe, Middle East, Asia, Japan, Singapore and South America. The size of the condoms conform to international standards, 49 mm and 52 mm. As there is a greater demand for the 52 mm. condoms overseas, the company produces more of this than the 49 mm. condoms. In April 1975, the Standard Institution and Industrial Research of Malaysia gave its quality control approval to a condom which can hold 5 gallons of water and with thickness varying from 0.03 mm, 0.06 mm. and 0.05-0.07 mm. A 10% tax/piece and a 5% surtax are imposed on imported condoms to protect the local industry from foreign competition. Local condoms are sold tax-free. Pink and black colored condoms appear to be popular among consumers. Although complaints are few, 1 in 10,000 users may suffer from allergic problems because of the silicone oil treatment of the condoms. Another local condom factory which uses Malaysian rubber for condom manufacture is located in Klang, approximately 24 miles from Kuala Lumpur; the factory has 25 workers producing 12,000 gross of lubricated and non-lubricated condoms for local consumption only. There is increasing evidence that condoms are increasing in popularity in Malaysia and that the average consumer is now being more selective in choosing contraceptive methods.
Regan, Rotrease; Morisky, Donald E.
Because consistent condom use is an effective strategy in the prevention of sexually transmitted infections and HIV transmission, it is important to examine social cognitive influences of consistent condom use not only among female sex workers (FSWs) but also among their male clients, for whom less is known. Because little is known about how HIV…
Okafor, Uchenna; Crutzen, Rik; Okekearu, Ifeanyi; Adebajo, Sylvia; Uzoh, Adaora; Awo, Egbe Aneotah; Chima, Chukwuemeka; Agwagwa, Ogechukwu; Van Den Borne, Bart
Background The HIV prevalence among female populations involved in sex work in Nigeria has heightened interest in HIV prevention programming for this sub-population with brothel-based female sex workers (BB FSWs) having a prevalence of 27.4%, six times higher than the prevalence in the general
Chandran, Thoovakkunon Moorkoth; Berkvens, Dirk; Chikobvu, Perpetual; Nöstlinger, Christiana; Colebunders, Robert; Williams, Brian Gerard; Speybroeck, Niko
This study investigated the extent and predictors of condom use and condom refusal in the Free State province in South Africa. Through a household survey conducted in the Free Sate province of South Africa, 5,837 adults were interviewed. Univariate and multivariate survey logistic regressions and classification trees (CT) were used for analysing two response variables 'ever used condom' and 'ever refused condom'. Eighty-three per cent of the respondents had ever used condoms, of which 38% always used them; 61% used them during the last sexual intercourse and 9% had ever refused to use them. The univariate logistic regression models and CT analysis indicated that a strong predictor of condom use was its perceived need. In the CT analysis, this variable was followed in importance by 'knowledge of correct use of condom', condom availability, young age, being single and higher education. 'Perceived need' for condoms did not remain significant in the multivariate analysis after controlling for other variables. The strongest predictor of condom refusal, as shown by the CT, was shame associated with condoms followed by the presence of sexual risk behaviour, knowing one's HIV status, older age and lacking knowledge of condoms (i.e., ability to prevent sexually transmitted diseases and pregnancy, availability, correct and consistent use and existence of female condoms). In the multivariate logistic regression, age was not significant for condom refusal while affordability and perceived need were additional significant variables. The use of complementary modelling techniques such as CT in addition to logistic regressions adds to a better understanding of condom use and refusal. Further improvement in correct and consistent use of condoms will require targeted interventions. In addition to existing social marketing campaigns, tailored approaches should focus on establishing the perceived need for condom-use and improving skills for correct use. They should also incorporate
Mehra, Devika; Östergren, Per-Olof; Ekman, Björn; Agardh, Anette
Feminization of the HIV/AIDS epidemic has been a prominent phenomenon in sub-Saharan Africa. Inconsistent condom use among young people is one of the major risk factors in the continued propagation of the epidemic. Therefore, it is of importance to increase knowledge of gender aspects of condom use among young people. To investigate whether gender differences regarding individual and social factors determine the association between condom efficacy and inconsistent condom use with a new sex partner, among Ugandan university students. In 2010, 1954 Ugandan students participated in a cross-sectional survey, conducted at Mbarara University of Science and Technology in southwestern Uganda. A self-administered questionnaire assessed socio-demographic factors, alcohol consumption, sexual behaviors (including condom use and condom efficacy), and peer norms. The data were stratified by sex and examined by multivariate logistic regression analysis. A total of 1,179 (60.3%) students reported having had their sexual debut. Of these, 231 (37.4%) males and 209 (49.2%) females reported inconsistent condom use with a new sex partner. Students with low condom efficacy had a higher risk of inconsistent condom use with a new sex partner, even after adjusting for the potential confounders. A synergistic effect was observed between being a female and low condom efficacy with inconsistent condom use. The association between inconsistent condom use and low condom efficacy was found among both males and females, but females were found to be at a higher risk of inconsistent condom use compared to their male counterparts. Therefore, gender power relations should be addressed in policies and interventions aiming at increasing condom use among young people in sub-Saharan settings. Programs could be designed with intervention strategies that focus on interactive and participatory educational activities and youth-friendly counseling of young people, which in turn may improve their interpersonal
Full Text Available Background: Feminization of the HIV/AIDS epidemic has been a prominent phenomenon in sub-Saharan Africa. Inconsistent condom use among young people is one of the major risk factors in the continued propagation of the epidemic. Therefore, it is of importance to increase knowledge of gender aspects of condom use among young people. Objective: To investigate whether gender differences regarding individual and social factors determine the association between condom efficacy and inconsistent condom use with a new sex partner, among Ugandan university students. Design: In 2010, 1954 Ugandan students participated in a cross-sectional survey, conducted at Mbarara University of Science and Technology in southwestern Uganda. A self-administered questionnaire assessed socio-demographic factors, alcohol consumption, sexual behaviors (including condom use and condom efficacy, and peer norms. The data were stratified by sex and examined by multivariate logistic regression analysis. Results: A total of 1,179 (60.3% students reported having had their sexual debut. Of these, 231 (37.4% males and 209 (49.2% females reported inconsistent condom use with a new sex partner. Students with low condom efficacy had a higher risk of inconsistent condom use with a new sex partner, even after adjusting for the potential confounders. A synergistic effect was observed between being a female and low condom efficacy with inconsistent condom use. Conclusion: The association between inconsistent condom use and low condom efficacy was found among both males and females, but females were found to be at a higher risk of inconsistent condom use compared to their male counterparts. Therefore, gender power relations should be addressed in policies and interventions aiming at increasing condom use among young people in sub-Saharan settings. Programs could be designed with intervention strategies that focus on interactive and participatory educational activities and youth
Regan, Rotrease; Morisky, Donald E
Because consistent condom use is an effective strategy in the prevention of sexually transmitted infections and HIV transmission, it is important to examine social cognitive influences of consistent condom use not only among female sex workers (FSWs) but also among their male clients, for whom less is known. Because little is known about how HIV knowledge and condom attitudes affect condom use among male clients of FSWs in the Philippines, the main objective was to determine what characteristics (age, education, HIV knowledge, marital status) as well as attributes taken from protection motivation theory (perceived vulnerability, perceived severity, response efficacy) are significantly associated with consistent condom use among male clients of FSWs. Logistic regression analyses showed that the odds of using condoms consistently with an FSW are 13% higher for those with more years of education (adjusted odds ratio [AOR] = 1.13; 95% confidence interval [CI] = 1.03, 1.23), higher versus lower perception of severity of HIV/AIDS (AOR = 1.97; 95% CI = 1.04, 3.73), and had a higher score for response efficacy of condoms (AOR = 1.14; 95% CI = 1.03, 1.27). Future HIV/AIDS prevention interventions that address condom use among male clients should promote educational attainment and focus on awareness of the enduring negative health consequences of acquiring HIV/AIDS, as well as cultivate positive attitudes toward the efficacy of condom use, using creative social marketing strategies.
Okafor, Uchenna O.; Crutzen, Rik; Sylvia, Adebajo; Ifeanyi, Okekearu; Van Den Borne, Bart
Support by brothel leaders and the promotion of a conducive environment for HIV prevention programs within brothel establishments are important to promote a safe working environment for Brothel-Based Female Sex Workers (BB FSWs). This study assesses the effects of a cluster randomized pilot trial
Bond, V; Dover, P
Understanding cultural attitudes to condoms is of the utmost importance in promoting their use as a means of protection against HIV transmission. This article examines condom use in relation to what people see as the purpose of sex, what good sex entails and how this relates to ideas of being a proper woman or man. It seems that the underlying and pervasive ideal is that sex is essentially a procreative act, since an emphasis on male potency and male and female fertility often overrides anxieties about contracting HIV and other sexually transmitted diseases. Hence condom use is usually only negotiated within some short-term relationships and then not consistently. Whilst both men and women have negative attitudes to condoms, women because of their economic and ideological dependence on men are in a much weaker position to negotiate condom use.
Condoms are an effective contraceptive and disease prevention device used correctly and consistently by millions of people around the world. That condoms do not work, HIV can pass through them, and condoms frequently break are simply myths. Condom efficacy is directly related to their correct and consistent usage. Condoms are therefore very effective when properly used. While HIV is only 0.1 micron wide and the head of a human sperm cell is 3 microns wide, scanning electron microscopy has shown latex condoms to block the passage of both. Most condom breakage is due to incorrect usage rather than poor condom quality. Prolonged exposure to heat and/or sunlight and the use of oil-based lubricants such as Vaseline can weaken condoms and cause them to break during use. Opening the condom pack with teeth or sharp fingernails can also damage a condom. Finally, a condom should not be used if its expiration date has passed or if it is more than 5 years from the manufacturing date.
Full Text Available ABSTRACTIntroduction:It is known that a single prevention strategy is not enough to control multiple HIV epidemics around the world and in Brazil. However, it is not only necessary to recognize the importance of condoms as part of the policy of HIV/AIDS prevention but also discuss its limits. In this article, we aim to investigate the use of condoms in Brazil, draw critical reflections, and understand how they can once again be highlighted in Brazil's prevention strategy going forward.Methods:A narrative review of literature was conducted using keywords in PubMed. Reports from national surveys that guide the epidemiological and behavioral surveillance of the Brazilian Ministry of Health were also included.Results:A total of 40 articles and 3 reports were included in the review and 11 intervention studies to promote the condom use; the main findings were as follows: 1 Despite the increase in national studies on sexual behavior, little attention is given to the role of condom use; 2 There are few studies examining the factors associated with condom use among key populations such as men who have sex with men (MSM, female sex workers (FSW, drug users (DU, and transvestites and transexuals (TT, while substantial studies focus on adolescents and women; 3 Evidence suggests that a combination of interventions is more effective.Discussion:new prevention technologies must not lose sight of the critical importance of condoms, and efforts to reintroduce them should focus on the role of pleasure in addition to their potential to minimize the risk of HIV.
Reducing violence and increasing condom use in the intimate partnerships of female sex workers: study protocol for Samvedana Plus, a cluster randomised controlled trial in Karnataka state, south India
Tara S. Beattie
Full Text Available Abstract Background Female sex workers (FSWs are at increased risk of HIV and STIs compared to women in the general population, and frequently experience violence in their working and domestic lives from a variety of perpetrators, which can enhance this risk. While progress has been made in addressing violence by police and clients, little work has been done to understand and prevent violence by intimate partners (IPs among FSW populations. Methods Samvedana Plus is a multi-level intervention programme that works with FSWs, their IPs, the sex worker community, and the general population, and aims to reduce violence and increase consistent condom use within these ‘intimate’ relationships. The programme involves shifting norms around the acceptability of beating as a form of discipline, challenging gender roles that give men authority over women, and working with men and women to encourage new relationship models based on gender equity and respect. The programme will aim to cover 800 FSWs and their IPs living in 47 villages in Bagalkot district, northern Karnataka. The study is designed to assess two primary outcomes: the proportion of FSWs who report: (i physical or sexual partner violence; and (ii consistent condom use in their intimate relationship, within the past 6 months. The evaluation will employ a cluster-randomised controlled trial design, with 50 % of the village clusters (n = 24 randomly selected to receive the intervention for the first 24 months and the remaining 50 % (n = 23 receiving the intervention thereafter. Statisticians will be blinded to treatment arm allocation. The evaluation will use an adjusted, cluster-level intention to treat analysis, comparing outcomes in intervention and control villages at midline (12 months and endline (24 months. The evaluation design will involve quantitative and qualitative assessments with (i all FSWs who report an IP (ii IPs; and process/ implementation monitoring. Baseline
Lindemann, Dana F; Brigham, Thomas A
HIV risk-reduction interventions frequently teach correct condom use skills, yet few researchers actually measure those skills. Without measuring condom use skills, it is not possible to evaluate the effectiveness of condom use interventions, or determine what variables may be related to those skills. The Measure of Observed Condom Use Skills (MOCUS) was developed using standard Guttman scaling procedures, and administered to 106 female and 71 male undergraduates. The MOCUS was administered by the primary investigator to each participant individually. Guttman scale analyses demonstrated the MOCUS has acceptable reproducibility. These findings support future use of the MOCUS to assess condom use skills.
Sandøy, Ingvild Fossgard; Blystad, Astrid; Shayo, Elizabeth H.
study findings indicate that substantial further efforts should be made to secure that condoms are easily accessible in places where sexual relationships are initiated. Although condom distribution in drinking places has been pinpointed in the HIV/AIDS prevention strategies of all the three countries......Background A number of studies from countries with severe HIV epidemics have found gaps in condom availability, even in places where there is a substantial potential for HIV transmission. Although reported condom use has increased in many African countries, there are often big differences...... in the availability of condoms in places where people meet new sexual partners in these three African districts. Considering that previous studies have found that improved condom availability and accessibility in high risk places have a potential to increase condom use among people with multiple partners, the present...
Marie Stopes International says a project it supports in Nigeria is making good progress in its efforts to promote the use of condoms to protect against STDs and for contraception. The program, which uses social marketing methods, is headed by Stewart Parkinson from the UK. His previous experience has been in the private sector; he has worked in sales, marketing, and advertising for companies like Coca Cola, Budweiser, Securicor, and Mates. "Social marketing," he says, "is simply getting people to buy a product". He sees no clash with more conventional health education practitioners, believing that the two approaches can complement each other. "Much of the work simply involves pointing out the benefits of condoms," says Parkinson. "You can convert large numbers of people to the idea in a short space of time if you get the message right]" Nevertheless, as he points out, the conversion rate usually drops after that. "At first the take-up is from middle-income people, who already have a latent demand for condoms. The poor are harder to reach." He says Nigeria is a very suitable country for a private sector approach to condom promotion, as there is no functioning public sector. He recently paid a visit to Zimbabwe, where the public sector is strong, and agrees that different approaches may be suitable there. The scheme provided 85% of the 65 million condoms used in Nigeria last year. Stewart Parkinson says, "It's working out at only US$5 to provide protection for one couple per year--a very cheap intervention]" full text
Chen, Yi; Abraham Bussell, Scottie; Shen, Zhiyong; Tang, Zhenzhu; Lan, Guanghua; Zhu, Qiuying; Liu, Wei; Tang, Shuai; Li, Rongjian; Huang, Wenbo; Huang, Yuman; Liang, Fuxiong; Wang, Lu; Shao, Yiming; Ruan, Yuhua
Clients of female sex workers (CFSWs) are a bridge population for the spread of HIV and syphilis to low or average risk heterosexuals. Most studies have examined the point prevalence of these infections in CFSWs. Limited evidence suggests that older age CFSWs are at a higher risk of acquiring sexually transmitted diseases compared with younger clients. Thus, we sought to describe long-term trends in HIV, syphilis, and hepatitis C (HCV) to better understand how these infections differ by sex worker classification and client age. We also examined trends in HIV, syphilis, and HCV among categories of female sex workers (FSWs).We conducted serial cross-sectional studies from 2010 to 2015 in Guangxi autonomous region, China. We collected demographic and behavior variables. FSWs and their clients were tested for HIV, syphilis, and HCV antibodies. Positive HIV and syphilis serologies were confirmed by Western blot and rapid plasma regain, respectively. Clients were categorized as middle age (40-49 years) and older clients (≥50 years). FSWs were categorized as high-tier, middle-tier, or low-tier based on the payment amount charged for sex and their work venue. Chi-square test for trends was used for testing changes in prevalence over time.By 2015, low-tier FSWs (LTFSWs) accounted for almost half of all FSWs; and they had the highest HIV prevalence at 1.4%. HIV prevalence declined significantly for FSWs (high-tier FSW, P = 0.003; middle-tier FSWs; P = 0.021; LTFSWs, P HIV prevalence increased for older age clients (1.3%-2.0%, P = 0.159) while syphilis prevalence remained stable. HCV infections were halved among older clients in 3 years (1.7%-0.8%, P sex with men or intravenous drug use. Clients preferred LTFSWs, especially older clients (81.9%).Our results suggest that HIV and syphilis infections are increasing in older clients who prefer LTFSWs. HIV and syphilis are likely increasing in Guangxi Province through heterosexual transmission.
Hall, Karina M; Brieger, Daniel G; De Silva, Sukhita H; Pfister, Benjamin F; Youlden, Daniel J; John-Leader, Franklin; Pit, Sabrina W
Objectives . To determine the confidence and ability to use condoms correctly and consistently and the predictors of confidence in young Australians attending a festival. Methods . 288 young people aged 18 to 29 attending a mixed-genre music festival completed a survey measuring demographics, self-reported confidence using condoms, ability to use condoms, and issues experienced when using condoms in the past 12 months. Results . Self-reported confidence using condoms was high (77%). Multivariate analyses showed confidence was associated with being male ( P < 0.001) and having had five or more lifetime sexual partners ( P = 0.038). Reading packet instructions was associated with increased condom use confidence ( P = 0.011). Amongst participants who had used a condom in the last year, 37% had experienced the condom breaking and 48% had experienced the condom slipping off during intercourse and 51% when withdrawing the penis after sex. Conclusion . This population of young people are experiencing high rates of condom failures and are using them inconsistently or incorrectly, demonstrating the need to improve attitudes, behaviour, and knowledge about correct and consistent condom usage. There is a need to empower young Australians, particularly females, with knowledge and confidence in order to improve condom use self-efficacy.
Afecto, besos y condones: el ABC de las prácticas sexuales de las trabajadoras sexuales de la Ciudad de México Affection, kisses and condoms: the basics of sexual practices of female sex workers in Mexico City
trend, and dispersion measures were calculated. Qualitative data were interpreted using Grounded Theory and a feminist perspective. RESULTS: Female sex workers accepted vaginal penetration with clients and oral penetration to a lesser extent, while anal penetration and kissing were rejected. All sexual modalities were accepted with personal partners. In their practice, FSW use psychophysical dissociation as a psychological defense mechanism and to construct their identities. Services requested by their latest clients were: 98.4% vaginal, 39.1% oral, and 7.7% anal sex. Condom use was reported by 94%. With their personal partner, 72.6% of FSW never used condoms. The week before the study, FSW worked 3.7±1.5 days on average and had sexual intercourse with 8.6±8.1 clients. CONCLUSIONS: Interventions are needed to promote safe sex among FSW in their private and professional lives.
Percepções de casais heterossexuais acerca do uso da camisinha feminina Percepciones de parejas heterosexuales acerca del uso del preservativo femenino Heterosexual couples perception about the using of female condom
Vera Lúcia de Oliveira Gomes
factores que desencadenan grande parte de las dificultades, evidenciando la necesidad de implementar nuevas estrategias de educación en salud.This descriptive exploratory, qualitative, research was aimed to know the perception of young heterosexual couples, relating to the use of female condoms and understand the factors that propitiate and make difficult its routine use. The data had been collected in October and November of 2007, through self-administered survey. The Discourse of the Collective Subject was used in the analysis. The age of the 26 informants vary from 20 to 27 years. It had been learned that they know the efficiency of this method, but they recognize the difficulty of women to the negotiation. As limitations to the use they express the low and the high cost. From the sexual relation protected by female condom emerged conflicting statements. Some focus on the discomfort, pain and grotesque appearance, others approach the practicality, reliability and pleasure, however they stress that the lack of familiarity and knowledge are factors that trigger many of the difficulties, evidencing the necessity of implement new strategies of health education.
Bankole, Akinrinola; Ahmed, Fatima H.; Neema, Stella; Ouedraogo, Christine; Konyani, Sidon
Using data from the 2004 National Adolescent Surveys, this paper undertook a detail analysis of knowledge of correct condom use and consistency of use, as well as their covariates, among adolescents in Burkina Faso, Ghana, Malawi and Uganda. The strongest predictor of knowledge of correct condom use among both male and female adolescents is exposure to a condom use demonstration. In Burkina Faso, Ghana and Uganda, adolescents who have seen a condom demonstration are 2 to 5 times as likely as ...
Hernández-Girón, C; Cruz-Valdez, A; Quiterio-Trenado, M; Avila-Burgos, L; Peruga, A; Hernández-Avila, M
At the beginning of 1999, Mexico occupied third place, after USA and Brazil, in the number of accumulated cases of AIDS (38,390 notified cases) in America. More than 80% of the cases corresponded to men between 20 and 44 years old. The transmission by sexual route has increased in both sexes, the proportion of men infected by sexual contact increased from 85% in 1991 to 90% in 1998 and in women this proportion increased from 41% in 1991 to 57% in 1998. The ratio male/female of cases of AIDS has varied from 17:1 in 1983 to 6:1 in 1998. Condom use is considered an effective method for the prevention of the transmission of STI's/HIV and therefore the availability is of paramount importance to promote use with the finality of combating these diseases. A simple randomized sampling was done in 612 establishments that included: drugstore, bars and nightclubs, hotels and motels, self-service shops and health centers in Mexico City, where am cross sectional study was performed during June and July of 1995, to evaluate the availability of condoms considering three important items: a) percent per capita required to buy an annual endowment of 100 condoms in comparison with this same indicator reported in other countries; b) physical availability, on behalf of the Secretaría de Salud, Mexico City, that considers the volume of existing condoms to be utilized for a year by the public sector in this city; c) physical availability of condoms in different evaluated locations. In order to purchase an annual supply of condoms an individual needs the assign $500 (Pesos) which represents 2.3 to 2.6% of the annual GNP per capita for 1998 and 1997 respectively. The physical availability of condoms, on behalf of the Secretaría de Salud, Mexico City, was 94.9% in health centers. In drugstores, hotels and motels, self-service shops, bars and nightclubs the availability of condoms was 100%, 82.9%, 75% and 1.2%, respectively. It has been documented that the adequate use of condom is an
Wells, Christopher J; Alano, Abraham
Risky sexual behavior among Ethiopian university students, especially females, is a major contributor to young adult morbidity and mortality. Ambaw et al. found that female university students in Ethiopia may fear the humiliation associated with procuring condoms. A study in Thailand suggests condom machines may provide comfortable condom procurement, but the relevance to a high-risk African context is unknown. The objective of this study was to examine if the installation of condom machines in Ethiopia predicts changes in student condom uptake and use, as well as changes in procurement related stigma. Students at a large urban university in Southern Ethiopia completed self reported surveys in 2010 (N = 2,155 surveys) and again in 2011 (N = 2,000), six months after the installation of condom machines. Mann-Whitney and Chi-square tests were conducted to evaluate significant changes in student sexual behavior, as well as condom procurement and associated stigma over the subsequent one year period. After installing condom machines, the average number of trips made to procure condoms on-campus significantly increased 101% for sexually active females and significantly decreased 36% for sexually active males. Additionally, reports of condom use during last sexual intercourse showed a non-significant 4.3% increase for females and a significant 9.0% increase for males. During this time, comfort procuring condoms and ability to convince sexual partners to use condoms were significantly higher for sexually active male students. There was no evidence that the condom machines led to an increase in promiscuity. The results suggest that condom machines may be associated with more condom procurement among vulnerable female students in Ethiopia and could be an important component of a comprehensive university health policy.
Social marketing entails promoting the appropriate and quality product to be sold in the right places at the right price. Even though mass media advertisement of condoms is forbid in Zaire, condoms have been effectively promoted and sold in the country using alternate approaches. 8 million units of the condom, Prudence, were sold in 1990, and Prudence has become the generic name for condoms in the Zaire. Noting that Coca-Cola, beer, and cigarettes may be purchased virtually ubiquitously, commercial outlets and local traders were enlisted to sell condoms at reduced prices on the market. Reduced price sales are possible since donor and government agencies provide the condoms to wholesalers and merchants free of charge. The successful social marketing of condoms expands condom availability to a greater segment of a country's population while recovering some public sector costs and shifting health care away from the public sector. Condoms are especially promoted to high risk groups such as commercial sex workers and their clients in Zaire. Similar programs have been inspired in 10 African countries including Cameroon and Burundi, as well as in Brazil, Haiti, and India. Prevention programs in Latin America and Asia will benefit from these program experiences in Africa. In closing, the article notes the need for an adequate and predictable commodity supply in attaining effective social marketing. Marked program success may, however, lead to sustainability problems.
Dec 2, 2006 ... latex derivative, had met international standards for dual protection against ... existing STI/HIV prevention options. PROMISING NEW ..... preventing sexually transmitted infections and HIV: current evidence and future research ...
The aim of the study is to investigate knowledge and sexual practices with reference to correct use of condoms among first year South African University students. The sample consisted of 206 participants, 146 female and 60 male, the mean age was 20.9 years (SD = 3.4), with a range from 17 to 34 years. Results indicated that one third (29.2%) of the sample reported never using condoms, 35.4% always, 19.8% regularly and 8.5% irregularly in the past three months. About 90% levels of correct answers for condom use were found for the items of 'condoms as protection against STD and AIDS', 'expiry date of condoms', and 're-using condoms'. More than 15% were not aware that a condom should be put on before any contact with the vagina. The most common mistakes with respect to condom use were ignorance about the correct moment to put on a condom (56%), and when to take off a condom (55%). Male sex and especially increasing recent sexual encounters was associated with correct condom knowledge. The most common reasons for not using a condom were 'I do not have the AIDS virus' and 'I thought I was safe' seems to indicate a low perceived susceptibility. Findings are discussed in view of condom promotion programmes.
Zukoski, Ann P; Harvey, S Marie; Branch, Meredith
A growing body of literature provides evidence of a link between communication with sexual partners and safer sexual practices, including condom use. More research is needed that explores the dynamics of condom communication including gender differences in initiation, and types of communication strategies. The overall objective of this study was to explore condom use and the dynamics surrounding condom communication in two distinct community-based samples of African American and Latino heterosexual couples at increased risk for HIV. Based on 122 in-depth interviews, 80% of women and 74% of men reported ever using a condom with their primary partner. Of those who reported ever using a condom with their current partner, the majority indicated that condom use was initiated jointly by men and women. In addition, about one-third of the participants reported that the female partner took the lead and let her male partner know she wanted to use a condom. A sixth of the sample reported that men initiated use. Although over half of the respondents used bilateral verbal strategies (reminding, asking and persuading) to initiate condom use, one-fourth used unilateral verbal strategies (commanding and threatening to withhold sex). A smaller number reported using non-verbal strategies involving condoms themselves (e.g. putting a condom on or getting condoms). The results suggest that interventions designed to improve condom use may need to include both members of a sexual dyad and focus on improving verbal and non-verbal communication skills of individuals and couples.
Full Text Available Condoms have been a subject of curiosity throughout history. The idea of safer sex has been explored in ancient and modern history, and has been used to prevent venereal diseases. We conducted a historical and medical review of condoms using primary and secondary sources as well as using the RSM library and the internet. These resources show that the first use of a condom was that of King Minos of Crete. Pasiphae, his wife, employed a goat′s bladder in the vagina so that King Minos would not be able to harm her as his semen was said to contain "scorpions and serpents" that killed his mistresses. To Egyptians, condom-like glans caps were dyed in different colours to distinguish between different classes of people and to protect themselves against bilharzia. The Ancient Romans used the bladders of animals to protect the woman; they were worn not to prevent pregnancy but to prevent contraction of venereal diseases. Charles Goodyear, the inventor, utilized vulcanization, the process of transforming rubber into malleable structures, to produce latex condoms. The greater use of condoms all over the world in the 20 th and 21 st centuries has been related to HIV. This account of the use of condoms demonstrates how a primitive idea turned into an object that is used globally with a forecast estimated at 18 billion condoms to be used in 2015 alone.
Anyanwu, Philip Emeka; Fulton, John
Although sexually transmitted infections (STIs) are a global health problem affecting every region of the world, the higher prevalence and mortality rate of STIs in developing countries of the world, like Nigeria, make them serious public health issues in this region. The aim of this study is to assess the knowledge and perception of young adults in Nigeria on the role of condom (both male and female condoms) as a preventive measure against STIs during heterosexual and homosexual intercourse. Data was collected from participants selected from the northern and southern Nigeria using self-administered questionnaire specifically designed for this study. Knowledge of condom efficacy in STI prevention was satisfactory. However, knowledge and practice of the correct use of condom was poor. Only 47.1% of the 102 participants in this study reported correct condom use of wearing condoms before staring intercourse and removing condoms after ejaculation. As a strategy to include the experiences, knowledge and perception of men who have sex with men, this study asked the question on condom use during anal sex. Only 24.4% of the male participants indicated they have never had anal sex while for females, the percentage was more than half (53.5%). Condom use during anal sex was low with only 20.6% of participants reporting condom use during anal sex. Negative perceptions about condom use - such as that condom use promotes sexual promiscuity, and not using condoms with steady sexual partners - were significant in this study. Also, condom use errors were common in this study. There is a wide gap in knowledge of correct condom use in this population. There is need for interventions that address the issue of condom use during anal and same-sex sexual intercourse in this population.
French, Sabine Elizabeth; Holland, Kathryn J
College students are a group at high risk of sexually transmitted infections due to inconsistent condom use and engaging in other risky sexual behaviors. This study examined whether condom use self-efficacy predicted the use of condom negotiation strategies (i.e., condom influence strategies) and whether condom influence strategies mediated the relationship between condom use self-efficacy and condom use within this population, as well as whether gender moderated the mediation model. Results showed a strong relationship between condom use self-efficacy and condom influence strategies. Additionally, condom influence strategies completely mediated the relationship between condom use self-efficacy and condom use. Although condom use self-efficacy was related to condom use, the ability to use condom negotiation strategies was the most important factor predicting condom use. The mediation model held across genders, except for the condom influence strategy withholding sex, where it was not significant for men. For women, condom use self-efficacy promoted the use of a very assertive negotiation strategy, withholding sex, and was consequently related to increased condom use. Overall, using assertive condom negotiation strategies (e.g., withholding sex and direct request) were found to be the most important aspects of increasing condom use for both women and men. Implications and suggestions for prevention programming are discussed.
This article reports on the public debate on whether condoms should be made publicly available on the streets, in neighborhoods, and in schools, which could trigger discussions about sex in China. Condom vending machines have been installed in China since August 1999, and most regard the installations as a symbol of China's openness and progress, as well as an improvement in livelihood. However, some have objected to the public display and sale of condoms. Some teachers see it as damaging the reputation of the schools. Others suggest that they represent greater tolerance for premarital sex among youths, and a professor of sexual ethics stated that, while breaking the sex taboo is evidence of progress, condoms are a special type of commodity which should not be made available anywhere. In addition to the public debate concerning condoms, the banning of commercials featuring a condom-shaped cartoon character overcoming AIDS and sexually transmitted diseases touched off a debate between reproductive health advocates and government regulators. Reports indicate that the commercial was banned because it contravened the Advertisement Law, which provides that no sex product advertisement be aired or printed in the media. However, Zhang Konglai contended that condoms are not sex products but merely a means for preventing pregnancy and diseases and should be promoted actively. Moreover, Qui Renzong described the government's ban as a mistake and called on them to revise the law.
Sri Lanka's Family Planning Association has stopped selling its Preethi Regular condom, the backbone of its social marketing program for nearly a decade. Last year nearly 7 times as many Preethi condoms were sold as all other brands combined. The decision was reported to be caused by budget constraints following the International Planned Parenthood Federation's (IPPF) new policy of limiting the number of Preethi Regular condoms supplied to Sri Lanka. IPPF's Asian Regional Officer reported that the Preethi condom is a costly product, and that as many as needed of a US Agency for International Development (USAID) supplied product will be sent to Sri Lanka. The Contraceptive Retail Sales (CRS) program has devised a new sales strategy, based partly on the introduction of a high-priced condom to fill the gap left by the discontinuation of the Preethi Regular. The new Preethi Gold condom is expected to help the project become more financially self-reliant while taing advantage of Preethi's marketplace popularity. Preethi Gold is manufactured by the Malaysia Rubber Company and costs the project US $4.85/gross. It is sold for US $.14 for 3, about 3 times the price of a Preethi Regular. The project is also pushing the Panther condom, donated to IPPF by USAID. 2 Panther condoms sell for about 3.6U, about the cost of Preethi Regulars. The project also sells Moonbeam, Rough Rider, and Stimula condoms, the latter 2 at full commercial prices. A smooth transfer of demand from Preethi to Panther had been desired, but by the end of 1983 some retailers were hesitating to make the product switch because some Preethi Regulars were still available. Total condom sales in 1983 were down by nearly 590,000 from the approximately 6,860,000 sold in 1982. Total condom sales for the 1st quarter of 1984 were slightly over 1,218,000 pieces, compared to about 1,547,000 for the same quarter in 1983, a decline of 21%. The Family Planning Association is gearing up to reverse the downward trend
Smalyanna Sgren da Costa Andrade
Full Text Available OBJECTIVE Assessing the adequacy of knowledge, attitude and practice of women regarding male and female condoms as STI/HIV preventive measures. METHOD An evaluative Knowledge, Attitude and Practice (KAP household survey with a quantitative approach, involving 300 women. Data collection took place between June and August 2013, in an informal urban settlement within the municipality of João Pessoa, Paraiba, Northeast Brazil. RESULTS Regarding the male condom, most women showed inadequate knowledge and practice, and an adequate attitude. Regarding the female condom, knowledge, attitude and practice variables were unsatisfactory. Significant associations between knowledge/religious orientation and attitude/education regarding the male condom were observed. CONCLUSION A multidisciplinary team should be committed to the development of educational practices as care promotion tools in order to improve adherence of condom use.
Dr. E. P. Gharoro
knowledge of family planning. Condom ... relationship between respondents with multiple ... cause of healthy life lost. ... power imbalance between women ... working on female reproductive health ..... consequences among student nurses.
Phillips, S R
Results from a 1991-92 survey of the condom use beliefs, attitudes, and practices of 373 US inner-city high school students reveal educational policy implications which would further the goal of encouraging sexually active youth to use condoms. First, the issue of sexual desire must be treated realistically. Many teenage girls, as well as boys, want to fulfill their desires by having sexual intercourse. The standard educational approach to teenage boys also assumes that they are sexual exploiters, but this may also simply be a cultural construct rather than a reality. Addressing physical pleasure issues may be particularly important in encouraging condom use, but it would be inappropriate for such discussions to encourage sexual activity. Adolescent ambivalence towards risk taking and mortality must also be considered. Standard definitions of risk (which exclude the health risk of pregnancy) contain the common perception that adolescent males are greater risk-takers than females. When such definitions exclude certain behaviors, the classification of risk becomes a social construct. Adolescents are not completely unaware of the dangers of risky behavior and may even overestimate their chances of getting pregnant or contracting HIV. Adolescents may find the risk of offending a partner to be more important than the risk of contracting a disease in 10 years. When teenagers believe themselves to be in love, they are less likely to insist on condom use. Educators must deconstruct risks and address each one specifically. High levels of knowledge about HIV transmission fail to predict previous, current, or intended condom use. Thus, while facts are important, teenagers also need to learn the social skills surrounding condom use. Students have easy accessibility to condoms, but embarrassment may pose a barrier to acquisition. This embarrassment, however, showed no correlation to actual or intended condom use. By working within the context of the adolescent mind and world
Full Text Available The aim of the study is to investigate knowledge and sexual practices with reference to correct use of condoms among first year South African University students. The sample consisted of 206 participants, 146 female and 60 male, the mean age was 20.9 years (SD=3.4, with a range from 17 to 34 years. Results indicated that one third (29.2% of the sample reported never using condoms, 35.4% always, 19.8% regularly and 8.5% irregularly in the past three months. About 90% levels of correct answers for condom use were found for the items of ‘condoms as protection against STD and AIDS’, ‘expiry date of condoms’, and ‘re-using condoms’. More than 15% were not aware that a condom should be put on before any contact with the vagina. The most common mistakes with respect to condom use were ignorance about the correct moment to put on a condom (56%, and when to take off a condom (55%. Male sex and especially increasing recent sexual encounters was associated with correct condom knowledge. The most common reasons for not using a condom were ‘I do not have the AIDS virus’ and ‘I thought I was safe’ seems to indicate a low perceived susceptibility. Findings are discussed in view of condom promotion programmes.
Lindemann, Dana F; Brigham, Thomas A; Harbke, Colin R; Alexander, Teresa
Traditionally, researchers have focused HIV/AIDS prevention efforts on increasing condom use, yet few researchers have assessed condom use skills. Because incorrect condom use may lead to condom failure, promoting condom use without ensuring participants have the skills necessary for correct condom use may lead to increased risk of exposure. This study compared the effects of two condom use courses on condom use skills. These courses were administered as part of a HIV/AIDS educational program for college students. Participants in the treatment groups (n=179) attended either a limited, 1-Session, or extensive, 3-Session, condom use course, and an additional 108 participants served as a Control Group. Condom use skills increased among participants in both treatment groups; however, the greatest improvement was among those in the 3-Session Group. This finding supports use of the extensive, 3-Session course as a more effective means for improving condom use skills.
Full Text Available Abstract Background This study investigated the extent and predictors of condom use and condom refusal in the Free State province in South Africa. Methods Through a household survey conducted in the Free Sate province of South Africa, 5,837 adults were interviewed. Univariate and multivariate survey logistic regressions and classification trees (CT were used for analysing two response variables ‘ever used condom’ and ‘ever refused condom’. Results Eighty-three per cent of the respondents had ever used condoms, of which 38% always used them; 61% used them during the last sexual intercourse and 9% had ever refused to use them. The univariate logistic regression models and CT analysis indicated that a strong predictor of condom use was its perceived need. In the CT analysis, this variable was followed in importance by ‘knowledge of correct use of condom’, condom availability, young age, being single and higher education. ‘Perceived need’ for condoms did not remain significant in the multivariate analysis after controlling for other variables. The strongest predictor of condom refusal, as shown by the CT, was shame associated with condoms followed by the presence of sexual risk behaviour, knowing one’s HIV status, older age and lacking knowledge of condoms (i.e., ability to prevent sexually transmitted diseases and pregnancy, availability, correct and consistent use and existence of female condoms. In the multivariate logistic regression, age was not significant for condom refusal while affordability and perceived need were additional significant variables. Conclusions The use of complementary modelling techniques such as CT in addition to logistic regressions adds to a better understanding of condom use and refusal. Further improvement in correct and consistent use of condoms will require targeted interventions. In addition to existing social marketing campaigns, tailored approaches should focus on establishing the perceived need
Scott-Sheldon, Lori A J; Glasford, Demis E; Marsh, Kerry L; Lust, Sarah A
Correct and consistent condom use has been promoted as a method to prevent sexually transmitted infections including HIV. Yet research has repeatedly shown that people fail to use condoms consistently. One influence on the pervasive lack of condom use that has received relatively little attention is the context in which consumers are exposed to condoms (i.e., how condoms are displayed in retail settings). In this paper we present two studies explored variations in condom shelf placement and its effects on people's condom attitudes and acquisition. Study 1 explored the shelf placement of condoms in 59 retail outlets in Connecticut, USA and found that condoms were typically located in areas of high visibility (e.g., next to the pharmacy counter) and on shelves adjacent to feminine hygiene and disease treatment products. In Study 2, 120 heterosexual undergraduate students at the University of Connecticut were randomly assigned to evaluate condoms adjacent to sensual, positive, neutral, or negative products and found that overall men reported more positive attitudes and acquired more condoms when exposed to condoms in a sensual context compared to women in the same condition. Among women, condom attitudes were more positive in the context of neutral products; condom acquisition was strongest for women exposed to condoms in the positive aisles. These results suggest a gender-specific approach to condom promotion. Implications of these studies for HIV prevention, public health, and condom marketing strategies are discussed.
Amy, Jean-Jacques; Thiery, Michel
The literature concerning the history of condoms is replete with errors. The paper Youssef published in 1993 is in our opinion the best. We update and expand the information. To mention only established facts, we accessed primary sources, which are identified in the article. The origin of the term 'condom' remains an enigma. Plausible hypotheses are that it is derived from either (i) the Latin 'condĕre' (to sheathe) or the corresponding noun 'condus' (receptacle); or (ii) the Venetian variant 'gondon' of the Italian word 'guantone' (glove). The earliest identified mention of a similar barrier method is in the legend of Minos and Pasiphae written (in the 2nd century AD) by Antoninus Liberalis. A penile sheath, made from animal gallbladder, was advocated in the 10th century by the Persian physician Al-Akhawayni. The earliest surviving condoms made of animal membranes date back to between 1642 and 1646. Such 'skin' condoms became increasingly popular for prevention of venereal disease, but as early as the 18th century their value as contraceptives was appreciated. Rubber condoms were available from 1855; since 1930, they are made of latex. We mention, in parallel, the most striking changes over time in sexual mores and behaviours, and illustrate these by referring to colourful figures such as, among others, Boswell, Mrs Philips, Casanova, Marguerite Gourdan, and Richard Carlile. Papers related to this topic often contain errors, which we identify. Condoms over time evolved from animal gut receptacles to reliable contraceptives protecting also against certain sexually transmitted infections, including HIV.
Full Text Available Judith Lammers,1 Sweder JG van Wijnbergen,2 Daan Willebrands3 1Academic Medical Center, 2Faculty of Economics and Business, University of Amsterdam, 3Atradius Credit Insurance, Amsterdam, The Netherlands Background: This paper analyzes how different types of Human immunodeficiency virus (HIV knowledge influences condom use across the sexes. Methods: The empirical work was based on a household survey conducted among 1979 households of a representative group of stallholders in Lagos, Nigeria in 2008. Condom use during last sexual intercourse was analyzed using a multivariate model corrected for clustering effects. The data included questions on socioeconomic characteristics, knowledge of the existence of HIV, HIV prevention, HIV stigma, intended pregnancy, and risk perceptions of engaging in unprotected sex. Results: A large HIV knowledge gap between males and females was observed. Across the sexes, different types of knowledge are important in condom use. Low-risk perceptions of engaging in unprotected sex and not knowing that condoms prevent HIV infection appear to be the best predictors for risky sexual behavior among men. For females, stigma leads to lower condom use. Obviously, lack of knowledge on where condoms are available (9.4% and 29.1% of male and female respondents, respectively reduced condom use in both males and females. Conclusion: The results call for programmatic approaches to differentiate between males and females in the focus of HIV prevention campaigns. Moreover, the high predictive power of high-risk perceptions of engaging in unprotected sex (while correcting for other HIV knowledge indicators calls for further exploration on how to influence these risk perceptions in HIV prevention programs. Keywords: Africa, condom, males, females, HIV/AIDS, knowledge, prevention, risk perception
Dec 1, 2012 ... Nigeria. Study design: Both qualitative (focus group discussions) and quantitative (cross-sectional ... Keywords: Condom, unsafe sex, HIV, gender, undergraduates. ..... QUESTIONS: the following may influence condom.
Castaneda, D M; Collins, B E
Perceptions of persons who introduce condoms in an ongoing sexual interaction, and the effects of gender and ethnicity on these perceptions, were explored in a study involving 243 students at a large, urban university in the western US. 133 of these students identified themselves as Mexican American; the remaining students indicated they were White. A vignette methodology was used to elicit perceptions of condom introducers on six scales (Nice, Exciting, Sexually Attractive, Promiscuous, Good Relationship Partner, Unpersonable/Personable). Data were analyzed in a 2 (gender of participant) x 2 (gender of condom introducer) x 3 (low acculturated Mexican American, high acculturated Mexican American, White) x 2 (presence/absence of close relationship theme) analysis of variance and covariance. In terms of the Nice Scale, women rated condom introducers significantly higher than men, female condom introducers were rated significantly higher than male introducers, and condom introducers who expressed a care and responsibility theme while introducing a condom were rated significantly higher than those who expressed no theme. On the Exciting Scale, women condom introducers were rated significantly higher than men. Condom introducers who expressed a care and responsibility theme were rated significantly higher than those who expressed no theme on the Good Relationship Partner scale. Men rated the female condom introducer significantly higher than women on the Promiscuous scale. Low acculturated Mexicans rated the female condom introducer significantly higher than the male introducer on the Promiscuous scale and rated the condom introducer significantly higher than Whites on the Sexually Attractive scale. These findings attest that many often contradictory interpersonal gender- and ethnicity-related perceptions operate in sexual encounters.
Rubens, Muni; McCoy, H. Virginia; Shehadeh, Nancy
Consistent and correct use of condoms is important to prevent the transmission of HIV and other sexually transmitted diseases. We evaluated condom use skills on an 11-point scale in which participants were observed placing a condom on a penile model. Participants were 375 sexually active African American and Hispanic migrant workers. For analysis, subjects were divided into skilled and unskilled groups by a median split of the condom use skills score. Sexual risk behaviors were analyzed betwe...
Full Text Available The National Family Planning Programme of India had introduced condom as one of the family planning methods in the late1960s. Condom was promoted as a family planning method through social marketing since its inception. With the increasing prevalence and incidence of sexually transmitted infections (STIs including HIV/AIDS, condom was also promoted as a dual method for protection against both unintended pregnancies as well as sexually transmitted infections. Despite efforts at various levels, the overall use of condom among couples in India is low. Here we present literature review of studies to understand the condom acceptability among couples in India. Specifically, the paper assesses research and programmes that have been carried out to increase the use of condom among couples; determinants of condom use; reason for not using condom; and perception versus experience of condom failure. The reported problems related to condom use included non acceptance by partner, perceived ineffectiveness, less comfort, lack of sexual satisfaction, husband′s alcohol use, depression, and anxiety, and not available at that instant. The role of media in the promotion of condom use was indicated as an important way to increase awareness and use. Multiple strategies would help in acceptance of male condom.
Tsay, Sharon; Childs, Gwendolyn; Cook-Heard, Dayna; Sturdevant, Marsha
The purpose of this study was to enhance awareness of modes of HIV transmission and increase HIV/sexually transmitted diseases (STD) prevention efforts for incarcerated youth through use of an HIV/STD prevention program guided by the Making Proud Choices! curriculum. A convenience sample of 662 youth aged 13 to 18 was recruited from Alabama juvenile detention facilities. Participants took part in three 2-hour sessions. Baseline and postintervention data were collected. There was no significant difference between males and females in intent to use condoms at baseline and postintervention. Intent to use condoms was the most influential predictor of condom self-efficacy. However, there was little change in condom self-efficacy among males and females at baseline and postintervention.
Andrade, Smalyanna Sgren da Costa; Zaccara, Ana Aline Lacet; Leite, Kamila Nethielly Souza; Brito, Karen Krystine Gonçalves de; Soares, Maria Júlia Guimarães Oliveira; Costa, Marta Miriam Lopes; Pinheiro, Ana Karina Bezerra; Oliveira, Simone Helena dos Santos
OBJECTIVE Assessing the adequacy of knowledge, attitude and practice of women regarding male and female condoms as STI/HIV preventive measures. METHOD An evaluative Knowledge, Attitude and Practice (KAP) household survey with a quantitative approach, involving 300 women. Data collection took place between June and August 2013, in an informal urban settlement within the municipality of João Pessoa, Paraiba, Northeast Brazil. RESULTS Regarding the male condom, most women showed inadequate knowl...
Aug 3, 2011 ... experience a highly negative social stigma and face barri- ers to healthcare ... bile or outreach sites include workplace or home based counselling; vehicles .... Female. 3,034 (37.2). 620 (100.0). 4 (2.0). Male. 5,097 (62.7). 0 (0). 199 (98.0) ..... men who have sex with men, and barriers to condom use and HIV ...
Full Text Available Abstract Background The PLACE-method presumes that targeting HIV preventive activities at high risk places is effective in settings with major epidemics. Livingstone, Zambia, has a major HIV epidemic despite many preventive efforts in the city. A baseline survey conducted in 2005 in places where people meet new sexual partners found high partner turnover and unprotected sex to be common among guests. In addition, there were major gaps in on-site condom availability. This study aimed to assess the impact of a condom distribution and peer education intervention targeting places where people meet new sexual partners on condom use and sexual risk taking among people socializing there. Methods The 2005 baseline survey assessed the presence of HIV preventive activities and sexual risk taking in places where people meet new sexual partners in Livingstone. One township was selected for a non-randomised intervention study on condom distribution and peer education in high risk venues in 2009. The presence of HIV preventive activities in the venues during the intervention was monitored by an external person. The intervention was evaluated after one year with a follow-up survey in the intervention township and a comparison township. In addition, qualitative interviews and focus group discussions were conducted. Results Young people between 17-32 years of age were recruited as peer educators, and 40% were females. Out of 72 persons trained before the intervention, 38 quit, and another 11 had to be recruited. The percentage of venues where condoms were reported to always be available at least doubled in both townships, but was significantly higher in the intervention vs. the control venues in both surveys (84% vs. 33% in the follow-up. There was a reduction in reported sexual risk taking among guests socializing in the venues in both areas, but reporting of recent condom use increased more among people interviewed in the intervention (57% to 84% than in the
Sandøy, Ingvild Fossgard; Zyaambo, Cosmas; Michelo, Charles; Fylkesnes, Knut
The PLACE-method presumes that targeting HIV preventive activities at high risk places is effective in settings with major epidemics. Livingstone, Zambia, has a major HIV epidemic despite many preventive efforts in the city. A baseline survey conducted in 2005 in places where people meet new sexual partners found high partner turnover and unprotected sex to be common among guests. In addition, there were major gaps in on-site condom availability. This study aimed to assess the impact of a condom distribution and peer education intervention targeting places where people meet new sexual partners on condom use and sexual risk taking among people socializing there. The 2005 baseline survey assessed the presence of HIV preventive activities and sexual risk taking in places where people meet new sexual partners in Livingstone. One township was selected for a non-randomised intervention study on condom distribution and peer education in high risk venues in 2009. The presence of HIV preventive activities in the venues during the intervention was monitored by an external person. The intervention was evaluated after one year with a follow-up survey in the intervention township and a comparison township. In addition, qualitative interviews and focus group discussions were conducted. Young people between 17-32 years of age were recruited as peer educators, and 40% were females. Out of 72 persons trained before the intervention, 38 quit, and another 11 had to be recruited. The percentage of venues where condoms were reported to always be available at least doubled in both townships, but was significantly higher in the intervention vs. the control venues in both surveys (84% vs. 33% in the follow-up). There was a reduction in reported sexual risk taking among guests socializing in the venues in both areas, but reporting of recent condom use increased more among people interviewed in the intervention (57% to 84%) than in the control community (55% to 68%). It is likely that the
Current surveys indicate that more than 70% of married couples in Japan use condoms as their primary contraceptive method. The popularity of condoms is due to the oral contraceptive (OC) pills not being recognized as safe forms of contraception and IUDs not being legalized by the government until 1974. The history of condom use in Japan goes back to 1872 when condoms of thin leather were imported into Japan from England and France. Manufacturing of condoms in Japan began in 1909, mainly as a method for venereal disease prevention. The condom and induced abortion are now the major methods of contraception. 60% of the distribution of condoms is through pharmacies and cosmetic stores; 50% of the buyers are women. Since 1955, teams of family planning workers have distributed condoms by selling on a door-to-door basis, especially to lower middle class couples. Between 1969-75, 75% of contraceptive users were using condoms. Currently there are 81% users. The rhythm method ranks second in popularity at 30% between 1969-75. OCs have gradually increased recently to 3% users, but side effects have deterred people from selecting them. The proportion of IUD users has remained at a consistently low level for the past several years. Japan accounts for 1/3 of the total world production of condoms.
Rubens, Muni; McCoy, H Virginia; Shehadeh, Nancy
Consistent and correct use of condoms is important to prevent the transmission of HIV and other sexually transmitted diseases. We evaluated condom use skills on an 11-point scale in which participants were observed placing a condom on a penile model. Participants were 375 sexually active African American and Hispanic migrant workers. For analysis, subjects were divided into skilled and unskilled groups by a median split of the condom use skills score. Sexual risk behaviors were analyzed between condom use skilled and unskilled groups and level of condom use skills between African Americans and Hispanics. African Americans showed better skills in using condoms, and participants in the condom-use skilled group used condoms more frequently. Finally, a logistic regression was conducted to find predictors of condom use skills. Significant predictors were ethnicity, language, and assistance-related social support (obtaining advice from people who could provide tangible assistance). Copyright © 2014 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.
Sub-Saharan Africa (SSA) is the region with the world's highest rates of HIV and other sexually transmissible infections (STIs), yet numerous studies show that condom use is generally rare. This suggests a need for a better understanding of how condoms fit within sexual practices and relationships in SSA. This paper seeks to address this need by reviewing research published between the late 1980s and 2011 on use and factors influencing use of male condoms in SSA. What is evident from this research is that condom use involves complex social and interpersonal dynamics, with structural and cultural conditions exerting an influence through framing social cognitions and setting boundaries on autonomy that make the apparently irrational choice of eschewing condoms a rational decision. The influences of poverty; relationships with parents, peers and partners; limited, insufficient or absent information especially in rural areas and among men who have sex with men; gender and sexual norms, and the dynamics of gendered power; and beliefs and attitudes about HIV, condoms and sexuality all have been shown to work against condom use for a large proportion of Africa's people. However, promising results are shown in trends towards increased condom use among single women in numerous countries, increasing acceptance and use of condoms among some university students, successes in producing potentially sustainable condom use resulting from select interventions, and resistance to succumbing to the dominant gender-power dynamics and structural-cultural impediments that women in groups have mobilised.
Htat, Han Win; Longfield, Kim; Mundy, Gary; Win, Zaw; Montagu, Dominic
Concerns about appropriate pricing strategies and the high market share of subsidized condoms prompted Population Services International (PSI)/Myanmar to adopt a total market approach (TMA). This article presents data on the size and composition of the Myanmar condom market, identifies inefficiencies and recommends methods for better targeting public subsidy. Data on condom need and condom use came from PSI/Myanmar's (PSI/M's) behavioural surveys; data for key populations' socioeconomic status profiles came from the same surveys and the National Tuberculosis Prevalence Survey. Data on market share, volumes, value and number of condoms were from PSI/M's quarterly retail audits and Joint United Nations Programme on HIV/AIDS (UNAIDS). Between 2008 and 2010, the universal need for condoms decreased from 112.9 to 98.2 million while condom use increased from 32 to 46%. Free and socially marketed condoms dominated the market (94%) in 2009-11 with an increase in the proportion of free condoms over time. The retail price of socially marketed condoms was artificially low at 44 kyats ($0.05 USD) in 2011 while the price for commercial condoms was 119-399 kyats ($0.15-$0.49 USD). Equity analyses demonstrated an equal distribution of female sex workers across national wealth quintiles, but 54% of men who have sex with men and 55% of male clients were in the highest two quintiles. Donor subsidies for condoms increased over time; from $434,000 USD in 2009 to $577,000 USD in 2011. The market for male condoms was stagnant in Myanmar due to: limited demand for condoms among key populations, the dominance of free and socially marketed condoms on the market and a neglected commercial sector. Subsidies for socially marketed and free condoms have prevented the growth of the private sector, an unintended consequence. A TMA is needed to grow and sustain the condom market in Myanmar, which requires close co-ordination between the public, socially marketed and commercial sectors. Published
Longfield, Kim; Mundy, Gary; Win, Zaw; Montagu, Dominic
Background Concerns about appropriate pricing strategies and the high market share of subsidized condoms prompted Population Services International (PSI)/Myanmar to adopt a total market approach (TMA). This article presents data on the size and composition of the Myanmar condom market, identifies inefficiencies and recommends methods for better targeting public subsidy. Methodology Data on condom need and condom use came from PSI/Myanmar’s (PSI/M’s) behavioural surveys; data for key populations’ socioeconomic status profiles came from the same surveys and the National Tuberculosis Prevalence Survey. Data on market share, volumes, value and number of condoms were from PSI/M’s quarterly retail audits and Joint United Nations Programme on HIV/AIDS (UNAIDS). Results Between 2008 and 2010, the universal need for condoms decreased from 112.9 to 98.2 million while condom use increased from 32 to 46%. Free and socially marketed condoms dominated the market (94%) in 2009–11 with an increase in the proportion of free condoms over time. The retail price of socially marketed condoms was artificially low at 44 kyats ($0.05 USD) in 2011 while the price for commercial condoms was 119–399 kyats ($0.15–$0.49 USD). Equity analyses demonstrated an equal distribution of female sex workers across national wealth quintiles, but 54% of men who have sex with men and 55% of male clients were in the highest two quintiles. Donor subsidies for condoms increased over time; from $434 000 USD in 2009 to $577 000 USD in 2011. Conclusion The market for male condoms was stagnant in Myanmar due to: limited demand for condoms among key populations, the dominance of free and socially marketed condoms on the market and a neglected commercial sector. Subsidies for socially marketed and free condoms have prevented the growth of the private sector, an unintended consequence. A TMA is needed to grow and sustain the condom market in Myanmar, which requires close co-ordination between the
Meekers, Dominique; Agha, Sohail; Klein, Megan
To measure the reach of the "100% Jeune" social marketing campaign and to assess its impact on condom use and on the predictors of condom use. The campaign aims to improve condom use through intensive youth-oriented mass media and interpersonal communications and widespread distribution of subsidized condoms. We analyzed data from the 2000 and 2002 waves of a reproductive health survey of youth aged 15-24 years, with sample sizes of 2097 and 3536, respectively. Exposure to campaign activities was high. During the course of the intervention, there were significant changes in perceived condom attributes and access, self-efficacy, and perceived social support. Consistent with these changes, the percentage of youth who used a condom in last sex with their regular partner increased from 32% to 45% for females (p < .05) and from 44% to 61% for males (p < .01). Additional analyses suggest that exposure to the "100% Jeune" campaign has contributed to these trends. The multi-faceted mass media and interpersonal communication campaign was effective for reaching youth. During the first 18 months of the campaign, significant changes occurred in perceived social support and condom use self-efficacy. Significant increases in levels of condom use also were achieved. However, the program was more effective among males than females. This indicates a need for more and possibly different campaign activities to focus specifically on risk perception and self-efficacy among females. The results also show that repeated program exposure is needed to achieve behavior change. Hence, future programs can enhance their effectiveness by using a mix of mass media and interpersonal communications to repeatedly expose youth to key campaign messages.
Sanders, Stephanie A; Graham, Cynthia A; Yarber, William L; Crosby, Richard A
To comprehensively assess condom use errors and problems reported by women who apply condoms, given the lack of data on this aspect of condom use. Data from a questionnaire survey, using a 3-month recall period, was analyzed for a convenience sample of 102 college women who put condoms on their male partner(s) for sex (vaginal, anal, or oral). The percentage of the sample reporting that an error or problem occurred at least once is presented. Fifty-one percent put the condom on after starting sex, and 15% took the condom off before ending sex. Forty-eight percent wanted a condom but didn't have one, 46% did not leave space at the tip, 30% put the condom on wrong side up and had to flip the condom over, 26% did not use a lubricant, and 15% wanted a water-based lubricant and did not have any available. Twenty-five percent reported that their partners lost erections in association with condom use. Twenty-eight percent reported breakage, slippage, or both. Higher error scores were found for those who reported: 1) breakage or slippage, 2) partner erection problems, 3) use of another form of contraception, and 4) not having received instruction in correct condom use. Educating women as well as men about correct condom use, in addition to promoting consistent condom use, may be an important public health strategy.
de Graaf, R; van Zessen, G; Vanwesenbeeck, I; Straver, C J; Visser, J H
We report responses from 559 clients of female prostitutes, with a view to determining to what extent previously identified factors play a part in condom use. To increase the response rate to advertisements in daily and weekly newspapers, interviews were held by phone. This procedure had the advantage of ensuring the anonymity many clients demanded. Of those clients having vaginal or anal contact (91%), 14% had not always used condoms in the previous year. Compared with consistent condom users, these men were less highly educated, had twice as many commercial contacts, and had more contacts with "steady" prostitutes. They were either more emotionally motivated to visit prostitutes than were consistent condom users or exhibited a stronger need for sexual variation. They showed a more compulsive attitude toward visiting prostitutes, had a more negative attitude toward prostitution in general, evaluated condoms more negatively, had a higher personal efficacy to achieve unsafe contacts, and had a higher general risk assessment, commensurate with their behavior. Men with only safe contacts had either an intrinsic or an extrinsic motivation for condom use. Among extrinsically motivated men, their behavior change was more recent and had not yet taken root: They still envisioned unsafe commercial sex to be possible in the future. Education aimed at the small group of men practicing unsafe contacts will not easily and directly lead to behavior change. But these educational activities may support prostitutes to persist in (consistent) condom use, regardless of clients' pressure to do otherwise.
Sun, Xinying; Liu, Xiaona; Shi, Yuhui; Wang, Yanling; Wang, Peiyu; Chang, Chun
The purposes of this study were to assess sexual behavior and condom use among Chinese college students, and to explore social-environmental and social-cognitive determinants associated with risky sexual behaviors within this population. A survey was conducted among 19,123 Chinese college students recruited through stratified cluster sampling. About 9% of the students reported having had sex (male=13.3%, female=5.0%, OR=2.918), 3.6% had multiple sexual partners (male=5.7%, female=1.6%, OR=3.624), and 0.9% had commercialized sex (male=1.6%, female=0.3%, OR=6.169). Only 24.8% of sexually active students had used a condom for every sexual encounter, and there was no significant difference in condom use between male students and female students. Logistic regression showed that sex (female, OR=0.769), age (older, OR=1.263), exposure to pornographic information (higher, OR=1.751), drinking (intoxication, OR=1.437), and smoking (OR=2.123-5.112) were all determinants of sexual behaviors. Path analysis showed that exposure to pornographic information, level of consumption, and sex education were important social-environmental factors of condom use. Condom use was more common among those who had greater HIV/AIDS knowledge, attitudes toward high-risk behavior, self-efficacy, and intent to use a condom. Intentions were the most important and direct factor influencing condom use. The study concluded that college students are vulnerable to sexually transmitted diseases - including HIV/AIDS infection - through sexual contact. Therefore, future HIV/AIDS prevention and safer sex interventions should focus on self-protection skills and target behavior change.
Vincent, Wilson; Gordon, Derrick M; Campbell, Christina; Ward, Nadia L; Albritton, Tashuna; Kershaw, Trace
Although studies have shown that adherence to traditional masculine norms (i.e., Status, Toughness, Antifemininity) affect men's attitudes toward sexual health, there is little research on how men's adherence to these norms affect them in the context of heterosexual, dyadic relationships. Among 296 young pregnant couples, we investigated the extent to which adherence to traditional masculine norms affected male and female partners' own condom-related beliefs (i.e., condom self-efficacy, positive condom attitudes) and that of their partners. We tested an interdependence model using a dyadic-analytic approach to path analysis. We also tested for differences across gender and race-ethnicity (i.e., African American, Hispanic). Results showed that adherence to the Antifemininity and Toughness masculine norms predicted negative condom-related beliefs, whereas, overall, adherence to the Status norm predicted positive condom-related beliefs. Men's and women's adherence to traditional norms about masculinity were associated with their partner's condom self-efficacy, and moderated associations based on gender and race-ethnicity were detected. In contrast, each dyad member's traditional masculine norms were not associated with his or her partner's positive condom attitudes. Taken together, findings indicated that the roles of traditional masculinity and condom-related beliefs in sexual health should be addressed within the context of relationships and associations between masculine norms and condom-related beliefs are not uniformly negative.
Peasant, Courtney; Parra, Gilbert R; Okwumabua, Theresa M
The aim of this review was to summarize factors associated with condom negotiation among heterosexual men. Literature searches were conducted using multiple databases spanning several disciplines. Studies examining psychological, demographic, relational, communication, and environmental factors related to condom negotiation are described, and a three-dimensional framework of condom negotiation is proposed. This framework of condom negotiation may aid researchers in operationalizing this construct, organizing this literature, and facilitating measurement development. We used this three-dimensional framework to articulate the influence of gender, ethnicity, relationship type, partner characteristics, trauma history, post-traumatic stress, and alcohol use on condom negotiation. Areas for future research are outlined. More research is needed to understand how these factors interact to influence condom negotiation, as well as the interaction between gender and the identified factors.
Crosby, R A; Yarber, W L; Sanders, S A; Graham, C A; McBride, K; Milhausen, R R; Arno, J N
To identify (1) the prevalence of condom breakage, and demographic and sexuality-related differences among young men who have sex with women reporting and not reporting this event; (2) condom-specific behaviours associated with breakage. Young men (n = 278) attending a clinic for treatment of sexually transmitted infections (STIs) responded to an anonymous questionnaire aided by a CD recording of the questions. The samples were screened to include only men who had used a condom during penile-vaginal sex at least three times in the past 3 months. Condom-specific behaviours (including breakage) were assessed using these last three acts of condom use as the recall period. Correlates achieving bivariate significance were subjected to multivariate analysis. Nearly one third (31.3%) of the men reported recent breakage. The breakage rate was 15%. Three correlates significantly distinguished between men who did and did not report breakage. Men who had past STIs were more likely to report breakage (adjusted odds ratio (AOR) 2.08), as were men who also reported condom slippage (AOR 2.72). Less self-efficacy for correct condom use was also significantly associated with breakage (AOR 1.07). Further, three condom-specific behaviours were significantly associated with breakage: allowing condoms to contact sharp objects (AOR 2.6), experiencing problems with the "fit or feel" of condoms (AOR 2.3) and not squeezing air from the receptacle tip (AOR 2.0). Breakage may be common and may occur in a larger context of difficulties with condoms. STI clinics could potentially benefit some men by providing instructions on the correct use of condoms.
Worldwide, at least 33 million people are infected with HIV, another 14 million have died, and approximately 16,000 people are newly infected each day, 60% of whom are women. An estimated 6-9 billion condoms are currently used throughout the world each year. However, a report from the Johns Hopkins University School of Hygiene and Public Health has determined that the level of condom use must be increased to 24 billion units annually in order to check the spread of HIV/AIDS and other sexually transmitted diseases. An estimated 71% of total condom need is among sexually active unmarried men, while the rest of the need is among married men who have extramarital affairs and by married couples. Condoms should be made accessible to all at subsidized prices and provided not only through health clinics and retail shops, but also in hotels, bars, grocery stores, and vending machines. New efforts are needed to make condoms more accessible, including lowering their cost, effectively promoting their use, and overcoming the many social and personal obstacles to their use, especially in developing countries where the impact of AIDS is the most severe. Special programs should target specific groups, including youth, unmarried men, and prostitutes, while condom promotion should also aim to improve the image of condoms by portraying them as fun, reliable, and important. Finally, political and religious leaders should speak out in favor of condom use, while the mass media should openly discuss condoms.
Full Text Available The aim of the study is to investigniefi2ctors affecting condom use among junior Secondary School pupi1s in South Africa. The sample included 446 Grade 10 Secondary school pupils, 200 (44.896 ma1e and 246 (55.2%,females within the age range of I0 to 30 years (M age 16.6 years, SD = 2.5 from three rural schools in one region of the Northern Province in South Africa. Main outcomes measures included sexual activity and condom use (12 items, source of “condom” information (12 items, knowledge of correct condom use (10 items, a 16-item AIDS Health Belief Scale and a 28-item Condom Use Self-Efficiency Scale. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.
Elys de Oliveira Bezerra
Full Text Available The objective of this investigation was to identify how adolescents structure the social representations of sexual intercourse and use of condoms. Exploratory and descriptive research was conducted with a convenience sample consisting of 234 students of a public secondary school in Fortaleza-CE, Brazil, between July 2009 and April 2010. Data were collected using a questionnaire with variables on socioeconomic status and sexual behaviour, and Free Association test with three terms: 'sex', 'unprotected sex' and 'sex with a condom'. Sexual intercourse was represented by love and affection among the women, while men associated sex to pleasure, desire and attraction toward the female body. The condom was considered important by both groups, but men represented condoms as being something bad that restricts pleasure. Health professionals are granted the opportunity to identify vulnerabilities of this population to DST/HIV/AIDS and work with these vulnerabilities in the most appropriate way.
Li, Qing; Li, Xiaoming; Stanton, Bonita; Wang, Bo
This study was designed to assess the psychometric properties of a pictorial scale of correct condom use (PSCCU) using data from female sex workers (FSWs) in China. The psychometric properties assessed in this study include construct validity by correlations and known-group validation. The study sample included 396 FSWs in Guangxi, China. The results demonstrate adequate validity of the PSCCU among the study population. FSWs with a higher level of education scored significantly higher on the PSCCU than those with a lower level of education. FSWs who self-reported appropriate condom use with stable partners scored significantly higher on PSCCU than their counterparts. The PSCCU should provide HIV/STI prevention researchers and practitioners with a valid alternative assessment tool among high-risk populations, especially in resource-limited settings.
Piot, Bram; Mukherjee, Amajit; Navin, Deepa; Krishnan, Nattu; Bhardwaj, Ashish; Sharma, Vivek; Marjara, Pritpal
Objectives This study reports on the results of a large-scale targeted condom social marketing campaign in and around areas where female sex workers are present. The paper also describes the method that was used for the routine monitoring of condom availability in these sites. Methods The lot quality assurance sampling (LQAS) method was used for the assessment of the geographical coverage and quality of coverage of condoms in target areas in four states and along selected national highways in...
Heeren, G Anita; Jemmott, John B; Mandeya, Andrew; Tyler, Joanne C
Whether certain behavioral beliefs, normative beliefs, and control beliefs predict the intention to use condoms and subsequent condom use was examined among 320 undergraduates at a university in South Africa who completed confidential questionnaires on two occasions separated by 3 months. Participants' mean age was 23.4 years, 47.8% were women, 48.9% were South Africans, and 51.1% were from other sub-Saharan African countries. Multiple regression revealed that condom-use intention was predicted by hedonistic behavioral beliefs, normative beliefs regarding sexual partners and peers, and control beliefs regarding condom-use technical skill and impulse control. Logistic regression revealed that baseline condom-use intention predicted consistent condom use and condom use during most recent intercourse at 3-month follow-up. HIV/STI risk-reduction interventions for undergraduates in South Africa should target their condom-use hedonistic beliefs, normative beliefs regarding partners and peers, and control beliefs regarding technical skill and impulse control.
-prevention policies that promote condoms. I examine how discourse on condom policy has been used to depict condom-promotion policies as inherently simple and rational, scientifically and economically sound, and, by implication, neutral ...
, ... prevention, and their use has increased significantly over the past decade. Correct ... vulnerability, perceived self-efficacy, condom efficacy, discussing condom use or ... longevity and self-efficacy for use of condom with long-term partners.
Broaddus, Michelle R; Morris, Heather; Bryan, Angela D
We examined effects of proposer gender and condom negotiation strategy on perceptions of condom proposers in undergraduates in the southwestern regions of the US. Using a video manipulation (N=150), a female proposer was evaluated no more harshly than a male proposer, and was evaluated more positively in some ways. In a vignette manipulation (N=193) a female proposer using an Eroticization negotiation strategy (compared to Refusal of sex or Explanation of consequences) was seen as more exciting and likely to engage in sex. Surprisingly, women were harsher judges than men of a female condom proposer using an Eroticization strategy. Greater attention should be paid to the nature of condom negotiation within the framework of the sexual script.
Condoms are the only form of contraception that, when used correctly, can reduce the risk of pregnancy and transmission of sexually transmitted infections. This article outlines strategies for promoting correct male condom use. The availability, variety and history of condoms are explored. Possible reasons for people not wanting to use condoms are examined and advantages of condom use are provided. The author suggests ways in which healthcare workers can promote condom use and improve the experience and efficacy of this contraceptive device.
An advertisement in the Uganda weekly Topic printed in 1990 is the center of the controversy over whether promoting condom use to prevent AIDS is really promoting immorality and promiscuity. The ad states: "The bible may save your soul but this condom will save you life." Critics have called the ad blasphemy for showing a condom package alongside the Bible; claimed the condom fools people into thinking they are safe from AIDS; and blamed the practice of supplying condoms for the moral decadence that is destroying the country. In contrast the national AIDS Control Program (ACP) believes that supplying university students, who may be the group at highest risk, with condoms, is wise because they at lest know how to use them properly. A spokesman for the ACP said that the condom is one of the limited options that exist to fight the life-threatening epidemic. Present Museven changed his views to November 1990 from a policy of encouraging abstinence and monogamy, to promoting condoms. This change in government policy coincided with the report of 17,422 cases of AIDS, and the estimate that 1.3 million people in Uganda are infected with HIV.
Tingey, Lauren; Chambers, Rachel; Rosenstock, Summer; Lee, Angelita; Goklish, Novalene; Larzelere, Francene
American Indian (AI) adolescents experience inequalities in sexual health, in particular, early sexual initiation. Condom use intention is an established predictor of condom use and is an important construct for evaluating interventions among adolescents who are not yet sexually active. This analysis evaluated the impact of Respecting the Circle of Life (RCL), a sexual and reproductive health intervention for AI adolescents, on predictors of condom use intention. We utilized a cluster randomized controlled trial design to evaluate RCL among 267 AIs ages 13-19. We examined baseline psychosocial and theoretical variables associated with condom use intention. Generalized estimating equation regression models determined which baseline variables predictive of condom use intention were impacted. Mean sample age was 15.1 years (standard deviation 1.7) and 56% were female; 22% had initiated sex. A larger proportion of RCL versus control participants had condom use intention post intervention (relative risk [RR] = 1.39, p = .008), especially younger (ages 13-15; RR = 1.42, p = .007) and sexually inexperienced adolescents (RR = 1.44, p = .01); these differences attenuated at additional follow-up. Baseline predictors of condom use intention included being sexually experienced, having condom use self-efficacy, as well as response efficacy and severity (both theoretical constructs). Of these, the RCL intervention significantly impacted condom use self-efficacy and response efficacy. Results demonstrate RCL intervention efficacy impacting variables predictive of condom use intention at baseline, with greater differences among younger, sexually inexperienced adolescents. To sustain intervention impact, future RCL implementation should reinforce education and training in condom use self-efficacy and response efficacy and recruit younger, sexually inexperienced AI adolescents. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All
Onja Holisoa Rahamefy, Michèle Rivard, Madeleine Ravaoarinoro, Lala Ranaivoharisoa, Andriamiliharison Jean Rasamindrakotroka, Richard Morisset
Mar 26, 2008 ... intercourse (Directorate of Demography and Social Statistics,. 2000). ..... partner refusal, immediate unavailability of condoms, intention ... of sexual acts, embarrassment when purchasing condoms, ..... Available online at.
their sexual and condom use behaviors in a diary. Less educated participants may have become more aware of their sexual and condom use behaviors by...demographics and sexual and condom use behaviors. Following the baseline period, intervention condoms were distributed for 1 month: two sites received either...scented or unscented condoms in a blue wrapper, while the other two received the same condoms in a camouflaged wrapper. Sexual activity was measured pre
Corbett, A Michelle; Dickson-Gómez, Julia; Hilario, Helena; Weeks, Margaret R
Condoms are less likely to be used in primary relationships than in other relationship types. An understanding of what women and men expect when entering into these relationships, as well as how they make decisions about condom use and other prevention behaviors, is essential to efforts to curb the spread of HIV. Qualitative in-depth interviews were conducted with 25 high-risk heterosexual couples, including HIV-serodiscordant couples, participating in a trial of the female condom in Hartford in 2004-2007. Data were coded and analyzed in an iterative inductive and deductive process. Participants described nonuse of condoms as a strategy to fi nd and maintain a primary relationship, establish trust and increase intimacy. Many had unprotected intercourse while recognizing their risk of HIV and other STDs, placing their love for their partner and other emotional needs over concerns about their health. Several couples reduced their STD risk by practicing negotiated safety (i.e., using condoms until their serostatus had been determined) or similar strategies, including sharing sexual or drug use history, disclosing HIV test results and using condoms until they decided that their relationship would be monogamous. HIV prevention approaches must recognize the importance of love and the needs that primary relationships satisfy if they are to be considered relevant by those at greatest risk. Negotiated safety and similar strategies may be an important risk reduction tool for heterosexuals, particularly those in HIV-affected relationships, but their potential effectiveness may vary.
Full Text Available BACKGROUND. Condoms offer the best protection against sexually transmitted infections including HIV. In Ukraine, little research has been conducted to explore possible predictors of condom use at sexual debut. It was hypothesized that the more youth know about possible ways of HIV transmission, the more they are likely to use condoms during the first sexual intercourse.METHODS: Data analyzed in this paper comes from a cross-sectional European School Survey Project on Alcohol and other Drugs conducted among Ukrainian school youth in 2007. The survey involved a total of 5122 students (15–17 year old from all types of secondary schools in 24 oblasts and AR Crimea. Analysis was confined to 1077 students (715 males and 362 females who reported that they have ever had sexual intercourse. Associations were assessed in bivariate analysis using Chi-square test and later using binary logistic regression analysis in order to identify the significant predictors after controlling for other variables.RESULTS: Among the sexually experienced students, more than 70% had used condoms during first sexual intercourse. The results from the logistic regression analysis revealed that the age at first sexual intercourse, HIV awareness, alcohol consumption and family characteristics were significant predictors of condom use at first sexual intercourse among the Ukrainian schoolchildren. Students who had first sex at the age from 14 to 16 years were more likely to use condom at their first sexual intercourse than those with sexual debut before 14 years old (odds ratios 2,4; 2,1; and 3,3, respectively. Moreover, those students who were aware that using condom may protect against getting HIV were more likely (OR 2,1 to use condom at first sex.CONCLUSIONS: The results indicate the necessity of providing educational programs which aim to raise the level of awareness about HIV among Ukrainian youth.
Full Text Available Background: Human Immunodeficiency Virus (HIV incidence has been increasing in Thai youth, mostly from unsafe sex. Embarrassment with carrying condom was one of the main reasons. This study aims to evaluate attitude towards condom use, sexual behavior and the new condom packaging that merges with daily life products in Thai youth. Methods: A cross-sectional study was conducted among volunteers aged 15-24. New packaging were demonstrated and the volunteers were provided with questionnaires to complete in privacy booth and submit anonymously. Results: Of 680 participants with mean age of 19.7±2.7 years and 59.9% females, half of them thought condom should be carried and used. However, the same group did not actually do. Two-thirds of participants were interested and would use the packaging, citing these reasons charming, convenience, and disguise of condom. Females preferred the packaging significantly more than males. Conclusion: Disguising condom packaging, as phone charm and key ring, might be another safe and practical way to encourage youth to carry condoms around.
Vera, Eduardo Gayón; Orozco, Hilda Hernández; Soto, Selene Sam; Aburto, Esther Lombardo
Sexual transmitted diseases (included HIV/AIDS) are a common and preventable cause of perinatal morbidity and mortality. When used consistently and correctly, condoms are effective to prevent these diseases, however, its protection does not account for 100%. To know the effectiveness of male condom, through bibliographic evidence, to prevent sexual transmitted infections in heterosexual serodiscordant partners. A bibliographical review of Medline/Pubmed, LILACS and Cochrane databases, and publications of the National Health Institutes, Centers for Disease Control and Prevention, World Health Organization, and WHO AIDS Global Program was done to analyze male condom effectiveness to prevent sexual transmitted diseases. Reports demonstrated that male condom protection against HIV/AIDS in heterosexual serodiscordant partners goes from 60 to 95%. Most recent information (2006) showed 80%. Two studies demonstrated no HPV protection with male condom, and another one 70% of protection. Male condom demonstrated no HPV-1 protection, but decrease of risk in HVS-2 transmission in women (0.85 of protection). Male condom protection against sexual transmitted diseases is not 100%. There must be used additional measures that have demonstrated its utility to decrease transmission risk.
Fitz, Caroline C; Zucker, Alyssa N
Understanding factors related to condom use is critical in reducing the spread of sexually transmitted infections (STIs), especially for women, who are disproportionately affected by many STIs. Extant work has shown that perceived sexism is one such factor associated with lower levels of condom use among women, but has yet to explore whether benevolent sexism in particular-a subtle form of sexism that often goes unnoticed and increases cognitions and behaviors consistent with traditional female gender roles (e.g., sexual submissiveness)-relates negatively to this safer-sex practice. The present research tested this possibility and, in addition, examined whether relational sex motives, which reflect a desire to engage in sex as a means to foster partners' sexual satisfaction, mediated the relation between benevolent sexism and condom use. During the spring of 2011, female college students (N = 158) reported how often they experienced benevolent sexism in their daily lives and, 2 weeks later, their relational sex motives and condom use. Supporting hypotheses results indicated that greater exposure to benevolent sexism was associated significantly with lower condom use, and that relational sex motives mediated this relationship. We discuss implications for women's well-being, including ways to promote safer sex in the face of sexism.
... Stages Listen Español Text Size Email Print Share Teaching Teens To Use Condoms Faithfully Page Content Article ... this much-maligned form of contraception. Some young women, for example, say that using rubbers makes them ...
Organista, P B; Organista, K C; Soloff, P R
AIDS-related knowledge, attitudes, and behaviors were assessed in female Mexican migrant laborers. Thirty-two women were administered a modified version of the Hispanic Condom Questionnaire. Respondents were knowledgeable about the major modes of HIV transmission, but one-third to one-half of the women believed that they could contract AIDS from unlikely casual sources. Although respondents reported few negative beliefs about condom use, actual condom use with sex partners was low and knowledge of proper condom use was problematic. Consequently, 75 percent reported never carrying condoms. Implications of these findings for future research and provision of services for female Mexican migrants are discussed.
Sexual sterilization is highly effective in preventing pregnancy, but it does not protect against sexually transmitted diseases (STDs). People who accept sterilization as their method of family planning therefore need to be encouraged to protect themselves against HIV/AIDS and STDs even after they have been sterilized. Since women return less often to family planning providers following their sterilization procedure, they need to be advised to protect themselves against HIV and STDs before the sterilization is performed. 42% of the 2782 women who underwent tubal sterilizations at the Baylor College of Medicine in Houston during 1991-96 indicated their intention in a cross-sectional study to use condoms after sterilization. 20% of all respondents, aged 18-51 years, had a known risk factor for HIV, and almost 25% reported regular condom use for contraception or disease protection during the 3 months before sterilization. Planned condom use increased from 32% in 1991 to 51% in 1996, irrespective of age, marital status, or ethnic background. Of the 646 women who used condoms before being sterilized, almost half indicated no plans to do so after the procedure. The following factors were associated with condom use: relatively younger age, black ethnicity, unmarried status, history of previous STD, no steady partner, having a higher number of previous sex partners, past use of condoms to prevent disease transmission, and lack of partner involvement in the decision to undergo sterilization.
Pick De Weiss, S
The Institute Mexicano de Investigacion de Familia y Poblacion, A.C. (IMIFAP) tested the effectiveness of a training course and educational materials that were designed to increase the awareness and knowledge of pharmacy employees concerning acquired immunodeficiency syndrome (AIDS) and its prevention, and to promote condoms. 174 employees participated in workshops that included information on transmission and prevention of sexually transmitted diseases (STDs) and AIDS, and condom usage. Pre- and post-session tests were performed to ascertain the short-term retention of information; the long-term effect was assessed via incognito shopper visits and monitoring of condom sales. Short, intensive training, when reinforced by posters, pamphlets, and video, significantly increased knowledge of AIDS (symptoms, transmission, and prevention) and correct condom usage. Awareness of risk behaviors and groups at risk for AIDS improved. Printed materials alone did not have a substantial impact on knowledge or sales of condoms, and increased knowledge alone did not increase information disseminated. After 6 months there was a significantly higher rise in condom sales (16%) in the course-plus-materials group. This group also took a greater initiative in providing information to clients. In spite of these positive results, knowledge and initiative are still unsatisfactory, especially when the role of pharmacies in general health care and the suspected prevalence of sexually transmitted diseases and human immunodeficiency virus in Mexico are considered.
Sharma, V; Dave, S; Sharma, A; Chauhan, P
Condoms are a common denominator for three prestigious national prevention programmes in India, none of which has been a real success. The present study was undertaken to investigate prevalence of condom use and to assess knowledge about correct use of condoms among married, sexually active men, who had not adopted any permanent method of contraception. The study was conducted by a house-to-house survey in eight randomly selected villages of Anand, Gujarat (a 10% sample). All married men (ages: 18-55 years) were interviewed with the help of a pre-tested, structured questionnaire, comprising questions on: (a) their sexual practices; (b) knowledge about the correct use of condoms; and (c) reasons for their use/non-use. Respondents were evaluated for knowledge about correct use of condoms by scoring on a scale of 10. The sample consisted of 1,478 men whose mean age was 29.8 (± 6.75) years and mean duration of married life was 8.4 (± 6.25) years. Almost 52% (n = 771) were either illiterate or had been educated up to primary level; while 131 (8.8%) had university qualifications. More than 74% (n = 1,092) had never used condoms; 24.4% had used them irregularly and only 1.8% (n = 26) were using them regularly. The mean knowledge score for the correct use of condoms was 1.44 ± 2.29 on a scale of 10 and it was positively related to regularity of use and educational status of respondents (p condoms offer protection against STDs and/or AIDS. The most common mistakes related to incorrect use of condoms were use of oil-based lubricants with condoms, ignorance about the technique of putting on a condom, re-use of condoms, etc. The commonly cited reasons for non-use of condoms were interference with sexual activity; lack of privacy; fear of losing it inside the woman's body, and lack of confidence in its effectiveness as a contraceptive. To be effective as a contraceptive and to offer protection against sexually transmitted diseases and AIDS, condoms need to be used regularly
Avaliação da continuidade de uso do preservativo feminino em usuárias do Sistema Único de Saúde em unidades da região metropolitana de São Paulo, Brasil Evaluation of continuity of use of female condoms among users of the Brazilian National Health System (SUS: longitudinal analysis in units in the metropolitan region of São Paulo, Brazil
pregnancy - the female condom (FC as a possible alternative. The objective of this study was to assess continuity of the high initial acceptability of FC described in different studies. Vulnerable groups were monitored for 12 months: 16 public services of the São Paulo metropolitan area (7 specialized in STD/AIDS; 6 primary care units and 3 community projects. 2,469 women were enrolled, 713 from STD/AIDS services, 1,417 from primary care units and 339 from community projects. Kaplan-Meier, log-rank and the Cox regression model were used to analyze survival curves, CI=95%. At the end of follow-up, 355 (14.4% women were using female condom continuously. The mean period of use of all participants was 3.55 months (CI 95%: 3.37- 3.73. Results showed type of service providing the device and frequency of sexual intercourse as factors statistically significant related to continuity of use. The high number of women accepting the use of female condom in different services showed an important demand for the device, the need to provide appropriate access to orientation and of making female condom continuously available.
Yzer, M.C; Siero, F.W.; Buunk, Abraham (Bram)
A prospective study of 94 Dutch adults who have casual sexual partners examined whether two important aspects of safe sex. namely bringing up condom use (BCU) and actual condom use (ACU) are intentional or habitual. For each of these aspects, a model based on the Theory of Planned Behaviour (TPB:
The first AIDS case in Egypt was reported almost 10 years ago, yet Egypt still does not have reliable statistics on the HIV/AIDS epidemic (officially, 513 HIV infections and 88 AIDS cases; more likely, 3000 and 10,000, respectively). HIV/AIDS bears a stigma. The government claims that every HIV-infected Egyptian acquired the infection through a blood transfusion while in the Gulf or through sexual intercourse in Europe. Cultural, social, and religious norms that discourage promiscuity may explain the low HIV/AIDS rate but these same taboos put women at risk by making it difficult for them to protect themselves. Islamic fundamentalist women reinforce the Islamic principle of forbidding sex education. They consider AIDS a plague of immoral Western society. They refuse to accept the fact that many men do not practice safer sex. These women consider condoms immoral. They think God will curse women who refuse to have sexual intercourse at their husbands' bidding. Many nongovernmental organizations consider an intensive education program as the only means to avert disaster. Egypt has yet to implement its model AIDS program. All hospitals in Cairo and some hospitals in rural areas have equipment to test for HIV. Surveillance systems have been limited to high risk groups. In Egypt, it is mandatory to test foreigners for HIV. Prisoners, prostitutes, homosexuals, and blood donors are tested randomly without their consent. Positive results are often reported to authorities before the persons learn their HIV status. A campaign for widespread sex education is the only action recommended so far. It includes a mass media component and community meetings and conferences. An Egyptian physician has found an anti-viral drug that stimulates the immune system, but his work does not receive much coverage outside Egypt. Egyptians need to tackle their cultural taboos about discussion of sex to curb the HIV/AIDS epidemic.
Ross, Dana; Schumacher, Joseph E
The purpose of this study was to objectively and quantitatively assess individual skill level of male condom use. This study developed a reliable and face valid assessment of correct male condom use based on Centers for Disease Control and Prevention criteria. Participants (N= 163) were recruited from persons in treatment for cocaine addiction. Condom use was assessed on the basis of correct completion of eight discrete steps. An overall score of 40% correct condom use indicated the need for training in this sample. Assessment showed training needs especially related to steps involving reduction of ejaculate leakage and steps related to potential hazards of nonoxynol-9 use. Frequency of condom use was also assessed; there was no correlation between frequency of condom use and condom use skill. Drug addiction treatment programs are encouraged to incorporate HIV risk reduction programs that teach condom use skills and use the CUDOS as an empirical measure of condom skill acquisition.
Stoner, Susan A; Norris, Jeanette; George, William H; Morrison, Diane M; Zawacki, Tina; Davis, Kelly Cue; Hessler, Danielle M
This experiment examined relationships among adulthood victimization, sexual assertiveness, alcohol intoxication, and sexual risk-taking in female social drinkers (N=161). Women completed measures of sexual assault and intimate partner violence history and sexual assertiveness before random assignment to 1 of 4 beverage conditions: control, placebo, low dose (.04%), or high dose (.08%). After drinking, women read a second-person story involving a sexual encounter with a new partner. As protagonist of the story, each woman rated her likelihood of condom insistence and unprotected sex. Victimization history and self-reported sexual assertiveness were negatively related. The less sexually assertive a woman was, the less she intended to insist on condom use, regardless of intoxication. By reducing the perceived health consequences of unprotected sex, intoxication indirectly decreased condom insistence and increased unprotected sex. Findings extend previous work by elucidating possible mechanisms of the relationship between alcohol and unprotected sex - perceived health consequences and situational condom insistence - and support the value of sexual assertiveness training to enhance condom insistence, especially since the latter relationship was robust to intoxication.
Crosby, Richard; Salazar, Laura F; DiClemente, Ralph J; Yarber, William L; Caliendo, Angela M; Staples-Horne, Michelle
To determine whether a measure of unprotected vaginal sex that is adjusted for condom failures would produce improved accuracy in predicting biologically confirmed STDs (chlamydia and gonorrhea) among female teens. Self-reported measures were collected using audio-computer-assisted self-interviewing. DNA amplification for the presence of Chlamydia trachomatis and Neisseria gonorrhoeae was conducted. The unadjusted measure of unprotected vaginal sex was not significantly associated with biologically confirmed prevalence of STDs (prevalence ratio [PR] = 1.51; 95% CI = 0.71-3.21; P = 0.28). Alternatively, the adjusted measure achieved significance (PR = 3.59; 95% CI = 1.13-11.38; P = 0.014). More than one quarter (25.6%) of teens using condoms inconsistently and/or incorrectly tested positive for an STD compared to 7.1% among those reporting the consistent and correct use of condoms. Findings demonstrate that studies of condom effectiveness should use an adjusted measure of condom use to achieve precision and rigor.
Bankole, Akinrinola; Ahmed, Fatima H; Neema, Stella; Ouedraogo, Christine; Konyani, Sidon
Using data from the 2004 National Adolescent Surveys, this paper undertook a detail analysis of knowledge of correct condom use and consistency of use, as well as their covariates, among adolescents in Burkina Faso, Ghana, Malawi and Uganda. The strongest predictor of knowledge of correct condom use among both male and female adolescents is exposure to a condom use demonstration. In Burkina Faso, Ghana and Uganda, adolescents who have seen a condom demonstration are 2 to 5 times as likely as those who have not to have good knowledge of correct condom use. Age, ever received sex education in school, ever attended school and exposure to the radio are also significant predictors of knowledge of correct use, particularly among men. As indicated by behavior among young men, the extent to which adolescents use the condom consistently varies across countries. Yet, it is nowhere near the required 100% level. The proportion reporting consistent use of the method in the 3 months preceding the survey is 38% in Burkina Faso, 47% in Ghana, 20% in Malawi and 36% in Uganda. Age difference between partners is a major determinant of consistent use of condoms: young men whose partner is 0-4 years younger are about two and a half times more likely to use condoms consistently than those who whose partner is 5-9 years younger. Other important predictors of consistent condom use are residence, education, living arrangement and exposure to mass media, specifically the radio and newspaper. Findings from this study point to areas that policy and program can address to provide adolescents access to the kinds of information and service they need to achieve healthy sexual and reproductive lives.
necessary for the design of a behavior change. Page 2. African Health Sciences Vol 13 Issue 4 December 2013. 1028 communication (BCC) toolkit for use in addressing. HIV/STI risk-taking behaviors among FSWs and truckers operating along ... and truckers, or were patrons of bars and other entertainment venues that ...
Full Text Available Zambia experiences high unmet need for family planning and high rates of HIV, particularly among youth. While male condoms are widely available and 95% of adults have heard of them, self-reported use in the past 12 months is low among young adults (45%. This study describes factors associated with non-use of male condoms among urban young adults in Zambia.A household cross-sectional survey in four urban districts was conducted from November 2015 to January 2016 among sexually active young adults ages 18-24 years. A random walk strategy was implemented in urban areas; eligible, enrolled participants were administered a survey on household characteristics, health access, and knowledge, attitudes and practices related to contraception. Relative risk regression models were built to determine factors associated with the decision to not use a male condom (non-use at most recent sexual intercourse.A total of 2,388 individuals were interviewed; 69% were female, 35% were married, and average lifetime sex partners was 3.45 (SD±6.15. Non-use of male condoms was 59% at most recent sexual intercourse. In a multivariate model, women were more likely to report non-use of a male condom compared with men (aRR = 1.24 [95% CI: 1.11, 1.38], married individuals were more likely to report non-use compared with unmarried individuals (aRR = 1.59 [1.46, 1.73], and those residing in the highest poverty wards were more likely to report non-use compared with those in the lowest poverty wards (aRR = 1.31 [1.16, 1.48]. Those with more negative perceptions of male condom use were 6% more likely to report non-use (aRR = 1.06 [1.03, 1.09]. Discussion regarding contraception with a partner decreased non-use 13% (aRR = 0.87 [0.80, 0.95] and agreement regarding male condom use with a partner decreased non-use 16% (aRR = 0.84 [0.77, 0.91].Non-use of male condoms is high among young, married adults, particularly women, who may be interested in contraception for family planning but
Des Jarlais, Don C; McKnight, Courtney; Arasteh, Kamyar; Feelemyer, Jonathan; Perlman, David; Hagan, Holly; Cooper, Hannah L F
We assessed awareness and use of the "NYC Condom" among persons who use heroin and cocaine in New York City. The NYC Condom distribution program is the largest free condom distribution program in the USA, with over 30 million condoms distributed per year. It includes a condom social marketing program for a specific brand, the NYC Condom with its own packaging and advertising. People who use heroin and cocaine are at relatively high risk for HIV infection and are an important target population for the program. In order to assess awareness of the NYC Condom, structured interviews and blood testing for HIV, HSV-2, and sexually transmitted infections (STI) were conducted among entrants to the Beth Israel Medical Center drug detoxification and methadone treatment programs. Participants were asked about drug use, sexual risk behaviors, and awareness and use of the NYC Condom. Univariate and multivariable regression analyses were conducted to examine the associations between use of NYC Condoms and consistent condom use with primary and casual sexual partners. A total of 970 subjects were recruited between February 2011 and December 2012. Subjects were primarily African-American and Hispanic, with a mean age of 43. Fifty-five percent of subjects reported being sexually active with primary sexual partners, and 25 % reported being sexually active with a casual partner for the 6 months prior to the interview. Sixty-five percent of subjects had heard of the NYC Condom, 48 % of those who had heard of the condom had used it, and 58 % of those who had ever used it were currently using it (in the previous 6 months). In multivariable regression analyses, current use of NYC Condoms was strongly associated with consistent condom use with primary sexual partners (adjusted odds ratio (AOR) = 3.99, 95 % confidence interval (CI) 1.85-8.58) and consistent condom use with casual sexual partners (AOR = 4.48, 95 % CI 1.49-13.42). In terms of market share, 38 % of subjects consistently using
Liddell, Christine; Giles, Melanie; Rae, Gordon
To examine attitudes toward condoms and their association with culturally grounded beliefs among young South African adults. A questionnaire survey undertaken in three different locations (urban, rural, and mixed), including 1100 participants, and implementing both a cross-validational and a bootstrap multivariate design. Outcome measures were intention to use a condom at next sex and condom salience (i.e., confidence in the protective value of condoms). Culturally grounded predictors included traditional beliefs about illness, beliefs in ancestral protection, endorsement of AIDS myths, and mortality salience (CONTACT). Participants exhibited strong endorsement of indigenous beliefs about illness and ancestral protection, and moderate endorsement of AIDS myths. Participants who viewed condoms as important for HIV prevention were more likely to show strong endorsement of both beliefs in ancestral protection and traditional beliefs about illness. Participants who strongly endorsed AIDS myths viewed condoms as less important and also had lower intention to use scores. Finally, participants who knew HIV positive people, and/or people who had died of HIV-related illnesses, had higher condom salience and higher intention to use scores. Results challenge the assumption that culturally grounded variables are inherently adversarial in their relationship to biomedical models of HIV prevention, and offer insights into how traditional beliefs and cultural constructions of HIV/AIDS might be used more effectively in HIV education programs.
Full Text Available Mercy Mvundura, Neeti Nundy, Maggie Kilbourne-Brook, Patricia S Coffey Technology Solutions Global Program, PATH, Seattle, WA, USA Background: Female condoms are the only currently available woman-initiated option that offers dual protection from pregnancy and sexually transmitted infections, including HIV. The Woman’s Condom is a new female condom designed to provide dual protection and to be highly pleasurable and acceptable. Objective: We sought to estimate the potential dual health impact and cost-effectiveness of a Woman’s Condom distribution program in 13 sub-Saharan African countries with HIV prevalence rates >4% among adults aged 15–49 years. We used two separate, publicly available models for this analysis, the Impact 2 model developed by Marie Stopes International and the Population Services International disability-adjusted life years (DALY calculator program. We estimated the potential numbers of pregnancies and DALYs averted when the Woman’s Condom is used as a family planning method and the HIV infections and DALYs averted when it is used as an HIV prevention method. Results: Programming 100,000 Woman’s Condoms in each of 13 countries in sub-Saharan Africa during a 1-year period could potentially prevent 194 pregnancies and an average of 21 HIV infections in each country. When using the World Health Organization CHOosing Interventions that are Cost-Effective (WHO-CHOICE criteria as a threshold to infer the potential cost-effectiveness of the Woman’s Condom, we found that the Woman’s Condom would be considered cost-effective. Conclusion: This was a first and successful attempt to estimate the impact of dual protection of female condoms. The health impact is greater for the use of the Woman’s Condom as an HIV prevention method than for contraception. Dual use of the Woman’s Condom increases the overall health impact. The Woman’s Condom was found to be very cost-effective in all 13 countries in our sample. Keywords
Twa-Twa, J M; Oketcho, S; Siziya, S; Muula, A S
Correct and consistent condom use remains an important public health intervention against the spread of Human Immunodeficiency Virus and other sexually transmitted infections. There is paucity of information on sexual behaviour of in-school adolescents in Uganda. We, therefore, used secondary data of the Uganda Global School-based Health Survey (UGSHS) conducted in 2003 to determine the prevalence and correlates of condom use at last sexual intercourse in urban areas of Uganda. A two-stage cluster sampling technique was used to obtain a representative sample. Altogether 1709 students participated in the survey in urban areas of whom 179 (14.9% of males, and 7.9% of females) had sexual intercourse within 12 months before the survey. Overall 77.3% (79.7% of male, and 72.3% of female) adolescents used a condom at last sexual intercourse. Adolescents who drank alcohol and used drugs were 64% (OR = 1.64, 95% CI 1.54, 1.75) and 68%, (OR = 1.68, 95% CI 1.56, 1.81) more likely to have used a condom, respectively. Meanwhile, adolescents who ever got drunk, and who reported to ever had 2 or more sex partners were 55% (OR = 0.45, 95% CI 0.42, 0.48) and 35% (OR = 0.65, 95% CI 0.62, 0.68) less likely to have used a condom compared to those who had never got drunk, and who ever had 1 sex partner, respectively. Finally, adolescents who reported receiving no parental supervision were 45% (OR = 0.55, 95% CI 0.53, 0.58) less likely to have used a condom compared to those who reported receiving parental supervision. Parental supervision may be effective in promoting condom use among adolescents. Furthermore, drinking alcohol was associated with condom use probably due to peer pressure and easy access of condoms in drinking places as condoms are not actively promoted in schools. There is need for further research on how in-school adolescents could access condoms.
Oct 26, 2017 ... State. The predictors of condom use are level of wealth, being unmarried, and primary level of .... barriers. However, condom cost, gender inequality, ..... Kamal and Huda in India, using the 2006 Indian DHS, found that ...
Kim, Jiyun; Lee, Jong-Eun
The purpose of this study was to investigate the factors related to sexual debut among adolescents, and to examine the association between subject characteristics and condom nonuse among those who experienced sexual intercourse in South Korea. Data were obtained from the 2009 Korean Youth Risk Behaviour Survey, a nationally representative sample. Logistic regression analysis was conducted to investigate the factors related to sexual debut, associations of condom nonuse and subject characteristics. Among male adolescents, age, early age at first emission, low academic achievement, living with a step-parent, perceived low level of household income, frequent drinking and smoking, and depressive feelings were associated with early sexual debut. Attending a coeducational school, living with a single biological parent and step-parent, risky health behaviour such as drinking and smoking, and depressive feelings were related risks factors for early sexual debut among female students. Factors associated with condom nonuse included early sexual debut (less than 16 years of age) (odds ratio (OR)=1.79, 95% confidence interval (CI)=1.32-2.43) and frequent smoking behaviour (OR=1.49, 95% CI=1.08-2.05) for males and early sexual debut (OR=4.37, 95% CI=1.02-18.68) and frequent drinking (OR=2.05, 95% CI=1.12-3.75) for females. Appropriate interventions should be implemented for adolescents in Korea to delay sexual debut and educate them on the proper use of condoms.
Mola, Rachel; Pitangui, Ana Carolina Rodarti; Barbosa, Sháyra Anny Moura; Almeida, Layane Sá; Sousa, Mayara Ruth Marinho de; Pio, Wellypâmela Pauliny de Lima; Araújo, Rodrigo Cappato de
To determine the association between not using the male condom and alcohol consumption in adolescents and schoolchildren. An epidemiological study, with a cross-sectional, descriptive, and correlation design carried out from March to July 2014. The sample consisted of students in public primary and secondary education, aged between 12 and 24 years. The social and demographic survey and the Youth Risk Behavior Survey questionnaire were used. The study included 1,275 students, of these; 37.0% reported having had sexual relations. The prevalent age of sexual initiation was 14-16 years 55.7% and 65.6% used condom in the last sexual intercourse. Regarding the lack of condom use at the last intercourse, girls showed an association with drunkenness in the previous 30 days (2.19; 95%CI: 1.06-4.54). In females, the non-use of condoms was associated with drunkenness in the previous 30 days. Identificar os fatores associados ao não uso de preservativo masculino e ao consumo de bebida alcoólica em adolescentes e jovens escolares. Estudo epidemiológico, com delineamento transversal, descritivo e correlacional, desenvolvido de março a julho de 2014. A amostra foi composta por estudantes dos Ensinos Fundamental e Médio da rede pública estadual, com idades entre 12 e 24 anos. Empregaram-se o inquérito sociodemográfico e o questionário Youth Risk Behavior Survey. Foram incluídos 1.275 estudantes; 37,0% deles relataram terem tido relação sexual. A idade prevalente de iniciação sexual foi de 14 a 16 anos, com 55,7%; 65,6% usaram preservativo na última relação. Com relação ao não uso de preservativo na última relação, as meninas apresentaram associação com bebedeira nos últimos 30 dias (2,19; IC95%: 1,06-4,54). O não uso de preservativos esteve associado com bebedeira nos últimos 30 dias nas meninas.
Lopez, Laureen M; Otterness, Conrad; Chen, Mario; Steiner, Markus; Gallo, Maria F
Unprotected sex is a major risk factor for disease, disability, and mortality in many areas of the world due to the prevalence and incidence of sexually transmitted infections (STI) including HIV. The male condom is one of the oldest contraceptive methods and the earliest method for preventing the spread of HIV. When used correctly and consistently, condoms can provide dual protection, i.e., against both pregnancy and HIV/STI. We examined comparative studies of behavioral interventions for improving condom use. We were interested in identifying interventions associated with effective condom use as measured with biological assessments, which can provide objective evidence of protection. Through September 2013, we searched computerized databases for comparative studies of behavioral interventions for improving condom use: MEDLINE, POPLINE, CENTRAL, EMBASE, LILACS, OpenGrey, COPAC, ClinicalTrials.gov, and ICTRP. We wrote to investigators for missing data. Studies could be either randomized or nonrandomized. They examined a behavioral intervention for improving condom use. The comparison could be another behavioral intervention, usual care, or no intervention. The experimental intervention had an educational or counseling component to encourage or improve condom use. It addressed preventing pregnancy as well as the transmission of HIV/STI. The focus could be on male or female condoms and targeted to individuals, couples, or communities. Potential participants included heterosexual women and heterosexual men.Studies had to provide data from test results or records on a biological outcome: pregnancy, HIV/STI, or presence of semen as assessed with a biological marker, e.g., prostate-specific antigen. We did not include self-reported data on protected or unprotected sex, due to the limitations of recall and social desirability bias. Outcomes were measured at least three months after the behavioral intervention started. Two authors evaluated abstracts for eligibility and
Liu, Hongjie; Kennedy, May; Liu, Hui; Hong, Fuchang; Ha, Toan; Ning, Zheng
Money boys (MBs) are male sex workers who sell sex to men who have sex with men. The objectives of this study were to assess (a) the sexual HIV risk of MBs; (b) the ability of the theory of planned behaviour (TPB) to predict MBs' intentions to use condoms; and (c) the manner in which TPB constructs (attitudes towards condom use, subjective norms and perceived behavioural control) combine to influence condom use intentions. Participants came from 10 MB-frequented clubs in two cities in China. Multiple regression and path analytic models were used to test inter-relationships among the TPB constructs. Seventy-eight percent of the 122 MB participants reported having used condoms for every anal sex act. About one-third reported having had female sexual partners in the past 2 months; of these MBs, half (53%) used condoms for every sex act. A revised model using TPB constructs accounted for 52% of the variance of condom use intentions and revealed that perceived behavioural control was a mediator in pathways beginning with attitudes and ending with condom use intentions, and beginning with subjective norms and ending with intentions. The findings suggest that a revised model of TPB applies to condom use intentions among Chinese MBs. It may be appropriate to adapt HIV interventions that are grounded in TPB and that have been shown to be effective elsewhere for use with Chinese MBs. HIV interventions for this population should give perceived behavioural control and its predictors special consideration.
A comparative study was design to assess quality of condoms by comparing the physical parameters, packaging and labeling standards of the condoms from retail outlets and the Service Delivery Points in accordance with the Standards as Prescribed in the official monographs. Methods: 4 batches of condoms from public ...
AJRH Managing Editor
23408033565210 ... 20.5±2.4, 62.0% ever used condom and 49.5% currently using condom. ... Condom use among unmarried male youths in Nigeria is low. .... reported that the commonest reason for non- .... cigarettes, covered by health insurance, recent.
Objectives: Despite widespread knowledge that condoms offer protection against STIs/HIV when used correctly and consistently, many young people do not regularly use condoms, thus leading to new sexually transmitted infections, including HIV and AIDS. This study explored condom use behaviour, specifically the extent ...
Conclusion: The reported prevalence of ever use of a condom amongst antenatal clinic attendees is low and inconsistent especially among HIV positive women. Deliberate effort should be used to ensure condom access, availability and correct and consistent use of condoms by women in all sexual acts.
Background: Correct and consistent use of condoms has been reported as effective in the prevention of transmission of HIV. There have been many studies reporting on attitudes (perceptions) of communities on condoms and other aspects of HIV and AIDS and yet there is paucity of data on the perception towards condoms ...
Lescano, Celia M; Vazquez, Elizabeth A; Brown, Larry K; Litvin, Erika B; Pugatch, David
This study examined adolescents' attitudes about and behaviors toward condom use with "casual" vs. "main" sexual partners. Participants were sexually active adolescents aged 15-21 years (n = 1316) recruited from primary care clinics and through outreach activities in three major cities in the United States. Assessment of condom use within the past 90 days, relevant attitudes, substance use, and demographic data were obtained via audio computer-assisted self-interview (ACASI). Participants were divided into two groups: the 65% who reported main partners only (MP group) and the 35% who had at least one casual partner (CP group). Adolescents in the MP group were more likely to be female, whereas males were significantly more likely to report casual partners. Race/ethnicity, age, education level, household income, and sexually transmitted infection (STI) history were unrelated to group status (i.e., sexual partner type). Greater substance use and riskier attitudes were reported by teens in the CP group. The number of unprotected sex acts in the past 90 days was substantial and equivalent between the main and casual partner groups (19.2 vs. 21.5, respectively). Regression analyses revealed that perceptions of main partner attitudes toward condom use and condom use expectations were significantly related to condom use with MPs, but that attitudes were not related to condom use with CPs. Adolescents with either casual or main partners may be at continued risk for contracting human immunodeficiency virus (HIV) and STIs, given high rates of unprotected sex. Interventions that do not target attitudes and practices related to casual partners as compared with main partners may miss an opportunity to change risk behaviors. This study demonstrates the importance of understanding an adolescent's perception of partner types in order to design effective interventions.
Kaplan, Herb; Houlberg, Rick
Examines a San Francisco television station's decision to accept paid condom advertising. Notes that station leaders debated questions of public interest and public tastes in a city hard hit by AIDS. Finds that the station devised careful guidelines and began broadcasting the commercials on a trial basis. Notes that nearly all public and media…
... t know how to put it on." This one's easy: "Here, let me show you." Timing After you've familiarized yourself with condoms and practiced your routine, you'll want to pick the right time to bring up the subject with your ...
Lennart P. Maljaars
Full Text Available Background: Approximately 3 million adolescents and young adults (AYA, between the ages of 15 years and 24 years, are living with HIV in sub-Saharan Africa. The use of pre-exposure prophylaxis (PrEP may be a promising HIV prevention tool to bridge the high-risk years of AYA between sexual debut and adulthood. Objectives: Concerns have been raised that the use of PrEP could lead to an increase in sexual risk behaviour and sexually transmitted infections in general and less condom use in particular among adolescents. Methods: This study assesses condom use among South African adolescents enrolled on a demonstration PrEP study, called Pluspills, being conducted in Cape Town and Soweto. A questionnaire on sexual risk behaviour was administered at baseline and after 4, 8 and 12 weeks. Three different questions on condom use were asked at each visit. Unless all answers indicated condom use at all times, a participant was scored ‘at risk’. McNemar’s tests and a Cochran’s Q test were used to investigate changes in condom use over time. Results: We interviewed 148 adolescents (66% female at baseline. Eighty-nine participants completed all visits. In this group, an increase in condom use was observed over the period of 12 weeks. Most participants who reported behavioural changes mentioned an increase in condom use. Conclusion: There was no sign of sexual risk compensation in the 12 weeks of the study. Observed increase in condom use can be explained by an increased awareness of personal HIV risk or by social desirability or recall biases. In future research, additional data including other biomarkers of unprotected sex and longer follow-up time would be useful to help understand the relationship between PrEP use, sexual risk perception and consequent behaviours, especially in adolescents.
Shilo, Guy; Mor, Zohar
In Israel, as in other industrialized countries, the age of sexual debut among adolescents has declined, and the rate of sexually transmitted infections (STI) has risen, but the motivations and attitudes of Israeli adolescents toward carrying condoms have yet to be studied. The aims of this study were to establish the associations (if any) between demographic characteristics and the knowledge held by Jewish Israeli adolescents about HIV transmission, their attitudes toward condom use and sexual experience, and to explore their recommendations to increase condom use. The method used was an analysis of sexual experience and practices, attitudes toward condom carrying and condom use among a national representative sample of Jewish adolescents aged 15-18. Two dichotomized measures were assessed: (i) sexual experience (defined as having had previous consensual oral/vaginal/anal sex); and (ii) the practice of carrying a condom on a regular basis. Of all 410 participants, 14.6% carried condoms, 18.3% had sexual experience, and 70.7% of those used condoms. Those who thought condoms to be protective against HIV, and those who thought they are difficult to wear, were more likely to have sexual experience. The perception of condom use as important, and the perception that condoms are difficult to wear, were predictors of condom carrying. The participants' knowledge of the risk of HIV in vaginal intercourse was deficient. Participants did not consider school sex education to be effective in promoting condom use, and recommended the use of graphic, deterrent personal accounts told by youths to encourage wider use of condoms. Health educators should consider the barriers cited by adolescents and the deterrent techniques they recommend when planning interventions to encourage condom use. © 2015 International Society for Sexual Medicine.
Collado, Anahí; Johnson, Patrick S; Loya, Jennifer M; Johnson, Matthew W; Yi, Richard
The study examined sexual delay discounting, or the devaluation of condom-protected sex in the face of delay, as a risk factor for sexually transmitted infection (STI) among college students. Participants (143 females, 117 males) completed the sexual delay discounting task (Johnson & Bruner, 2012) and questionnaires of risky sexual behavior, risk perception, and knowledge. Participants exhibited steeper sexual delay discounting (above and beyond general likelihood of having unprotected sex) when partners were viewed as more desirable or less likely to have a STI, with males demonstrating greater sexual delay discounting than females across most conditions. Importantly, greater self-reported risky sexual behaviors were associated with higher rates of sexual delay discounting, but not with likelihood of using a condom in the absence of delay. These results provide support for considering sexual delay discounting, with particular emphasis on potential delays to condom use, as a risk factor for STI among college students.
Planes, Montserrat; Gras, M Eugenia; Cunill, Mónica; Cassamo, Hachimo; Sullman, Mark J M; Gómez, Ana B
The main aim of the current study was to compare Spanish and Mozambican male and female secondary students, with regard to sexual behaviors and perceptions surrounding the acceptance of condom use. The participants were 773 secondary students-412 from Spain and 361 from Mozambique, aged from 15 to 17 years old. Data collection was done using questionnaires. Analysis was carried out using multivariate methods. Spanish adolescents took more precautions than Mozambican adolescents. Furthermore, Spanish adolescents perceived that the acceptance of condom use by their referents were higher than those reported by the Mozambican adolescents. Among Spanish youths, only the perceived acceptance of their current partner predicted condom use in their most recent sexual encounter. Differences in the decision-making power of males and females and the type of partner might explain the differences observed in the preventive behavior of the students in both countries.
Fortenberry, J Dennis; Schick, Vanessa; Herbenick, Debby; Sanders, Stephanie A; Dodge, Brian; Reece, Michael
Data on adolescents' sexual and condom use behaviors provides an empirical basis for a range of social, educational, clinical, and public health endeavors. This study has two purposes: to describe the recent and lifetime prevalence of a variety of sexual behaviors; and, to describe factors associated with condom use at last penile-vaginal intercourse. Data included those from male (N = 414) and female (N = 406) adolescents (ages 14-17 years) from a nationally representative probability sample. Survey items addressed occurrence (past 90 days, past year, lifetime) of solo masturbation, partnered masturbation, oral sex given to a partner, oral sex received from a partner, vaginal intercourse, and anal intercourse. Participants reporting partnered sexual behaviors in the past year completed additional items about condom use, location of sex, partner characteristics, other sexual behaviors, and alcohol or marijuana use at the most recent sexual event. Adjusted rates (by gender) of sexual behaviors, and characteristics of most recent vaginal sex event as a function of condom use/non-use. Lifetime prevalence of solo masturbation was common for males (80%) and females (48%). Lifetime prevalence of penile-vaginal sex increased with each year of age for both adolescent men and women; however, penile-vaginal sex within the previous 90 days was much less frequently reported. Rates of condom use for penile-vaginal sex were 80% for males and 69% for females. Lifetime anal sex rates were 4.7% for males and 5.5% for females. Sexual behavior among adolescents was more prevalent and diverse in older adolescent cohorts. Condom use for penile-vaginal intercourse was reported for a majority of events. © 2010 International Society for Sexual Medicine.
Wang, Lian-Hong; Yan, Jin; Yang, Guo-Li; Long, Shuo; Yu, Yong; Wu, Xi-Lin
Money boys with inconsistent condom use (less than 100% of the time) are at high risk of infection by human immunodeficiency virus (HIV) or sexually transmitted infection (STI), but relatively little research has examined their risk behaviors. We investigated the prevalence of consistent condom use (100% of the time) and associated factors among money boys. A cross-sectional study using a structured questionnaire was conducted among money boys in Changsha, China, between July 2012 and January 2013. Independent variables included socio-demographic data, substance abuse history, work characteristics, and self-reported HIV and STI history. Dependent variables included the consistent condom use with different types of sex partners. Among the participants, 82.4% used condoms consistently with male clients, 80.2% with male sex partners, and 77.1% with female sex partners in the past 3 months. A multiple stepwise logistic regression model identified four statistically significant factors associated with lower likelihoods of consistent condom use with male clients: age group, substance abuse, lack of an "employment" arrangement, and having no HIV test within the prior 6 months. In a similar model, only one factor associated significantly with lower likelihoods of consistent condom use with male sex partners was identified in multiple stepwise logistic regression analyses: having no HIV test within the prior six months. As for female sex partners, two significant variables were statistically significant in the multiple stepwise logistic regression analysis: having no HIV test within the prior 6 months and having STI history. Interventions which are linked with more realistic and acceptable HIV prevention methods are greatly warranted and should increase risk awareness and the behavior of consistent condom use in both commercial and personal relationship. © 2015 International Society for Sexual Medicine.
U.S. condom manufacturers are receiving competition from high quality Japanese products. However, the sale of a plastic polyurethane condom by U.S. manufacturer, London International, could potentially outsell Japanese ultra-thin condoms. The polyurethane products can be made at a uniform thinness, resulting in a more sensitive condom. Industry analysts are not sure about the impact of a plastic condom. Some feel that even if they prove to be safer than latex condoms, polyurethane condoms will have a difficult time competing against established brands. Others feel that if consumer response is positive, the potential profits provide a strong incentive for companies to invest in the efficacy studies and marketing of a polyurethane product.
Prata, Ndola; Morris, Leo; Mazive, Elizio; Vahidnia, Farnaz; Stehr, Mark
The relationship between individuals' perception of their risk for acquiring HIV and their use of condoms is poorly understood. Understanding this relationship is crucial to the development of effective strategies to fight HIV and AIDS. Data from the Mozambique 2001 Adolescent and Young Adult Reproductive Health and Behavior Risk Survey are used to compare 15-24-year-olds' assessments of their HIV risk with assessments based on current and past sexual behavior. In bivariate and probit regression analyses, the relationship between correct risk assessment and the likelihood of condom use at last intercourse is examined. Twenty-seven percent of women and 80% of men who considered themselves to have no risk or a small risk of contracting HIV were actually at moderate or high risk. For both men and women, the prevalence of condom use at last sex was more than twice as high among those who assessed their risk correctly (30% and 16%, respectively) as among those who did not (14% and 6%). Multivariate analysis showed that correct assessment was positively associated with condom use; the association was driven by use among never-married individuals. Never-married males who assessed their risk correctly were 18% more likely than other males to report condom use; never-married females, 17% more likely than other females. Educational messages should aim at enabling individuals to correctly assess their own HIV risk and encouraging behavior change based on self-assessment of risk.
Grimley, D M; Prochaska, J O; Velicer, W F; Prochaska, G E
The Transtheoretical Model of Behavior Change was examined for its applicability to contraceptive and condom use adoption and maintenance using N = 248 heterosexually active college-age men and women. The model posits that individuals do not go directly from old behaviors to new behaviors to new behaviors, but progress through a sequence of stages: precontemplation, contemplation, preparation, action, and maintenance. The stages of change offer a temporal dimension that provides information regarding when a particular shift in attitudes, intentions, and behavior may occur. The model also postulates a set of or outcome variables--the pros and cons of change and self-efficacy. The results demonstrated that individuals were furthest along in the stages of change for general contraceptive use, followed closely by condom use with other (e.g., casual) partners, and then condom use with main partners. Although no sex differences were found for the stages for the three separate contraceptive behaviors, males and females differed on the pros and cons and levels of self-efficacy when engaging in intercourse with the two types of partners. MANOVA/ANOVA results indicated that the relationship between stages and other constructs follows predicted patterns suggesting that the transtheoretical model may provide a useful framework or paradigm for understanding contraceptive and condom use behavior.
Harris, A O; Jubwe, S; Kennedy, S B; Taylor, C H; Martin, R B; Bee, E M; Perry, O S; Massaquoi, M T; Woods, D V; Barbu, E M
Youths in sub-Saharan Africa (SSA) account for a large burden of the global HIV/STI crises. As such, strategies directed at promoting behavioral modifications would be critical to reducing the prevalence of risky sexual behaviors among high risk adolescents in post-conflict environments. This study describes a condom promotion strategy to prevent HIV/STIs among highly vulnerable urban youth in a post-conflict, resource-constrained environment via the provision of both male and female condoms to nontraditional venues like music and photo shops, ice cream parlors, money exchange centers and beauty salons. Community members in the designated catchment areas volunteered their services and the use of their small businesses to support this endeavor. In this paper, we describe the condom promotion strategy and its implications within the context of a community-based participatory social marketing program to prevent risky sexual behaviors among highly vulnerable urban youth in a post-conflict country. We postulate that this approach may likely increase condom use among urban youth in Monrovia, the capital city of Liberia.
Hernandez-Giron, C A; Cruz-Valdez, A; Quiterio-Trenado, M; Uribe-Salas, F; Peruga, A; Hernández-Avila, M
Sexually transmitted diseases (STDs) are an important public health problem, due to their medical, social and economic repercussions. Therefore, more knowledge is needed about the sexual behaviour that promotes their spread, in order to improve control and prevention strategies. Our aim was to determine the frequency of male condom use associated with sexual behaviour factors, a history of and knowledge about STDs in a sample of the male population in Mexico City. During 1994 a cross-sectional epidemiological study was carried out, using multi-stage sampling with conglomerates, in 1377 men from 15 to 49 years old. The mean age was 34.5 years (SD 7.5 years). Mean age at first sexual relations was 17.7 years (SD 2.8 years). The global proportion of condom use during the last sexual relation was 24.6%; use according to type of female sex partner in the last year was 18.8% with regular partners and 62.5% with occasional partners. The principal predictors of male condom use, identified through statistical modelling, were: younger age (9 years), middle and high socioeconomic level and type of sexual partners (occasional and regular). This population has risk factors for acquiring and transmitting some STDs, such as occasional sexual partners and a history of STDs. Characteristics which are important in relation to male condom use were identified, such as age (younger than 35), education (complete junior high school or more) and type of sexual partners (occasional and regular).
Everett, S A; Warren, C W; Santelli, J S; Kann, L; Collins, J L; Kolbe, L J
To examine the use of contraception at last sexual intercourse among currently sexually active adolescents. We analyzed data from national school-based Youth Risk Behavior Surveys (YRBS) conducted in 1991, 1993, 1995, and 1997. The YRBS is a self-administered, anonymous survey which uses a national probability sample of U.S. students in public and private schools from grades 9 through 12. From 1991 to 1997, condom use significantly increased (from 46% to 57%), birth control pill use decreased (from 21% to 17%), and use of withdrawal significantly decreased (from 18% to 13%). In 1997, although more students were using condoms, 13% reported using withdrawal and 15% reported using no method to prevent pregnancy at last sexual intercourse. In 1997, condom use among females was significantly lower in the 9th grade than in the 12th grade (p birth control pill use was higher (p birth control pill use by their partner increased (p schools, and other influential societal institutions should promote the correct and continued use of condoms as essential protection against sexually transmitted diseases and human immunodeficiency virus infection.
Full Text Available Abstract Background HIV/AIDS remains being a disease of great public health concern worldwide. In regions such as sub-Saharan Africa (SSA where women are disproportionately infected with HIV, women are reportedly less likely capable of negotiating condom use. However, while knowledge of condom use for HIV prevention is extensive among men and women in many countries including Tanzania, evidence is limited about the role of condom negotiation on condom use among women in rural Tanzania. Methods Data originate from a cross-sectional survey of random households conducted in 2011 in Rufiji, Kilombero and Ulanga districts in Tanzania. The survey assessed health-seeking behaviour among women and children using a structured interviewer-administered questionnaire. A total of 2,614 women who were sexually experienced and aged 15-49 years were extracted from the main database for the current analysis. Linkage between condom negotiation and condom use at the last sexual intercourse was assessed using multivariate logistic regression. Results Prevalence of condom use at the last sexual intercourse was 22.2% overall, ranging from12.2% among married women to 54.9% among unmarried (single women. Majority of the women (73.4% reported being confident to negotiate condom use, and these women were significantly more likely than those who were not confident to have used a condom at the last sexual intercourse (OR = 3.13, 95% CI 2.22-4.41. This effect was controlled for marital status, age, education, religion, number of sexual partners, household wealth and knowledge of HIV prevention by condom use. Conclusion Confidence to negotiate condom use is a significant predictor of actual condom use among women in rural Tanzania. Women, especially unmarried ones, those in multiple partnerships or anyone needing protection should be empowered with condom negotiation skills for increased use of condoms in order to enhance their sexual and reproductive health outcomes.
Exavery, Amon; Kanté, Almamy M; Jackson, Elizabeth; Noronha, John; Sikustahili, Gloria; Tani, Kassimu; Mushi, Hildegalda P; Baynes, Colin; Ramsey, Kate; Hingora, Ahmed; Phillips, James F
HIV/AIDS remains being a disease of great public health concern worldwide. In regions such as sub-Saharan Africa (SSA) where women are disproportionately infected with HIV, women are reportedly less likely capable of negotiating condom use. However, while knowledge of condom use for HIV prevention is extensive among men and women in many countries including Tanzania, evidence is limited about the role of condom negotiation on condom use among women in rural Tanzania. Data originate from a cross-sectional survey of random households conducted in 2011 in Rufiji, Kilombero and Ulanga districts in Tanzania. The survey assessed health-seeking behaviour among women and children using a structured interviewer-administered questionnaire. A total of 2,614 women who were sexually experienced and aged 15-49 years were extracted from the main database for the current analysis. Linkage between condom negotiation and condom use at the last sexual intercourse was assessed using multivariate logistic regression. Prevalence of condom use at the last sexual intercourse was 22.2% overall, ranging from12.2% among married women to 54.9% among unmarried (single) women. Majority of the women (73.4%) reported being confident to negotiate condom use, and these women were significantly more likely than those who were not confident to have used a condom at the last sexual intercourse (OR = 3.13, 95% CI 2.22-4.41). This effect was controlled for marital status, age, education, religion, number of sexual partners, household wealth and knowledge of HIV prevention by condom use. Confidence to negotiate condom use is a significant predictor of actual condom use among women in rural Tanzania. Women, especially unmarried ones, those in multiple partnerships or anyone needing protection should be empowered with condom negotiation skills for increased use of condoms in order to enhance their sexual and reproductive health outcomes.
AugsJoost, Brett; Jerman, Petra; Deardorff, Julianna; Harley, Kim; Constantine, Norman A
Expanding condom-related knowledge and skills and reducing barriers to condom use have the potential to help reduce pregnancies and sexually transmitted infections among youth. These goals are sometimes addressed through condom education and availability (CEA) programs as part of sexuality education in school. Parents are a key constituency in efforts to implement such programs. A representative statewide sample of households with children (N = 1,093) in California was employed to examine parent support for CEA and the potential influences of demographics (gender, age, and Hispanic ethnicity), sociodemographics (education, religious affiliation, religious service attendance, and political ideology), and condom-related beliefs (belief in condom effectiveness and belief that teens who use condoms during sex are being responsible) on parent support for CEA. The parents in our sample reported a high level of support for CEA (M = 3.23 on a 4-point scale) and believing in a high level of condom effectiveness (M = 3.36 on a 4-point scale). In addition, 84% of the parents agreed that teens who use condoms during sex are being responsible. Hierarchical regression analyses showed that parents who were younger, Hispanic, with a lower educational attainment, without a religious affiliation, less religiously observant, and politically liberal were more supportive of CEA. After controlling for these demographic and sociodemographic factors, condom effectiveness and responsibility beliefs each added independently to the predictability of parent support for CEA. These findings suggest that parent education related to condom effectiveness could help increase support for school-based CEA programs.
Evans, W Douglas; Taruberekera, Noah; Longfield, Kim; Snider, Jeremy
Zimbabwe suffers from one of the greatest burdens of HIV/AIDS in the world that has been compounded by social and economic instability in the past decade. However, from 2001 to 2009 HIV prevalence among 15-49 year olds declined from 26% to approximately 14%. Behavior change and condom use may in part explain this decline.PSI-Zimbabwe socially markets the Protector Plus (P+) branded line of condoms. When Zimbabwe converted to a dollar-based economy in 2009, the price of condoms was greatly increased and new marketing efforts were undertaken. This paper evaluates the role of condom marketing, a multi-dimensional scale of brand peceptions (brand equity), and price in condom use behavior. We randomly sampled sexually active men age 15-49 from 3 groups - current P+ users, former users, and free condom users. We compared their brand equity and willingness to pay based on survey results. We estimated multivariable logistic regression models to compare the 3 groups. We found that the brand equity scale was positive correlated with willingness to pay and with condom use. Former users also indicated a high willingness to pay for condoms. We found differences in brand equity between the 3 groups, with current P+ users having the highest P+ brand equity. As observed in previous studies, higher brand equity was associated with more of the targeted health behavior, in this case and more consistent condom use. Zimbabwe men have highly positive brand perceptions of P+. There is an opportunity to grow the total condom market in Zimbabwe by increasing brand equity across user groups. Some former users may resume using condoms through more effective marketing. Some free users may be willing to pay for condoms. Achieving these objectives will expand the total condom market and reduce HIV risk behaviors.
The aim of the study is to investigate knowledge and sexual practices with reference to correct use of condoms among first year South African University students. The sample consisted of 206 participants, 146 female and 60 male, the mean age was 20.9 years (SD=3.4), with a range from 17 to 34 years. Results indicated that one third (29.2%) of the sample reported never using condoms, 35.4% always, 19.8% regularly and 8.5% irregularly in the past three months. About 90% levels of correct answer...
Teye-Kwadjo, Enoch; Kagee, Ashraf; Swart, Hermann
Background Growing cross-sectional research shows that the theory of planned behaviour (TPB) is robust in predicting intentions to use condoms and condom use behaviour. Yet, little is known about the TPB’s utility in explaining intentions to use condoms and condom use behaviour over time. Methods This study used a longitudinal design and latent variable structural equation modelling to test the longitudinal relationships postulated by the TPB. School-going youths in Ghana provided data on attitudes, subjective norms, perceived control, intentions, and behaviour regarding condom use at three-time points, spaced approximately three-months apart. Results As predicted by the TPB, the results showed that attitudes were significantly positively associated with intentions to use condoms over time. Contrary to the TPB, subjective norms were not significantly associated with intentions to use condoms over time. Perceived control did not predict intentions to use condoms over time. Moreover, intentions to use condoms were not significantly associated with self-reported condom use over time. Conclusion These results suggest that school-going youths in Ghana may benefit from sex education programmes that focus on within-subject attitude formation and activation. The theoretical and methodological implications of these results are discussed. PMID:27925435
Caouette, Justin D; Hudson, Karen A; Bryan, Angela D; Feldstein Ewing, Sarah W
To reduce rates of sexually transmitted infections (STIs) and unwanted pregnancy among adolescents, it is critical to investigate brain connectivity that may underlie adolescents' sexual health decision-making in the context of intercourse. This study explored relationships between adolescent condom use frequency and the brain's resting-state functional connectivity, to identify differential patterns of social-affective processing among sexually active youth. In this study, N = 143 sexually active adolescents (68.5% male, Mage = 16.2 years, SD = 1.06) completed magnetic resonance imaging and reported past 3-month frequency of condom use. Resting-state connectivity, seeded on a social region of the brain, the temporoparietal junction (TPJ), was assessed to determine its correspondence with protected sex (condom use). Condom use was associated with positive connectivity between the left TPJ and bilateral inferior frontal gyrus (IFG). This relationship was observed in adolescent males only; no connectivity differences were observed with adolescent females. This study reflects functional synchrony between nodes of the "social brain," including the TPJ, and a region of planfulness and control, the IFG. The relationship between these regions suggests that adolescents who have more coordinated systems of communication between these critical components of the brain are more likely to be successful in planning and engaging in safer sexual decision-making; for young males, this differentiated more frequent from less frequent condom use. In turn, interventions designed to reduce STIs/human immunodeficiency virus may benefit from targeting social-planfulness dimensions to help youth implement safer sex behaviors.
may engage in risky sexual behaviours, such as having unprotected sex with sex workers .4 Furthermore, studies have found high HIV risk- taking...did not use a condom the last time they had sex with a sex worker . 11 And in the 1Naval Health Research Center, Department of Defense HIV /AIDS...only found in 16-20% of participants,7 and 41% did not use a condom the last time they had sex with a sex worker .4 In the Rwanda Defence Forces, 24
Bergmann, Julie N; Stockman, Jamila K
Intimate partner violence (IPV) is estimated to affect 25% of adult women in the United States alone. IPV directly impacts women's ability to use contraception, resulting in many of unintended pregnancies and STIs. This review examines the relationship between IPV and condom and oral contraceptive use within the United States at two levels: the female victim's perspective on barriers to condom and oral contraceptive use, in conjunction with experiencing IPV (Aim 1) and the male perpetrator's perspective regarding condom and oral contraceptive use (Aim 2). We systematically reviewed and synthesized all publications meeting the study criteria published since 1997. We aimed to categorize the results by emerging themes related to each study aim. We identified 42 studies that met our inclusion criteria. We found 37 studies that addressed Aim 1. Within this we identified three themes: violence resulting in reduced condom or oral contraceptive use (n=15); condom or oral contraceptive use negotiation (n=15); which we further categorized as IPV due to condom or oral contraceptive request, perceived violence (or fear) of IPV resulting in decreased condom or oral contraceptive use, and sexual relationship power imbalances decreasing the ability to use condoms or oral contraceptives; and reproductive coercion (n=7). We found 5 studies that addressed Aim 2. Most studies were cross-sectional, limiting the ability to determine causality between IPV and condom or oral contraceptive use; however, most studies did find a positive relationship between IPV and decreased condom or oral contraceptive use. Quantitative, qualitative, and mixed methods research has demonstrated the linkages between female IPV victimization/male IPV perpetration and condom or oral contraceptive use. However, additional qualitative and longitudinal research is needed to improve the understanding of dynamics in relationships with IPV and determine causality between IPV, intermediate variables (e
Full Text Available Sustained or consistent use of condoms by men remains a challenge. A study was carried out to identify factors associated with failure to use condoms consistently by men attending STD clinics in Pune, India.Among 14137 STI clinic attendees, 8360 HIV sero-negative men were enrolled in a cohort study. The changes in condom usage behavior were studied among 1284 men who returned for first scheduled quarterly follow up, 309 reported consistent condom use at the time of enrollment in the cohort. Data pertaining to heterosexual men practicing high risk behavior were analyzed to identify factors associated with change in condom use behavior using logistic regression model. Demographic, behavioral and biological factors observed to be associated with condom use were fitted in five Cox proportional hazards models to calculate hazard ratios and their 95% confidence intervals to identify independent predictors of failure to sustain condom use behavior.The univariate analysis showed that men who were 30 years or older in age (p = 0.002 and those who did not have contact female sex worker (FSW were more likely to fail to sustain consistent condom use. However both these factors did not show significant association in multivariable analysis. Marital status and contact with Hijra (eunuch in lifetime were associated with failure to change in their condom use behavior [AOR 0.33 (CI 0.13-0.82; p = 0.017]. During the follow up of 2 years, 61 events (15.5 per 100 person years, 95% CI 12.3-19.5 years of 'failure of condom use' were recorded despite counseling. Older age, contact with non CSW partner and presence of genital ulcer disease / discharge syndrome were significant predictors of failure to sustain condom use.Married monogamous older men, who report contact with sex worker and present with genital ulcer disease are at risk of failure to use condom after first exposure to voluntary HIV counseling and testing. This is a scenario of primary prevention program
Martin, D J
Use of condoms has been advocated as an important method of reducing the risk of human immunodeficiency virus (HIV) transmission among high-risk groups such as homosexual and bisexual men, prostitutes, intravenous drug users, adolescents, and hemophiliacs. Despite risk-reduction education campaigns directed to gay men since the early 1980s, evidence shows continued deficits in condom-use skills and knowledge among gay men. Because most failures in the use of condoms are attributed to errors i...
Full Text Available Abstract Background A number of studies from countries with severe HIV epidemics have found gaps in condom availability, even in places where there is a substantial potential for HIV transmission. Although reported condom use has increased in many African countries, there are often big differences by socioeconomic background. The aim of this study was to assess equity aspects of condom availability and uptake in three African districts to evaluate whether condom programmes are given sufficient priority. Methods Data on condom availability and use was examined in one district in Kenya, one in Tanzania and one in Zambia. The study was based on a triangulation of data collection methods in the three study districts: surveys in venues where people meet new sexual partners, population-based surveys and focus group discussions. The data was collected within an overall study on priority setting in health systems. Results At the time of the survey, condoms were observed in less than half of the high risk venues in two of the three districts and in 60% in the third district. Rural respondents in the population-based surveys perceived condoms to be less available and tended to be less likely to report condom use than urban respondents. Although focus group participants reported that condoms were largely available in their district, they expressed concerns related to the accessibility of free condoms. Conclusion As late as thirty years into the HIV epidemic there are still important gaps in the availability of condoms in places where people meet new sexual partners in these three African districts. Considering that previous studies have found that improved condom availability and accessibility in high risk places have a potential to increase condom use among people with multiple partners, the present study findings indicate that substantial further efforts should be made to secure that condoms are easily accessible in places where sexual relationships are
Sandøy, Ingvild Fossgard; Blystad, Astrid; Shayo, Elizabeth H; Makundi, Emmanuel; Michelo, Charles; Zulu, Joseph; Byskov, Jens
A number of studies from countries with severe HIV epidemics have found gaps in condom availability, even in places where there is a substantial potential for HIV transmission. Although reported condom use has increased in many African countries, there are often big differences by socioeconomic background. The aim of this study was to assess equity aspects of condom availability and uptake in three African districts to evaluate whether condom programmes are given sufficient priority. Data on condom availability and use was examined in one district in Kenya, one in Tanzania and one in Zambia. The study was based on a triangulation of data collection methods in the three study districts: surveys in venues where people meet new sexual partners, population-based surveys and focus group discussions. The data was collected within an overall study on priority setting in health systems. At the time of the survey, condoms were observed in less than half of the high risk venues in two of the three districts and in 60% in the third district. Rural respondents in the population-based surveys perceived condoms to be less available and tended to be less likely to report condom use than urban respondents. Although focus group participants reported that condoms were largely available in their district, they expressed concerns related to the accessibility of free condoms. As late as thirty years into the HIV epidemic there are still important gaps in the availability of condoms in places where people meet new sexual partners in these three African districts. Considering that previous studies have found that improved condom availability and accessibility in high risk places have a potential to increase condom use among people with multiple partners, the present study findings indicate that substantial further efforts should be made to secure that condoms are easily accessible in places where sexual relationships are initiated. Although condom distribution in drinking places has been
Rich, Antonia; Mullan, Barbara A; Sainsbury, Kirby; Kuczmierczyk, Andrzej R
To examine how the prediction of condom-related cognitions, intentions, and behaviour amongst adolescents may differ according to gender and sexual experience within a theory of planned behaviour (TPB) framework. Adolescents (N = 306) completed questionnaires about sexual experience, condom use, TPB variables, perceived risk, and safe sex knowledge. Significant differences in TPB variables, perceived risk, and knowledge were found; males and sexually experienced participants were generally less positive about condom use. Twenty percent of the variance in attitudes was accounted for by four variables; specifically, female gender, no previous sexual experience, better safe sex knowledge, and greater risk perceptions were associated with more positive attitudes. The prediction of intentions separately amongst sexually experienced (R(2) = 0.468) and inexperienced (R(2) = 0.436) participants revealed that, for the former group, attitudes and subjective norms were the most important considerations. In contrast, among the inexperienced participants, attitudes and the gender-by-perceived risk interaction term represented significant influences. The results suggest that interventions designed to improve adolescents' intentions to use condoms and rates of actual condom use should consider differences in gender and sexual experience.
Norris, Jeanette; George, William H.; Morrison, Diane M.; Zawacki, Tina; Davis, Kelly Cue; Hessler, Danielle M.
This experiment examined relationships among adulthood victimization, sexual assertiveness, alcohol intoxication, and sexual risk-taking in female social drinkers (N = 161). Women completed measures of sexual assault and intimate partner violence history and sexual assertiveness before random assignment to 1 of 4 beverage conditions: control, placebo, low dose (.04%), or high dose (.08%). After drinking, women read a second-person story involving a sexual encounter with a new partner. As protagonist of the story, each woman rated her likelihood of condom insistence and unprotected sex. Victimization history and self-reported sexual assertiveness were negatively related. The less sexually assertive a woman was, the less she intended to insist on condom use, regardless of intoxication. By reducing the perceived health consequences of unprotected sex, intoxication indirectly decreased condom insistence and increased unprotected sex. Findings extend previous work by elucidating possible mechanisms of the relationship between alcohol and unprotected sex – perceived health consequences and situational condom insistence – and support the value of sexual assertiveness training to enhance condom insistence, especially since the latter relationship was robust to intoxication. PMID:18556139
Jin, Shan Shan; Bu, Kai; Chen, Fang Fang; Xu, Hui Fang; Li, Yi; Zhao, Dong Hui; Xu, Fang; Li, Jing Yan; Han, Meng Jie; Wang, Ning; Wang, Lu
To explore the predictors of condom-use self-efficacy in Chinese college students according to the extended parallel process model (EPPM)-based integrated model. A total of 3,081 college students were anonymously surveyed through self-administered questionnaires in Guangzhou and Harbin, China. A structural equation model was applied to assess the integrated model. Among the participants, 1,387 (46.7%) were male, 1,586 (53.3%) were female, and the average age was 18.6 years. The final integrated model was acceptable. Apart from the direct effect (r = 0.23), perceived severity had two indirect effects on condom-use self-efficacy through the attitude to HIV education (r = 0.40) and intention to engage in premarital sex (r = -0.16), respectively. However, the perceived susceptibility mediated through the intention to engage in premarital sex (intent-to-premarital-sex) had a poor indirect impact on condom-use self-efficacy (total effect was -0.06). Furthermore, attitude toward HIV health education (r = 0.49) and intent-to-premarital-sex (r = -0.31) had a strong direct effect on condom-use self-efficacy. In addition, male students perceived higher susceptibility, stronger intent-to-premarital-sex, and lower condom-use self-efficacy than female students. The integrated model may be used to assess the determinants of condom-use self-efficacy among Chinese college students. Future research should focus on raising the severity perception, HIV-risk-reduction motivation, and the premarital abstinence intention among college students. Furthermore, considering the gender differences observed in the present survey, single-sex HIV education is required in school-based HIV/sex intervention. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.
Muñoz-Silva, A; Sánchez-García, M; Nunes, C; Martins, A
There is much evidence that demonstrates that programs and interventions based on the theoretical models of the Theory of Reasoned Action (TRA) and the Theory of Planned Behaviour (TPB) have been effective in the prevention of the sexual transmission of HIV. The objective of this work is to compare the effectiveness of both models in the prediction of condom use, distinguishing two components inside the variable Perceived Behavioural Control of the TPB model: self-efficacy and control. The perspective of gender differences is also added. The study was carried out in a sample of 601 Portuguese and Spanish university students. The results show that the females have a higher average in all the TPB variables than males, except in the frequency of condom use: females request the use of condoms less frequently than males. On the other hand, for both females and males the TPB model predicts better condom-use intention than the TRA. However there are no differences between the two models in relation to the prediction of condom-use behaviour. For prediction of intention, the most outstanding variable among females is attitude, while among males they are subjective norm and self-efficacy. Finally, we analyze the implications of these data from a theoretical and practical point of view.
Full Text Available Compared to the general population, men who have sex with men (MSM are at greater risk for HIV and less understood due to their more hidden and stigmatized nature. Moreover, the discrepancy in findings in the literature merits further investigations in MSM populations from different cultures and settings. We therefore conducted this study to explore factors associated with inconsistent condom use among high-risk MSM in Cambodia.This cross-sectional study was conducted in 2014 among 367 MSM randomly selected from Battembang and Siem Reap using a two-stage cluster sampling method. A structured questionnaire was used for face-to-face interviews to collect information on characteristics of respondents, HIV testing history, self-perception of HIV risk, substance use, sexual behaviors, mental disorders, and HIV knowledge. Multivariable logistic regression analysis was performed to identify factors independently associated with inconsistent condom use.On average, 62.3% of respondents reported that they always used condoms over the past three months. The rates varied with types of sexual partners; the proportion of respondents who reported always using condoms was 55.1%, 64.2%, 75.9%, 73.0%, 78.1%, and 70.3%, for sexual partners who were girlfriends, boyfriends, female sex workers, male sex workers, female clients, or male clients, respectively. After adjustment, inconsistent condom use was significantly associated with age of ≥25 (AOR = 1.77, 95% CI = 1.09-2.86, self-rated quality of life as good or very good (AOR = 4.37, 95% CI = 1.79-5.67, self-perception of higher HIV risk compared to the general population (AOR = 2.37, 95% CI = 1.35-4.17, illicit drug use in the past three months (AOR = 5.76, 95% CI = 1.65-10.09, and reported consistent lubricant use when selling anal sex to men in the past three months (AOR = 2.85, 95% CI = 1.07-8.12.We found risky sexual behaviors to be considerably high among MSM in this study, especially among those who used
The condom industry in the US is dominated by Carter Wallace and the London International Group. They offer very little product differentiation. Ten years ago, however, two engineers in a small California laboratory began working on a nonlatex condom which would be both stronger and more sensitive than the traditional male latex condom. Their efforts resulted in the development of the polyurethane Avanti condom currently being marketed in thirteen states of the Western US. Made by London International Group plc in Cambridge, England, Avanti should be available nationwide as of April 1995. The public, however, has received only very little information about the product and the US Food and Drug Administration (FDA) is concerned about the safety and efficacy of polyurethane/plastic condoms. Six other condom manufacturers are developing plastic condoms, with at least five such condoms awaiting FDA premarket clearance to be marketed. Recent delays in marketing Avanti are due to disagreements between the manufacturer and the FDA over labeling. Other delays have involved safety and efficacy concerns. Bob Kohmescher, public health analyst with the US Centers for Disease Control office of the assistant director of HIV/AIDS, notes that even his agency is moving slower than expected on the polyurethane condom and has not reached a consensus over how to describe them. In the effort to protect themselves, FDA officials have insisted upon labeling which recommends plastic condoms for use by only people who are allergic to latex. These labeling guidelines, finalized in November, are so restrictive that some manufacturers cannot take their products to market. Despite these current FDA obstacles to bringing a higher quality condom to the US market, industry experts and health officials hope that the polyurethane and other plastic condoms will expand the practice of safer sex, while providing an alternative method of barrier protection for the estimated 1-2 million American adults
The Pressler Amendment, a law prohibiting US assistance to any country that does not sign the UN Nuclear Nonproliferation Treaty, is forcing USAID to shut down its highly successful Social Marketing of Contraceptives (SMC) program in Pakistan. Adopted in 1985, the amendment calls for an end of funding for projects in Pakistan as of fiscal year 1991, since the country has refused to sign the treaty. Only previously committed funds have kept SMC running, but it may soon have a close shop. The cutoff comes at an especially inopportune time--just when SMC had begun to make an impact. Introduced 5 years ago, Sathi condoms (the project's main product) account for 2/3 of all condoms used in Pakistan. Sales jumped from 30 million in 1978 to 74 million last year. SMC administrators explain that the country has a vast potential for social marketing. But because of the cutoff in aid, the program will exhaust its supply of condoms by March 1992. The end of the SMC program will mean a serious setback for Pakistan, which already has the 2nd largest population in southern Asia, and which has double the fertility of the most populous country in the region, India. Only 7% of the women in Pakistan rely on a modern method of contraception, compared to 42% in India and 26% in Bangladesh. USAID officials explain that the organization is working with the Pakistani government to find ways to continue funding the program after US funds run out. They add that this development will provide Pakistani Prime Minister Nawaz Sharif an opportunity to demonstrate his stated commitment to curb population growth.
Malebranche, David J; Gvetadze, Roman; Millett, Gregorio A; Sutton, Madeline Y
Gender role conflict may influence condom use among black MSM. We examined relationships between the Gender Role Conflict Scale (GRCS), social/demographic variables and condom use among 456 black MSM. Higher total GRCS scores did not predict unprotected insertive anal intercourse (UIAI) or unprotected receptive anal intercourse (URAI) with men, but were associated with unprotected vaginal or anal intercourse (UVI/UAI) with women among bisexually active participants (n = 69). Higher perceived HIV risk reduced the likelihood of both UIAI and URAI with men. Internet recruitment venues, sexual discrimination experiences, higher numbers of sex partners and UVI/UAI with women all increased the likelihood of UIAI with men, while education (college/technical school or college degree) was associated with URAI with men. Future sexual health interventions for black MSM should emphasize broader social/demographic and alternative gender role variables with male sexual partners, while traditional GRCS variables may prove useful among those with female sexual partners.
Kraus, Shane W.; Rosenberg, Harold
Objective: Investigate male college students' attitudes toward actors' use of condoms in pornography. Participants: Two hundred thirteen undergraduate males attending a large, state-supported midwestern university in the fall semester, 2012. Methods: Using a Web-based procedure, participants completed questionnaires assessing their pornography…
Sacco, William P.; And Others
Many heterosexuals have not altered their sexual practices in response to the threat of Acquired Immune Deficiency Syndrome (AIDS). Knowledge of risk alone appears to have little effect on altering sexual behavior; more complex psychological factors seem to be involved. Condom use to prevent the spread of Human Immunodeficiency Virus is a unique…
Walsh, Terri L; Frezieres, Ron G; Peacock, Karen; Nelson, Anita L; Clark, Virginia A; Bernstein, Leslie
To reduce unintended pregnancy and HIV infection, it is critical to develop reliable male condoms that will attract consumers who reject conventional latex condoms. In a prospective clinical trial conducted in 1998-2000, 830 monogamous couples were randomized in equal numbers to use either a nonlatex condom or a commercial natural latex condom for six months as their only method of birth control. Couples completed detailed reports for the first five condom uses and recorded intercourse and condom use in coital diaries. Pregnancy rates associated with typical and consistent condom use were calculated using life-table analysis. Rates of clinical failure (condom breakage or slippage) were determined for the first five condom uses. During the first five uses, the nonlatex condom had a higher frequency of breakage or slippage during intercourse or withdrawal (4.0%) than latex condoms (1.3%); the breakage rate for the nonlatex condom was about eight times that of latex condoms. The six-cycle typical-use pregnancy rate did not differ significantly between users of nonlatex (10.8%) and latex condoms (6.4%). The six-cycle consistent-use pregnancy rate was higher for nonlatex condom users than for latex condom users (4.9% vs. 1.0%). The data present strong indirect support for public health messages that promote the use of latex condoms and, for individuals who cannot or are unwilling to use latex condoms, the use of nonlatex condoms for prevention of pregnancy and disease.
Sep 13, 2017 ... barriers also differ as a function of gender, age, and culture. For example ... condom use are affected by explicit (Deliberate cognitions and intentions) ... ify predictors of condom use such as implicit attitudes toward condoms ...
Worldwide, it is increasingly recognized that sex occurs in prisons and this condition promotes HIV transmission among men. It is noted that in prisons, men usually engage in consensual or forced anal sex for lust, comfort, privileges or domination. This sexual behavior is one of the riskiest sexual practices in transmitting HIV infection because of the frequent tearing of sensitive anal membranes. In view of such a serious problem, that will also impact widely on the community when prisoners are released, a multi-pronged strategy is needed. Several initiatives addressing the issue are being reviewed or implemented in various countries. In Zimbabwe, among the listed options under consideration in the draft National Policy on HIV/AIDS, the most debated policy issue is the dissemination of condoms in prison. Much public dissent has been noted, in which the fear is that this would be seen as condoning homosexuality. However, it is emphasized that the issue in prisons is not one of homosexuality, but of recognizing that many heterosexual men in prison will take the only sexual outlet available to them (in addition to masturbation). In doing so, they are at great risk of HIV infection, hence encouraging mutual or self masturbation and actively promoting condom use must be part of the response to the epidemic issue.
Simkhada, Padam; van Teijlingen, Edwin R; Regmi, Pramod R; Bhatta, Prakash
People in Nepal generally hold fairly traditional views about sex and sexual health, whilst Western tourists often have a more liberal approach towards sex and relationships. There is evidence that significant sexual interaction occurs between male trekking guides and female travellers and/or local female sex workers in Nepal. This qualitative study explored trekking guides' sexual health knowledge, sexual relationships and condom use with female trekkers and local female sex workers. A total of 21 in-depth interviews were conducted with male trekking guides. Most reported having had sexual relationships with female trekkers and local female sex workers. Explanations for intercourse with female trekkers included: financial support; getting future trekkers through word-of-mouth advertising from the women they have had sex with; and opportunities for emigration. Interestingly, sexual intercourse is reported as more likely to be initiated by female trekkers than by guides, and more so by older women. In contrast, the main reasons for having sex with local female sex workers included: romantic love or sexual excitement and novelty. Awareness regarding sexual health was high among guides, but several factors discouraged the regular use of condoms. Further research with female tourists would help understand the motivations and reasons for their sexual behaviour.
Full Text Available Community pharmacies may place condoms in locked displays or behind glass, thereby reducing access and consequent use.Objective: Quantify sales and theft of condoms when condoms were unlocked and removed from behind glass in grocery pharmaciesMethods: Design. In this pilot study, condom displays were unlocked in selected pharmacies for three months. Participants. Eight grocery pharmacies in central Iowa agreed to participate. Intervention. Stores provided inventory at baseline, sales/theft thereafter in three monthly reports and sales for the same period one-year earlier. Outcome measures. Descriptive statistics quantified condom theft and sales. Number of pharmacies leaving condoms unlocked after the intervention was determined.Results: Theft varied by pharmacy and ranged from an average of 1.33 boxes (units per month to 27.33 per month. All stores experienced some increase in sales during the intervention. Two locations decided to re-lock their displays, only one indicated theft as the reason.Conclusion: After removing condoms from locked displays, more condoms were purchased and stolen from the study pharmacies. Sales outweighed theft in all pharmacies.
SIPHAMBE, H.K. (PROF.)
There was a negative relationship between condom use and age differences with partner ... to investigate the role of gender imbalance in the use of condoms as a preventive ... use force and women are not treated as equals at work, in the household .... Violence is both a cause and a consequence of HIV/AIDS and 10 to 69 ...
Literature Review Predictors of non-condom use intentions by university students in Britain and Greece: The impact of attitudes, time perspective, relationship ... influences, participants high in fatalistic TP were strongly inclined not to use condoms, irrespective of their attitudes, but TP did not differ as a function of culture.
Evidence from empirical surveys in Nigeria documented some issues around condom use. For instance, in a study in Ile Ife it was reported that the determinants of condom use among in-school adolescents include age, multiple sexual partners, and ability to refuse sex.8 Also, in a study of sexual debut among young people, ...
Bortot, Andrea T; Risser, William L; Cromwell, Polly F
Information is limited on how well adolescents use condoms and where they learn how. The objective of this study was to determine how often incarcerated males used condoms incorrectly and where, how, and from whom they learned condom use. This study consisted of an interviewer-administered survey during intake physicals at a juvenile detention center. Results were based on self-report; condom use models were not used. During usual use among 141 males, errors included failure to secure the condom to the penis on withdrawal (37%), loss of erection before condom removal (18%), and failure to leave space at the tip (14%). Learning occurred at home (27%), school (23%), probation/detention facilities (14%), and community programs (3.4%). Subjects learned from educators/counselors (37%), family (27%), and friends (6.9%). Methods of learning included reading the package insert (45%), demonstrations (39%), explanations (33%), and media (19%). These adolescents had relatively few condom errors. Common methods of learning correct condom use included observing a demonstration, reading the package insert, and hearing an explanation. The last 2 methods are easy to implement.
Lammers, J.; van Wijnbergen, S.; Willebrands, D.
This paper analyzes how different types of HIV-knowledge influence condom use across the sexes. The empirical work is based on a household survey conducted among 1,979 households of a representative group of market persons in Lagos in 2008. Last time condom use is analyzed based on a Probit model
Ashwood, Daniel; Farris, Karen B; Campo, Shelly; Aquilino, Mary L; Losch, Mary
Community pharmacies may place condoms in locked displays or behind glass, thereby reducing access and consequent use. Quantify sales and theft of condoms when condoms were unlocked and removed from behind glass in grocery pharmacies. Design. In this pilot study, condom displays were unlocked in selected pharmacies for three months. Participants. Eight grocery pharmacies in central Iowa agreed to participate. Intervention. Stores provided inventory at baseline, sales/theft thereafter in three monthly reports and sales for the same period one-year earlier. Outcome measures. Descriptive statistics quantified condom theft and sales. Number of pharmacies leaving condoms unlocked after the intervention was determined. Theft varied by pharmacy and ranged from an average of 1.33 boxes (units) per month to 27.33 per month. All stores experienced some increase in sales during the intervention. Two locations decided to re-lock their displays, only one indicated theft as the reason. After removing condoms from locked displays, more condoms were purchased and stolen from the study pharmacies. Sales outweighed theft in all pharmacies.
Gabler, Joanna; Kropp, Fredric; Silvera, David H; Lavack, Anne M
This study examines the condom purchasing and use habits of 256 college students in Norway and English-speaking Canada, and develops a structural equation model to explain condom purchase and use. In the model, intention to purchase condoms is influenced by self-efficacy in condom purchasing, as well as by intention to use condoms. Intention to use condoms is influenced by having a positive attitude toward condom usage and by self-efficacy in persuading a partner to use condoms. The implications for health promotion and social marketing campaigns are discussed.
Crosby, Richard A; DiClemente, Ralph J; Wingood, Gina M; Salazar, Laura F; Head, Sara; Rose, Eve; McDermott-Sales, Jessica
The influence that female partners exert regarding condom use is not well known. In the present study, the relative roles of personal sexual agency and relational factors in determining whether young African American women engaged in unprotected vaginal sex (UVS) were studied. A cross sectional study of 713 young, African American women (aged 15-21 years) was conducted. Data were collected using an audio-computer assisted self-interview. Three measures of sexual agency were assessed and three relational factors were assessed. To help assure validity in the outcome measure, condom use was assessed in five different ways. Multivariate analyses were used to determine whether variables independently predicted UVS. Two of the six predictor variables achieved multivariate significance with all five measures of condom use: (1) fear of negotiating condom use with male partners, and (2) indicating that stopping to use condoms takes the fun out of sex. A relational factor (male-dominated power imbalances) achieved multivariate significance for four of the five measures of UVS. A sexual agency factor (whether young women greatly enjoyed sex) achieved multivariate significance for three of the five measures. The results suggest that young African American women at high-risk of sexually transmissible infections (STI)/HIV acquisition may experience male-dominated power imbalances and also fear the process of negotiating condom use with their male partners. Although these factors were independently associated with UVS, two factors pertaining to sexual agency of these young women were also important predictors of UVS. Intervention efforts designed to avert STI/HIV acquisition among young African American women should therefore include programs to address both sexual agency and relational factors.
Piot, Bram; Mukherjee, Amajit; Navin, Deepa; Krishnan, Nattu; Bhardwaj, Ashish; Sharma, Vivek; Marjara, Pritpal
This study reports on the results of a large-scale targeted condom social marketing campaign in and around areas where female sex workers are present. The paper also describes the method that was used for the routine monitoring of condom availability in these sites. The lot quality assurance sampling (LQAS) method was used for the assessment of the geographical coverage and quality of coverage of condoms in target areas in four states and along selected national highways in India, as part of Avahan, the India AIDS initiative. A significant general increase in condom availability was observed in the intervention area between 2005 and 2008. High coverage rates were gradually achieved through an extensive network of pharmacies and particularly of non-traditional outlets, whereas traditional outlets were instrumental in providing large volumes of condoms. LQAS is seen as a valuable tool for the routine monitoring of the geographical coverage and of the quality of delivery systems of condoms and of health products and services in general. With a relatively small sample size, easy data collection procedures and simple analytical methods, it was possible to inform decision-makers regularly on progress towards coverage targets.
Mlunde Linda B
Full Text Available Abstract Background The number of people newly infected with human immunodeficiency virus (HIV has been decreasing in sub-Saharan Africa, but prevalence of the infection remains unacceptably high among young people. Despite the alarming pervasiveness of the virus, young people in this region continue to engage in risky sexual behaviors including unprotected sexual intercourse. In developed countries, parents can play important roles in protecting young people from such behaviors, but evidence regarding the impact of parental involvement is still limited in sub-Saharan Africa. Therefore, we conducted this study to examine the magnitude of risky sexual behaviors and the association of parental monitoring and parental communication with condom use at last sexual intercourse among secondary school students in Dar es Salaam, Tanzania. Methods We conducted this cross-sectional study among 2,217 male and female students aged 15 to 24 years from 12 secondary schools in Dar es Salaam. From October to November 2011, we collected data using a self-administered questionnaire. Multiple logistic regression analyses were conducted to examine the association of parental monitoring and parental communication with condom use at last sexual intercourse, adjusting for potential confounders. Results A total of 665 (30.3% secondary school students reported being sexually active within the year prior to data collection. Among them, 41.7% had multiple sexual partners, 10.5% had concurrent sexual partners, and 41.1% did not use a condom at last sexual intercourse. A higher level of parental monitoring was associated with increased likelihood of condom use at last sexual intercourse among male students (AOR: 1.56, 95% CI: 1.05-2.32; p = 0.03 but not among female students (AOR: 1.54, 95% CI: 0.71-3.37; p = 0.28. The association between parental communication and condom use at last sexual intercourse among both male and female students was not statistically
Thomas, Joanna; Shiels, Chris; Gabbay, Mark B
To date, most condom research has focused on young or high-risk groups, with little evidence about influences on condom use amongst lower-risk community samples. These groups are not risk free and may still wish to negotiate safer sex; yet the considerations involved could be different from those in higher-risk groups. Our research addresses this gap: We report a cross-sectional questionnaire study enquiring about recent condom use and future use intentions in community settings. Our sample (n = 311) purposively included couples in established relationships, known to be condom users. Items included demographics, sexual history and social-cognitive variables taken from the theory of planned behaviour. The strongest association with condom use/use intentions amongst our respondents was sexual partner's perceived willingness to use them. This applied across both univariate and multivariate analyses. Whilst most social-cognitive variables (attitudes; self-efficacy and peer social norms) were significant in univariate analyses, this was not supported in multivariate regression. Of the social-cognitive variables, only "condom-related attitudes" were retained in the model explaining recent condom use, whilst none of them entered the model explaining future use intentions. Further analysis showed that attitudes concerning pleasure, identity stigma and condom effectiveness were most salient for this cohort. Our results suggest that, in community samples, the decision to use a condom involves different considerations from those highlighted in previous research. Explanatory models for established couples should embrace interpersonal perspectives, emphasising couple-factors rather than individual beliefs. Messages to this cohort could usefully focus on negotiation skills, condom advantages (other than disease prevention) and reducing the stigma associated with use.
Thapa, S; Prasad, C V; Rao, P H; Severy, L J; Rao, S R
Contraceptive social marketing is a way of supplying contraceptives to consumers who cannot afford to buy them at full market price, yet are not reached by the free public distribution program. The process involves supplying a subsidized product through existing commercial distribution networks, using the mass media and other retail marketing techniques to commercially advertise the products. India was the first country to introduce this concept to its family planning program. India's social marketing program is also the largest in the world. Over the past 25 years, total condom sales in India have expanded under the program from less than 10 million per year to more than one billion. The authors present an overview of India's social marketing initiative, describe the firms participating in the program, and summarize the lessons learned from the social marketing experience. Problems and prospects, and experiences and implications are discussed.
Elvis E. Tarkang
Full Text Available Persons with disabilities have been identified as one of the groups vulnerable to HIV, due to several challenges posed by their disabilities. They also suffer external stigma from their able bodied peers. However, they have largely been ignored as part of HIV prevention programs, largely due to the perceptions that they are not at risk, and information is not being accessible. About 5.4% of the Cameroon population lives with a disability. In Cameroon, no official statistics exist on perception of factors associated with condom use to prevent HIV among persons with disabilities, which creates a challenge for understanding the extent of the pandemic in this population. The objective of this study was therefore to investigate perceptions of factors associated with condom use among persons with physical disability in an urban town of Cameroon. The qualitative study from which this paper is based, used semi-structured in-depth interviews, conducted with a purposive sample of ten (5 male and 5 female persons with physical disability, aged 18 years and above, in April 2015. The findings of this study as interpreted according to the components of the Health Belief Model, indicated that perceived susceptibility to HIV, perceived severity of HIV, perceived benefit of condom use, perceived barriers to condom use and perceived self-efficacy for condom use were the factors perceived by persons with physical disability, to be associated with condom use. It is therefore recommended that there should be educational programs in HIV/AIDS targeted specifically at persons with physical disability. These programs should pertinently promote the understanding and perceptions of persons with physical disability of the real threat of HIV/AIDS, and also equip them with condom negotiation skills and strategies to overcome barriers to condom use.
Sou, Julie; Shannon, Kate; Li, Jane; Nguyen, Paul; Strathdee, Steffanie A; Shoveller, Jean; Goldenberg, Shira M
Migrant women in sex work experience unique risks and protective factors related to their sexual health. Given the dearth of knowledge in high-income countries, we explored factors associated with inconsistent condom use by clients among migrant female sex workers over time in Vancouver, BC. Questionnaire and HIV/sexually transmitted infection testing data from a longitudinal cohort, An Evaluation of Sex Workers Health Access, were collected from 2010 to 2013. Logistic regression using generalized estimating equations was used to model correlates of inconsistent condom use by clients among international migrant sex workers over a 3-year study period. Of 685 participants, analyses were restricted to 182 (27%) international migrants who primarily originated from China. In multivariate generalized estimating equations analyses, difficulty accessing condoms (adjusted odds ratio [AOR], 3.76; 95% confidence interval [CI], 1.13-12.47) independently correlated with increased odds of inconsistent condom use by clients. Servicing clients in indoor sex work establishments (e.g., massage parlors) (AOR, 0.34; 95% CI, 0.15-0.77), and high school attainment (AOR, 0.22; 95% CI, 0.09-0.50) had independent protective effects on the odds of inconsistent condom use by clients. Findings of this longitudinal study highlight the persistent challenges faced by migrant sex workers in terms of accessing and using condoms. Migrant sex workers who experienced difficulty in accessing condoms were more than 3 times as likely to report inconsistent condom use by clients. Laws, policies, and programs promoting access to safer, decriminalized indoor work environments remain urgently needed to promote health, safety, and human rights for migrant workers in the sex industry.
Elvis E. Tarkang
Full Text Available Persons with disabilities have been identified as one of the groups vulnerable to HIV, due to several challenges posed by their disabilities. They also suffer external stigma from their able bodied peers. However, they have largely been ignored as part of HIV prevention programs, largely due to the perceptions that they are not at risk, and information is not being accessible. About 5.4% of the Cameroon population lives with a disability. In Cameroon, no official statistics exist on perception of factors associated with condom use to prevent HIV among persons with disabilities, which creates a challenge for understanding the extent of the pandemic in this population. The objective of this study was therefore to investigate perceptions of factors associated with condom use among persons with physical disability in an urban town of Cameroon. The qualitative study from which this paper is based, used semi-structured in-depth interviews, conducted with a purposive sample of ten (5 male and 5 female persons with physical disability, aged 18 years and above, in April 2015. The findings of this study as interpreted according to the components of the Health Belief Model, indicated that perceived susceptibility to HIV, perceived severity of HIV, perceived benefit of condom use, perceived barriers to condom use and perceived self-efficacy for condom use were the factors perceived by persons with physical disability, to be associated with condom use. It is therefore recommended that there should be educational programs in HIV/AIDS targeted specifically at persons with physical disability. These programs should pertinently promote the understanding and perceptions of persons with physical disability of the real threat of HIV/AIDS, and also equip them with condom negotiation skills and strategies to overcome barriers to condom use.
Hatherall, B; Ingham, R; Stone, N; McEachran, J
To assess the prevalence of, and factors associated with, vaginal penetration before condom application and following condom removal among young people in education in England. A large cross sectional survey (n = 1373) was conducted in educational establishments in England and sexual event diaries were completed by a subsample of young people over a 6 month period. Of the 375 survey respondents who reported having used a condom on the most recent occasion of vaginal sex, 6% had applied the condom after penetration and 6% had continued penetration after condom removal. Of the 74 diary respondents, 31% applied a condom late and 9% removed a condom early at least once over a 6 month period. The odds of "imperfect" condom use were found to decrease with overall consistency of condom use, confidence in correct condom use, positive reported relationship with mother, non-use of other contraception, and desire to use a condom. Given that late application and early removal of condoms fail to maximise their effectiveness as a method of STI prevention, it is important to address "imperfect" condom use and the factors associated with such use in public health policies and programmes. It is essential that young people understand the importance of using condoms consistently and correctly, and are also equipped with the skills and knowledge to do so.
Partner trust, non-availability of condoms, not achieving the desired sexual satisfaction and embarrassment of condom purchase were the main barriers to condom-use. Prevention strategies based on perceived severity or adequate knowledge about HIV/AIDS may not be sufficient to induce condom-use. Reproductive ...
Coyle, Karin K.; Franks, Heather M.; Glassman, Jill R.; Stanoff, Nicole M.
Background: School-based human immunodeficiency virus (HIV)/sexually transmitted infection (STI), and pregnancy prevention programs often focus on consistent and correct condom use. Research on adolescents' experience using condoms, including condom slippage/breakage, is limited. This exploratory study examines proper condom use and the…
Yarber, William L; Milhausen, Robin R; Crosby, Richard A; Torabi, Mohammad R
Public opinion is important in determining condom and condom education policies in public high schools. A random telephone survey of 517 Indiana residents was conducted from July through October 2003 to assess public opinion about education on correct condom use for HIV and STD prevention; condom availability in Indiana public high schools; and issues related to condom use, effectiveness and promotion. Data were analyzed using bivariate and linear regression techniques. A majority of respondents strongly or somewhat agreed that instruction on correct condom use for HIV and STD prevention should be provided in public high schools (77%), classroom instruction should include condoms (71%), only medically accurate information about condoms should being given (94%) and the federal government should promote condoms (70%). Fewer than half (48%) strongly or somewhat agreed that condoms should be made available to teenagers in public high schools without parental permission. Nearly all (92%) considered condoms at least somewhat effective in preventing HIV and other STDs. Non-Republican party affiliation, younger age and condom use within the previous five years were each significantly associated with having positive opinions on many of the condom-related statements. Public opinion appears to support the provision of correct condom use information in Indiana public schools. Schools should consider providing only medically accurate information about condoms and including condoms in instruction so students can see and touch them.
Jimenez, Michelle M; Andrade, Flavia C D; Raffaelli, Marcela; Iwelunmor, Juliet
Gendered dynamics in heterosexual relationships compromise women's self-efficacy and increase their vulnerability to acquiring HIV. This study examines the impact of socioeconomic determinants, media exposure, and sexual expectations on sexual behaviors of men and women in the Dominican Republic (DR). We analyzed cross-sectional data from 51,018 adults in the Dominican Republic age 15 to 45 years collected by the Demographics and Health Survey (DHS) in 2007. Measures included demographic and socioeconomic indicators, social exposures, sexual expectations and sexual behaviors. Logistic regression models explored gender differences in condom use. Study findings indicated that women were less likely to use a condom at last intercourse than men (odds ratio [OR] = 0.29; 95 % CI = 0.27, 0.31). Among men, secondary (OR = 1.43; 95 % CI = 1.16, 1.76) and higher education (OR = 1.58; 95 % CI = 1.25, 2.00), being in the richest quintile (OR = 1.25; 95 % CI = 1.07, 1.47), and living in a female-headed household (OR = 1.13; 95 % CI 1.03, 1.23) increased the likelihood of condom use. Compared to never married men, currently and formerly married men were less likely to use condoms (OR = 0.03; 95 % CI = 0.03, 0.04 and OR = 0.67; 95 % CI = 0.60, 0.75, respectively). The odds of condom use increased for young women 15-19 years old in comparison with women age 30-34 years, but decreased as they grew older. For women, being in the richer quintile (OR = 1.28; 95 % CI = 1.06, 1.54), living in a female-headed household (OR = 1.26; 1.12, 1.41), and having good access to media (OR = 1.24; 95 % CI = 1.12, 1.42) increased the likelihood of condom use. Being currently married or formerly married and living in rural areas decreased such likelihood among women. Study findings provide evidence that, in the DHS, socioeconomic and cultural differences between men and women affects condom use. Efforts to reduce HIV transmission
Senn, Theresa E.; Scott-Sheldon, Lori A. J.; Vanable, Peter A.; Carey, Michael P.
Background The Information-Motivation-Behavioral Skills (IMB) model often guides sexual risk reduction programs even though no studies have examined covariation in the theory’s constructs in a dynamic fashion with longitudinal data. Purpose Using new developments in latent growth modeling, we explore how changes in information, motivation, and behavioral skills over 9 months relate to changes in condom use among STD clinic patients. Methods Participants (N = 1281, 50% female, 66% African American) completed measures of IMB constructs at three time points. We used parallel process latent growth modeling to examine associations among intercepts and slopes of IMB constructs. Results Initial levels of motivation, behavioral skills, and condom use were all positively associated, with behavioral skills partially mediating associations between motivation and condom use. Changes over time in behavioral skills positively related to changes in condom use. Conclusions Results support the key role of behavioral skills in sexual risk reduction, suggesting these skills should be targeted in HIV prevention interventions. PMID:21638196
AJRH Managing Editor
Keywords: condom temponade, postpartum haemorrhage, management. Résumé. L'hémorragie du ..... and affordable strategies to help overcome some of the challenges .... Prendiville WJ, Elbourne D, McDonald S. Active versus expectant ...
HIV/AIDS misconceptions may be associated with condom use among black South Africans: an exploratory analysis. Laura M Bogart, Donald Skinner, Lance S Weinhardt, Laura Glasman, Cheryl Sitzler, Yoesrie Toefy, Seth C Kalichman ...
repeated sexual contact among HIV-discordant couples, 98-100% of those who used latex condoms correctly and ... Quick Response Code: ... Human immunodeficiency virus (HIV) ..... en/wpraids2001.pdf [Last accessed on 2009 Apr 20]. 2.
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AFRICAN JOURNAL OF CLINICAL AND EXPERIMENTAL MICROBIOLOGY. MAY 2009 ... A pre-tested semi-structured questionnaire was administered. Results: Out of 386 ... their sexual behaviours, perception of condom and its use in casual ...
Factors influencing condom use among Nigerian undergraduates: A mixed method study. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... group discussions) and quantitative (cross-sectional survey) methods were utilised for this study.
1Institute of Community Health, College of Pharmacy, University of Houston, Houston, Texas 77030; 2 University of Texas, School of Public. Health .... marijuana use, and attitude towards condom ... adjust for the possible confounding effects.
Sales, J. M.; DiClemente, R. J.; Davis, T. P.; Sullivan, S.
Human immunodeficiency virus (HIV) interventions can significantly reduce risky sexual behaviors among vulnerable populations. However, not everyone exposed to an intervention will reduce their sexual risk behavior. This qualitative study sought to identify factors associated with young African American females' lack of increase in condom use…
Stover, John; Rosen, James E; Carvalho, Maria Nadia; Korenromp, Eline L; Friedman, Howard S; Cogan, Matthew; Deperthes, Bidia
When used correctly and consistently, the male condom offers triple protection from unintended pregnancy and the transmission of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). However, with health funding levels stagnant or falling, it is important to understand the cost and health impact associated with prevention technologies. This study is one of the first to attempt to quantify the cost and combined health impact of condom use, as a means to prevent unwanted pregnancy and to prevent transmission of STIs including HIV. This paper describes the analysis to make the case for investment in the male condom, including the cost, impact and cost-effectiveness by three scenarios (low in which 2015 condom use levels are maintained; medium in which condom use trends are used to predict condom use from 2016-2030; and high in which condom use is scaled up, as part of a package of contraceptives, to meet all unmet need for family planning by 2030 and to 90% for HIV and STI prevention by 2016) for 81 countries from 2015-2030. An annual gap between current and desired use of 10.9 billion condoms was identified (4.6 billion for family planning and 6.3 billion for HIV and STIs). Under a high scenario that completely reduces that gap between current and desired use of 10.9 billion condoms, we found that by 2030 countries could avert 240 million DALYs. The additional cost in the 81 countries through 2030 under the medium scenario is $1.9 billion, and $27.5 billion under the high scenario. Through 2030, the cost-effectiveness ratios are $304 per DALY averted for the medium and $115 per DALY averted for the high scenario. Under the three scenarios described above, our analysis demonstrates the cost-effectiveness of the male condom in preventing unintended pregnancy and HIV and STI new infections. Policy makers should increase budgets for condom programming to increase the health return on investment of scarce resources.
Hall, Karina M.; Brieger, Daniel G.; De Silva, Sukhita H.; Pfister, Benjamin F.; Youlden, Daniel J.; John-Leader, Franklin; Pit, Sabrina W.
Objectives. To determine the confidence and ability to use condoms correctly and consistently and the predictors of confidence in young Australians attending a festival. Methods. 288 young people aged 18 to 29 attending a mixed-genre music festival completed a survey measuring demographics, self-reported confidence using condoms, ability to use condoms, and issues experienced when using condoms in the past 12 months. Results. Self-reported confidence using condoms was high (77%). Multivariate...
Morrison-Beedy, D; Lewis, B P
To understand women's readiness to use condoms and their perceived pros and cons for condom use. Comparative, descriptive design guided by the Transtheoretical Model. Data were collected at two urban primary health care centers in western New York. 364 single urban women with steady (main) or other (casual, concurrent, multiple, new) sexual partners. Most participants were young (mean age of 27 years), economically disadvantaged women of color. Each participant completed an anonymous questionnaire that included items for the stage of change algorithm, decisional balance of the pros and cons of condom use, sexual history, and HIV risk information. Most women were in the early stages of change (not intending to use condoms), but those with other partners were further along in the stages of change for condom use than those with steady partners. The pros or advantages of condom use differed for these women depending on partner type. The change in the balance between the pros and cons occurred as theoretically predicted for women with steady and other partners. Effectiveness of HIV prevention interventions for women may be enhanced if they are tailored to both readiness to change and partner type.
Roth, Mara Y; Amory, John K
Nearly half of all pregnancies worldwide are unplanned, despite numerous contraceptive options available. No new contraceptive method has been developed for men since the invention of condom. Nevertheless, more than 25% of contraception worldwide relies on male methods. Therefore, novel effective methods of male contraception are of interest. Herein we review the physiologic basis for both male hormonal and nonhormonal methods of contraception. We review the history of male hormonal contraception development, current hormonal agents in development, as well as the potential risks and benefits of male hormonal contraception options for men. Nonhormonal methods reviewed will include both pharmacological and mechanical approaches in development, with specific focus on methods which inhibit the testicular retinoic acid synthesis and action. Multiple hormonal and nonhormonal methods of male contraception are in the drug development pathway, with the hope that a reversible, reliable, safe method of male contraception will be available to couples in the not too distant future. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Reece, Michael; Dodge, Brian; Herbenick, Debby; Fisher, Christopher; Alexander, Andreia; Satinsky, Sonya
To offer an empirical understanding of characteristics associated with the fit and feel of condoms among African-American men who have sex with men (MSM), a particularly high-risk group for HIV and other sexually transmitted infections (STI) in the United States. Survey data were collected from 178 adult African-American MSM attending a community event in Atlanta, Georgia. Although the majority of participants reported that condoms generally fit properly and felt comfortable, a substantial number of men reported a variety of problems with the fit and feel of condoms. Specifically, 21% reported that condoms felt too tight, 18% reported that condoms felt too short, 10% reported that condoms felt too loose, and 7% reported that condoms felt too long. There were significant associations between men's reports of condom breakage and slippage, and their perceptions of condom fit and feel. Perceptions of condom fit and feel were also related to men's reports of seeking condoms for their size-specific properties. The fit and feel issues that men in this sample identified may be among those that contribute to their likelihood of using, or not using, condoms consistently and correctly. A better understanding of these factors will be beneficial to both condom manufacturers and sexual health professionals who share a common goal of increasing consistent and correct condom use and reducing the incidence of HIV and other STI among this and other communities.
Crosby, Richard A; Mena, Leandro; Arnold, Trisha
Background The first purpose of the present study was to determine whether young Black men who have sex with men (YBMSM) disclose their newly diagnosed HIV infection to a male or female partner, and to determine whether this disclosure is related to condom use; the second was to identify correlates of disclosing newly diagnosed HIV infection to male sex partners, including a measure of partner-related barriers to condom use. A sample of 125 HIV-infected YBMSM (age 15-29 years) provided cross-sectional data used for both study purposes. Recruitment occurred in a mid-size city in the southern US experiencing inordinately high prevalence and incidence rates of HIV among YBMSM. Significance was defined by an α level of <0.05. Eighty-eight YBMSM (70.4%) indicated disclosing their newly diagnosed HIV status to the first male partner they had sex with after being diagnosed. Of these, nine (9.1%) reported that condoms were not used during ensuing sex with that partner. However, of the men not disclosing, 27.0% reported not using condoms for ensuing sex (P=0.009). Similar findings were observed relative to sex with females (P=0.057). Regarding the second study purpose, in addition to a protective effect of advancing age, men scoring at or above the median on a measure of partner-related barriers to condom use were 2.4-fold more likely to not disclose compared with men scoring below the median (P=0.04). For YBMSM, a beneficial counselling objective relative to disclosing newly diagnosed HIV may be to help men resolve perceptions of partner-related barriers to condom use.
This study aims to highlight the tensions between the 'risks' of condom negotiation to feminine identity and safer sex health education messages of individual choice and responsibility. Effective education incorporates nurses' recognition that deterrents to women practising safer sex may increase subsequent to a diagnosis of a viral sexually transmitted infection. Health educational messages and clinicians' teaching emphasise rational decision-making with regard to condom use with a focus on the acquisition of technical information and ready access to condoms. These messages do not take into account the social complexities for women in negotiating condom use with men that deter condom use. A qualitative, feminist post-structuralist research design was used. In-depth email interviews were conducted with 12 clinicians with expertise in the sexual health field and 26 women with a diagnosis of either herpes simplex virus or human papilloma virus. A thematic analysis approach was used to analyse the semi-structured and interactive interviews. Few women in the study had received any direct safer sex education from clinicians and wanted them to initiate this discussion. Most women found the topic of safer sex became more difficult once diagnosed with a viral sexually transmitted infection. Women's dilemmas were whether to disclose the diagnosis as part of insisting on condom use, whether condom use mitigated the obligation to disclose or whether any talk or condom use was avoided as too 'risky' to feminine identity. Paradoxically, it may be harder for women to negotiate safer sex and ask for condoms to be used, once diagnosed with a viral sexually transmitted infection. Women want clinicians to give advice about the dissonance between 'rational' safer sex messages and social expectations of appropriate femininity. Relevance to clinical practice. Nurses have a key role in engaging with women in considering safer sex practices. Nurses need to be able to demonstrate to
Social marketing of condoms in Zaire began in 1987 and sales rose to 8 million in 1990, a notable change from the previous situation where about half a million condoms were distributed by government health clinics only. Social marketing is the use of for-profit sales and marketing techniques for public health problem.s When the Zaire National AIDS Committee initiated social marketing of condoms, with the assistance of Population Services International, they had the experience of successful Asian programs of the 1970s, and the political sanction resulting from the AIDS threat to back them up. Efforts were made to find just the right product name, "Prudence," logo, package, color and slogan by consumer research. Prudence implies responsible behavior, capturing both the AIDS and STD prevention and the family planning markets. Consumers like the package and associate it with quality, since most condoms sold before in Zaire had no special packaging. Distribution outlets include 7000 retail shops, groceries, pharmacies, hotel, social clubs, 300 bars and even Congo River barges which sex workers frequent. The price was set close to that of a pack of gum for 3, or that of a bottle of beer for a dozen. Promotion is limited by a government ban of advertising in mass media, so point of purchase materials, special offers and promotional items are being used. Prudence condoms are now being marketed in Cameroon and Burundi.
Mindel, Adrian; Sawleshwarkar, Shailendra
The present review assesses the protection that condoms offer against sexually transmissible infections (STI) and the impact that social, political and religious opinion in the USA has had in the past 8 years on promoting condoms for safer sex. Condoms offer protection against most STI. However, the degree of protection depends on correct and consistent use, the type of sexual activity and the biological characteristics of different infections. Cross-sectional and case-control studies and other observational data provide the majority of evidence for STI prevention. Condoms provide a high level of protection against those infections that are transmitted mainly via infected secretions, including HIV, gonorrhoea, chlamydia and trichomoniasis. Protection against those infections transmitted via skin and mucous membrane contact, including Herpes simplex virus infection and human papilloma virus, appears to be less. The Bush administration, driven by conservative political, social and religious elements in the USA, has mounted a concerted campaign to undermine the role of the condom in health-promotion activities in the USA and overseas by undervaluing and misrepresenting scientific data, and through a sustained and well-funded promotion of abstinence-only education. However, this has lead to considerable controversy and disillusionment with abstinence-only education, both at home and abroad, and there is now incontrovertible evidence that abstinence-only programs are ineffectual.
Piet, D L; Hendrata, L
The development of an out-of-clinic method for marketing condoms in Indonesia is described. A jamu company (jamu referes to any herbal medicant, many of which are related to sexual activity, whose use is firmly integrated into the Indonesian way of life) was contracted by the private, non-profit Prosperous Indonesia Foundation (YIS) to distribute condoms as a jamu item. The condoms are donated to YIS by the U.S. Agency for International Development, and are retailed at 20 rupees for a package of 3, with a profit of 4 rupees for the retailer. Mobile promotional/sales units are the most effective means for selling the devices. The approach appeals to the cultural and sexual character of the people. The media is used extensively to promote condoms and family planning. Although it is too early to assess the impact of the program, it is anticipated that this novel approach will spread the use of condoms to all areas of Indonesia.
Papo, Jacqueline K; Bauni, Evasius K; Sanders, Eduard J; Brocklehurst, Peter; Jaffe, Harold W
to explore the extent of the condom gap, investigating the relative roles of supply-side and demand-side factors in determining condom use. GPS mapping of condom outlets, and population-based survey. an urban and a rural site were selected within the Epidemiological and Demographic Surveillance Site in Kilifi district, Kenya. Potential condom outlets (n = 281) were mapped and surveyed, and questionnaires on condom access and use (n = 630) were administered to a random sample of men and women aged 15-49. Multivariate logistic regression was performed to assess the relative roles of supply-side and demand-side barriers on condom use. the median straight-line distance to free condoms was 18-fold higher in the rural versus urban site. Among sexually active respondents, 42% had ever used a condom, and 23% had used a condom over the past 12 months, with lower levels among rural versus urban respondents (P supply-side or demand-side barriers, compared with individuals experiencing both types of barriers. Despite low levels of usage and the presence of supply-side and demand-side barriers, reported unmet need for condoms was low. there is an urgent need for renewed condom promotion efforts aimed at building demand, in addition to improving physical access, in resource-limited settings with generalized HIV epidemics in sub-Saharan Africa. 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Full Text Available Abstract Background Community engagement strategies are often integrated in public health interventions designed to promote condom use among men who have sex with men (MSM, a key population for HIV prevention. However, the ways in which condom use peer norms and self-efficacy play a role in the association between community engagement and condom use is unclear. This study examines the potential mediating roles of peer norms and self-efficacy in this association. Methods A nationwide cross-sectional online survey was conducted among Chinese MSM in 2015. Recruitment criteria included being born biologically male, being older than 16 years, having had anal sex with a man at least once during their lifetime, and having had condomless anal or vaginal sex in the past three months. Mplus 6.11 was used to conduct confirmatory factor analysis and path modeling analysis to examine the structural relationships between HIV/sexual health community engagement (e.g., joining social media and community events related to HIV and sexual health services, condom use peer norms, condom use self-efficacy, and frequency of condom use. Results The study found that HIV/sexual health community engagement, condom use peer norms, condom use self-efficacy, and frequency of condom use were mutually correlated. A good data model was achieved with fit index: CFI = 0.988, TLI = 0.987, RMSEA = 0.032, 90% CI (0.028, 0.036. HIV/sexual health community engagement was associated with frequency of condom use, which was directly mediated by condom use peer norms and indirectly through self-efficacy. Conclusion The study suggests that condom use peer norms and self-efficacy may be mediators in the pathway between community engagement and condom use, and suggests the importance of peer-based interventions to improve condom use.
Li, Haochu; Xue, Li; Tucker, Joseph D; Wei, Chongyi; Durvasula, Maya; Hu, Wenqi; Kang, Dianming; Liao, Meizhen; Tang, Weiming; Ma, Wei
Community engagement strategies are often integrated in public health interventions designed to promote condom use among men who have sex with men (MSM), a key population for HIV prevention. However, the ways in which condom use peer norms and self-efficacy play a role in the association between community engagement and condom use is unclear. This study examines the potential mediating roles of peer norms and self-efficacy in this association. A nationwide cross-sectional online survey was conducted among Chinese MSM in 2015. Recruitment criteria included being born biologically male, being older than 16 years, having had anal sex with a man at least once during their lifetime, and having had condomless anal or vaginal sex in the past three months. Mplus 6.11 was used to conduct confirmatory factor analysis and path modeling analysis to examine the structural relationships between HIV/sexual health community engagement (e.g., joining social media and community events related to HIV and sexual health services), condom use peer norms, condom use self-efficacy, and frequency of condom use. The study found that HIV/sexual health community engagement, condom use peer norms, condom use self-efficacy, and frequency of condom use were mutually correlated. A good data model was achieved with fit index: CFI = 0.988, TLI = 0.987, RMSEA = 0.032, 90% CI (0.028, 0.036). HIV/sexual health community engagement was associated with frequency of condom use, which was directly mediated by condom use peer norms and indirectly through self-efficacy. The study suggests that condom use peer norms and self-efficacy may be mediators in the pathway between community engagement and condom use, and suggests the importance of peer-based interventions to improve condom use.
Peasant, Courtney; Sullivan, Tami P; Weiss, Nicole H; Martinez, Isabel; Meyer, Jaimie P
HIV and sexually transmitted infections (STIs) disproportionately affect women who experience intimate partner violence (IPV). The current study (1) applied a syndemic framework to study the collective effects of problematic drug use, hazardous drinking, depression, and posttraumatic stress disorder (PTSD) on fear of condom negotiation, condom negotiation, and condom use and (2) evaluated condom negotiation (controlling for fear of condom negotiation) as a mediator of the association between syndemic severity and condom use among low-income IPV-exposed women. Participants were 158 women living in the community and experiencing ongoing IPV who completed face-to-face, computer-assisted interviews. Almost three-fourths of the participants reported problematic drug use, hazardous drinking, depression, and/or PTSD; many of these factors were correlated, indicating a syndemic. Multivariate logistic and linear regression analyses revealed associations between syndemic severity and fear of condom negotiation (OR = 1.57, p = .02), condom negotiation (β = -8.51, p = .001), and condom use (β = -8.26, p = .01). Meditation analyses identified condom negotiation as a mediator of the association between syndemic severity and condom use (effect = -6.57, SE = 2.01, [95% CI: -10.66, -2.77]). Results fill a critical gap in previous research by identifying condom negotiation as a mechanism through which this syndemic affects condom use. Prevention and intervention programs should consider addressing condom negotiation to reduce sexual risk among this high-risk population. Further, because IPV-exposed women may experience fear related to condom negotiation, it is critical that prevention and intervention efforts for this population offer skills to safely negotiate condom use, increase condom use, and reduce STI and HIV risk.
McQuiston, C; Gordon, A
Unprotected sex is a critical issue in the Hispanic community, with the incidence of new Hispanic acquired immune deficiency syndrome (AIDS) cases three times that of non-Hispanic Whites. The researchers used focus groups to examine: (a) whether newly immigrated Mexican men and women in the Southeast United States discussed human immunodeficiency virus (HIV)/sexually transmitted disease (STD) prevention with each other, and (b) how condom use was discussed. For the women, communication was safe sex, and for the men, trust was safe sex. Both communication and trust were dependent on timing in the relationship. Participants could not discuss condoms in a new or established relationship because of issues of trust. This study highlights the complexity of HIV/STD prevention and suggests that trust and timing should be considered within the cultural context of condom introduction.
Nash, W A
Outside of abstinence, correct and consistent condom use is the single most effective tool to prevent the transmission human immunodeficiency virus (HIV). This is particularly true in countries such as Belize where incidence rates remain high. Women are physiologically at higher risk for HIV, and many feel powerless to insist on condom use. Although nurses are in a position to promote condom use, variables that influence this decision are not clearly understood. In this study, we examined variables that influence a nurses' self-efficacy to promote and teach condom use to women specifically to reduce their HIV risk. Data related to self-efficacy, vicarious experience related to condom use promotion and a nurse's sexual relationship power were collected from nurses practising in Belize (n = 60). These data were cross-sectional and collected at the annual nurses' conference. Both years of nursing education and positive vicarious experience promoting and teaching condom use to women were positively correlated to their self-efficacy to do so. Vicarious experience was significantly correlated to self-efficacy in a subgroup of nurses with lower sexual relationship power but not in those with higher sexual relationship power. When designing HIV continuing education programmes for nurses in Belize, it is important to consider level of nursing education and access to vicarious experience such as mentoring and role modelling. An additional factor to consider is the influence that a nurse's power in her own primary sexual relationship may play in the formation of her self-efficacy. © 2011 The Author. International Nursing Review © 2011 International Council of Nurses.
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Council reporting that condom use declined significantly from 2008 ... The bushcan initiative highlighted the fact that condoms are not as easily accessible to all South Africans as is ... Women Living with HIV: Global Lessons from Local Voices.
Bucardo, Jesus; Semple, Shirley J; Fraga-Vallejo, Miguel; Davila, Wendy; Patterson, Thomas L
Previous research has documented high rates of STDs and increased risk of HIV infection among female sex workers (FSWs) in Mexico; however, little is known about the sexual risk behaviors of this population. The purpose of this study was to explore work history, context of sex work, sexual risk practices, client characteristics, attitudes toward condoms, and potential barriers to condom use in a sample of FSWs in Tijuana, Mexico. Analysis of qualitative data from 25 FSWs revealed that most women entered the sex trade at a young age ( M = 23 years), primarily as a result of financial need. Forty percent were single mothers supporting children. Women worked an average of 6-7 days per week; work shifts ranged from 4 to 13 hr per day. Clients were both Mexican and foreign (mostly American and Asian), and ranged in age from 18 to 80 years. Positive aspects of the job included flexible work hours and good income. Negative aspects of sex work included risks associated with physical assault, diseases, and unwanted pregnancies. Most clients did not want to use a condom and many offered additional money for unprotected sex. FSWs did not like to use condoms because they were perceived as uncomfortable. Most FSWs did not negotiate the use of condoms, had a low knowledge regarding the proper use of condoms, and were reticent to report their own unsafe sex practices. These results suggest the need to develop culturally appropriate safer sex interventions for FSWs in Mexican border cities.
Emmanuel, Wamalwa; Edward, Neyole; Moses, Poipoi; William, Ringera; Geoffrey, Otomu; Monicah, Bitok; Rosemary, Mbaluka
The male condom remains the single, most efficient and available technology to reduce sexual transmission of HIV as well as sexually transmitted infections. This study sought to establish condom use determinants and practices among people living with HIV (PLHIVs) in Kisii County, Kenya. We interviewed 340 PLHIVs and 6 health workers. Although most PLHIVs had correct knowledge and approved condoms as effective for HIV prevention, consistent use and condom use at last sex were notably low espec...
Bjekić, Milan; Sipetić-Grujičić, Sandra; Vlajinac, Hristina; Nikolić, Aleksandra
Dear Editor, Proper and consistent use of male condoms can be a highly effective method of preventing the transmission of sexually transmitted infections (STIs) and HIV (1), but this method relies on men's willingness and ability to use condoms. In the United States of America, about 20% overall and less than 50% of adults with multiple partners used a condom at last intercourse (2). In Serbia in 2013 (3), 50.0% of women and 62.5% of men aged 15-49 who had more than one partner in the past year used a condom during their last intercourse. Heterosexual men often use condoms to prevent pregnancy rather than the transmission of venereal diseases (4). For better public promotion of condom use, it is necessary to know the reasons for its inconsistent or incorrect use. With this in mind, we asked 200 consecutive chlamydia-positive heterosexual men admitted to the City Institute for Skin and Venereal Diseases in Belgrade to complete an anonymous questionnaire, taken from a Danish study (5), about their attitudes to/or experience with condoms. Patients were divided into two groups; Group I consisted of 109 (54.5%) men who reported that they had never or sometimes used condoms during intercourse and Group II consisted of 91 (45.5%) men who had used a condom often or always. The majority of participants (68.5%) were ≤30 years old, while the rest were older. The analysis of differences between these two groups was performed using a chi-square test. Attitudes concerning use of condoms are presented in Table 1. The majority of our participants (43.5%) did not use a condom because they had sexual intercourse with regular partners. This may be explained by trust and misperception of risk of contracting STIs during sex with a regular partner or lack of discussion with the partner about condom use. The results of another study about condom use with a steady partner (6) have shown that 31% of participants reported using condoms consistently with steady partners. The second most
Yeakley, Anna M.; Gant, Larry M.
Discusses the failure to use condoms among U.S. Latino populations and identifies six "myths" related to traditional cultural values and gender roles, and associations between condoms and prostitution, infidelity, and disease, that prevent condom use in these populations. Suggests ways that programs can address these myths in HIV…
Mbulo, Lazarous; Newman, Ian M.; Shell, Duane F.
This study explored factors that may predict condom use among college and high school students in Zambia. Using the Social Cognitive Theory, this study examined the relationship of drinking behaviors, alcohol-sexual expectations, education level, and religion to condom use among 961 students. The results of the study show that condom use was low…
Tran, Bonnie Robin; Thomas, Anne Goldzier; Ditsela, Mooketsi; Vaida, Florin; Phetogo, Robert; Kelapile, David; Chambers, Christina; Haubrich, Richard; Shaffer, Richard
Preventing HIV infection is a priority for militaries. HIV prevention research is needed to monitor existing programs, identify areas for modification, and develop new interventions. Correct and consistent condom use is highly effective against HIV. However, use among soldiers is lower than ideal. This study describes condom use behaviors and examines correlates of use in the Botswana Defence Force (BDF). Analyses were based on 211 male personnel, aged 18–30, who completed a cross-sectional survey that collected baseline data for an intervention study. Results showed that 51% of participants reported always using condoms, 35% used condoms most times, and 14% used condoms occasionally/never. Condom use varied by partner type and was typically higher with casual partners in comparison to regular partners. After adjustment for age and marital status, factors associated with lower condom use included excessive alcohol use, perception that using condoms reduce sexual pleasure, and having a trusted partner. However, higher levels of HIV knowledge and reports of being circumcised were protective against lower condom use. HIV interventions aimed at increasing condom use in the BDF should address condom perceptions, alcohol abuse, and issues of trust. Innovative ways to increase condom use in this population should also be explored. PMID:23970609
Tran, Bonnie Robin; Thomas, Anne Goldzier; Ditsela, Mooketsi; Vaida, Florin; Phetogo, Robert; Kelapile, David; Chambers, Christina; Haubrich, Richard; Shaffer, Richard
Preventing HIV infection is a priority for militaries. HIV prevention research is needed to monitor existing programme, identify areas for modification, and develop new interventions. Correct and consistent condom use is highly effective against HIV. However, use among soldiers is lower than ideal. This study describes condom use behaviours and examines correlates of use in the Botswana Defence Force (BDF). Analyses were based on 211 male BDF personnel, aged 18-30, who completed a cross-sectional survey that collected baseline data for an intervention study. Results showed that 51% of participants reported always using condoms, 35% used condoms most times, and 14% used condoms occasionally/never. Condom use varied by partner type and was typically higher with casual partners in comparison to regular partners. After adjustment for age and marital status, factors associated with lower condom use included excessive alcohol use, perception that using condoms reduce sexual pleasure, and having a trusted partner. However, higher levels of HIV knowledge and reports of being circumcised were protective against lower condom use. HIV interventions aimed at increasing condom use in the BDF should address condom perceptions, alcohol abuse, and issues of trust. Innovative ways to increase condom use in this population should also be explored.
Saxton, Peter J; Dickson, Nigel P; Hughes, Anthony J; Ludlam, Adrian H
To identify predictors of non-condom use among gay and bisexual men (GBM) in New Zealand with casual male partners. We analysed anonymous self-completed data from GBM who participated in the communitybased Gay Auckland Periodic Sex Survey (GAPSS) and Internet-based Gay Online Sex Survey (GOSS), undertaken in 2014. Infrequent condom use was defined as not using condoms "always" or "almost always" during anal intercourse in the prior six months. Of the 1,912 GBM reporting anal intercourse with a casual partner, 27.2% reported infrequent condom use. Being recruited from Internet dating sites, Pacific ethnicity, having over 20 recent male partners, infrequent condom use with a current regular partner, or being HIV-positive were independently predictive of infrequent condom use. Conversely, being older, having a tertiary degree, using a condom at first anal intercourse, being exclusively receptive with a casual partner/s, and seeing condoms promoted through multiple channels predicted frequent condom use. Attitudes to condoms and safe sex were strongly predictive of actual condom use. Social marketing should target the modifiable predictors of condom use, such as attitudes to safe sex. Interventions also need to engage successfully with GBM reporting non-modifiable traits such as HIV-positive GBM.
Boldsen, J L; Jeune, B; Madsen, P C
In nearly 2,000 intercourses 14 different types of condoms were tested by 80 heterosexual and seven homosexual volunteer couples. The test couples were generally quite experienced in the use of condoms. It appears that the condoms rarely (1.3%) ruptured or slipped off during the actual intercourse...
Agha, Sohail; Meekers, Dominique
This study describes an assessment of the impact on condom use in urban Pakistan of the second phase of an intensive condom advertising campaign conducted as part of a social marketing program. Between April and June 2009, advertisements for Touch condoms appeared on private television channels and on radio stations. To assess the impact of the campaign, a nationally representative panel survey of men married to women aged 15-49 was conducted, collecting information on behaviors related to condom use and recall of contraceptive advertisements. We employed conditional change regression analysis to determine whether awareness of the Touch ad at follow-up was associated with improved attitudes toward condoms and condom use. Respondents with confirmed awareness of the Touch campaign experienced significant improvements in indicators related to condom use, even after controlling for region, socioeconomic and demographic characteristics, the values of the indicators at baseline, and exposure to the first phase of the campaign. They experienced increases in the following: perceived availability of condoms; discussion of family planning; approval of family planning; procurement of condoms; and ever use, current use, and consistent use of condoms with wife. The study indicates that condom advertising can be effective in increasing condom use in urban Pakistan.
Church, Kathryn; Wringe, Alison; Fakudze, Phelele; Kikuvi, Joshua; Nhlabatsi, Zelda; Masuku, Rachel; Initiative, Integra; Mayhew, Susannah H
Objectives To (i) describe the contraceptive practices of HIV care and treatment (HCTx) clients in Manzini, Swaziland, including their unmet needs for family planning (FP), and compare these with population-level estimates; and (ii) qualitatively explore the causal factors influencing contraceptive choice and use. Methods Mixed quantitative and qualitative methods were used. A cross-sectional survey conducted among HCTx clients (N=611) investigated FP and condom use patterns. Using descriptive statistics, findings were compared with population-level estimates derived from Swaziland Demographic and Health Survey data, weighted for clustering. In-depth interviews were conducted with HCTx providers (n=16) and clients (n=22) and analysed thematically. Results 64% of HCTx clients reported current contraceptive use; most relied on condoms alone, few practiced dual method use. Rates of condom use for FP among female HCTx clients (77%, 95% CI 71% to 82%) were higher than population-level estimates in the study region (50% HIV-positive, 95% CI 43% to 57%; 37% HIV-negative, 95% CI 31% to 43%); rates of unmet FP needs were similar when condom use consistency was accounted for (32% HCTx, 95% CI 26% to 37%; vs 35% HIV-positive, 95% CI 28% to 43%; 29% HIV-negative, 95% CI 24% to 35%). Qualitative analysis identified motivational factors influencing FP choice: fears of reinfection; a programmatic focus on condoms for people living with HIV; changing sexual behaviours before and after antiretroviral therapy (ART) initiation; failure to disclose to partners; and contraceptive side effect fears. Conclusions Fears of reinfection prevailed over consideration of pregnancy risk. Given current evidence on reinfection, HCTx services must move beyond a narrow focus on condom promotion, particularly for those in seroconcordant relationships, and consider diverse strategies to meet reproductive needs. PMID:24695990
Church, Kathryn; Wringe, Alison; Fakudze, Phelele; Kikuvi, Joshua; Nhlabatsi, Zelda; Masuku, Rachel; Mayhew, Susannah H
To (i) describe the contraceptive practices of HIV care and treatment (HCTx) clients in Manzini, Swaziland, including their unmet needs for family planning (FP), and compare these with population-level estimates; and (ii) qualitatively explore the causal factors influencing contraceptive choice and use. Mixed quantitative and qualitative methods were used. A cross-sectional survey conducted among HCTx clients (N=611) investigated FP and condom use patterns. Using descriptive statistics, findings were compared with population-level estimates derived from Swaziland Demographic and Health Survey data, weighted for clustering. In-depth interviews were conducted with HCTx providers (n=16) and clients (n=22) and analysed thematically. 64% of HCTx clients reported current contraceptive use; most relied on condoms alone, few practiced dual method use. Rates of condom use for FP among female HCTx clients (77%, 95% CI 71% to 82%) were higher than population-level estimates in the study region (50% HIV-positive, 95% CI 43% to 57%; 37% HIV-negative, 95% CI 31% to 43%); rates of unmet FP needs were similar when condom use consistency was accounted for (32% HCTx, 95% CI 26% to 37%; vs 35% HIV-positive, 95% CI 28% to 43%; 29% HIV-negative, 95% CI 24% to 35%). Qualitative analysis identified motivational factors influencing FP choice: fears of reinfection; a programmatic focus on condoms for people living with HIV; changing sexual behaviours before and after antiretroviral therapy (ART) initiation; failure to disclose to partners; and contraceptive side effect fears. Fears of reinfection prevailed over consideration of pregnancy risk. Given current evidence on reinfection, HCTx services must move beyond a narrow focus on condom promotion, particularly for those in seroconcordant relationships, and consider diverse strategies to meet reproductive needs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
The dataset was analyzed using SPSS version 21.0 software (SPSS, IBM Corp, Armonk, NY, USA). Condom utilization prevalence rate was calculated for the 393 males, while predictors were determined by logistic regression. P ≤ 0.05 was considered statistically significant. Results: Mean age of the respondents was ...
Objectives: Correct and consistent condom use remains an important public health intervention against the spread of Human Immunodeficiency Virus and other sexually transmitted infections. There is paucity of information on sexual behaviour of in-school adolescents in Uganda. We, therefore, used secondary data of the ...
Chequer, P; VanOss Marín, B; Paiva, L; Hudes, E S; Piazza, T; Rodrigues, L; Hearst, N
A telephone survey was conducted to measure AIDS knowledge, media usage and condom attitudes and behaviors among 500 adults aged 18 to 49 in Brasilia, as well as to evaluate the feasibility of the telephone survey method in a developing country. The response rate was 91.6%. Respondents had good knowledge about correct modes of HIV transmission and prevention but also believed HIV was transmitted through blood donation, public toilets, swimming pools, and mosquito bites. TV and newspapers were the most important sources of information on health matters and AIDS, though health workers were considered the most credible sources of such information. Only 19% of sexual encounters in the 4 weeks prior to the survey included condoms. Single and younger respondents and those with more positive attitudes used condoms more frequently. More work is needed to identify appropriate messages to motivate people to use condoms. Telephone surveys regarding AIDS and sexual attitudes and behaviors are feasible in Brasilia, a planned community with universal telephone coverage.
Most HIV prevention strategies for African youth have been ineffective in changing key behaviors like condom use, partly because community antagonism and structural barriers have rarely been addressed. Through qualitative research in rural Western Kenya, we sought to describe the attitudes of different segments of ...
Jan 31, 2014 ... most Nigeria cultures that demand premarital abstinence have almost disappeared (Orubuloye et ... preventing most STIs including HIV (Gardner et al.,. 1999). By implication, cardinal strategy in the ..... Gardner, R., Blackburn, R. and Upadhyay, U. (1999). Closing the condom gap. Popul. Rep. H, Ser. H.; 9:1 ...
Using data from the Integrated Biological and Behavioural Surveillance Survey implemented by the International Organisation for Migration in 2010 among farm workers, this study seeks to investigate factors associated with condom use among migrant men and women in selected commercial farms in two provinces of ...
Individual bishops in France and other European countries have argued that condom use can save lives by preventing the spread of HIV. The French Bishops' Conference social commission published a 200-page report which in which agreement was expressed with widespread medical opinion that condom use is the sole and necessary barrier against the sexual spread of HIV. Extensive media coverage ensued and led to Bishop Albert Rouet, the bishop of Poitiers and chairman of the French Bishops' Conference, being interviewed by the Holy See's official radio. In the interview, Bishop Rouet distanced the Roman Catholic Church in France from the report, claiming that the media had exaggerated the issue and that his commission was not bound by the reference. The Vatican remains staunchly opposed to condom use against HIV infection and preaches abstinence outside of marriage and fidelity within marriage as the only true ways to avoid HIV infection. In 1995, the Vatican fired Jacques Gaillot, the former bishop of Evreux in Normandy, for his outspoken endorsement of condom use against HIV.
Manji, A; Peña, R; Dubrow, R
There are few peer-reviewed studies of HIV/AIDS-related knowledge, attitudes, beliefs and practices among adolescents in Central America. A population-based cross-sectional survey was conducted among 246 adolescents in León, Nicaragua, where there is reason for concern about a rise in HIV infections. In many respects, León adolescents were typical of those in other Latin American countries, with a mixture of correct and incorrect knowledge about transmission of HIV and sexually transmitted infections, a higher proportion of males than females reporting having had sex or using condoms, and inconsistent condom use. While some sexual attitudes conformed to the ideology of machismo, others did not, providing an opening for prevention interventions. Some dimensions of HIV/AIDS stigma were high, and most adolescents disapproved of same-sex sexual behaviour. Intervention against homosexuality-related stigma is particularly urgent because a concentrated HIV epidemic may be emerging in Nicaragua among men who have sex with men. Personal religious beliefs did not appear to pose a barrier to condom use. In a multivariate model, being out of school was a significant correlate of having had sex and of insufficient HIV/AIDS-related knowledge. Accordingly, HIV prevention interventions must reach adolescents both in and out of school. A multi-component approach to prevention is needed, including programmes based in schools, communities, the mass media and health facilities.
Tu, Yu-Ching; Wang, Hsiu-Hung; Lin, Yi-Jung; Chan, Te-Fu
Human papillomavirus (HPV) is a frequent cause of sexually transmitted infection worldwide, and has a key role in the etiology of cervical cancer. Young people are the most vulnerable age group for acquiring HPV infection, but this particular age group in Taiwan knows little about it. This study investigated Taiwanese adolescent women's knowledge of HPV and factors associated with intention to use condoms for reducing HPV-related diseases among adolescent women. A descriptive cross-sectional design was used, and a convenience sample of 384 adolescent women aged 15 to 16 years in Southern Taiwan was recruited. Data were collected using a self-administered questionnaire and analyzed with descriptive statistics, t-test or ANOVA, and multiple regression analysis. Only 26.6% of the participants were aware of HPV. The percentage of correct answers for knowledge about HPV was 35.4%. Factors associated with intention to use condoms for HPV prevention were discussion of sexual issues, attitude, subjective norm, perceived behavioral control, and HPV knowledge. These variables accounted for 55.8% of the variance in scores for intention to use condoms for HPV prevention. These findings could be used in future HPV prevention education and campaigns. Future intervention programs might be particularly focused on insufficient HPV knowledge among adolescent females.
Johnson, Patrick S; Sweeney, Mary M; Herrmann, Evan S; Johnson, Matthew W
Alcohol use, especially at binge levels, is associated with sexual HIV risk behavior, but the mechanisms through which alcohol increases sexual risk taking are not well-examined. Delay discounting, that is, devaluation of future consequences as a function of delay to their occurrence, has been implicated in a variety of problem behaviors, including risky sexual behavior. Probability discounting is studied with a similar framework as delay discounting, but is a distinct process in which a consequence is devalued because it is uncertain or probabilistic. Twenty-three, nondependent alcohol users (13 male, 10 female; mean age = 25.3 years old) orally consumed alcohol (1 g/kg) or placebo in 2 separate experimental sessions. During sessions, participants completed tasks examining delay and probability discounting of hypothetical condom-protected sex (Sexual Delay Discounting Task, Sexual Probability Discounting Task) and of hypothetical and real money. Alcohol decreased the likelihood that participants would wait to have condom-protected sex versus having immediate, unprotected sex. Alcohol also decreased the likelihood that participants would use an immediately available condom given a specified level of sexually transmitted infection (STI) risk. Alcohol did not affect delay discounting of money, but it did increase participants' preferences for larger, probabilistic monetary rewards over smaller, certain rewards. Acute, binge-level alcohol intoxication may increase sexual HIV risk by decreasing willingness to delay sex in order to acquire a condom in situations where one is not immediately available, and by decreasing sensitivity to perceived risk of STI contraction. These findings suggest that delay and probability discounting are critical, but heretofore unrecognized, processes that may mediate the relations between alcohol use and HIV risk. Copyright © 2016 by the Research Society on Alcoholism.
Kabwama, Steven Ndugwa; Ssewanyana, Derrick; Berg-Beckhoff, Gabriele
Introduction: The protective benefit of male circumcision against spreading HIV is well established. Aim: The objective of this Meta-analysis was to investigate behavioral risk compensation measured as the change in condom use behavior in light of knowledge of the benefits of circumcision. Material...... does not influence condom use behavior in the medium and short term. Keywords: Condom use, behavioral change, circumcision, sexual health....... and Methods: A systematic search was conducted from 6 bibliographic databases for studies that quantitatively assessed a link between male circumcision and condom use behavior. Pooled odd ratios (OR) of condom use during any sexual activity were generated from three cohort studies and two Randomized Control...
Strader, M K; Beaman, M L; McSweeney, M
Data from a 1989 survey using the condom attitude and belief instrument with 310 clients from two sexually transmitted disease clinics identified significant social referents who influence condom-use intentions. They are sexual partner, father and friends. The present study found that communication with these referents had a positive net effect on beliefs about and intentions to use condoms. Implications applicable for intervention programmes to increase condom use are to promote talking about condoms between the sexual partners and important social referents and to develop such communication skills.
Sakondhavat, C; Werawatanakul, Y; Bennett, A; Kuchaisit, C; Suntharapa, S
Brothel workers in Thailand are at high risk of HIV infection but they alone do not have adequate bargaining power to insist on condom use with all clients. Brothel managers, on the other hand, are a source of influence over both clients and their workers and can promote universal condom use in their establishments. To test whether brothel managers in Khon Kaen City would adopt and successfully implement a condom-only policy in their establishments, all 24 brothel managers in Khon Kaen City attended a meeting on the dangers of HIV and benefits of an all-condom policy. Ideas on how to implement the policy were discussed. Follow-up visits were made once a month to brothels to resupply condoms, provide reinforcement and to collect data. All brothel managers approved of the condom-only in principle and are now implementing the policy. Results of the evaluation of condom use and degree of solidarity in these 24 brothels are available for the AIDS prevention programme. However, a condom-only policy in brothels can only succeed if managers and brothel workers show solidarity in rejecting all non-condom using clients. Laws to promote condom use may not be needed if brothels are given the opportunity to implement a condom-only policy using their own resourcefulness and determination.
Davis, Kelly Cue; Schraufnagel, Trevor J; Kajumulo, Kelly F; Gilmore, Amanda K; Norris, Jeanette; George, William H
The purpose of this study was to investigate the variability in young heterosexual men's perceptions of the advantages and disadvantages of condom use in their casual sexual relationships. Because men who perceive greater disadvantages of condom use may be more likely to resist using them, we also explored the tactics that men employ to avoid using condoms. Semi-structured focus groups were conducted with single men who have sex with women (n = 60), aged 21-35 years, all of whom reported using condoms inconsistently. Transcripts were analyzed using a framework analysis approach. As expected, participants reported advantages and disadvantages to condom use that pertained to the likelihood and quality of sex, physical sensations during intercourse, and the risk of sexually transmitted infections and unwanted pregnancies. Within each of these topics, however, participants' appraisals of the relative pros and cons of condom use varied considerably. Additionally, participants reported that men use a wide range of condom use resistance tactics, including seduction, deception, and condom sabotage, and that the use of these tactics was viewed as normative behavior for men their age. These findings suggest that the effectiveness of sexual health prevention efforts could be enhanced by increasing young men's motivations to use condoms and by targeting social norms regarding condom use resistance. Additionally, the issue of men's condom use resistance clearly merits increased empirical investigation and intervention attention.
Lopez, Vera; Kopak, Albert; Robillard, Alyssa; Gillmore, Mary Rogers; Holliday, Rhonda C.; Braithwaite, Ronald L.
Sexual risk taking among female delinquents represents a significant public health problem. Research is needed to understand the pathways leading to sexual risk taking among this population. This study sought to address this issue by identifying and testing two pathways from child maltreatment to non-condom use among 329 White and 484 African…
Huang, Wen; Dong, Yanyan; Chen, Lin; Song, Dandan; Wang, Jun; Tao, Haidong; Zaller, Nickolas; Zhang, Hongbo; Operario, Don
Sexual behavior is the dominant mode of HIV transmission in China, and young female migrants are among the populations at highest risk. This article examines how HIV-related risk behaviors among female migrants might vary according to workplace settings. Participants were young female migrants recruited from three workplace settings-factories, restaurants and entertainment venues. In a cross-sectional survey, we assessed 457 participants' sociodemographic characteristics, HIV/AIDS-related knowledge, condom use knowledge, sexual behaviors, condom use behavior and reproductive health factors. Participants working in entertainment venues were significantly more likely than those working in factories and restaurants to report sexual behavior, unprotected sex, multiple pregnancy terminations and sexually transmitted infections (STI). However, participants working in factories and restaurants reported significantly lower levels of HIV/AIDS knowledge, condom use knowledge, condom use self-efficacy and history of HIV/AIDS counseling and testing. Independent correlates of unprotected sex included employment in an entertainment venue, abortion history and sexual self-efficacy. Independent correlates of STI or genitourinary tract infection included employment in an entertainment venue, abortion history, recent migration and recent unprotected sex. These findings indicate a need for sexual and reproductive health interventions prioritizing young female migrants, and call for programs that can be incorporated into different workplace settings. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
The labeling of the Avanti polyurethane condom selling in 10 Western states makes misleading claims about protection from pregnancy and sexually transmitted diseases (STDs) according to officials at the US Food and Drug Administration (FDA). Avanti is sold in a foil package printed with the claim that it is effective against pregnancy, HIV, and STDs. However, polyurethane condoms have not undergone clinical efficacy testing for contraception or STDs, according to officials. The manufacturer of the condom refuted this allegation, stating that latex condoms have the same claims on them. In early 1995 the FDA met with the manufacturer and other companies developing plastic condoms, and concluded that these condoms could not make such claims, nor any claims about slippage and breakage rates. Despite warnings in 1993 to the manufacturer of Avanti about labeling restrictions, the company printed pregnancy and STD efficacy claims on the boxes and individual packages. The FDA later worked out a compromise with the firm in which only the boxes had to be reprinted with the generic label. The FDA had to weigh the risk of the public health cost of delaying sale of the condom, which is the first impermeable condom proven safe for people with latex allergies. In 1991 the FDA was defining standards for clinical testing and labeling of polyurethane condoms under congressional mandate, but the manufacturer of Avanti began mass production based on a preliminary approval determining that the condom was equivalent to latex condoms already on the market. 7000 Avanti condoms were subsequently tested in five countries, but these user tests did not compare Avanti to latex condoms and did not test for pregnancy and STD protection. Test results submitted to the FDA by the company indicated that, although Avanti is more than 1/3 less elastic than latex condoms, it did not break more frequently in an in-use study involving 187 couples.
Grov, Christian; Wells, Brooke E.
As researchers and community-based providers continue to encourage latex condom use as a chief strategy to prevent HIV transmission among men who have sex with men, research is needed to better explore the intersecting associations among penis size (length and circumference), condom feel, ease of finding condoms, recent experience of condom failure (breakage and slippage), and unprotected anal sex. Data were taken from a 2010 community-based survey of self-identified gay and bisexual men in New York City (n = 463). More than half (51.4 %) reported penile length as 6–8 in. long (15–20 cm) and 31.5 % reported penile circumference as 4–6 in. around (10–15 cm). Variation in self-reported penile dimensions was significantly associated with men’s attitudes toward the typical/average condom, difficulty finding condoms that fit, and the experience of condom breakage. Men who had engaged in recent unprotected insertive anal intercourse reported significantly higher values for both penile length and circumference, and these men were significantly more likely to report that the average/typical condom was “too tight.” Most men had measured their length (86.2 %) and/or circumference (68.9 %), suggesting that penile measurement might be a common and acceptable practice among gay and bisexual men. As HIV and STI prevention providers continue to serve as leading distributers of free condoms, these findings further highlight the need for condom availability to be in a variety of sizes. Improving condom fit and attitudes toward condoms may also improve condom use and minimize condom slippage and breakage. PMID:22552706
Sweat, Michael D; Denison, Julie; Kennedy, Caitlin; Tedrow, Virginia; O'Reilly, Kevin
To examine the relationship between condom social marketing programmes and condom use. Standard systematic review and meta-analysis methods were followed. The review included studies of interventions in which condoms were sold, in which a local brand name(s) was developed for condoms, and in which condoms were marketed through a promotional campaign to increase sales. A definition of intervention was developed and standard inclusion criteria were followed in selecting studies. Data were extracted from each eligible study, and a meta-analysis of the results was carried out. Six studies with a combined sample size of 23,048 met the inclusion criteria. One was conducted in India and five in sub-Saharan Africa. All studies were cross-sectional or serial cross-sectional. Three studies had a comparison group, although all lacked equivalence in sociodemographic characteristics across study arms. All studies randomly selected participants for assessments, although none randomly assigned participants to intervention arms. The random-effects pooled odds ratio for condom use was 2.01 (95% confidence interval, CI: 1.42-2.84) for the most recent sexual encounter and 2.10 (95% CI: 1.51-2.91) for a composite of all condom use outcomes. Tests for heterogeneity yielded significant results for both meta-analyses. The evidence base for the effect of condom social marketing on condom use is small because few rigorous studies have been conducted. Meta-analyses showed a positive and statistically significant effect on increasing condom use, and all individual studies showed positive trends. The cumulative effect of condom social marketing over multiple years could be substantial. We strongly encourage more evaluations of these programmes with study designs of high rigour.
Rugpao, S; Wanapirak, C; Sirichotiyakul, S; Yutabootr, Y; Prasertwitayakij, W; Suwankiti, S; Wongworapat, K; Tovanabutra, S; Natpratan, C; Saba, J
One hundred and ninety five (195) brothel-based commercial sex workers (CSW) in Chiang Mai, Thailand, were screened for sexually transmitted disease (STD) between October 1994 and April 1995, prior to their enrollment in a multi-center comparative trial of the effectiveness of two strategies using male and female condoms. These CSW had a mean age of 22.2 (SD 4.3) years. Forty-seven per cent were Thai and 57.4 per cent had no formal education. Median duration of prostitution was 16 months and median cost for sexual service was 50 baht (US$ 2) per client. Ninety-four per cent of CSW reported always using condoms with clients. There were 63 (32.3%) CSW infected with at least one type of the STD screened. The prevalence of STD included chlamydial infection (16.9%), gonococcal infection (14.4%), condyloma accuminata (4.6%), moluscum contagiosum (2.6%) and trichomoniasis (1.0%). There was no statistically significant risk factor for STD found in this study. Despite an active programme for prevention of STD in CSW and the provision of free condoms, STD were diagnosed in one-third of the screened CSW in Chiang Mai. The programme needs to be strengthened by more intensive education and practice in the correct and consistent use of condoms and integrated with other STD prevention programmes.
Nesoff, Elizabeth D.; Dunkle, Kristin; Lang, Delia
This study sought to explore the impact of condom negotiation self-efficacy, interpersonal factors, and sensational factors on condom use behavior among a population of college-educated women with different patterns and types of sexual partner. We administered an online questionnaire capturing sexual behavior, partnership patterns, perceived…
Malcolm, Shandey; Huang, Shi; Cordova, David; Freitas, Derek; Arzon, Margaret; Jimenez, Giselle Leon; Pantin, Hilda; Prado, Guillermo
Hispanic problem behavior youth are at an increased risk of engaging in HIV risk behaviors, including low condom use. However, relatively little research has examined factors that affect condom use in this population. Although research indicates that family processes, such as higher levels of family functioning and open parent-adolescent…
Full Text Available Purpose. Little is known about the risky sexual behaviors of HIV-positive female sex workers (FSWs in the developing world, which is critical for programmatic purposes. This study aims to shed light on their condom use with regular clients as well as husband/cohabiting partner, a first in India. Methods. Multivariate logistic regression analyses for consistent condom use with regular clients and husband/cohabiting partner are conducted for the sample of 606 HIV-positive FSWs. Results. Older FSWs are 90% less likely and nonmobile FSWs are 70% less likely to consistently use condoms. FSWs on ART are 3.84 times more likely to use condoms. Additionally, FSWs who changed their occupation after HIV diagnosis are 70% less likely to use condoms. FSWs who are currently cohabiting are more likely to consistently use condoms with repeat clients and are 3.22 times more likely to do so if they have felt stigma associated with being HIV-positive. FSWs who have multiple repeat clients, and who do not know the sexual behavior of these clients, are more likely to use condoms consistently. Conclusion. This study would help inform programs to target the following particularly vulnerable HIV-positive FSWs: those who are older, those who changed their occupation post-HIV diagnosis, and those who are nonmobile.
Schmid, Amy; Leonard, Noelle R.; Ritchie, Amanda S.; Gwadz, Marya V.
Purpose Assertive communication has been associated with higher levels of condom use among youth using self-report survey methodology. The purpose of this study was to examine the subjective ratings of assertiveness among young, romantically-involved couples in the context of a condom negotiation task. Methods Using an innovative video-recall procedure, 32 couples (64 youth) engaged in a videotaped condom negotiation task and then rated self and partners’ level of assertiveness. Both individual ratings of assertiveness and couple-level assertiveness were assessed using dyadic hierarchical linear modeling. Results Individuals’ assertiveness was positively associated with condom use. Unexpectedly, the overall level of assertiveness in couples showed a curvilinear association with condom use. Very high and very low assertiveness was associated with lower condom use, while moderate levels of assertiveness were associated with higher condom use. Conclusions Moderate levels of assertiveness during condom negotiation may facilitate condom use in young couples. Increasing condom use among romantic partners may require developing interventions that strengthen youths’ ability to engage in assertive communication strategies that balance emotional intimacy with self-advocacy. PMID:25937470
Schmid, Amy; Leonard, Noelle R; Ritchie, Amanda S; Gwadz, Marya V
Assertive communication has been associated with higher levels of condom use among youth using self-report survey methodology. The purpose of this study was to examine the subjective ratings of assertiveness among young, romantically involved couples in the context of a condom negotiation task. Using an innovative video-recall procedure, 32 couples (64 youth) engaged in a videotaped condom negotiation task and then rated self and partners' level of assertiveness. Both individual ratings of assertiveness and couple-level assertiveness were assessed using dyadic hierarchical linear modeling. Individuals' assertiveness was positively associated with condom use. Unexpectedly, the overall level of assertiveness in couples showed a curvilinear association with condom use. Very high and very low assertiveness was associated with lower condom use, whereas moderate levels of assertiveness were associated with higher condom use. Moderate levels of assertiveness during condom negotiation may facilitate condom use in young couples. Increasing condom use among romantic partners may require developing interventions that strengthen youths' ability to engage in assertive communication strategies that balance emotional intimacy with self-advocacy. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Paz-Bailey, Gabriela; Koumans, Emilia H; Sternberg, Maya; Pierce, Antonya; Papp, John; Unger, Elizabeth R; Sawyer, Mary; Black, Carolyn M; Markowitz, Lauri E
To evaluate the relationship between self-reported correct and consistent condom use and chlamydial and gonococcal infection. Cross-sectional study. An urban adolescent health care clinic. Patients A total of 509 adolescent girls tested for Chlamydia trachomatis and Neisseria gonorrhoeae infection by urine nucleic acid amplification tests. Main Outcome Measure Effect of condom use on infection rates of chlamydia and gonorrhea. Consistent condom use was defined as using condoms for every act of vaginal sex and correct use as consistent use without any of the following: beginning sex without a condom, taking it off before finishing sex, flipping it over, condom breakage, or condom slippage. A total of 95% of the participants were African American, with a mean age of 16.6 years. Chlamydia prevalence was 21% (105/509) and gonorrhea prevalence was 7% (36/509). Condom errors were reported by 316 (71%) of 442 participants who had reported using a condom at least once in the previous 3 months. Consistent use was reported by 176 patients (35%); however, both correct and consistent use was reported by only 80 patients (16%). After adjusting for confounders, correct and consistent use was protective for chlamydia (odds ratio, 0.4; 95% confidence interval, 0.2-1.0) and highly protective for gonorrhea (odds ratio, 0.1; 95% confidence interval, 0-0.7). Our findings indicate that assessing both correctness and consistency of use is important for evaluation of condom effectiveness.
Koss, Catherine A; Dunne, Eileen F; Warner, Lee
Although systematic reviews of epidemiologic studies have been conducted for condom use and the risk of several sexually transmitted diseases, there have been no such reviews for condom use and syphilis. A systematic literature review of epidemiologic studies published from 1972 to 2008 was conducted to evaluate study methods and measures of association reported for condom use and risk of syphilis. All 12 included studies had significant methodologic limitations. Nine (75%) studies were cross-sectional. Although 11 (92%) studies assessed consistent condom use, no studies assessed correct use or condom use problems, nor did any document exposure to a partner infected with syphilis. Ten studies had insufficient information to distinguish prevalent from incident infections. Two studies that assessed both incident infection and consistent condom use suggested a reduced risk of syphilis with consistent condom use; 1 study was statistically significant. Significant methodologic limitations exist for all reviewed studies of syphilis and condom use. Among the 2 most rigorously designed studies, both suggested a reduced risk of syphilis with consistent condom use. Additional studies incorporating rigorous methods are needed to further assess the effect of condom use on risk of syphilis.
AIDS has become a major cause of death in Tanzania and young people represent the most vulnerable group. Recent HIV prevalence data showed that young women are more likely than young men to become infected. This paper examined commonalties and differences in the sociodemographic and ideational predictors of condom use among young men and women in Tanzania. The data derive from a 2004 sample survey among young people aged 15-24 years in five regions of Tanzania. The sample on which the analyses were based included 1,523 single women and 1,200 single men. An ideation framework guided the analyses of the predictors of consistent condom use. Logistic regression was the main analytic method used and separate models were estimated for men and women. The most significant correlates of consistent condom use for men included perceived self-efficacy for correct condom use, discussing condom use with friends, and perceived self-efficacy for using condoms with a long-term partner. Discussing condom use with a sex partner and the perceived self-efficacy to refuse sex if the sex partner refused to use a condom were the most significant predictors for women. One implication of the findings is that for men, effective interventions should emphasize correct condom use know-how and address the issue of negative peer pressure and group norms around condom use. For women, interventions should focus on sexual empowerment.
Full Text Available BACKGROUND: Using condoms consistently could prevent unintended pregnancy among young people. This study highlights multiple domains of inﬂuence on condom use among male college students in China, including knowledge, attitudes, health services utility on condom use and reproductive health information sources. METHODOLOGY/PRINCIPAL FINDINGS: To identify factors associated with condom use in Chinese male college students, we examined a sample of 870 sexually experienced male students in seven colleges in Wuhan, China, 2009. 535 (61.5% of 870 male students reported condom use during their most recent sexual encounter. Male students with steady partners were more likely to use condoms than students with casual partners (adjusted OR = 3.11, 95%CI 2.30-4.20. And positive attitudes toward contraceptive responsibility were associated with greater odds of condom use (adjusted OR = 1.40, 95%CI 1.02-1.92. Only 54(6.2% and 83(9.5% of respondents reported that free condoms and reproductive health counseling were available at the student health center. Providing free condoms and reproductive health counseling at the student health central were associated with increased condom use among college students (both P<0.05. In addition, students who gained reproductive health information mainly through websites, television and radio programs were more likely to use condoms than through school education (all P<0.05. CONCLUSIONS: Improving attitudes of male students toward contraceptive responsibility, providing proper reproductive health information through mass media and making free condoms and reproductive health counseling available in school may help increase condom use among college students in China.
Reece, Michael; Briggs, Lindsay; Dodge, Brian; Herbenick, Debby; Glover, Richard
Promoting consistent and correct condom use remains a priority public health activity, although some HIV- and STI-related providers remain challenged by some men's resistance to condoms, which some claim do not fit properly or do not feel comfortable. Although these perceptions have been examined across multiple populations, they have not been documented among men living with HIV. During spring 2008, data were collected from 215 men living with HIV at HIV service organizations in the Midwestern and Southeastern United States. Participants completed the Condom Fit and Feel Scale and measures related to demographics and condom use during sexual interactions within the past 90 days. Men were primarily homosexual, African American, with a high school degree or higher, and unemployed. More than half of participants had used condoms for sexual intercourse within the previous 90 days. The majority of the men reported few problems with the fit and feel of condoms, with 63.1% reporting that condoms "fit my penis just fine," and 80.9% reported being able consistently to find condoms that they perceived to be "sized appropriately for my penis." Some men did report specific characteristics of condoms that challenged fit and feel, including 20.6% endorsing (always or often) that condoms feel too tight, 15.9% that condoms are too short, 17.8% or that condoms would not roll down far enough to cover their penis completely (15.6%). These data provide insights into mechanisms through which providers can help to increase men's access to the diverse range of condoms in the marketplace.
Zhao, Rui; Wu, Jun-Qing; Li, Yu-Yan; Zhou, Ying; Ji, Hong-Lei; Li, Yi-Ran
To evaluate and compare the effectiveness of the combined regimen (consisting of condoms and emergency contraception pills (ECP)) and using condoms only for the purpose of preventing pregnancy. One-thousand-five-hundred-and-sixty-two (1,562) couples as volunteers enrolled at nine centers in Shanghai. Eight-hundred-and-twelve (812) were randomized to use male condoms and ECP (i.e., Levonorgestrel) as a back-up to condoms (the intervention group) and 750 to use male condoms only(the control group), according to their working unit. Participants were visited at admission and at the end of 1, 3, 6, 9, and 12 months. The cumulative life table rates were calculated for pregnancy and other reasons for discontinuation. The gross cumulative life table rates showed that the cumulative discontinuation rates for all reasons during the year of follow-up in the condoms plus emergency contraception group and the condoms only group were 7.76 ± 0.94 and 6.61 ± 0.91, respectively, per 100 women (χ2 = 0.41, p = 0.5227). The cumulative gross pregnancy rate of the condoms plus emergency contraception group and the condoms only group were 2.17 ± 0.52 and 1.25 ± 0.41, respectively, per 100 women (χ2 = 1.93, p = 0.1645). The Pearl Index in the condoms plus emergency contraception group and the condoms only group were 2.21% and 1.26%, respectively. Male condoms remain a highly effective contraceptive method for a period of one year while consistently and correctly used. In addition, the lowest pregnancy rate followed from perfect use condom.
Ritchwood, Tiarney D.; Penn, Dolly; Peasant, Courtney; Albritton, Tashuna; Corbie-Smith, Giselle
This study examines the role of condom use knowledge and attitudes, and parent-teen communication about sex and relationship quality on reports of condom use self-efficacy among rural, African American youth. Participants were 465 North Carolinian youth (10–14 years). Results indicated that greater condom use self-efficacy was predicted by greater knowledge of condom use (β = .206; p parent-teen communication about sex (β = .13; p parent-teen communication about sex and dating (β = .14; p parents and youth on measures related to parent-teen communication about sex. Findings call for interventions targeting improvement of condom use knowledge among early adolescents, as well as parent-teen communication about sex. In addition, given the low parent-teen agreement regarding sexual communication, parent-teen sexual communication is an important point of intervention. PMID:28461714
Eduardo Nagib Boery
Full Text Available The AIDS pandemic has emerged as a serious disease, synonymous of programmed death, prevalent among people belonging to the called "risk group", like the homosexual men and intravenous drug users. Over the years, the profile of those infected has gone through major epidemiological transition, characterized by internalization, juvenização, pauperization, heterosexuality, feminization and blackening. This new hillside led to understanding the incorporation of the term, risk behavior, that was recently replaced by the concept of vulnerability as it incorporates cultural, social, economic and programmatic dimensions, among others. Considering the relevant morbidity and mortality due of the infection, their prevention and control are highlighted in the scope of public health. In this context, we have the use of condoms in all sexual relations, as a fundamental strategy to contain the spread of Sexually Transmitted Infections (STIs in general. Were objectives of the study: check the university adherence to the use of condoms; compare if there are differences between the adherence to condom use among university enrolled in nursing course from I to IV semesters and students of V to VII semester; identify factors that facilitate and / or make hard the adherence of the university to the use of condoms. The research, has a exploratory character and qualitative nature and was based on the principles of social representations theory. Were informants of the study 20 students of nursing from a public university, located in Bahia. Data were collected through interviews guided by a semi – structured script. The analysis was done using the technique of thematic content analysis. Considering the results, were demonstrated the vulnerability of academics due to non-adherence to condom use in all sexual relations. The fact deserves attention as all highlighted the importance of using the method in the prevention of STIs and / or unplanned pregnancy. Is important
Bowen, A M; Williams, M; McCoy, H V; McCoy, C B
Prevalence rates of HIV infection acquired through heterosexual contacts have risen steadily since 1982. Crack cocaine smokers are at particular risk of HIV infection due to heterosexual exposure. HIV risk reduction interventions seeking to increase condom use among drug users have met with minimal success, and there is a need for interventions to be strongly grounded in psychosocial models of behaviour change. This study presents the results of an investigation of predictors of intention to use condoms and related therapy processes among heterosexual drug users. Data were analyzed from 586 crack smokers recruited in Washington, DC, Miami, Florida, and Collier County, Florida who reported having both primary and casual sex partners. Participants responded to items derived from the theory of reasoned action, the theory of planned behaviour and the transtheoretical model of change. Condom use beliefs and therapy processes used to initiate and maintain condom use were assessed. Outcome expectancies and normative beliefs were the strongest predictors of intention to use condoms with a primary sexual partner. In turn, beliefs that condoms inhibit sexual romance and decrease sexual pleasure strongly predicted outcome expectancies. Therapy processes found to be associated with these constructs included: self-liberation, counter conditioning and stimulus control/reinforcement. Results suggest that HIV risk reduction interventions using a group format and targeting condom beliefs related to sexual romance and pleasure will decrease negative outcome expectancies about condom use. Also, reinforcing attempts to use condoms with intimate partners should increase positive outcome expectancies and intention to initiate or maintain condoms with a primary sexual partner.
Duff, Putu; Shoveller, Jean; Dobrer, Sabina; Ogilvie, Gina; Montaner, Julio; Chettiar, Jill; Shannon, Kate
Background This study aims to: report on a newly developed ‘Safer Indoor Work Environmental Scale’ that characterizes the social, policy and physical features of indoor venues and social cohesion; and using this scale, longitudinally evaluate the association between these features on sex workers’ (SWs’) condom use for pregnancy prevention. Methods Drawing on a prospective open cohort of female SWs working in indoor venues, a newly-developed ‘Safer Indoor Work Environment Scale’ was used to build six multivariable models with generalized estimating equations (GEE), to determine the independent effects of social, policy and venue-based features and social cohesion on condom use. Results Of 588 indoor SWs, 63.6% used condoms for pregnancy prevention in the last month. In multivariable GEE analysis, the following venue-based features were significantly correlated with barrier contraceptive use for pregnancy prevention: managerial practices and venue safety policies (Adjusted Odds Ratio (AOR)=1.09; 95% Confidence Interval (95%CI) 1.01–1.17) access to sexual and reproductive health services/supplies (AOR=1.10; 95%CI 1.00–1.20) access to drug harm reduction (AOR=1.13; 95%CI 1.01–1.28), and social cohesion among workers (AOR=1.05; 95%CI 1.03–1.07). Access to security features was marginally associated with condom use (AOR=1.13; 95%CI 0.99–1.29). Conclusion The findings of the current study highlight how work environment and social cohesion among SWs are related to improved condom use. Given global calls for the decriminalization of sex work, and potential legislative reforms in Canada, this study points to the critical need for new institutional arrangements (e.g., legal and regulatory frameworks; labour standards) to support safer sex workplaces. PMID:25678713
Duff, Putu; Shoveller, Jean; Dobrer, Sabina; Ogilvie, Gina; Montaner, Julio; Chettiar, Jill; Shannon, Kate
This study aims to report on a newly developed Safer Indoor Work Environmental Scale that characterises the social, policy and physical features of indoor venues and social cohesion; and using this scale, longitudinally evaluate the association between these features on sex workers' (SWs') condom use for pregnancy prevention. Drawing on a prospective open cohort of female SWs working in indoor venues, a newly developed Safer Indoor Work Environment Scale was used to build six multivariable models with generalised estimating equations (GEE), to determine the independent effects of social, policy and physical venue-based features and social cohesion on condom use. Of 588 indoor SWs, 63.6% used condoms for pregnancy prevention in the last month. In multivariable GEE analysis, the following venue-based features were significantly correlated with barrier contraceptive use for pregnancy prevention: managerial practices and venue safety policies (adjusted OR (AOR)=1.09; 95% CI 1.01 to 1.17), access to sexual and reproductive health services/supplies (AOR=1.10; 95% CI 1.00 to 1.20), access to drug harm reduction (AOR=1.13; 95% CI 1.01 to 1.28) and social cohesion among workers (AOR=1.05; 95% CI 1.03 to 1.07). Access to security features was marginally associated with condom use (AOR=1.13; 95% CI 0.99 to 1.29). The findings of the current study highlight how work environment and social cohesion among SWs are related to improved condom use. Given global calls for the decriminalisation of sex work, and potential legislative reforms in Canada, this study points to the critical need for new institutional arrangements (eg, legal and regulatory frameworks; labour standards) to support safer sex workplaces. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Nichols, Sara; Javdani, Shabnam; Rodriguez, Erin; Emerson, Erin; Donenberg, Geri
Younger sisters of teenage parents have elevated rates of engaging in unprotected sex. This may result from changes in parenting behavior after a sibling becomes pregnant or impregnates a partner, and be particularly pronounced for girls seeking mental health treatment. The current study examines condom use over time in 211 African-American girls recruited from outpatient psychiatric clinics. Findings indicate that having a sibling with a teenage pregnancy history predicts less consistent condom use two years later. After accounting for earlier condom use and mental health problems, maternal monitoring moderates condom use such that for girls with a sibling with a pregnancy history, more vigilant maternal monitoring is associated with increased condom use, while for girls with no sibling pregnancy history, maternal monitoring is unrelated to adolescents’ condom use two years later. Findings suggest that targeted interventions to increase maternal monitoring of high-risk teens may be beneficial for girls with a sibling history of teenage pregnancy. PMID:27172111
Browne, Felicia A.; Wechsberg, Wendee M.; Bowling, J. Michael; Luseno, Winnie K.
This exploratory study examines the performance of 295 South African women—who recently traded sex for goods or had unprotected sex—on a male condom use mastery index. Bivariate and multivariate logistic regression analyses were conducted to determine whether age, marital status, highest education obtained, male condom use at first penetrative sex, receiving prior demonstration of male condom use, recent sexually transmitted infection (STI) symptoms, and recently trading sex were significantly associated with index scores. Adjusted odds ratios indicated that age and STI symptoms were negatively associated with condom skills; women who were older and had a higher number of recent STI symptoms were more likely to have lower scores. Furthermore, participants executed, on average, approximately one-third of condom use steps correctly. These findings suggest a need for increased behavioral skills training for women engaging in sexual risk behaviors because many lack the skills required to use a male condom properly. PMID:21660835
M. de Wet
Full Text Available In the effort to stem the HIV pandemic, the promotion of the correct and consistent use of condoms has to be a priority in the primary health care sector. This study, concentrating on the southern Free State, sought to identify obstacles to condom usage and to develop strategies to encourage condom usage. Both primary health care workers and their clients served as respondents in the study.
Anglewicz, Philip; Clark, Shelley
A large and increasing proportion of HIV transmissions in sub-Saharan Africa occur within marriage. Condom use within marriage could, therefore, be an important prevention strategy, but there is considerable debate about whether married couples would be willing to use condoms. This paper contributes to this debate by identifying key factors that affect the acceptability of condom use within marriage and actual condom use among men and women in rural Malawi, using three waves of longitudinal data from 2004, 2006 and 2008. Specifically, we focused on the effect of (1) entry into first marriage, (2) respondent's HIV status, HIV perceptions, and risk behaviors, and (3) spouse's HIV characteristics on condom use acceptability within marriage and actual condom use with a spouse or steady partner. Using fixed-effects regression, we found that getting married coincides with a pronounced attitudinal shift regarding the acceptability of condom use within marriage that cannot be explained by differences in fertility status or selection into marriage. In addition, we found that, for women, perceived HIV status of the respondent and spouse generally had greater influence than actual HIV status on the acceptability of condom use within marriage and actual condom use with a spouse or steady partner, even after HIV status is known; while actual HIV status and HIV risk behaviors are generally more important among men. Although condom use within marriage remained low, these findings suggest that attitudes about and use of condoms are susceptible to change and that both marital status and perceptions of risk are important influences on condom use. Copyright © 2013 Elsevier Ltd. All rights reserved.
Adolescents and young adults are highly impacted by sexually transmitted infections (STIs) and unplanned pregnancy in the United States and globally. Consistent and correct use of male latex condoms is associated with protection against both STIs and pregnancy. Providing adolescents and young adults with access to free condoms in schools may increase the use of condoms by improving condom availability, eliminating cost, and decreasing embarrassment associated with purchasing condoms. Studies demonstrate that condom availability in schools is associated with the increased use of condoms and improved overall sexual health. The Society for Adolescent Health and Medicine encourages schools to make condoms available to students as part of efforts to decrease rates of STIs and unplanned pregnancy in adolescents and young adults. The Society for Adolescent Health and Medicine also encourages health care providers to advocate for and support the availability of condoms in local schools. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Cagle Henry H
Full Text Available Abstract Objectives This study examined condom acquisition by persons in a hospital setting when single versus assorted brand name condoms were provided. Methods Condom receptacles were placed in exam rooms of two clinics. During Phase 1, a single brand name was provided; for Phase 2, assorted brand names were added. Number of condoms taken was recorded for each phase. Results For one clinic there was nearly a two-fold increase in number of condoms taken (Phase 1 to Phase 2; for the second clinic there was negligible difference in number of condoms taken. Conclusions The provision of assorted brand name condoms, over a single brand name, can serve to increase condom acquisition. Locations of condoms and target population characteristics are related factors.
Elia John Mmbaga
Full Text Available Abstract Background Unsafe sexual practices continue to put adolescents at risk for a number of negative health outcomes in Tanzania. While there are some effective theory-based intervention packages with positive impact on important mediators of sexual behaviours, a context specific and tested intervention is urgently needed in Tanzania. Purpose To develop and evaluate an intervention that will have a significant effect in reducing sexual initiation and promoting condom use among adolescents aged 12–14 in Dar es Salaam, Tanzania. Design A school-based Cluster Randomised Controlled Trial was conducted during 2011–2014 in Kinondoni Municipality. Methods A total of 38 public primary schools were randomly selected, of which half were assigned to the intervention and half to the control group based on their size and geographic location. Participants were interviewed using a self-administered questionnaire at baseline before the PREPARE intervention and then, 6 and 12 months following intervention. The primary outcomes were self-reported sex initiation and condom use during the past 6 months. Data analysis was done using Generalized Estimating Equation (GEE modelling controlling for repeated measures and clustering of students within schools. Results A total of 5091 students were recruited at baseline, and interviewed again at 6 (n = 4783 and 12 months (n = 4370. Mean age of participants at baseline was 12.4 years. Baseline sociodemographic, psychometric and behavioural characteristics did not significantly differ between the two study arms. The GEE analysis indicated that the intervention had a significant effect on sexual initiation in both sexes after controlling for clustering and correlated repeated measures. A significantly higher level of action planning to use condoms was reported among female adolescent in the intervention arm than those in the control arm (p = 0.042. An effect on condom use behaviour was observed among male
Conclusion: The results showed evidence that the FC was a safe method of contraception and protection against STIs and that it empowers women to make decisions related to sexuality. However, awareness campaigns, increased availability of FCs and training of HCWs are essential to enhance positive perception and attitudinal change to reduce sexual risks related infections and poor quality of life for women.
Objectives: To identify and examine factors that influences the perception and attitude of HCWs towards the use and distribution FCs. Method: A quantitative, explorative and descriptive design was used to conduct the study based on the Health Belief Model (HBM as a conceptual framework. A pre-tested questionnaire was utilised in June 2013 to collect data from a convenience sample of 164 HCWs with a 100% return rate. Data was analysed using the Statistical Package for Social Sciences (SPSS version 13.0 and Statistical Analysis Systems (SAS version 9.2. Results: The results showed that 64.0% (n = 105 of the respondents perceived unavailability of FCs as contributing to lack of adequate use. Only 31.7% (n = 52 [95% CI: 24.7—39.4] of them reported to be using the FC. There was an association with increasing use of a FC with age (Fischer's exact = 0.05, marital status [Fischer's exact ¼ 0.037] and training [c2 = 53.3;p < 0.05]. The results revealed that lack of knowledge and training on the use of a FC might prevent its effective use and distribution. Conclusion: The results showed evidence that the FC was a safe method of contraception and protection against STIs and that it empowers women to make decisions related to sexuality. However, awareness campaigns, increased availability of FCs and training of HCWs are essential to enhance positive perception and attitudinal change to reduce sexual risks related infections and poor quality of life for women.
Full Text Available BACKGROUND: Use of condoms is recommended in all risky sexual contacts, as long as a couple becomes monogamous and tests for HIV and other STDs. This research aims to examine whether people in Ukraine follow this recommendation.MATERIAL AND METHODS: Associations between condom use at last sexual intercourse and type of sexual partner were explored separately for men and women based on data of 2007 survey by using regression models adjusted for knowledge about and attitude to STDs and HIV, contraception and pregnancy, risky behaviour and socio-demographic characteristics.RESULTS: Generally, 37.2% of men and 25.2% of women reported using condom at last sexual contact. Overall, use of condoms increased with less intimacy between partners: 22.6% of men and 19.2% of women used condoms with their spouses, 62.8% and 52.4% ― with girl-/boy-friends, somewhat less – 56.6% and 35.3% ― with casual acquaintance, respectively, and 71.4% of men – with commercial sex workers; in multivariate analysis direction of associations remained the same. Moreover, risky sexual behaviour for both genders, and drugs ever-use and alcohol consumption during last sex for men reduces odds of using condoms. Also, men demonstrating correct knowledge of ways of horizontal transmission of HIV and women aware about ways of prevention of HIV transmission had higher odds of using condoms, as well as women confident in their ability to buy condoms. For socio-demographic characteristics, having children, younger age and dwelling in non-Western regions and cities were positively associated with using condoms.DISCUSSION AND CONCLUSIONS: Although condom use in Ukraine is not prevalent enough, there is a tendency to more frequent use of them with high-risk sexual partners. At the same time, people practicing other types of risky behaviour use condoms less, too.
Msamanga, Gernard; Tchetgen, Eric; Spiegelman, Donna; Fawzi, Mary Kay Smith; Kaaya, Sylvia; Urassa, Willy; Hunter, David; Kapiga, Saidi; Fawzi, Wafaie
To determine the demographic, socio-economic and psycho-social factors associated with condom use amongst antenatal clinic attendees in Dar es Salaam. A cross sectional study design was employed in four antenatal clinics in Dar es Salaam. Pregnant women were interviewed between April 1995 and July 1997 to find out if they have ever used a condom and if so whether they had used them consistently for all coital acts in the previous year. Of 1,585 women interviewed, 41% had their first sexual experience before age of 18 years and 82% had a history of having more than two sexual partners during their lifetime. Sixty-two percent of women had never used a condom. Although 40% had used a condom in the previous year only 12% used them consistently. Ever use of a condom increased significantly with the number of years of education of the respondent and her partner also with the respondent's financial independence. Women with > 9 years of education were twice as likely as women with condom users (prevalence ratio (PR) = 2.1, 95% confidence interval (CI) = 1.6-2.7). Professional women were almost twice as likely as housewives to have ever used a condom (PR = 1.8, 95% CI = 1.3-2.3). Women who reported that they have had more than four sexual partners during their lifetime were associated with nearly a four-fold higher lifetime rate of having ever used a condom, compared with a single lifetime partnership (PR = 3.9, 95% CI = 2.8-5.4). The reported prevalence of ever use of a condom amongst antenatal clinic attendees is low and inconsistent especially among HIV positive women. Deliberate effort should be used to ensure condom access, availability and correct and consistent use of condoms by women in all sexual acts.
Full Text Available Augustine Ankomah,1 Samson B Adebayo,2,3 Jennifer Anyanti,3 Olaronke Ladipo,3,† Bright Ekweremadu31Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana; 2Directorate of Planning, Research and Statistics, National Agency for the Control of Food and Drugs Administration and Control, Abuja, Nigeria; 3Society for Family Health, Abuja, Nigeria†Olaronke Ladipo passed away on 30/10/2012Background: Extramarital sex is a high-risk behavior in terms of Human Immunodeficiency Virus (HIV transmission, yet condom use in extramarital relationships is an understudied area in Africa, and Nigeria in particular, where such liaisons are not uncommon. This study highlights key determinants of condom use among men who engage in extramarital sex in Nigeria.Methods: Results are based on a subsample of 642 married men from a combined dataset from three waves of the National HIV/AIDS and Reproductive Health Survey (NARHS, a set of multiround nationally representative surveys. Logistic regression was employed to explore possible determinants of condom use in extramarital sex. The motivation, opportunity, and ability model was applied in selecting the determinants.Results: HIV risk-reduction knowledge was found not to be associated with condom use. At the full logistic regression model, being of the Yoruba tribe, having no misconception about HIV transmission, ability to discuss condom use, and ability to wear condoms were the key variables significantly associated with condom use in extramarital sex.Conclusion: Implementing HIV risk-reduction behavior change requires more than knowledge. Behavioral skills in condom use are critical. Intervention efforts should move away from knowledge about risk to concentrate on improving skills on how to discuss condom use and wear condoms correctly.Keywords: married men, extramarital sex, condom use, motivation, opportunity, Nigeria
Katz, Karen R; McDowell, Misti; Green, Mackenzie; Jahan, Shamim; Johnson, Laura; Chen, Mario
Little is known about the sexual and reproductive health care needs of female sex workers in Dhaka, Bangladesh. Survey data were collected from 354 hotel-based and 323 street-based female sex workers using a venue-based stratified cluster sampling approach. In addition, in-depth interviews were conducted with 20 female sex workers recruited from drop-in centers. We calculated unmet need for family planning and examined fertility desires, use of condoms and other contraceptive methods, experiences with gender-based violence, sexual and reproductive health service needs, and preferences on where to receive services. The prevalence of unmet need was 25% among hotel-based female sex workers and 36% among street-based female sex workers. Almost all participants reported having used condoms in the past 30 days, and 44% of hotel-based sex workers and 30% of street-based sex workers reported dual method use during that period. Condom use was inconsistent, however, and condom breakage and nonuse for extra money were common. Many women reported experiencing gender-based violence. Sexual and reproductive health services had been obtained by 64% of hotel-based and 89% of street-based sex workers in the past six months; drop-in centers were their preferred site for receiving health services. Female sex workers in Dhaka need family planning and other sexual and reproductive health services and prefer receiving them from drop-in centers.
Increase in condom use and decline in prevalence of sexually transmitted infections among high-risk men who have sex with men and transgender persons in Maharashtra, India: Avahan, the India AIDS Initiative.
Ramanathan, Shreena; Deshpande, Sucheta; Gautam, Abhishek; Pardeshi, Dilip B; Ramakrishnan, Lakshmi; Goswami, Prabuddhagopal; Adhikary, Rajatashuvra; George, Bitra; Paranjape, Ramesh S; Mainkar, Mandar M
The present study assessed coverage, changes in condom use, and prevalence of HIV and other STIs among high-risk men who have sex with men (HR-MSM; highly visible, recruited from cruising sites/sex venues) and transgender (TG; male-to-female transgender persons, also called hijras) in the Indian state of Maharashtra. Data from Avahan's computerized management information system; two rounds of integrated behavioral and biological assessment (IBBA) surveys (Round 1 with 653 HR-MSM/TG and Round 2 with 652 HR-MSM/TG); and project-supported condom social marketing was used for the present analysis. Logistic regression models were used to assess changes in key indicators over these two rounds and to explore the association between exposure to Avahan interventions and condom use and STI prevalence in HR-MSM/TG. By December 2007, Avahan had reached about 90% of the estimated HR-MSM/TG population, and 83% of the estimated total population had visited STI clinics by March 2009. Free direct condom distribution by Avahan program NGOs and social marketing outlets in Maharashtra increased from about 2.7 million condoms in 2004 to 15.4 million in 2008. HR-MSM/TG were more likely to report higher consistent condom use (adjusted odds ratio [AOR]: 1.90; 95% confidence interval [CI] 1.01-3.58) with regular male partners (spouse/lover/boyfriend) in Round 2 of IBBA, compared to Round 1. HR-MSM/TG exposed to Avahan interventions were more likely to report consistent condom use with regular male partners (AOR: 2.46; CI 1.34-4.52) than those who were unexposed. Prevalence of reactive syphilis serology declined significantly from 8.8% in Round 1 to 1.1% in Round 2 (p = 0.001), while the observed change HIV prevalence (12.3% to 6.3%, p = 0.16) was insignificant. The current evaluation provides evidence for successful scale up and coverage of target population by Avahan interventions in Maharashtra. The assessment findings showed improved accessibility to condoms and reduced risk
President Bush complained yesterday about the "filth and indecent material" that Americans are exposed to through televised trials. Mr. Bush also criticized programs to combat AIDS that give condoms to teenagers and clean needles to drug addicts. He said such efforts undermine traditional values. He expressed hope that Earvin "Magic" Johnson's revelation that he is HIV positive "will teach people that wayward lifestyles or just kind of unsafe sex at random is not the way it ought to work." Mr. Bush made the comments in a series of satellite television interviews with ABC affiliates in major cities. In an apparent reaction to graphic testimony at the recent Palm Beach rape trial of William Kennedy Smith, Mr. Bush said, "I think the American people have a right to be protected against some of these excesses." Mr. Smith, a nephew of Sen. Edward M. Kennedy, D-Mass., was acquitted last week. The Cable News Network and Court TV provided virtually gavel-to-gavel coverage. Mr. Bush took a dim view of a plan to distribute condoms to juniors and seniors in Philadelphia city high schools as part of a program to combat acquired immune deficiency syndrome. "This is a disease that can be controlled for the most part by individual behavior," Mr. Bush said. "Indeed, I must tell you I'm worried about it. I'm worried about so much filth and indecent material coming in through the airwaves and through these trials into people's homes," he said. full text
Full Text Available availability: adult attitudes to condoms and sex; gendered power relations and the economic context of adolescent sexuality. Informants did not constitute a homogenous group in terms of their understandings of sexuality. While there was clear evidence...
Stanton, B; Deveaux, L; Lunn, S; Yu, S; Brathwaite, N; Li, X; Cottrell, L; Harris, C; Clemens, R; Marshall, S
Because of the continued importance of correct condom-use in controlling the HIV epidemic and the limited availability of tools for assessing correct condom-use, methods for assessing condom-application skills, especially when direct observation is not feasible, are needed. Accordingly, in the context of a high-risk population (The Bahamas) for HIV, a 17-item scale--the Condom-use Skills Checklist (CUSC)--was developed for use among young adolescents and adults. The rationale and approach to developing the scale and some measures of internal consistency, construct validity, and criterion-related validity have been described. It is concluded that the scale offers a reasonable alternative to direct observation among older subjects and that further development may make it more useful among pre-adolescents.
Widman, Laura; Noar, Seth M.; Choukas-Bradley, Sophia; Francis, Diane
Objective Condom use is critical for the health of sexually active adolescents, and yet many adolescents fail to use condoms consistently. One interpersonal factor that may be key to condom use is sexual communication between sexual partners; however, the association between communication and condom use has varied considerably in prior studies of youth. The purpose of this meta-analysis was to synthesize the growing body of research linking adolescents’ sexual communication to condom use, and to examine several moderators of this association. Methods A total of 41 independent effect sizes from 34 studies with 15,046 adolescent participants (Mage=16.8, age range=12–23) were meta-analyzed. Results Results revealed a weighted mean effect size of the sexual communication-condom use relationship of r = .24, which was statistically heterogeneous (Q=618.86, pcommunication topic and communication format were statistically significant moderators (pcommunication about condom use (r = .34) than communication about sexual history (r = .15) or general safer sex topics (r = .14). Effect sizes were also larger for communication behavior formats (r = .27) and self-efficacy formats (r = .28), than for fear/concern (r = .18), future intention (r = .15), or communication comfort (r = −.15) formats. Conclusions Results highlight the urgency of emphasizing communication skills, particularly about condom use, in HIV/STI prevention work for youth. Implications for the future study of sexual communication are discussed. PMID:25133828
Carvalho, Telma; Alvarez, Maria-João; Barz, Milena; Schwarzer, Ralf
Objective: Motivation is not sufficient to actually use condoms, as self-regulatory processes are needed to translate motivation into action. Buying condoms and carrying them constitute preparatory behaviors that may serve as proximal predictors of action. Whether or not such preparatory behaviors operate as mediators between intention and action…
Teitelman, Anne M.; Ratcliffe, Sarah J.; Morales-Aleman, Mercedes M.; Sullivan, Cris M.
This study examined the association between sexual relationship power, intimate partner violence, and condom use among African American and Hispanic urban girls. In this sample of 56 sexually active girls, 50% did not use condoms consistently and therefore were at higher risk for acquiring HIV or sexually transmitted diseases (STDs). Teens who…
Wong, M L; Lubek, I; Dy, B C; Pen, S; Kros, S; Chhit, M
To determine the social and behavioural factors associated with condom use among direct sex workers in Siem Reap, Cambodia. Using a structured behavioural questionnaire, interviews were conducted with 140 direct sex workers attending a health centre in Siem Reap for HIV screening. Consistent condom use with their clients was reported by 78% of sex workers compared to only 20% with their non-paying partners. Consistent condom use with clients was significantly higher among higher income than lower income sex workers (adjusted prevalence ratio: 1.91, 95% CI: 1.15 to 3.18) and those with good rather than poor negotiation skills (adjusted prevalence ratio: 1.51, 95% CI: 1.01 to 2.26), after adjustment for age, educational level, marital status, number of sexual encounters per week, and knowledge of AIDS/HIV and sexually transmitted infections. The most frequently reported reason for not using condoms with clients was not being able to persuade them (66.7%), while for non-paying partners, the reason was that they loved them (60.0%). To complement the government's current programme of client education, 100% condom policy and brothel administrative measures, additional strategies to increase condom use among clients and non-paying partners should be directed at (i) the social policy and community levels to address sex workers' economic and cultural barriers to condom use, and (ii) personal level empowerment through developing sex workers' condom negotiation skills.
Wilson, Michele D.; And Others
Examined male adolescent behavior, attitudes, and knowledge concerning condom use. Findings from 241 sexually active black adolescent males revealed that factors associated with condom use included higher grade level, having 2 or more sexual partners in past 6 months, communication about contraception with sexual partner, desire for sexually…
Lindemann, Dana F.; Harbke, Colin R.
Objective: To evaluate whether or not written condom use instructions successfully inform correct condom use skills. Design: Between-subjects, two-group design. Setting: Public university located in rural Midwestern region of the United States. Method: Participants were randomly assigned to either a control condition (read physical exercise…
Eastman-Mueller, Heather P.; Gomez-Scott, Jessica R.; Jung, Ae-Kyung; Oswalt, Sara B.; Hagglund, Kristofer
The U.S. Centers for Disease Control and Prevention advocate access to condoms as a critical sexual health prevention strategy. The purpose of this article is to discuss the implementation and evaluation of a condom availability program using dispensing machines in residence halls at a Midwestern U.S. university. Undergraduate students (N = 337)…
Yarber, William L.; Graham, Cynthia A.; Sanders, Stephanie A.; Crosby, Richard A.; Butler, Scott M.; Hartzell, Rose M.
Background: Although quantitative assessment of male condom use errors and problems has received increased research attention, few studies have qualitatively examined this sexual health behavior. Purpose: This study examined problems of male condom use as experienced by college men and women at a large, public Midwestern university. Methods:…
A cross-sectional survey was conducted to test an integrated model of condom use with a sample of 490 sexually active Chinese college students. A number of variables in the integrated model were predictors of condom use, explaining 33.4% of the variance in use. Partner communication was the strongest predictors (beta = 0.317, SE = 0.038, p less…
The condom plays a vital part in safe sex, the ideal outcome of mainstream Swedish sex education. As researchers have pointed out, however, the condom is not a neutral object; rather, it plays a part in shaping, in different ways, both sexual practices and the idea of what sex is. This paper focuses on sex education television programmes produced…
Lazarus, Jeff; Himedan, Himedan Mohammed; Østergaard, Lise Rosendal
This study explores the knowledge, attitudes and practices among Somali and Sudanese immigrants in Denmark with regard to HIV/AIDS and condom use.......This study explores the knowledge, attitudes and practices among Somali and Sudanese immigrants in Denmark with regard to HIV/AIDS and condom use....
Adams, Jeffery; Neville, Stephen
Objective: Ensuring men who have sex with men (MSM) adopt and maintain condom use for anal sex is a challenging health education goal. In order to inform the development of social marketing practices to encourage safe-sex practices, the views of MSM about a key HIV health education message ("using a condom every time for anal sex") were…
Full Text Available As embarrassment is a known obstacle to condom acquisition, selling condoms from physically inaccessible places that require personnel assistance constitutes a barrier to access. This study investigates the extent of this barrier in the Bronx, a high HIV/STI prevalence county of New York. 75 of 320 listed Bronx pharmacies were sampled via computer randomization. Investigators coded condom placement and physical accessibility within these pharmacies and 140 surrounding stores. 91% of sites sold condoms. In 82%, condoms could not be accessed without assistance. Condoms were physically inaccessible in venues most encountered in the community: grocery stores versus pharmacies (OR=15; 95% CI, 5–48, independent versus chain pharmacies (OR=32; 95% CI, 6–235. They were physically inaccessible more in the lowest SES/highest HIV prevalence areas versus the highest SES/lowest HIV prevalence areas (OR = 4.3, 95% CI, 1.1–17. Findings can inform efforts to increase accessibility of condoms, distribute condoms in alternative settings, and prompt similar investigations in other high-risk communities.
Kabiru, Caroline W.; Orpinas, Pamela
Background: Correct and consistent condom use is an effective strategy to reduce the risk of sexually transmitted infections (STIs). This study examines sociodemographic, behavioral, and psychosocial characteristics of 3 groups of adolescent males: consistent, sporadic, and non-condom users. Methods: The sample consisted of 931 sexually…
Alstead, Mark; Campsmith, Michael; Halley, Carolyn Swope; Hartfield, Karen; Goldblum, Gary; Wood, Robert W.
Describes the development, implementation, and evaluation of an HIV prevention program promoting condom use among sexually active adolescents. It mobilized target communities to guide program development and implementation; created a mass media campaign to promote correct condom use; and recruited public agencies and organizations to distribute…
Muula, Adamson S; Thomas, James C; Pettifor, Audrey E; Strauss, Ronald P; Suchindran, Chirayath M; Meshnick, Steve R
Correct and consistent condom use within an HIV-discordant partnership could prevent sexual transmission of human immunodeficiency virus (HIV). Data on ever-married women from rural Malawi were obtained from the Malawi Diffusion and Ideational Change Project (MDICP) of 2006. We assessed the strength of association between religion and acceptability of condom use within marriage in general and also when one of the partners is suspected or known to be HIV infected. A total of 1,664 ever-married women participated in the MDICP 2006. Of these, 66.7% believed condom use was acceptable within marriage when one partner suspects or knows that the other was HIV infected; 38.2% believed condoms were acceptable within marriage generally. Only 13.8% reported ever having used condoms within the current or most recent marriage. Multivariate analysis found no difference in acceptability of condoms within marriage between Christians and Muslims, or between Catholics and all but one of the individual denominations assessed. Christian women in rural Malawi were no more or no less likely to accept condom use than Muslim women; there was also no difference in attitude toward condom use within marriage among Malawian women.
Slaymaker, Emma; Zaba, Basia
Correct and consistent condom use can prevent susceptible people from acquiring HIV infection. However, in many countries repeated cross-sectional studies reveal a trend of increasing prevalence of HIV infection alongside an increase in reported condom use. Changes in sexual behaviour that reduce the number of new HIV infections will not become apparent through changes in HIV prevalence until some time after the behaviour change takes place. Limitations in the data used to assess condom use may also explain the concurrent increases in condom use and HIV prevalence. One common indicator of condom use, the UNGASS indicator (condom use at last higher risk sex of those aged 15-24), has been chosen to illustrate how changes in the proportion of people who report using condoms do not always explain changes in the size of the group who had high risk behaviour. Indicators based on the proportion of the whole population who have sex without using a condom would be better measures of the size of the group at highest risk of HIV infection.
Guigon, P; Breton, D; Mendes-Oustric, A C; Pech, A; Clair, P
Male condoms are undoubtedly the best protection against sexually transmitted diseases. The French Military Health Service buys condoms from civilian manufacturers using a public purchasing process. This process includes strict technical analysis that allows selection of the best supplier. In addition each batch of condoms delivered to French armed forces undergoes quality testing in the laboratory of the Armed Services Central Pharmacy before being distributed to troops. Despite these strict control measures, several isss remain unclear. One issue involves the shelf life of condoms stored in warm humid tropical conditions. Another issue involves the effect of lubricants on condom quality. The purpose of this report is to describe a study designed to gain insight into these two issues. This study was conducted by the Armed Services Central Pharmacy in colaboration with the Procuremnt and Central Establishment Directorate. Findings showed that stage conditions have no negative effects on the intrinsic physico-chemial properties of condoms supplied by two different manufacturers. Conversely use of inadequate lubricants (alimentary or cosmetic compounds) appeared to have extremely deleterious effects on condom quality. Laboratory tests showed that lubricants composed mainly of fatty acids dramatically decreased the effectiveness of condoms.
Sexually active young people are at high risk of unwanted pregnancies and sexually transmitted diseases. Consistent condom use is critically important for preventing both. This study examined sexual activity and pattern of condom use among in-school youths in Sagamu. Multi-staged sampling method was used to choose ...
Brady, Sonya S; Tschann, Jeanne M; Ellen, Jonathan M; Flores, Elena
Latino youth in the United States are at greater risk for contracting sexually transmitted infections (STIs) in comparison with non-Hispanic white youth. Sexually active heterosexual Latino youth aged 16 to 22 years (N = 647) were recruited for interviews through a large health maintenance organization or community clinics. Adjusting for gender, age, ethnic heritage, and recruitment method, woman's consistent use of hormonal contraceptives, ambivalence about avoiding pregnancy, longer length of sexual relationship, and greater overall trust in main partner were independently associated with inconsistent condom use and engagement in a greater number of sexual intercourse acts that were unprotected by condom use. Perception that one's main partner had potentially been unfaithful, but not one's own sexual concurrency, was associated with consistent condom use and fewer acts of unprotected sexual intercourse. Sexually concurrent youth who engaged in inconsistent condom use with other partners were more likely to engage in inconsistent condom use and a greater number of unprotected sexual intercourse acts with main partners. Increasing attachment between youth may be a risk factor for the transmission of STIs via normative declines in condom use. Perception that one's partner has potentially been unfaithful may result in greater condom use. However, many Latino adolescents and young adults who engage in sexual concurrency may not take adequate steps to protect their partners from contracting STIs. Some youth may be more focused on the emotional and social repercussions of potentially revealing infidelity by advocating condom use than the physical repercussions of unsafe sex.
Eloundou-Enyegue, Parfait M; Meekers, Dominique; Calvès, Anne Emmanuèle
This paper uses retrospective event-history data covering a four-year period to examine the timing of exposure to HIV/AIDS education and social marketing condom promotion campaigns, relative to the timing of changes in sexual risk behaviour in Tanzania. Analysis of the event-history data shows that the process of exposure to AIDS education messages and exposure to brand advertising for Salama brand condoms was very different. While exposure to AIDS education was early and gradual, exposure to Salama brand condoms started later, but was much more rapid. After one year of advertising, over half of the target population had been reached by the Salama advertising campaign, mostly through newspapers, radio and television. During the study period, condom use increased from 15% at the beginning of 1993 to 42% at the end of 1996. Increases in condom use were driven both by men who became sexually active, and by men who were not yet protected, or not fully protected. The results further show that it is uncommon for men who adopted condom use to return to more risky behaviour, which suggests that behaviour change in the study population is permanent.
Farr, G; Acosta Castro, L A; DiSantostefano, R; Claassen, E; Olguin, F
Condom use is one of the most important preventive measures sex workers can take to reduce the risk of becoming infected with a sexually transmitted disease. However, a client may refuse to use a condom when requested. Some sexually transmitted disease prevention programs are recommending that sex workers use spermicide as an alternative prophylaxis when a condom is refused, yet little is known about the effect of this recommendation on prophylactic condom use. To determine if using spermicide, either in conjunction with condoms or as a backup, influenced overall condom use among a group of sex workers at high risk of sexually transmitted diseases in Santa Fe de Bogota, Colombia. Participants were assigned randomly to one of three condom use groups: use of condoms only (Condoms Only), use of condoms and spermicides concurrently (Condom and Spermicide), or use of spermicide when condoms were refused (Spermicide as a Backup). A total of 199 sex workers entered the study and were asked to return for follow-up every 2 weeks for a period of 12 weeks. Women assigned to the Spermicide as a Backup group used a condom for an average of 78.1% of their reported acts of intercourse, compared with an average of 94.5% in the Condom Only and 92.3% in the Condom and Spermicide groups. However, women in the Spermicide as a Backup group used a condom or spermicide for an average of 96.9% of their acts of intercourse. Condoms were used for every intercourse act by less than 5% of the women in the Spermicide as a Backup groups, compared with 50.7% in the Condom Only group and 41.2% in the Condom and Spermicide group (P 0.001). When condoms were not used, client refusal was the primary reason reported. The incidence of sexually transmitted diseases and other urogenital inflammations in all groups was lower than expected. Among Colombian sex workers, condom use declined substantially when women were instructed to use spermicides if they were unable to persuade their partner to use a
Starace, F; Minaci, F; Semmola, A; Nespoli, M; Palumbo, F
A correct and consistent condom use can minimize the risk of acquiring HIV infection through sexual intercourse. The aim of this study has been to assess knowledge and attitudes towards condom use among adolescents and young adults living in southern Italy. 620 randomly selected subjects have been interviewed by means of a 16-item standardized questionnaire: 87.3% consider condom an useful tool in the prevention of sexually transmitted diseases; however, 53.5% think that condom may reduce sexual pleasure and 26.8% state that its cost is too high to allow regular use. These results emphasize the need of carefully planned programs aimed to overcome objective and subjective barriers in the use of condom to prevent HIV infection spreading.
Albarracín, D; Johnson, B T; Fishbein, M; Muellerleile, P A
To examine how well the theories of reasoned action and planned behavior predict condom use, the authors synthesized 96 data sets (N = 22,594) containing associations between the models' key variables. Consistent with the theory of reasoned action's predictions, (a) condom use was related to intentions (weighted mean r. = .45), (b) intentions were based on attitudes (r. = .58) and subjective norms (r. = .39), and (c) attitudes were associated with behavioral beliefs (r. = .56) and norms were associated with normative beliefs (r. = .46). Consistent with the theory of planned behavior's predictions, perceived behavioral control was related to condom use intentions (r. = .45) and condom use (r. = .25), but in contrast to the theory, it did not contribute significantly to condom use. The strength of these associations, however, was influenced by the consideration of past behavior. Implications of these results for HIV prevention efforts are discussed.
Kanekar, Amar; Sharma, Manoj
The absence of consistent and correct usage of condoms increases the risk of sexually transmitted infections (STI) and HIV/AIDS. However, most studies done to date across the nation indicate a low usage of condoms among college students. This study identifies protective and risk factors associated with condom use among college students. The National College Health Assessment was administered to a random sample of students at a state comprehensive university in south central Kentucky. Findings revealed that among the sexually active students, approximately half never used condoms during vaginal intercourse. Further, among students engaging in oral sex, an alarmingly high proportion (95%) reported never using a condom during this act. These findings, along with differences noted in various subgroups (gender, housing, class standing), and other risk behaviors (alcohol, illicit drug use) are discussed.
Davidoff-Gore, Alena; Luke, Nancy; Wawire, Salome
To date, research on the link between poverty and unsafe sexual behaviors has utilized limited measures of socioeconomic status and has overlooked key dimensions of poverty at the individual level. This study explored how various dimensions of socioeconomic status are associated with inconsistent condom use and how these associations vary by gender. We analyzed unique life history survey data from 261 young men and women in Kisumu, Kenya, and conducted analyses based on 959 person-months in which respondents had been sexually active in nonmarital relationships. Dependent variables were inconsistent condom use (not always using a condom) and never use of condoms. Condoms were used inconsistently in 57% of months and were never used in 31%. Corroborating existing literature, lower household wealth and lower educational attainment were associated with inconsistent condom use. Lower individual economic status (lower earned income, food insufficiency, and larger material transfers from partners) were also important determinants of inconsistent condom use. There were no significant differences in these associations by gender, with the exception of food insufficiency, which increased the risk of inconsistent condom use for young women but not for young men. None of these individual measures of socioeconomic status were associated with never use of a condom. The findings suggest that both household- and individual-level measures of socioeconomic status are important correlates of condom use and that individual economic resources play a crucial role in negotiations over the highest level of usage. The results highlight the importance of poverty in shaping sexual behavior, and, in particular, that increasing individual access to resources beyond the household, including ensuring access to food and providing educational and work opportunities, could prove to be effective strategies for decreasing the risk of HIV among youth.
Talukdar, Arunansu; Bal, Runa; Sanyal, Debasis; Roy, Krishnendu; Talukdar, Payel Sengupta
The propaganda for the use of condoms remains one of the mainstay for prevention of human immunodeficiency virus (HIV) transmission. In spite of the proven efficacy of condom, some moral, social and psychological obstacles are still prevalent, hindering the use of condoms. The study tried to construct a short condom-attitude scale for use among the migrant workers, a major bridge population in India. The study was conducted among the male migrant workers who were 18-49 years old, sexually active and had heard about condoms and were engaged in nonformal jobs. We recruited 234 and 280 candidates for Phase 1 and Phase 2 respectively. Ten items from the original 40-item Brown's ATC (attitude towards condom) scale were selected in Phase 1. After analysis of Phase 1 results, using principal component analysis six items were found appropriate for measuring attitude towards condom use. These six items were then administered in another group in Phase 2. Utilizing Pearson's correlations, scale items were examined in terms of their mean response scores and the correlation matrix between items. Cornbach's alpha and construct validity were also assessed for the entire sample. Study subjects were categorized as condom users and nonusers. The scale structure was explored by analyzing response scores with respect to the items, using principal component analysis followed by varimax rotation analysis. Principal component analysis revealed that the first factor accounted for 71% of the variance, with eigenvalue greater than one. Eigenvalues of the second factor was less than one. Application of screen test suggests only one factor was dominant. Mean score of six items among condom users was 20.45 and that among nonusers was 16.67, which was statistically significant (Pvulnerable people in India, can be included in any rapid survey for assessing the existing beliefs and attitudes toward condoms and also for evaluating efficacy of an intervention program.
Yah, Clarence S.; Simate, Geoffrey S.; Hlangothi, Percy; Somai, Benesh M.
Objective: The human immunodeficiency virus (HIV) is among the utmost destructive viruses humankind has ever faced in almost four decades. It carries with it profound socioeconomic and public health implications. Unfortunately, there is, currently, no effective cure for HIV infections. This review discusses the various types of condoms, microbicides, and the potential use of nanoparticle-coated condoms as a means of diminishing the risk of HIV transmission and sexually transmitted infections (STIs) during sexual intercourse. Methods: We identified 153 articles from 1989 to 2015 indexed in various journal platforms, reports, and magazines. Using the PRISMA guidelines as proxy in performing the research review process, only 53 articles were selected. Ideally, articles that failed to describe the nature and types of condoms, condom failures, nanoparticle-coated condoms, microbicides, and HIV prevention were excluded. Results and Discussion: In general, it has been shown that antiretroviral therapy (ART) currently available can only limit transmission and acquisition of HIV strains. Apart from ART treatment, the use of condoms has been identified globally as a cost-effective intervention for reducing the spread of HIV and other STIs. However, while condoms are supposed to be effective, reliable, and easy to use, research has shown that they are attributable to 20% failures including breakages. Nevertheless, other studies have shown that coating condoms with nanoparticles is an important and effective method for reducing condom breakage and HIV/STI transmission during sexual intercourse. Conclusions: A review of literature cited in this paper has shown that nanotechnology-based condom systems have the potential to prevent the spread of HIV and STIs. Furthermore, the antimicrobial nature of some nanoparticles could provide a safe and efficient way to disrupt and/or inactivate different STIs – including viral, bacterial, and fungal diseases. PMID:29536957
Full Text Available Abstract Background HIV prevention programs targeting youth often emphasize the role of peers, and assume that youths will model their behavior after their peers'. We challenge this view; we argue that adopting a given behavior requires social approval, and that youths do not necessarily turn to peers for such approval. This study analyzes survey data on youths in urban Cameroon to 1 identify which type of persons youths look to for social approval, and 2 establish how important social approval by these persons is for condom use among youths. Methods We analyzed data from three survey waves (2000, 2002, and 2003 of a reproductive health survey conducted among urban Cameroonian youth (aged 15-24. Only respondents who reported having at least one casual partner in the past year were retained for the analysis. Bivariate analyses and structural equation modeling were used to examine relationships among perceived social approval, attitudes towards condoms and condom use. Results The data show that only 3% of youths named their friends as people whose opinion they valued, while 93% mentioned family members. The perceived approval of condom use by these persons had a significant positive effect on the frequency of condom use among youths. The frequency of condom use was also affected by the respondents' attitudes toward condom use, the range of persons with whom they discussed reproductive health matters, whether they were enrolled in school, socioeconomic status, their self-efficacy, perceived severity of AIDS, risk perception and sexual risk behavior. The perceived social approval of condom use and the respondents' own condom attitudes were correlated. Conclusions Our analysis demonstrates that perceived social approval facilitates the adoption of condom use among urban Cameroonian youth. However, youths tend to value the opinions of family members much more than the opinions of their peers. These results suggest that interventions targeting youths
de Visser, Richard O; Badcock, Paul B; Rissel, Chris; Richters, Juliet; Smith, Anthony M A; Grulich, Andrew E; Simpson, Judy M
Background It is important to have current and reliable estimates of the frequency and correlates of condom use among Australian adults. A representative sample of 20094 men and women aged 16-69 years, from all states and territories, completed computer-assisted telephone interviews. The overall participation rate among eligible people was 66.2%. Although most respondents had used a condom at some time in their lives, fewer than half of those who were sexually active in the year before being interviewed had used a condom in that year. Condom use in the last year was associated with youth, speaking a language other than English at home, bisexual identity, greater education, residence in major cities, lower income and having multiple sexual partners in the last year. One-quarter of respondents used a condom the last time they had vaginal intercourse and one-sixth of these were put on after genital contact. Condom use during most recent vaginal sex was associated with youth, lower income, having sex with a non-regular partner and not using another form of contraception. Condom use appears to have increased between 2001-02 and 2012-13. Consistent with other research, this study showed that condom use was strongly associated with partner type and use of other contraception. There may be a need to highlight among people with multiple sexual partners the fact that non-barrier methods of contraception do not offer protection against sexually transmissible infections. The finding that many condoms were applied after genital contact suggests a need to promote both use and correct use of condoms.
Wasie, Belaynew; Belyhun, Yeshambel; Moges, Beyene; Amare, Bemnet
Young people between the ages of 15 and 24 years are both the most at risk of HIV and the greatest hope for turning the tide against HIV/AIDS. Although various surveys have been done on sexual behaviour of youth in Ethiopia, studies assessing the effect of emergency oral contraceptives on condom utilization of university students are lacking. A cross-sectional study was conducted in two major universities of Ethiopia from January to May 2011 using structured self administered questionnaire with the aim to assess the effect of introducing oral emergency contraceptive pills on condom utilization and sexual risk taking behaviours among female university students. Study participants were selected by simple random sampling using the list from the associate registrars of each University. Data were entered, cleaned and analyzed using SPSS version 17.0. Bivariate and multiple logistic regression analyses were used to determine factors associated with condom utilization. a total of 623 students out of 660 were included giving response rate of 94.4%. A total of 103(16.5%) had history of sexual intercourse and nearly half (45.6%) of them had sex before the age of 20 years. Forty (6.4%) students had history of sexually transmitted infections (STI). Sixty seven percent of students had heard about emergency oral contraceptives. One hundred and ninety one (45.7%) of students believe that EOC is effective in preventing pregnancy. Believing that EOC is effective in preventing pregnancy (adjusted Odds ratio, AOR = 0.22 95% CI 0.06, 0.87), condom prevents STI (AOR = 10.37, 95% CI 1.73, 62.24) and younger age below 20 years (AOR = 11.68 95% CI 1.25, 109.19) were statistically significantly associated with condom use. a significant number of students had history of sexual intercourse and used emergency contraception. The belief in the effectiveness of EOC negatively affects condom use. The preference for the pill may make teenagers less prepared to practice STI protective behaviours in
Full Text Available Abstract Background Young people between the ages of 15 and 24 years are both the most at risk of HIV and the greatest hope for turning the tide against HIV/AIDS. Although various surveys have been done on sexual behaviour of youth in Ethiopia, studies assessing the effect of emergency oral contraceptives on condom utilization of university students are lacking. Methods A cross-sectional study was conducted in two major universities of Ethiopia from January to May 2011 using structured self administered questionnaire with the aim to assess the effect of introducing oral emergency contraceptive pills on condom utilization and sexual risk taking behaviours among female university students. Study participants were selected by simple random sampling using the list from the associate registrars of each University. Data were entered, cleaned and analyzed using SPSS version 17.0. Bivariate and multiple logistic regression analyses were used to determine factors associated with condom utilization. Results a total of 623 students out of 660 were included giving response rate of 94.4%. A total of 103(16.5% had history of sexual intercourse and nearly half (45.6% of them had sex before the age of 20 years. Forty (6.4% students had history of sexually transmitted infections (STI. Sixty seven percent of students had heard about emergency oral contraceptives. One hundred and ninety one (45.7% of students believe that EOC is effective in preventing pregnancy. Believing that EOC is effective in preventing pregnancy (adjusted Odds ratio, AOR = 0.22 95% CI 0.06, 0.87, condom prevents STI (AOR = 10.37, 95% CI 1.73, 62.24 and younger age below 20 years (AOR = 11.68 95% CI 1.25, 109.19 were statistically significantly associated with condom use. Conclusion a significant number of students had history of sexual intercourse and used emergency contraception. The belief in the effectiveness of EOC negatively affects condom use. The preference for the
Liu, Chuncheng; Mao, Jessica; Wong, Terrence; Tang, Weiming; Tso, Lai Sze; Tang, Songyuan; Zhang, Ye; Zhang, Wei; Qin, Yilu; Chen, Zihuang; Ma, Wei; Kang, Dianming; Li, Haochu; Liao, Meizhen; Mollan, Katie; Hudgens, Michael; Bayus, Barry; Huang, Shujie; Yang, Bin; Wei, Chongyi; Tucker, Joseph D
Crowdsourcing has been used to spur innovation and increase community engagement in public health programmes. Crowdsourcing is the process of giving individual tasks to a large group, often involving open contests and enabled through multisectoral partnerships. Here we describe one crowdsourced video intervention in which a video promoting condom use is produced through an open contest. The aim of this study is to determine whether a crowdsourced intervention is as effective as a social marketing intervention in promoting condom use among high-risk men who have sex with men (MSM) and transgender male-to-female (TG) in China. We evaluate videos developed by crowdsourcing and social marketing. The crowdsourcing contest involved an open call for videos. Entries were judged on capacity to promote condom use, to be shareable or 'go viral' and to give value to the individual. 1170 participants will be recruited for the randomised controlled trial. Participants need to be MSM age 16 and over who have had condomless anal sex in the last 3 months. Recruitment will be through an online banner ad on a popular MSM web page and other social media platforms. After completing an initial survey, participants will be randomly assigned to view either the social marketing video or the crowdsourcing video. Follow-up surveys will be completed at 3 weeks and 3 months after initial intervention to evaluate condomless sex and related secondary outcomes. Secondary outcomes include condom social norms, condom negotiation, condom self-efficacy, HIV/syphilis testing, frequency of sex acts and incremental cost. Approval was obtained from the ethical review boards of the Guangdong Provincial Center for Skin Diseases and STI Control, UNC and UCSF. The results of this trial will be made available through publication in peer-reviewed journals. NCT02516930. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Cecil, Michael; Warner, Lee; Siegler, Aaron J
Across studies, 35-50% of men describe condoms as fitting poorly. Rates of condom use may be inhibited in part due to the inaccessibility of appropriately sized condoms. As regulated medical devices, condom sizes conform to national standards such as those developed by the American Society for Testing and Materials (ASTM) or international standards such as those developed by the International Organisation for Standardisation (ISO). We describe the initial online sales experience of an expanded range of condom sizes and assess uptake in relation to the current required standard dimensions of condoms. Data regarding the initial 1000 sales of an expanded range of condom sizes in the United Kingdom were collected from late 2011 through to early 2012. Ninety-five condom sizes, comprising 14 lengths (83-238mm) and 12 widths (41-69mm), were available. For the first 1000 condom six-pack units that were sold, a total of 83 of the 95 unique sizes were purchased, including all 14 lengths and 12 widths, and both the smallest and largest condoms. Initial condom purchases were made by 572 individuals from 26 countries. Only 13.4% of consumer sales were in the ASTM's allowable range of sizes. These initial sales data suggest consumer interest in an expanded choice of condom sizes that fall outside the range currently allowable by national and international standards organisations.
Bradley, Heather; Leichliter, Jami S; Gift, Thomas L
Young people may be more likely to use condoms if they discuss sexual risks with their parents. However, no previous study has examined whether discussing sexual risks with a parent is differently associated with condom use among women using and not using other contraceptive methods. Using weighted data from the 2006-2008 National Survey of Family Growth, we examined condom use at last sex among 1206 sexually active unmarried women aged 15-24 years. Using logistic regression, we examined the association between condom use and discussing sexually transmissible infections (STIs) with parents before the age of 18 years, adjusted for women's characteristics (age, ethnicity, income and condom use at first sex). We estimated the predicted probability of condom use by whether women discussed STIs with parents, stratified by use of other contraceptive methods. Overall, 53% of women used condoms at last sex. Among 564 women using other contraceptives, 42% used condoms, versus 64% of 642 women not using other contraceptive methods (P<0.01). After adjustment for covariates, the predicted probability of condom use among women using other contraceptives was 47% among women who discussed STIs with their parents (v. 31% of those not discussing STIs; P<0.01). Among women not using other contraceptives, the predicted probability of condom use remained 64% regardless of whether they discussed STIs with their parents. Young women who use other contraceptive methods are less likely to use condoms, but discussing STIs with parents is associated with increased condom use among these women.
Chen, Xinguang; Dinaj-Koci, Veronica; Brathwaite, Nanika; Cottrell, Lesley; Deveaux, Lynette; Gomez, Perry; Harris, Carole; Li, Xiaoming; Lunn, Sonja; Marshall, Sharon; Stanton, Bonita
This research evaluates condom-use self-efficacy and its increase throughout adolescence. Documentation of the development of condom-use self-efficacy would be important for prevention efforts given the influence of self-efficacy on actual condom usage. This study assesses a hypothesized mediation mechanism of the development of self-efficacy…
Shih, Shirley L; Kebodeaux, Chelsea A; Secura, Gina M; Allsworth, Jenifer E; Madden, Tessa; Peipert, Jeffrey F
: To provide protection against sexually transmitted infections and pregnancy, condoms must be used consistently and correctly. However, a significant proportion of couples in the United States fail to do so. Our objective was to determine the demographic and behavioral correlates of inconsistent and incorrect condom use among sexually active, condom-using women. : Analysis of baseline data from a prospective cohort of sexually active, condom-using women in the Contraceptive CHOICE Project (n = 2087) using self-reported demographic and behavioral characteristics. Poisson regression was used to determine the relative risk of inconsistent and incorrect condom use after adjusting for variables significant in the univariate analysis. : Inconsistent and incorrect condom use was reported by 41% (n = 847) and 36% (n = 757) of women, respectively. A greater number of unprotected acts was most strongly associated with reporting 10 or more sex acts in the past 30 days, younger age at first intercourse, less perceived partner willingness to use condoms, and lower condom use self-efficacy. Incorrect condom use was associated with reporting 10 or more sex acts in the past 30 days, greater perceived risk for future STIs, and inconsistent condom use. : Inconsistent and incorrect condom use is common among sexually active women. Targeted educational efforts and prevention strategies should be implemented among women at highest risk for STIs and unintended pregnancies to increase consistent and correct condom use.
Xiao, Zhiwen; Li, Xiaoming; Lin, Danhua; Tam, Cheuk Chi
The current study aimed to identify the sources of HIV prevention information for female sex workers in Beijing and assess the associations between levels of mass media exposure of HIV/AIDS prevention information and HIV/AIDS knowledge as well as condom use-related attitudes, beliefs, and behaviors. Cross-sectional data were collected from 359 female sex workers in Beijing, China. Chi-square tests and one-way ANOVA tests were employed. Female sex workers sampled in Beijing were more likely to obtain HIV/AIDS prevention information from television and street posters than radio and the Internet. However, a higher level of exposure to and a lasting impression on online information were significantly associated with a higher level of condom use self-efficacy and more consistent condom use among the participants. Exposure to HIV/AIDS prevention information delivered by radio, street posters, and the Internet was found to be associated with sexual communication about HIV or condom use with sexual partners. Overall, this study provides preliminary evidence of the utility of various mass media outlets in delivering HIV/AIDS prevention information among female sex workers in China. Future studies are needed to systematically examine the effectiveness of mass media-based prevention education on HIV/AIDS related attitudes and behaviors among female sex workers and other populations in China.
Kalolo, Albino; Kibusi, Stephen Matthew
Despite the declining trends of Human immunodeficiency virus (HIV) infection in Sub-Saharan Africa (SSA), unsafe sexual behaviours among adolescents still represent a public health challenge. It is important to understand factors acting at different levels to influence sexual behaviour among adolescents. This study examined the influence of perceived behaviour control, subjective norms, attitudes and empowerment on intention to use condoms and reported use of condoms among adolescents in rural Tanzania. We used a questionnaire to collect data from 403 adolescents aged 14 through 19 years from nine randomly selected secondary schools in the Newala district located in the Southern part of Tanzania. The self-administered questionnaire collected information on sexual practices and factors such as attitudes, subjective norms, perceived behaviour control and empowerment. Binary logistic regression was performed to identify factors associated with intention to use and reported use of condoms. Sexually active adolescents constituted 40.6 % of the sample, among them 49.7 % did not use a condom at last sexual intercourse and 49.8 % had multiple sex partners. Many (85 %) of sexually active respondents had their sexual debut between the ages of 14 to 17 years. Girls became sexually active earlier than boys. Perceived behaviour control predicted intentions to use condoms (AOR = 3.059, 95 % CI 1.324-7.065), thus demonstrating its importance in the decision to use a condom. Empowerment (odds ratio = 3.694, 95 % CI 1.295-10.535) and a positive attitude (AOR = 3.484, 95 % CI 1.132-10.72) predicted reported condom use, thus turning the decision to actions. Subjective norms had only indirect effects on intention and reported use of condoms. The findings suggest that unsafe sex practices are prevalent among school adolescents in rural areas of Tanzania. Perceived behaviour control and positive attitudes predict intensions to use condoms whereas empowerment
Subramanian, Thilakavathi; Ramakrishnan, Lakshmi; Aridoss, Santhakumar; Goswami, Prabuddhagopal; Kanguswami, Boopathi; Shajan, Mathew; Adhikary, Rajat; Purushothaman, Girish Kumar Chethrapilly; Ramamoorthy, Senthil Kumar; Chinnaswamy, Eswaramurthy; Veeramani, Ilaya Bharathy; Paranjape, Ramesh Shivram
This paper presents an evaluation of Avahan, a large scale HIV prevention program that was implemented using peer-mediated strategies, condom distribution and sexually transmitted infection (STI) clinical services among high-risk men who have sex with men (HR-MSM) and male to female transgender persons (TGs) in six high-prevalence state of Tamil Nadu, in southern India. Two rounds of large scale cross-sectional bio-behavioural surveys among HR-MSM and TGs and routine program monitoring data were used to assess changes in program coverage, condom use and prevalence of STIs (including HIV) and their association to program exposure. The Avahan program for HR-MSM and TGs in Tamil Nadu was significantly scaled up and contacts by peer educators reached 77 percent of the estimated denominator by the end of the program's fourth year. Exposure to the program increased between the two rounds of surveys for both HR-MSM (from 66 percent to 90 percent; AOR = 4.6; p Tamil Nadu achieved a high coverage, resulting in improved condom use by HR-MSM with their regular and commercial male partners. Declining STI prevalence and stable HIV prevalence reflect the positive effects of the prevention strategy. Outcomes from the program logic model indiacte the effectiveness of the program for HR-MSM and TGs in Tamil Nadu.
Martins, Laura B Motta; da Costa-Paiva, Lúcia Helena S; Osis, Maria José D; de Sousa, Maria Helena; Pinto-Neto, Aarão M; Tadini, Valdir
This study aimed to compare knowledge about STD/AIDS and identify the factors associated with adequate knowledge and consistent use of male condoms in teenagers from public and private schools in the city of São Paulo, Brazil. We selected 1,594 adolescents ranging 12 to 19 years of age in 13 public schools and 5 private schools to complete a questionnaire on knowledge of STD/AIDS and use of male condoms. Prevalence ratios were computed with a 95% confidence interval. The score on STD knowledge used a cutoff point corresponding to 50% of correct answers. Statistical tests were chi-square and Poisson multiple regression. Consistent use of male condoms was 60% in private and 57.1% in public schools (p > 0.05) and was associated with male gender and lower socioeconomic status. Female gender, higher schooling, enrollment in private school, Caucasian race, and being single were associated with higher knowledge of STDs. Teenagers from public and private schools have adequate knowledge of STD prevention, however this does not include the adoption of effective prevention. Educational programs and STD/AIDS awareness-raising should be expanded in order to minimize vulnerability.
Full Text Available External urine collecting devices have been a boon to patients of urinary incontinence since their invention in late 90s. They have replaced the need for uncomfortable indwelling catheters in these patients. As safe as they may be, ghastly complications have occurred infrequently, mostly due to their inappropriate application. Such penile and urethral complications add to the morbidity of the patients significantly. They can be easily avoided by following few simple steps of catheter care, thus emphasizing the need to aware clinicians and health care workers about the correct application methods. Here we discuss a case of 60 year old male who developed penile skin necrosis and urethral fistula due to chronic use of condom catheter.
Mitchell, Kate M; Foss, Anna M; Ramesh, Banadakoppa M; Washington, Reynold; Isac, Shajy; Prudden, Holly J; Deering, Kathleen N; Blanchard, James F; Moses, Stephen; Lowndes, Catherine M; Boily, Marie-Claude; Alary, Michel; Vickerman, Peter
The Avahan intervention promotes consistent (100%) condom use amongst men who have sex with men in southern India. We assessed how condom use varies with intervention exposure for men who have sex with men in Bangalore. Self-reported condom use and intervention exposure data were derived from a cross-sectional survey. Consistent condom use and condom use at last sex act with all, main, and casual male sex partners were assessed. Binary and continuous variables reflecting intervention exposure (including contact(s) with intervention staff, receiving condoms and seeing condom demonstrations) were used. Multivariable logistic regression was employed to assess the relationship between condom use with each type of partner and each exposure variable independently, controlling for socio-demographic and behavioural factors associated with condom use or intervention exposure. Condom use with all partners was higher among those who had ever been contacted by, received condoms from, or seen a condom demonstration by intervention staff (adjusted odds ratio >2, p condom use with all types of partner increased with the number of condom demonstrations seen in the last month (adjusted odds ratio = 2.1 per demonstration, p condom use at last sex act with a casual (but not main) partner increased with the number of condoms received from the intervention (adjusted odds ratio = 1.4 per condom, p = 0.04). Direct contact with Avahan program staff is associated with increased reported condom use among men who have sex with men in Bangalore. Reported consistent condom use and condom use at last sex act are associated with contacts involving demonstrations of correct condom use, and with receiving condoms, respectively.
Morrison-Beedy, Dianne; Carey, Michael P; Lewis, Brian P
This study was undertaken to identify and test a model of the cognitive antecedents to condom use stage of change in low-income, single, urban women. A convenience sample of 537 women (M=30 years old) attending two urban primary health care settings in western New York State anonymously completed questionnaires based primarily on two leading social-cognitive models, the transtheoretical model and the information-motivation-behavioral skills model. We used structural equation modeling to examine the direct and indirect effects of HIV-related knowledge, social norms of discussing HIV risk and prevention, familiarity with HIV-infected persons, general readiness to change sexual behaviors, perceived vulnerability to HIV, and pros and cons of condom use on condom-use stage of change. The results indicated two models that differ by partner type. Condom-use stage of change in women with steady main partners was influenced most by social norms and the pros of condom use. Condom-use stage of change in women with "other" types (multiple, casual, or new) of sexual partners was influenced by HIV-related knowledge, general readiness to change sexual behaviors, and the pros of condom use. These findings suggest implications for developing gender-relevant HIV-prevention interventions. Copyright 2002 Wiley Periodicals, Inc.
Matseke, Gladys; Peltzer, Karl; Louw, Julia; Naidoo, Pamela; McHunu, Gugu; Tutshana, Bomkazi
The high rate of HIV infections among tuberculosis (TB) patients in South Africa calls for urgent HIV reduction interventions in this subpopulation. While correct and consistent condom use is one of the effective means of HIV prevention among sexually active people, there is insufficient research on condom use among TB patients in South Africa. The aim of this paper was to determine the prevalence of inconsistent condom use among public primary care TB patients and its associated factors using a sample of 4900 TB patients from a cross-sectional survey in three health districts in South Africa. Results indicated that when asked about their consistency of condom use in the past 3 months, 63.5% of the participants reported that they did not always use condoms. In the multivariable analysis, being married (OR = 1.66; 95% CI 1.25-2.20) or cohabitating or separated, divorced, or widowed (OR = 3.67; 1.85-7.29), lower educational level (OR = 0.66; 0.46-0.94), greater poverty (OR = 1.60; 1.25-2.20), not having HIV status disclosed (OR = 0.34; 0.25-0.48), sexual partner on antiretroviral treatment (OR = 0.38; 0.23-0.60), and partner alcohol use before sex (OR = 1.56; 1.30-1.90) were significantly associated with inconsistent condom use in the past 3 months. The low proportion of consistent condom use among TB patients needs to be improved.
Roth, J; Krishnan, S P; Bunch, E
The consistent and correct use of condoms coupled with risk reduction education strategies, continue to play an important role in the reduction and prevention of HIV/AIDS transmission. Therefore understanding and incorporating strategies to overcome barriers to condom use in such education and prevention efforts are critical. This is particularly necessary in countries such as India, where HIV/AIDS has become a serious public health crisis. The current study documents and provides preliminary data on the use of condoms, reasons for and barriers to condom use, and sources of information about safer sex practices among a sexually active adult sample of 49 women and 203 men in Mumbai, India. Despite limitations such as the use of a nonrandom sample of participants composed predominantly of young, English-speaking males, the study findings provide some insights into the importance of and the need to address issues of privacy regarding condom purchase and use in India. Most notably, the lack of privacy in stores and the social stigma associated with condom use were indicated as the most significant barriers. These and other study findings suggest the need to ease the social costs and constraints to safe behaviors through increased acceptance of condoms and promotion of their consistent use. This could serve as an important means to curb the epidemic of HIV/AIDS in India.
Tomnay, Jane E; Hatch, Beth
Twenty-four hour access to condoms for young people living in rural Victoria is problematic for many reasons, including the fact that condom vending machines are often located in venues and places they cannot access. We partnered with three rural councils to install condom vending machines in locations that provided improved access to condoms for local young people. Councils regularly checked the machines, refilled the condoms and retrieved the money. They also managed the maintenance of the machine and provided monthly data. In total, 1153 condoms were purchased over 12 months, with 924 (80%) obtained from male toilets and 69% (801 out of 1153) purchased in the second half of the study. Revenue of $2626.10 (AUD) was generated and no negative feedback from residents was received by any council nor was there any negative reporting by local media. Vandalism, tampering or damage occurred at all sites; however, only two significant episodes of damage required a machine to be sent away for repairs. Condom vending machines installed in rural towns in north-east Victoria are accessible to young people after business hours, are cost-effective for councils and have not generated any complaints from residents. The machines have not suffered unrepairable damage and were used more frequently as the study progressed.
Schoueri, Nour; Bullock, Sandra L; Dubin, Joel A
Interracial relationships in Canada have increased over the years. However, little research has focused on comparing STI/HIV risk and condom use between those in intra- and interracial relationships, specifically among Middle Eastern-Canadians. A web-based survey was administered to Middle Eastern-Canadians. Logistic regression analysis was used to assess factors associated with consistent condom use. Analyses were stratified by partner's race (Middle Eastern or non-Middle Eastern). The analysis sub-sample consisted of 92 participants. Factors associated with consistent condom use varied between the stratified groups. Among those with Middle Eastern partners, attitude towards marriage and the family and control in the relationship were associated with condom use. Among participants with non-Middle Eastern partners, acculturation and HIV knowledge were found to be associated with condom use. Factors associated with condom use varied between Middle Eastern-Canadians in intra- and interracial relationships. These differences illustrate the need for tailored interventions aimed at increasing condom use among this racial group.
Mustanski, Brian; Ryan, Daniel T; Garofalo, Robert
Young men who have sex with men (YMSM) are disproportionately infected with sexually transmitted infections (STIs). Condom use is the most widely available means of preventing the transmission of STIs, but effectiveness depends on correct use. Condom errors such as using an oil-based lubricant have been associated with condom failures such as breakage. Little research has been done on the impact of condom problems on the likelihood of contracting an STI. Data came from Crew 450, a longitudinal study of HIV risk among YMSM (N = 450). All self-report data were collected using computer-assisted self-interview technology, and clinical testing was done for gonorrhea, chlamydia, and HIV. Nearly all participants made at least 1 error, with high rates of using oil-based lubricant and incomplete use. No differences were found in rates of condom problems during anal sex with a man versus vaginal sex with a woman. Black YMSM reported significantly higher use of oil-based lubricants than white and Hispanic YMSM, an error significantly associated with HIV status (adjusted odds ratio, 2.60; 95% confidence interval, 1.04-6.51). Participants who reported a condom failure were significantly more likely to have an STI (adjusted odds ratio, 3.27; 95% confidence interval, 1.31-8.12). Young men who have sex with men report high rates of condom problems, and condom failures were significantly associated with STIs after controlling for unprotected sex. Educational programs are needed to enhance correct condom use among YMSM. Further research is needed on the role of oil-based lubricants in explaining racial disparities in STIs and HIV.
Patel, V L; Gutnik, L A; Yoskowitz, N A; O'sullivan, L F; Kaufman, D R
HIV infection rates are rapidly increasing among young heterosexuals, making it increasingly important to understand how these individuals make decisions regarding risk in sexual encounters. Our objective in this study was to characterize young adults' safer sex behaviour and associate this behaviour with patterns of reasoning, using cognitive, information processing methods to understand the process of sexual risk taking. Sixty urban college students from NYC maintained diaries for two weeks and then were interviewed regarding lifetime condom use and sexual history. Using cognitive analysis, we characterized four patterns of condom use behaviour: consistent condom use (35.0%), inconsistent condom use (16.7%), shifting from consistent to inconsistent condom use (35.0%), and shifting from inconsistent to consistent condom use (13.3%). Directionality of reasoning (i.e. data-driven and hypothesis-driven reasoning) was analysed in the explanations provided for condom use decisions. The consistent and inconsistent patterns of condom use were associated with data-driven heuristic reasoning, where behaviour becomes automated and is associated with a high level of confidence in one's judgment. In the other two patterns, the shift in behaviour was due to a significant event that caused a change in type of reasoning to explanation-based reasoning, reflecting feelings of uncertainty and willingness to evaluate their decisions. We discuss these results within the framework of identifying potentially high-risk groups (e.g. heterosexual young adults) as well as intervention strategies for risk reduction. Further, our findings not only identify different patterns of condom use behaviour, but our investigation of the cognitive process of decision-making characterizes the conditions under which such behaviour and reasoning change.
Hill, Brandon J; Sanders, Stephanie A; Crosby, Richard A; Ingelhart, Kara N; Janssen, Erick
Background Previous studies have associated men who experience condom-associated erection problems (CAEP) with incomplete condom use and/or foregoing using condoms altogether. However, how men respond to CAEP and what they attribute CAEP to, remains unclear. Understanding young men's CAEP responses and attributions could help improve sexually transmissible infections (STI)/HIV prevention programs and interventions. Behavioural responses to, and attributions for, CAEP during application (CAEP-Application) and/or during penile-vaginal intercourse (CAEP-PVI) were reported using an online questionnaire by 295 young, heterosexual men (aged 18-24 years) who were recruited via social media websites and university Listservs across major cities in the Midwestern USA. Behavioural responses to CAEP-Application included receiving oral or manual stimulation, stimulating a partner, self-stimulation, foregoing condom use and applying the condom after starting intercourse. Attributions for CAEP-Application included: distraction, fit and feel problems, application taking too long and having consumed too much alcohol. Behavioural responses to CAEP-PVI included increasing the intensity of intercourse, removing the condom to receive oral or manual stimulation and removing condom and continuing intercourse. Attributions for CAEP-PVI included: lack of sensation, taking too long to orgasm, not being 'turned on' enough, fit and feel problems and partner-related factors. Men who report CAEP respond with both STI/HIV risk-reducing and potentially risk-increasing behaviours (e.g. forgoing condom use). Men attribute their experiences to a wide range of individual- and partner-level factors. Addressing men's CAEP behavioural responses and attributions may increase the efficacious value of condom programs and STI/HIV prevention interventions - particularly among men who experience CAEP.
Stone, Nicole; Graham, Cynthia; Anstee, Sydney; Brown, Katherine; Newby, Katie; Ingham, Roger
Condoms remain the main protection against sexually transmitted infections (STIs) when used correctly and consistently. Yet, there are many reported barriers to their use such as negative attitudes, reduced sexual pleasure, fit-and-feel problems and erection difficulties. The UK home-based intervention strategy (HIS-UK) is a behaviour change condom promotion intervention for use among young men (aged 16-25 years) designed to increase condom use by enhancing enjoyment of condom-protected intercourse. The objective of this feasibility study was to test HIS-UK for viability, operability and acceptability. Along with an assessment of the recruitment strategy and adherence to the intervention protocol, the study tested the reliability and suitability of a series of behavioural and condom use outcome measures to assess condom use attitudes, motivations, self-efficacy, use experience, errors and problems and fit and feel. The HIS-UK intervention and associated assessment instruments were tested for feasibility using a single-arm, repeated measures design with baseline measurement and two follow-up measurements over 3 months. A 3-month target of 50 young men completing the baseline questionnaire was set. Twenty process and acceptability evaluation interviews with participants and health promotion professionals were conducted post trial. Of the 61 young men who registered for the study, 57 completed the baseline questionnaire and 33 met with the study researcher to receive the HIS-UK condom kit. Twenty-one young men remained for the duration of the study (64% retention). The Cronbach's alpha scores for the condom use outcome measures were 0.84 attitudes, 0.78 self-efficacy, 0.83 use experience, 0.69 errors and problems and 0.75 fit and feel. Participant and health professional feedback indicated strong acceptability of the intervention. The feasibility study demonstrated that our recruitment strategy was appropriate and the target sample size was achieved. Adherence was
Langer, L M; Zimmerman, R S; Cabral, R J
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...
Xiao, Zhiwen; Palmgreen, Philip; Zimmerman, Rick; Noar, Seth
This study adapts a multiple domain model (MDM) to explain condom use among a sample of sexually active Chinese college students. A cross-sectional survey was conducted and structural equation modeling was used to test the proposed model. Preparatory behaviors, theory of reasoned action (TRA)/theory of planned behavior variables, impulsivity, length of relationship, and alcohol use were significant direct predictors of condom use. The results suggest that MDM can provide a better understanding of heterosexual condom use among Chinese youth, and help in the design of HIV-preventive and safer sex interventions in China.
Full Text Available Unprotected sexual intercourse is a major risk factor for HIV transmission. Men who have sex with men (MSM face challenges in accessing HIV prevention services, including condoms. However, there is limited in-depth assessment and documentation of the barriers to condom use among MSM in sub-Saharan Africa. In this paper, we examine the barriers to condom use among MSM in Uganda.The data for this study were extracted from a larger qualitative study conducted among 85 self-identified adult (>18 years MSM in 11 districts in Uganda between July and December 2013. Data on sexual behaviours and access and barriers to condom use were collected using semi-structured interviews. All interviews were audio-recorded and transcribed verbatim. This paper presents an analysis of data for 33 MSM who did not use condoms at last sex, with a focus on barriers to condom use. Analysis was conducted using the content analysis approach.Six major barriers to condom use were identified: Difficulties with using condoms, access challenges, lack of knowledge and misinformation about condom use, partner and relationship related issues, financial incentives and socio-economic vulnerability, and alcohol consumption.The findings suggest that several reasons account for lack of condom use among high-risk MSM. The findings are valuable to inform interventions needed to increase condom use among MSM.
McMillan, Karen; Worth, Heather
Young people are a key group for HIV prevention in the Pacific region where levels of STIs are high and condom use is low. During 2008, 62 in-depth interviews were conducted with people aged between 18 and 25 years in Tonga and Vanuatu. The research was aimed at understanding factors impacting on young peoples' condom use in two Pacific Island nations. The data show a marked disjuncture between attitudes and practice with regard to condoms. This paper discusses factors underpinning that inconsistency and directs attention to the effect of social and cultural influences on young people's condom use. The authors conclude that individual-level approaches to improving rates of condom use will be inadequate unless they are informed by an understanding of the role of identity, culture and tradition in young peoples' decisions around condom use. The findings also underline the need for country-specific approaches to condom promotion efforts in the Pacific.
Peltzer, Karl; Oladimeji, Yetunde
A questionnaire was administered to 213 sexually active first-year Nigerian university students and 150 Black and 150 White South African adults. Nigerian students gave 90% correct answers on 6 of the 10 items of a measure of condom knowledge (M = 6.1). The most common mistakes with respect to condom use were ignorance about putting a condom on just before ejaculation (37%), the use of an oil-based lubricant with a condom (29%), and when to take off a condom (28%). For the South African sample utility of the Health Belief Model and Theory of Reasoned Action for HIV prevention could be confirmed by intention to use condoms. Race and preventive benefits were predictive for current condom use. Findings have relevant implications for developing culturally diverse HIV intervention programs if confirmed with larger diverse groups.
Du Bois, Steve N; Emerson, Erin; Mustanski, Brian
We described frequencies of condom-related problems in a racially diverse sample of young men who have sex with men (YMSM), and tested these condom-related problems as an explanation for racial disparities in HIV rates among YMSM. Participants were 119 YMSM from a longitudinal study of sexual minority health behaviors. Almost all participants (95.4%) experienced at least one condom error. On average, African American and non-African American YMSM experienced the same number of recent condom-related problems. Therefore, differences in condom-related problems are unlikely to explain racial disparities in HIV rates among YMSM. When serving YMSM, providers should both promote condom use and explain steps to correct condom use.
Parriault, Marie-Claire; Basurko, Célia; Melle, Astrid Van; Gaubert-Maréchal, Emilie; Rogier, Stéphanie; Couppié, Pierre; Nacher, Mathieu
French Guiana is the French territory that is most affected by HIV. AIDS incidence is much higher than in mainland France and sex work seems to be an important driver of the epidemic. The objective of this study was to describe consistent condom use among female sex workers with their clients and their intimate partners and to identify determinants of non-use of condoms. An HIV/AIDS Knowledge, Attitudes, Behaviours and Practices survey was conducted in 2009-2010 among sex workers in French Guiana. A total of 477 sex workers were interviewed. Female sex workers were more likely to use condoms with their clients (97%) than with their intimate partners (45%). The factors associated with non-consistent condom use with the intimate partner were having had an abortion, feeling at risk for HIV, not evaluating one's own risk for HIV, living as a couple, being Dominican, and not feeling comfortable asking intimate partners to use condoms. Although a high proportion of female sex workers declared using condoms with commercial partners, there is still room for improvement in the prevention of transmission with both commercial and intimate partners. © The Author(s) 2014.
Maya, Ernest T; Buntugu, Kennedy A; Aki, Lovelace; Srofenyoh, Emmanuel K
Postpartum haemorrhage is one of the major causes of maternal mortality worldwide. The leading cause of primary postpartum haemorrhage is uterine atony and active management of the third stage of labour with oxytocin is recommended for preventing primary postpartum haemorrhage. Parenteral oxytocin is also the drug of choice for medical management of postpartum haemorrhage secondary to uterine atony. Condom uterine balloon tamponade is .a low cost technique that can be used as a second-line option for treatment. We report retrospectively three cases of primary PPH secondary to uterine atony which were managed successfully with condom tamponade. Condom tamponade is effective in managing post partum haemorrhage secondary to uterine atony and we advocate for the training of all skilled attendants on how to insert the condom tamponade.
Teitelman, Anne M.; Ratcliffe, Sarah J.; Morales-Aleman, Mercedes M.; Sullivan, Cris M.
This study examined the association between sexual relationship power, intimate partner violence, and condom use among African American and Hispanic urban girls. In this sample of 56 sexually active girls, 50% did not use condoms consistently and therefore were at higher risk for acquiring HIV or sexually transmitted diseases (STDs). Teens who experienced more intimate partner violence had a significantly higher likelihood of inconsistent condom use and therefore a greater risk for HIV/STDs. Girls' sense of sexual control in their relationships was not directly associated with inconsistent condom use but was inversely related to verbal and emotional abuse. Interventions aimed at reducing HIV/STD risk for adolescent girls need to address patterns of dominance and control in adolescent relationships as well as multiple forms of partner violence. This suggests the need for multilevel intervention approaches that promote girls' agency and multiple ways to keep girls safe from perpetrators of partner abuse. PMID:18349344
the liberalization of sex. Liberalization of sex and stigma to condom were occurring together. ... 3% margin of error. The variable considered for sample size determination was ... self reports on a questionnaire developed by the investigators.
Full Text Available Condoms are one of the cornerstones to any response to the HIV epidemic. However, targetedmarketing strategies that make condoms more attractive to people at high risk of infection areoften overlooked. The South African National Department of Health has recently purchasedmore attractive condoms to distribute in higher-education settings free of charge, targeting atriskyouth including young women. The authors applaud this move but note the importance ofexpanding better branded condoms to young people elsewhere – for example, via youth clinicsand in high schools. Exploratory, routine data from Médecins Sans Frontières in Khayelitshaare presented, showing the popularity of alternatives to the government’s ‘Choice’ brand.
Full Text Available With high rates of HIV transmission in South Africa, the correct and consistent use of condoms has become critically important. The findings reported in this article form part of a larger study that investigated the vulnerability of women to HIV infection. This article concentrates on one dimension of the study: how a clash between real and ideal culture negatively impacts upon condom use. This study, conducted in Bloemfontein, revealed that an ideal culture of trust, resulted in non condom use. On the other hand, this study also revealed that despite the emphasis on an ideal culture of trust, a real culture of infidelity exists. This places individuals at risk of contracting HIV, as condom use is guided by ideal rather than real culture.
Ackermann, L; de Klerk, G W
With high rates of HIV transmission in South Africa, the correct and consistent use of condoms has become critically important. The findings reported in this article form part of a larger study that investigated the vulnerability of women to HIV infection. This article concentrates on one dimension of the study: how a clash between real and ideal culture negatively impacts upon condom use. This study, conducted in Bloemfontein, revealed that an ideal culture of trust, resulted in non condom use. On the other hand, this study also revealed that despite the emphasis on an ideal culture of trust, a real culture of infidelity exists. This places individuals at risk of contracting HIV, as condom use is guided by ideal rather than real culture.
Decker, Michele R.; Mack, Katelyn P.; Barrows, Jeffery J.; Silverman, Jay G.
Synopsis Prostituted women report disempowerment-related barriers to condom use, extensive violence victimization and trafficking experiences; findings indicate that disempowerment must be addressed within STI/HIV prevention efforts. PMID:19577234
Barbosa, Giselly Oseni Laurentino; Wanderley, Luana Duarte; Reboucas, Cristiana Brasil de Almeida; Oliveira, Paula Marciana Pinheiro de; Pagliuca, Lorita Marlena Freitag
The objectives were to develop and evaluate an assistive technology for the use of the male condom by visually impaired men. It was a technology development study with the participation of seven subjects. Three workshops were performed between April and May of 2010; they were all filmed and the statements of the participants were transcribed and analyzed by content. Three categories were established: Sexuality of the visually impaired; Utilization of the text, For avoiding STDs, condoms we wi...
Walker, Dilys M; Torres, Pilar; Gutierrez, Juan Pablo; Flemming, Kendra; Bertozzi, Stefano M
To evaluate the association between knowledge about, or experience with, emergency contraception (EC), and condom use among school-attending adolescents in the state of Morelos, Mexico. We analyzed data from anonymously self-administered questionnaires (n = 10,918), from a cluster-randomized controlled trial among first year students from 40 (75%) public high schools in Morelos, Mexico. The survey included specific questions about EC knowledge and experience as well as questions about perceived ability to negotiate and condition sexual relations on condom use; and condom use at first and last sexual intercourse. Overall, 61% (6384) of students had heard of EC, and 36% (1964) of girls and 39% (1997) of boys had correct knowledge about EC. Correct knowledge was based upon knowing that EC is pills taken up to 3 days after unprotected sex to prevent pregnancy. Of 1695 (15.6%) reporting lifetime sexual activity, 16.4 % (275) reported they had tried to obtain EC and almost of all them (263) reported having used EC. The probability of a student reporting he/she is capable of interrupting sexual intercourse to use a condom was significantly higher for those who had correct EC knowledge, and a history of EC use was strongly correlated with condom use at last sexual intercourse. Experience with emergency contraception has no adverse effects on condom use, but rather is associated with an increased probability of condom use and an increased perceived capacity to negotiate condom use. Despite concern that information about, and access to EC may encourage sexual risk taking, our results suggest the reverse is true. These data support the position that there is no justification to withhold EC information or access from adolescents.
Tran, Bonnie Robin; Thomas, Anne Goldzier; Ditsela, Mooketsi; Vaida, Florin; Phetogo, Robert; Kelapile, David; Chambers, Christina; Haubrich, Richard; Shaffer, Richard
Preventing HIV infection is a priority for militaries. HIV prevention research is needed to monitor existing programs, identify areas for modification, and develop new interventions. Correct and consistent condom use is highly effective against HIV. However, use among soldiers is lower than ideal. This study describes condom use behaviors and examines correlates of use in the Botswana Defence Force (BDF). Analyses were based on 211 male personnel, aged 18–30, who completed a cross-sectional s...
Albarracín, Dolores; Johnson, Blair T.; Fishbein, Martin; Muellerleile, Paige A.
To examine how well the theories of reasoned action and planned behavior predict condom use, the authors synthesized 96 data sets (N = 22,594) containing associations between the models’ key variables. Consistent with the theory of reasoned action’s predictions, (a) condom use was related to intentions (weighted mean r. = .45), (b) intentions were based on attitudes (r. = .58) and subjective norms (r. = .39), and (c) attitudes were associated with behavioral beliefs (r. = .56) and norms were ...
Full Text Available BACKGROUND: Sexually transmitted infections (STI create a great hazard to public health. STIs occur mostly as a result of different types of risky sexual behavior, such as early sexual debut, unprotected sexual intercourses, alcohol use during sex, multiple partnership etc. Condoms are known to provide the best protection against negative consequences of risky sexual behavior. In this study we aimed to determine factors associated with condom use at first sexual intercourses by women in Ukraine.METHODS: Secondary analysis of data of the 2007 Ukraine Demographic and Health Survey was conducted. Responses of 883 sexually experienced women aged 15–24 were included in the analysis. Associations between condom use at first sex and independent variables were assessed using multivariate binary logistic regression.RESULTS: Light (less than 3,5 drinks per week and heavy (3,5 drinks per week or more drinkers were more likely to use condoms at first sexual intercourse compared to abstainers or occasional drinkers (OR 1,83 (CI 1,32-2,53 and 2,21 (CI 1,43-3,42, respectively. Besides that, women from households with above average income had 1,65 (CI 1,17-2,33 higher odds to use condoms at sexual debut in comparison to women from households with lower income. Women who read printed media at least once a week had twice (CI 1,36-2,94 as high odds of using condoms at first intercourse as women who read newspapers or magazines rare. Non-Western region of residence and sexual partner of about the same age were positively associated with condom use as well.CONCLUSIONS: Wealthy young adults from industrially developed regions are active users of condoms during sexual debut, which is to be accounted for in determining target groups for social policy in Ukraine.
Cox, Mary F
Parenting style may be a determinant in reducing adolescent risk behavior. Previous studies have relied on a typological parenting approach, with classification into four groups: authoritative, authoritarian, permissive, and neglectful. In this study, two distinct parenting dimensions, demandingness and responsiveness, were examined as independent predictors of adolescent condom use. This study used a subsample of the National Longitudinal Study of Adolescent Health (Add Health) that included 153 adolescent-mother pairs. Maternal demandingness and responsiveness were measured using Wave I mother interviews. Logistic regression analyses were used to predict adolescent condom use at sexual debut at Wave II and to assess moderation by gender and race. (1) Maternal demandingness predicted increased likelihood of condom use in African American adolescents but decreased likelihood of condom use in White adolescents; (2) maternal responsiveness did not predict condom use; and (3) gender moderation was not present. To provide appropriate family counseling, public health nurses need to consider racial differences in contraceptive practices. Education regarding parental supervision practices should be considered as part of nursing interventions intended to increase condom use in African American adolescents.
Damani, R; Ross, M W; Aral, S O; Berman, S; St Lawrence, J; Williams, M L
Previous studies have reported an inverse relationship between condom use and emotional intimacy. The aim of this study was to determine the relationship between condom use and emotional intimacy. The study was a gonorrhoea case-comparison study with the samples being drawn from public health clinics (cases) and select bars/nightclubs (places) of Houston, TX (n = 215). Data were collected by questionnaires administered on a laptop computer. The majority of respondents were African-American (97.7%), women (69.3%) and had either high school or GED education (72.6%). Condom use with the last sexual partner was analysed along with intimacy with that partner assessed on a 3-point scale. Analysis showed that higher intimacy was related to greater condom use which was significant in men but not in women. In conclusion, these data were opposite to those of previous studies, which showed an inverse relationship between condom use and emotional intimacy. We hypothesize that in a high-risk environment, people exert more effort in protecting those they feel closer to. These data suggest a need to further explore the complex relationship between emotional intimacy and condom use.
Mcneal, J L
Despite all of the education and public awareness about AIDS in the US, some gay men have not adopted risk-reduction behaviors. Findings are reported from a study exploring the extent to which a gay man idealizes his partner is linked to reported condom use among gay male couples. The study also explored how the following intimacy factors are linked to condom use: relationship satisfaction, relationship excitement, and interpersonal closeness. Questionnaires were distributed to 125 gay male couples; both members of 45 of these couples completed and returned the questionnaire. The participants were recruited in the New York City area, were age 21-52 years (mean age, 33.06 years), and the couples had been together for an average period of 29.5 months (range, 1-163 months). The degree of idealization was found to have a significant negative correlation with condom use, suggesting that the more the men idealized each other, the less likely they were to use condoms during sex. Relationship satisfaction and excitement were also significantly negatively associated with condom use. No significant association was found between closeness and condom use.
Full Text Available This exploratory qualitative study aimed to identify perceived benefits, barriers and motivational factors impacting condom use for out-of-school youth ages 15-24 years. The study was carried out in Kinondoni Municipality of Tanzania between April and May 2010. A semi-structured guide was used in 8 in-depth interviews and two focus group discussions (FGDs among 30 respondents chosen through convenient sampling. The Health belief Model (HBM served as the conceptual framework for the study. Findings indicate that psychosocial and utilization problems were identified as main barriers to condom use. Additionally, lack of negotiation skills for safer sex was perceived as a serious impediment to condom use, particularly among women. An effective behavior-change programme for HIV prevention, which address psychosocial and utilization related barriers to condom use is needed. A well-designed strategy would improve condom use by putting emphasis on skills for correct condom use and negotiation for safer sex, particularly for women.