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
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...
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
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.
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…
Booysen, Frederik le Roux; Wouters, Edwin; de Walque, Damien; Over, Mead
Risky sexual behaviour in PLWHA on antiretroviral therapy threatens both prevention and treatment efforts, but disclosure promises to support safer sexual practices. This paper investigates the association between HIV self-disclosure and consistent condom use in a cohort of public sector patients on antiretroviral (ARV) treatment. Using data from the FEATS cohort study, logistic regression analysis shows that knowledge of your partner's HIV status is positively associated with consistent condom use (OR 2.73, 95% CI 1.37-5.43, p = 0.004) and so too mutual HIV disclosure (OR 3.38, 95% CI 1.60-7.18, p = 0.001). Prevention and treatment programmes, through couple HIV counselling and testing (CHCT) and other assistance programmes, should focus on supporting the mutual disclosure of HIV status among PLWHA on ARV treatment.
, ... 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.
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.
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…
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.
Full Text Available Besides access to medical male circumcision, HIV testing, access to condoms and consistent condom use are additional strategies men can use to prevent HIV acquisition. We examine male behavior toward testing and condom use.To determine factors associated with never testing for HIV and consistent condom use among men who never test in Soweto.A cross-sectional survey in Soweto was conducted in 1539 men aged 18-32 years in 2007. Data were collected on socio-demographic and behavioral characteristics to determine factors associated with not testing and consistent condom use.Over two thirds (71% of men had not had an HIV test and the majority (55%, n = 602 were young (18-23. Of those not testing, condom use was poor (44%, n = 304. Men who were 18-23 years (aOR: 2.261, CI: 1.534-3.331, with primary (aOR: 2.096, CI: 1.058-4.153 or high school (aOR: 1.622, CI: 1.078-2.439 education, had sex in the last 6 months (aOR: 1.703, CI: 1.055-2.751, and had ≥1 sexual partner (aOR: 1.749, CI: 1.196-2.557 were more likely not to test. Of those reporting condom use (n = 1036, 67%, consistent condom use was 43% (n = 451. HIV testing did not correlate with condom use.Low rates of both condom use and HIV testing among men in a high HIV prevalence setting are worrisome and indicate an urgent need to develop innovative behavioral strategies to address this shortfall. Condom use is poor in this population whether tested or not tested for HIV, indicating no association between condom use and HIV testing.
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.
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.
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.
Tsuyuki, Kiyomi; Gipson, Jessica D; Barbosa, Regina Maria; Urada, Lianne A; Morisky, Donald E
Syndemic Zika virus, HIV and unintended pregnancy call for an urgent understanding of dual method (condoms with another modern non-barrier contraceptive) and consistent condom use. Multinomial and logistic regression analysis using data from the Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (PNDS), a nationally representative household survey of reproductive-aged women in Brazil, identified the socio-demographic, fertility and relationship context correlates of exclusive non-barrier contraception, dual method use and condom use consistency. Among women in marital and civil unions, half reported dual protection (30% condoms, 20% dual methods). In adjusted models, condom use was associated with older age and living in the northern region of Brazil or in urban areas, whereas dual method use (versus condom use) was associated with younger age, living in the southern region of Brazil, living in non-urban areas and relationship age homogamy. Among condom users, consistent condom use was associated with reporting Afro-religion or other religion, not wanting (more) children and using condoms only (versus dual methods). Findings highlight that integrated STI prevention and family planning services should target young married/in union women, couples not wanting (more) children and heterogamous relationships to increase dual method use and consistent condom use.
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
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.
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...
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.
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 ...
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.
Ikramullah, Erum; Manlove, Jennifer
Teens in the United States have high rates of unintended pregnancy and sexually transmitted infections (STIs), and recent data indicate that U.S. teens are engaging in riskier sexual behaviors. Male adolescents can help to lower these rates and risks by using condoms consistently with their sexual partners. Child Trends drew on national survey…
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.
Thomsen, Christa; Nielsen, Anne Ellerup
This chapter first outlines theory and literature on CSR and Stakeholder Relations focusing on the different perspectives and the contextual and dynamic character of the CSR concept. CSR reporting challenges are discussed and a model of analysis is proposed. Next, our paper presents the results...... of a case study showing that companies use different and not necessarily consistent strategies for reporting on CSR. Finally, the implications for managerial practice are discussed. The chapter concludes by highlighting the value and awareness of the discourse and the discourse types adopted...... in the reporting material. By implementing consistent discourse strategies that interact according to a well-defined pattern or order, it is possible to communicate a strong social commitment on the one hand, and to take into consideration the expectations of the shareholders and the other stakeholders...
Bernabe-Ortiz, Antonio; Carcamo, Cesar P; Scott, John D; Hughes, James P; Garcia, Patricia J; Holmes, King K
Data on hepatitis B virus (HBV) prevalence are limited in developing countries. There is also limited information of consistent condom use efficacy for reducing HBV transmission at the population level. The study goal was to evaluate the prevalence and factors associated with HBV infection in Peru, and the relationship between anti-HBc positivity and consistent condom use. Data from two different surveys performed in 28 mid-sized Peruvian cities were analyzed. Participants aged 18-29 years were selected using a multistage cluster sampling. Information was collected through a validated two-part questionnaire. The first part (face-to-face) concerned demographic data, while the second part (self-administered using handheld computers) concerned sexual behavior. Hepatitis B core antibody (anti-HBc) was tested in 7,000 blood samples. Prevalences and associations were adjusted for sample strata, primary sampling units and population weights. Anti-HBc prevalence was 5.0% (95%CI 4.1%-5.9%), with the highest prevalence among jungle cities: 16.3% (95%CI 13.8%-19.1%). In the multivariable analysis, Anti-HBc positivity was directly associated with geographic region (highlands OR = 2.05; 95%CI 1.28-3.27, and jungle OR = 4.86; 95%CI 3.05-7.74; compared to coastal region); and inversely associated with age at sexual debut (OR = 0.90; 95%CI 0.85-0.97). Consistent condom use, evaluated in about 40% of participants, was associated with reduced prevalence (OR = 0.34; 95%CI 0.15-0.79) after adjusting for gender, geographic region, education level, lifetime number of sex partners, age at sexual debut and year of survey. Residence in highlands or jungle cities is associated with higher anti-HBc prevalences, whereas increasing age at sexual debut were associated with lower prevalences. Consistent condom use was associated with decreased risk of anti-HBc. Findings from this study emphasize the need of primary prevention programs (vaccination) especially in the jungle
Full Text Available Data on hepatitis B virus (HBV prevalence are limited in developing countries. There is also limited information of consistent condom use efficacy for reducing HBV transmission at the population level. The study goal was to evaluate the prevalence and factors associated with HBV infection in Peru, and the relationship between anti-HBc positivity and consistent condom use.Data from two different surveys performed in 28 mid-sized Peruvian cities were analyzed. Participants aged 18-29 years were selected using a multistage cluster sampling. Information was collected through a validated two-part questionnaire. The first part (face-to-face concerned demographic data, while the second part (self-administered using handheld computers concerned sexual behavior. Hepatitis B core antibody (anti-HBc was tested in 7,000 blood samples. Prevalences and associations were adjusted for sample strata, primary sampling units and population weights. Anti-HBc prevalence was 5.0% (95%CI 4.1%-5.9%, with the highest prevalence among jungle cities: 16.3% (95%CI 13.8%-19.1%. In the multivariable analysis, Anti-HBc positivity was directly associated with geographic region (highlands OR = 2.05; 95%CI 1.28-3.27, and jungle OR = 4.86; 95%CI 3.05-7.74; compared to coastal region; and inversely associated with age at sexual debut (OR = 0.90; 95%CI 0.85-0.97. Consistent condom use, evaluated in about 40% of participants, was associated with reduced prevalence (OR = 0.34; 95%CI 0.15-0.79 after adjusting for gender, geographic region, education level, lifetime number of sex partners, age at sexual debut and year of survey.Residence in highlands or jungle cities is associated with higher anti-HBc prevalences, whereas increasing age at sexual debut were associated with lower prevalences. Consistent condom use was associated with decreased risk of anti-HBc. Findings from this study emphasize the need of primary prevention programs (vaccination especially in the
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.
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.
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.
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.
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.
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
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…
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
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.
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
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
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.
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 ...
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 ...
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
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.
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.
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...
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
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.
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
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.
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.
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.
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.
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.
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.
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.
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
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
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.
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
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.
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.
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.
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.
Ramiro Caballero Hoyos
Full Text Available OBJETIVO: El estrato socioeconómico juega un rol importante en las desigualdades en salud. En México, la prevalencia más alta de casos de SIDA se encuentra en población de estratos más bajos. El propósito de lo estudio fue describir el estrato socioeconómico (ajustado por variables psicosociales, situacionales y demográficas como un factor predictor del uso consistente del condón, en adolescentes. MÉTODOS: Se incluyó en el estudio una muestra de una encuesta previa aplicada a 1.410 adolescentes de 15 a 19 años y estratificada por edad, género y estrato socioeconómico de Guadalajara, México. El análisis fue aplicado sobre los 251 adolescentes que reportaron actividad sexual. El análisis estadístico se realizó mediante Ji Cuadrada, t-test, ANOVA y regresión logística. RESULTADOS: La frecuencia de uso consistente de condón fue 30,7% y hubo una prevalencia de uso irregular. El estrato socioeconómico alto fue el principal predictor (OR= 11,1, CI95%= 2,6-47,6. Otros predictores significativos fueron el género masculino, el soporte de los pares y el nivel alto de conocimientos sobre VIH/SIDA. CONCLUSIÓN: El estrato socioeconómico es un importante factor predictor del uso consistente del condón.INTRODUCTION: Socioeconomic level plays an important role in health inequalities. In Mexico, the highest prevalence of AIDS cases is among individuals of lower socioeconomic level. The purpose of the study was to describe the socioeconomic level (adjusted for psychosocial, situational and demographic variables as a predictor factor for the consistent condom use among adolescents of Guadalajara, Mexico. METHODS: A sample of 1,410 adolescents, aged 15 to 19 years, drawn from a previous survey stratified by age, gender and socioeconomic strata was included in the study. Analysis was performed in 251 adolescents who reported sexual activity. Statistical analysis was performed using Chi-square, t-test, ANOVA, and logistic regression. RESULTS
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.
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.
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...
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.
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.
Rosenberg, Nora E; Graybill, Lauren A; Wesevich, Austin; McGrath, Nuala; Golin, Carol E; Maman, Suzanne; Bhushan, Nivedita; Tsidya, Mercy; Chimndozi, Limbikani; Hoffman, Irving F; Hosseinipour, Mina C; Miller, William C
In sub-Saharan Africa couple HIV testing and counseling (CHTC) has been associated with substantial increases in safe sex, especially when at least one partner is HIV infected. However, this relationship has not been characterized in an Option B+ context. The study was conducted at the antenatal clinic at Bwaila District Hospital in Lilongwe, Malawi in 2016 under an Option B+ program. Ninety heterosexual couples with an HIV-infected pregnant woman (female-positive couples) and 47 couples with an HIV-uninfected pregnant woman (female-negative couples) were enrolled in an observational study. Each couple member was assessed immediately before and 1 month after CHTC for safe sex (abstinence or consistent condom use in the last month). Generalized estimating equations were used to model change in safe sex before and after CHTC and to compare safe sex between female-positive and female-negative couples. Mean age was 26 years among women and 32 years among men. Before CHTC, safe sex was comparable among female-positive couples (8%) and female-negative couples (2%) [risk ratio (RR): 3.7, 95% confidence interval (CI): 0.5 to 29.8]. One month after CHTC, safe sex was higher among female-positive couples (75%) than among female-negative couples (3%) (RR: 30.0, 95% CI: 4.3 to 207.7). Safe sex increased substantially after CTHC for female-positive couples (RR 9.6, 95% CI: 4.6 to 20.0), but not for female-negative couples (RR: 1.2, 95% CI: 0.1 to 18.7). Engaging pregnant couples in CHTC can have prevention benefits for couples with an HIV-infected pregnant woman, but additional prevention approaches may be needed for couples with an HIV-uninfected pregnant woman.
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.
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.
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.
Wulandari, Luh Putu Lila; Kaldor, John; Januraga, Pande Putu
Men who purchase sex (MWPS) have long been considered as one of the population groups at risk of HIV transmission. However, while HIV-related interventions have been targeted towards this group, few studies have directly recruited MWPS to measure the impact of such interventions. This study aimed to fill the gap for Indonesia by identifying the level and predictors of condom use and HIV testing among MWPS, to inform prevention strategies. A cross-sectional study was conducted by surveying 200 MWPS in Bali, Indonesia in 2015. A structured questionnaire was administered to collect the data. Self-reported condom use on the occasion of last paid sex was very high (88.5%), while a history of HIV testing was low (8.1%). None of the variables identified in this study were associated with condom use at last paid sex. Men were more likely to report a history of HIV testing if they: perceived themselves to be at high risk of HIV, had a higher level of HIV-related knowledge, reported a history of genital ulcers or urethral discharge in the past 12 months, or were aware that confidential HIV testing was available. Implications and limitations of this study are discussed.
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
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.
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 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.
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.
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.
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.
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 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.
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.
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.
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.
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
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.
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.
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.
In this final report in the field of theoretical nuclear physics we note important accomplishments.We were confronted with 'anomoulous' magnetic moments by the experimetalists and were able to expain them. We found unexpected partial dynamical symmetries--completely unknown before, and were able to a large extent to expain them. The importance of a self consistent shell model was emphasized.
Lu, Mingshan; Ma, Ching-to Albert
In the health care market managed care has become the latest innovation for the delivery of services. For efficient implementation, the managed care organization relies on accurate information. So clinicians are often asked to report on patients before referrals are approved, treatments authorized, or insurance claims processed. What are clinicians responses to solicitation for information by managed care organizations? The existing health literature has already pointed out the importance of provider gaming, sincere reporting, nudging, and dodging the rules. We assess the consistency of clinicians reports on clients across administrative data and clinical records. For about 1,000 alcohol abuse treatment episodes, we compare clinicians reports across two data sets. The first one, the Maine Addiction Treatment System (MATS), was an administrative data set; the state government used it for program performance monitoring and evaluation. The second was a set of medical record abstracts, taken directly from the clinical records of treatment episodes. A clinician s reporting practice exhibits an inconsistency if the information reported in MATS differs from the information reported in the medical record in a statistically significant way. We look for evidence of inconsistencies in five categories: admission alcohol use frequency, discharge alcohol use frequency, termination status, admission employment status, and discharge employment status. Chi-square tests, Kappa statistics, and sensitivity and specificity tests are used for hypothesis testing. Multiple imputation methods are employed to address the problem of missing values in the record abstract data set. For admission and discharge alcohol use frequency measures, we find, respectively, strong and supporting evidence for inconsistencies. We find equally strong evidence for consistency in reports of admission and discharge employment status, and mixed evidence on report consistency on termination status. Patterns of
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.
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
Crosby, Richard A; Salazar, Laura F; Yarber, William L; Sanders, Stephanie A; Graham, Cynthia A; Head, Sara; Arno, Janet N
We employed the information-motivation-behavioral skills (IMB) model to guide an investigation of correlates for correct condom use among 278 adult (18-35 years old) male clients attending a sexually transmitted infection (STI) clinic. An anonymous questionnaire aided by a CD-recording of the questions was administered. Linear Structural Relations Program was used to conduct path analyses of the hypothesized IMB model. Parameter estimates showed that while information did not directly affect behavioral skills, it did have a direct (negative) effect on condom use errors. Motivation had a significant direct (positive) effect on behavioral skills and a significant indirect (positive) effect on condom use errors through behavioral skills. Behavioral skills had a direct (negative) effect on condom use errors. Among men attending a public STI clinic, these findings suggest brief, clinic-based, safer sex programs for men who have sex with women should incorporate activities to convey correct condom use information, instill motivation to use condoms correctly, and directly enhance men's behavioral skills for correct use of condoms.
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.
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 ...
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.
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.
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.
Snead, Margaret C; O'Leary, Ann M; Mandel, Michele G; Kourtis, Athena P; Wiener, Jeffrey; Jamieson, Denise J; Warner, Lee; Malotte, C Kevin; Klausner, Jeffrey D; O'Donnell, Lydia; Rietmeijer, Cornelis A; Margolis, Andrew D
Previous studies have found social cognitive theory (SCT)-framed interventions are successful for improving condom use and reducing sexually transmitted infections (STIs). We conducted a secondary analysis of behavioural data from the Safe in the City intervention trial (2003-2005) to investigate the influence of SCT constructs on study participants' self-reported use of condoms at last intercourse. The main trial was conducted from 2003 to 2005 at three public US STI clinics. Patients (n=38,635) were either shown a 'safer sex' video in the waiting room, or received the standard waiting room experience, based on their visit date. A nested behavioural assessment was administered to a subsample of study participants following their index clinic visit and again at 3 months follow-up. We used multivariable modified Poisson regression models to examine the relationships among SCT constructs (sexual self-efficacy, self-control self-efficacy, self-efficacy with most recent partner, hedonistic outcome expectancies and partner expected outcomes) and self-reported condom use at last sex act at the 3-month follow-up study visit. Of 1252 participants included in analysis, 39% reported using a condom at last sex act. Male gender, homosexual orientation and single status were significant correlates of condom use. Both unadjusted and adjusted models indicate that sexual self-efficacy (adjusted relative risk (RRa)=1.50, 95% CI 1.23 to 1.84), self-control self-efficacy (RRa=1.67, 95% CI 1.37 to 2.04), self-efficacy with most recent partner (RRa=2.56, 95% CI 2.01 to 3.27), more favourable hedonistic outcome expectancies (RRa=1.83, 95% CI 1.54 to 2.17) and more favourable partner expected outcomes (RRa=9.74, 95% CI 3.21 to 29.57) were significantly associated with condom use at last sex act. Social cognitive skills, such as self-efficacy and partner expected outcomes, are an important aspect of condom use behaviour. clinicaltrials.gov (NCT00137370). Published by the BMJ Publishing
Kim Han S
Full Text Available Abstract Background This study assesses the consistency of responses among women regarding their beliefs about the mechanisms of actions of birth control methods, beliefs about when human life begins, the intention to use or not use birth control methods that they believe may act after fertilization or implantation, and their reported use of specific methods. Methods A questionnaire was administered in family practice and obstetrics and gynecology clinics in Salt Lake City, Utah, and Tulsa, Oklahoma. Participants included women ages 18–50 presenting for any reason and women under age 18 presenting for family planning or pregnancy care. Analyses were based on key questions addressing beliefs about whether specific birth control methods may act after fertilization, beliefs about when human life begins, intention to use a method that may act after fertilization, and reported use of specific methods. The questionnaire contained no information about the mechanism of action of any method of birth control. Responses were considered inconsistent if actual use contradicted intentions, if one intention contradicted another, or if intentions contradicted beliefs. Results Of all respondents, 38% gave consistent responses about intention to not use or to stop use of any birth control method that acted after fertilization, while 4% gave inconsistent responses. The corresponding percentages for birth control methods that work after implantation were 64% consistent and 2% inconsistent. Of all respondents, 34% reported they believed that life begins at fertilization and would not use any birth control method that acts after fertilization (a consistent response, while 3% reported they believed that life begins at fertilization but would use a birth control method that acts after fertilization (inconsistent. For specific methods of birth control, less than 1% of women gave inconsistent responses. A majority of women (68% or greater responded accurately about the
Versteeg, Marije; Murray, Montagu
Correct and consistent condom usage remains a pivotal strategy in reaching the target set by the South African government to reduce new HIV infections by 50% in the next 5 years. Studies have found that there has been an increase in condom usage by some categories of the population, but usage has not yet reached the desired levels in order to meet the target. This article reports on the findings of a study on condom usage in eight communities in the North West Province, which was part of a wider HIV and AIDS programme evaluation commissioned by the North West Provincial Department of Health. The main aim was to assess accessibility to condoms, and knowledge, attitudes and practices around condom use by four sampled communities in the North West Province. Eight focus group discussions were held and 50 households were interviewed. The study found positive results regarding accessibility and awareness of condoms. However, this often did not lead to the desired behavioural change of using condoms in risky sexual interactions. The majority of respondents still resisted condom usage, used condoms inconsistently, or were not in a position to negotiate protected sexual intercourse. The main reasons reported for this were: reduced pleasure, perceived and real physical side-effects, myths, lack of information, status, financial reasons, distrust in the efficacy of condoms, family planning, cultural reasons, gender-related reasons and trust. Many of the barriers to consistent condom use cannot be overcome by strategies that target the individual. Interventions need to address underlying developmental factors such as the non-biological factors that increase the susceptibility of women to HIV infection. As this falls outside of the scope of the mandate of the Department of Health, various partnerships with other key role players need to be established and/or strengthened, such as with local government, non-governmental organisations and faith-based organisations.
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 ...
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.
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.
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.
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.
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.
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.
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.
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.
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.
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…
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.
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.
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.
Anne Le Manh-Béna; Olivier Ramond
Following the debate on the Conceptual Framework revision undertaken by the IASB and the FASB, this paper discusses three major concerns about the way financial reporting standards should be determined: (1) What is the role a Conceptual Framework?; (2) For whom and for which needs are accounting and financial reporting standards made?; and (3) What information set should financial reporting provide? We show that the perceived need of a Framework has resulted in practice in weak usefulness We ...
Reichow, Brian; Naples, Adam; Steinhoff, Timothy; Halpern, Jason; Volkmar, Fred R.
The World Wide Web is one of the most common methods used by parents to find information on autism spectrum disorders and most consumers find information through search engines such as Google or Bing. However, little is known about how the search engines operate or the consistency of the results that are returned over time. This study presents the…
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.
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.
Ridenour, James F.; Munger, Peter L.
Three methods for reporting the value of a deferred gift are described: the tax method, net realizable value, and fair market value. Three major categories of deferred gifts are identified: pooled income funds, charitable remainder trusts, and charitable gift annuities. (MLW)
Fantke, Peter; Arnot, Jon A; Doucette, William J
Experimental data and models for plant bioaccumulation of organic contaminants play a crucial role for assessing the potential human and ecological risks associated with chemical use. Plants are receptor organisms and direct or indirect vectors for chemical exposures to all other organisms. As new experimental data are generated they are used to improve our understanding of plant-chemical interactions that in turn allows for the development of better scientific knowledge and conceptual and predictive models. The interrelationship between experimental data and model development is an ongoing, never-ending process needed to advance our ability to provide reliable quality information that can be used in various contexts including regulatory risk assessment. However, relatively few standard experimental protocols for generating plant bioaccumulation data are currently available and because of inconsistent data collection and reporting requirements, the information generated is often less useful than it could be for direct applications in chemical assessments and for model development and refinement. We review existing testing guidelines, common data reporting practices, and provide recommendations for revising testing guidelines and reporting requirements to improve bioaccumulation knowledge and models. This analysis provides a list of experimental parameters that will help to develop high quality datasets and support modeling tools for assessing bioaccumulation of organic chemicals in plants and ultimately addressing uncertainty in ecological and human health risk assessments. Copyright © 2016 Elsevier Ltd. All rights reserved.
Nyembezi, Anam; Resnicow, Ken; Ruiter, Robert A C; van den Borne, Bart; Sifunda, Sibusiso; Funani, Itumeleng; Reddy, Priscilla
This article reports on the association between ethnic identity and condom use among Black African men in the rural areas of the Eastern Cape Province, South Africa. Individual face-to-face structured interviews were conducted by trained community research assistants among 1,656 men who had undergone traditional initiation and male circumcision. Logistic regression analyses were used to explore the association between two components of ethnic identity (cultural affiliation and cultural alienation) and condom use. Overall, 49.2 % of the participants reported using condoms consistently and, of these users, 66.4 % used them correctly. Logistic regression adjusting for age, employment status, education level, and nation of origin showed that participants who expressed high as opposed to low cultural affiliation were significantly more likely to use condoms consistently and correctly when having sex, especially if they reported to have more than one sexual partner. Cultural alienation was negatively related with consistent condom use, whereas its association with correct use was unclear. The findings of this study suggest that positively emphasizing the ethnic identity of African black men may promote condom use.
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
Legardy, Jennifer K; Macaluso, Maurizio; Artz, Lynn; Brill, Ilene
This study assessed whether participant baseline characteristics modified the effects of a skill-based intervention promoting condom use. The randomized, controlled trial enrolled 427 women from a sexually transmitted disease clinic in Birmingham, Alabama. The main outcome measures: consistent (100%) and problem-free (correct, no breakage or slippage) condom use were verified by sexual diary self-report and contraceptive product counts. The enhanced intervention group had a 60% higher consistent condom use rate compared to the basic group (risk ratio [RR], 1.6; 95% confidence interval [CI], 1.4-1.8). There was no statistically significant difference between groups in relationship to problem-free, consistent use (RR, 1.0; 95% CI, 0.9-1.1). A binomial regression analysis identified the following factors as significant modifiers of intervention effectiveness on consistent condom use: intention to use condoms next time, early-age sexual debut, marital status combined with place of intercourse, and substance use before sex. The results suggest that participant baseline characteristics can be modifiers of intervention effectiveness.
Full Text Available 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.
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.
Mahoney, C A
A sample of 879 undergraduate students were recruited from a public university in western New York state during the 1993-94 academic year in order to study condom use among sexually active young people 18-24 years old. A 104-item questionnaire was administered consisting of 5 instruments and single-item measures of sexual behavior and demographics. The instruments were: the Condom Use Self-Efficacy Scale (CUSES), the Perceived Barriers to Condom Use, the Perceived Susceptibility to HIV/AIDS and other STDs, the Cues to Condom Action Scale, and the Perceived Norms scale. 92% of students reported having had sexual intercourse in the past, while 86.75 reported having sexual intercourse in the previous year. About 61% reported having 1 sex partner in the previous 12 months, whereas 35.2% reported having 3 or more partners. 22.4% reported 2 or more 1-night stands. 54.5% reported worrying about HIV/AIDS occasionally, while 23.1% reported doing so frequently. 17.2% (99) of the students were classified as non-users of condoms, 50.2% (289) as sporadic users, and 32.6% (188) as consistent users. 78 (12%) could not be classified. A multiple discriminant function analysis was also conducted to distinguish among the 3 condom user groups totalling 576 cases. The variables were age, gender, frequency of drunkenness during sexual intercourse, number of sex partners, and number of 1-night stands in the past 12 months, perceived barriers, worrying about HIV/AIDS, perceived susceptibility, condom use self-efficacy, and cues to condom action. Two significant functions emerged. Function 1 clearly separated the sporadic users from the consistent users (p 0.001), while Function 2 clearly separated the sporadic users from the non-users (p 0.001). The discriminating variables correctly classified 64.58% of the respondents into the 3 condom user groups. The variables were most effective at correctly classifying non-users (68.7%), consistent users (67.8%), and sporadic users (61.2%). Sporadic
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.
Stephens, Torrance T; Gardner, Darius; Jones, Keena; Sifunda, Sibusiso; Braithwaite, Ronald; Smith, Selina E
This study was designed to identify the extent to which self-reported Mandrax use impacts condom-use beliefs amongst South African prison inmates. Participants were inmates from four prisons in the provinces of KwaZulu-Natal and Mpumalanga. In total, 357 inmates participated in the parent study of which 121 are included in this analysis based on their self-reported use of Mandrax. The questionnaire was developed in English, translated into Zulu, and back translated into English. Age significantly predicted the use of Mandrax: younger prison inmates reported higher use. Linear regression analysis was conducted to determine whether the use of Mandrax was associated with length of incarceration and other demographic variables, as well as participants' self-reported condom use beliefs behavior. Regression results indicated that two factors operationalizing condom-use beliefs were impacted by Mandrax use: 1) it is important to use condoms every time you have sex (pcondoms work well to prevent the spread of HIV (puse. STI prevention programs among prison inmates that seek to promote safer sex behaviors among men must address attitudes to condom use, specifically consistent and correct use of latex condoms and reducing substance misuse. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
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
Yarber, William L; Milhausen, Robin R; Beavers, Karly A; Ryan, Rebecca; Sullivan, Margaret J; Vanterpool, Karen B; Sanders, Stephanie A; Graham, Cynthia A; Crosby, Richard A
To conduct a pilot test of a brief, self-guided, home-based program designed to improve male condom use attitudes and behaviors among young women. Women aged 18-24 years from a large Midwestern University reporting having had penile-vaginal sex with two or more partners in the past 3 months. Sixty-seven enrolled; 91.0% completed the study. A repeated measures design was used, with assessments occurring at baseline, immediately post intervention (T2), and 30 days subsequent (T3). Condom use errors and problems decreased, condom-related attitudes and self-efficacy improved, and experiences of condom-protected sex were rated more positively when comparing baseline with T2 and T3 scores. Further, the proportion of condom-protected episodes more than doubled between T1 and T3 for those in the lowest quartile for condom use at baseline. This low-resource, home-based program improved condom-related attitudes and promoted the correct and consistent use of condoms.
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.
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
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.
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.
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.
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
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
Full Text Available BACKGROUND: Consistent and correct condom use and suppressive antiretroviral therapy for the infected partner are two of the primary strategies recommended for prevention of heterosexual HIV transmission in serodiscordant couples today. The applied effectiveness of treatment as a prevention strategy in China is still under investigation, and much less is known about its effects in the presence of other prevention strategies such as consistent condom use. METHODS: We conducted a systematic search in PubMed and three Chinese language databases to identify relevant articles for the estimation of relative effectiveness of a consistent condom use and b ART use by index partners for preventing HIV transmission in serodiscordant couples. We also estimated the prevention effectiveness of ART stratified by condom use level and the prevention effectiveness of consistent condom use stratified by ART use level. RESULTS: Pooled results from the eleven eligible studies found a pooled HIV seroconversion incidence of 0.92 cases per 100 person years (PY among HIV-negative spouses whose index partners were taking ART versus 2.45 cases per 100 PY in untreated couples. The IRR comparing seroconversion in couples where the index-partner was on ART versus not on ART was 0.47 (95%CI: 0.43, 0.52, while stratified by condom use, the IRR was 0.33(0.17,0.64. The IRR comparing incidence in couples reporting "consistent condom use" versus those reporting otherwise was 0.02(95%CI:0.01,0.04, after stratified by ART use level, the IRR was 0.01(95%CI: 0.00, 0.06. CONCLUSIONS: ART use by index partners could reduce HIV transmission in serodiscordant couples, and the effectiveness of this prevention strategy could be further increased with consistent condom use.
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.
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.
Buchacz, K; van der Straten, A; Saul, J; Shiboski, S C; Gomez, C A; Padian, N
We examined sociodemographic, behavioral, and clinical characteristics associated with inconsistent condom use in a cross-sectional analysis of 145 sexually active HIV-serodiscordant heterosexual couples who participated in the California Partners Study II. All couples were aware of their HIV-serodiscordant status. Forty-five percent of couples reported having had unprotected vaginal or anal sex in the previous 6 months. In the multivariate couple-level analyses, factors independently associated with inconsistent (i.e., <100%) condom use in the previous 6 months included lower educational level, unemployment, African-American ethnicity, and practice of anal sex by the couple. Injection drug use was associated with inconsistent condom use among couples with younger HIV-infected partners. In addition, couples with HIV-infected partners who had higher CD4 cell counts and couples in which the HIV-infected male partner ever had sex with a man were more likely to use condoms inconsistently. Consistency of condom use did not depend on the gender of the HIV-infected partner or duration of sexual relationship. The findings suggest that many HIV-serodiscordant heterosexual couples remain at high risk of HIV transmission and may benefit not only from behavioral interventions but also from structural interventions aimed at improving their social and economic conditions.
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.
Geoffrey L. Ream
Full Text Available Health behavior interventions based on Theory of Planned Behavior address participants’ personally-held beliefs, perceived social norms, and control over the behavior. New data are always needed to “member check” participants’ decision processes and inform interventions. This qualitative study investigates decision processes around condom use among 81 homeless LGBT youth ages 18–26. Findings indicated considerable endorsement of the conventional policy of always using condoms, promulgated in HIV prevention education targeting this population. Although some participants reported risk behavior in contexts of sex work, survival sex, casual encounters, open relationships, and substance use, most were aware of these risks and consistently safe in those situations. Condoms use boundaries became vulnerable in states of emotional need and negative mood. The only effect participants acknowledged of homelessness on condom use was indirect, through negative mood states. The most prevalent context of condom non-use was with long-term primary partners, a potential area of vulnerability because, of 13 participants for HIV or HCV, nine mentioned how they had been infected, and all nine believed they had acquired it from a primary partner. Findings imply programs should emphasize HIV risk potential within long-term romantic partnerships and mental health services to remediate negative mood states.
Ream, Geoffrey L.; Barnhart, Kate F.; Lotz, Kevin V.
Health behavior interventions based on Theory of Planned Behavior address participants' personally-held beliefs, perceived social norms, and control over the behavior. New data are always needed to “member check” participants' decision processes and inform interventions. This qualitative study investigates decision processes around condom use among 81 homeless LGBT youth ages 18–26. Findings indicated considerable endorsement of the conventional policy of always using condoms, promulgated in HIV prevention education targeting this population. Although some participants reported risk behavior in contexts of sex work, survival sex, casual encounters, open relationships, and substance use, most were aware of these risks and consistently safe in those situations. Condoms use boundaries became vulnerable in states of emotional need and negative mood. The only effect participants acknowledged of homelessness on condom use was indirect, through negative mood states. The most prevalent context of condom non-use was with long-term primary partners, a potential area of vulnerability because, of 13 participants for HIV or HCV, nine mentioned how they had been infected, and all nine believed they had acquired it from a primary partner. Findings imply programs should emphasize HIV risk potential within long-term romantic partnerships and mental health services to remediate negative mood states. PMID:22693658
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...
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
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, ...
Sayegh, M Aaron; Fortenberry, J Dennis; Shew, Marcia; Orr, Donald P
Consistent condom use is critical to efforts to prevent sexually transmitted infections among adolescents, but condom use may decline as relationships and contraceptive needs change. The purpose of this research is to assess changes in condom non-use longitudinally in the context of changes in relationship quality, coital frequency and hormonal contraceptive choice. Participants were women (aged 14-17 years at enrollment) recruited from three urban adolescent medicine clinics. Data were collected at three-month intervals using a face-to-face structured interview. Participants were able to contribute up to 10 interviews, but on average contributed 4.2 interviews over the 27-month period. Independent variables assessed partner-specific relationship quality (five items; scale range 5-25; alpha = .92, e.g., this partner is a very important person to me); and, number of coital events with a specific partner. Additional items assessed experience with oral contraceptive pills (OCP) use and injected depo medroxy-progesterone acetate (DMPA). The outcome variable was number of coital events without condom use during the past three months. Analyses were conducted as a three-level hierarchical linear growth curve model using HLM 6. The Level 1 predictor was time, to test the hypothesis that condom non-use increases over time. Level 2 predictors assessed relationship quality and coital frequency across all partners to assess hypotheses that participants' condom non-use increases over time as a function of relationship quality and coital frequency. Level 3 predictors assessed the participant-level influence of OCP or DMPA experience on time-related changes in condom non-use. A total of 176 women reported 279 sex partners and contributed 478 visits. Both average coital frequency and average condom non-use linearly increased during the 27-month follow-up. At any given follow-up, about 35% reported recent OCP use, and 65% reported DMPA use. HLM analyses showed that condom non
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.
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.
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.
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.
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.
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.
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.
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
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.
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.
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.
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.
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...
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.
Grimley, Diane M; Hook, Edward W
Brief face-to-face-behavioral interventions have been shown to be efficacious, but are costly to sustain and to widely disseminate. This study evaluated the efficacy of a 15-minute theory-based behavioral intervention designed to increase condom use and reduce new cases of Neisseria gonorrhoeae and Chlamydia trachomatis. Participants were randomly assigned via the computer to the intervention or the comparison group stratified by gender and their baseline stage of change (motivational readiness) for using condoms consistently (100%) with their main partners. Behavioral data and biologic specimens for testing of Neisseria gonorrhoeae and Chlamydia trachomatis were obtained at baseline and at 6 months post intervention. The intervention was delivered via an audio, multimedia, computerized application that provided individualized interventions to patients based on their responses to assessment items; comparison patients interacted with a 15-minute, computerized, multiple health risk assessment with no intervention. The majority of the sample (N = 430) was black (88%); 54.5% women; with a mean age = 24.5. Assuming all participants who did not return to the clinic at 6 months were not using condoms consistently, 32% of the treatment group versus 23% in the comparison group reported consistent condom use (P = 0.03). The combined Neisseria gonorrhoeae and Chlamydia trachomatis incidence declined to 6% in the intervention group versus 13% in the comparison group (P = 0.04). Results from a regression analysis revealed that the only statically significant predictor of sexually transmitted diseases infection at the follow-up was group assignment (OR = 1.91, 95% confidence index = 1.09-3.34; P = 0.043). These findings suggest that brief, interactive, computer-delivered interventions provided at the evaluation visit increase condom use and reduce sexually transmitted diseases without putting additional burden on clinicians or staff.
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.
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
García, Macarena C; Duong, Quyen L; Mercer, Licelot C Eralte; Meyer, Samantha B; Koppenhaver, Todd; Ward, Paul R
Survey data from men who have sex with men (MSM) in Asian cities indicate drastic increases in HIV prevalence. It is unknown which factors are most important in driving these epidemics. The objective of this study was to identify patterns of condom use among MSM Internet users living in Viet Nam, as well as risk factors associated with inconsistent condom use and non-condom use. A national Internet-based survey of sexual behaviours was administered in 2011. Results showed that 44.9% of MSM reported not using a condom during their last anal sex encounter with a male partner. MSM were less likely to report condom use during anal sex with long-term partners than with casual partners. Twenty-three and a half per cent of MSM surveyed had ever taken an HIV test and received the results. Study findings highlight the urgent need for targeted strategies focused on increasing the rate of consistent condom use during anal sex with male partners among MSM in Viet Nam.
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.
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.
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.
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.
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…
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
Full Text Available There is a general recognition of homosexuality being responsible for the high prevalence of HIV/AIDS among inmates in Nigerian prisons. However, the use of condoms which is an evidenced-based preventive measure is critical in the prison setting because of socio-cultural reasons. Due to the dynamic nature of the prison population, interventions targeting the prisons will have a significant effect on the general population. This study assessed condom acceptability for the prevention of HIV infection among male inmates in a convict prison in north-western, Nigeria in order to provide supplementary information that will corroborate some findings from quantitative methods. A qualitative study was conducted in Zaria prison between 18th December, 2012 and 8th January, 2013. Purposive sampling identified 48 inmates who had Focused Group Discussions (FGDs and In-depth Interviews (IDIs. Common trends and variations in the responses were identified and reflected as appropriate and presented as narratives with relevant quotations. Majority of the respondents agreed that homosexuality exists among the inmates, but all the inmates scowled at the distribution of condoms to inmates in prison. Majority were of the opinion that condom distribution will promote homosexuality which is prohibited by Nigerian laws and controlling HIV transmissions in Nigeria prisons can be effectively done through behavioral modifications that are geared towards total abstinence.
Full Text Available There is a general recognition of homosexuality being responsible for the high prevalence of HIV/AIDS among inmates in Nigerian prisons. However, the use of condoms which is an evidenced-based preventive measure is critical in the prison setting because of socio-cultural reasons. Due to the dynamic nature of the prison population, interventions targeting the prisons will have a significant effect on the general population. This study assessed condom acceptability for the prevention of HIV infection among male inmates in a convict prison in north-western, Nigeria in order to provide supplementary information that will corroborate some findings from quantitative methods. A qualitative study was conducted in Zaria prison between 18th December, 2012 and 8th January, 2013. Purposive sampling identified 48 inmates who had Focused Group Discussions (FGDs and In‐depth Interviews (IDIs. Common trends and variations in the responses were identified and reflected as appropriate and presented as narratives with relevant quotations. Majority of the respondents agreed that homosexuality exists among the inmates, but all the inmates scowled at the distribution of condoms to inmates in prison. Majority were of the opinion that condom distribution will promote homosexuality which is prohibited by Nigerian laws and controlling HIV transmissions in Nigeria prisons can be effectively done through behavioral modifications that are geared towards total abstinence.
III, Joseph Thomas; Paulet, Mindy; Rajpura, Jigar R.
Objectives. This study evaluated consistency between self-reported values for clinical measures and recorded clinical measures. Methods. Self-reported values were collected for the clinical measures: systolic blood pressure, diastolic blood pressure, glucose level, height, weight, and cholesterol from health risk assessments completed by enrollees in a privately insured cohort. Body mass index (BMI) was computed from reported height and weight. Practitioner recorded values for the clinical me...
Lisa B Haddad
Full Text Available Programs for integration of family planning into HIV care must recognize current practices and desires among clients to appropriately target and tailor interventions. We sought to evaluate fertility intentions, unintended pregnancy, contraceptive and condom use among a cohort of HIV-infected women seeking family planning services within an antiretroviral therapy (ART clinic.200 women completed an interviewer-administered questionnaire during enrollment into a prospective contraceptive study at the Lighthouse Clinic, an HIV/ART clinic in Lilongwe, Malawi, between August and December 2010.Most women (95% did not desire future pregnancy. Prior reported unintended pregnancy rates were high (69% unplanned and 61% unhappy with timing of last pregnancy. Condom use was inconsistent, even among couples with discordant HIV status, with lack of use often attributed to partner's refusal. Higher education, older age, lower parity and having an HIV negative partner were factors associated with consistent condom usage.High rates of unintended pregnancy among these women underscore the need for integ rating family planning, sexually transmitted infection (STI prevention, and HIV services. Contraceptive access and use, including condoms, must be improved with specific efforts to enlist partner support. Messages regarding the importance of condom usage in conjunction with more effective modern contraceptive methods for both infection and pregnancy prevention must continue to be reinforced over the course of ongoing ART treatment.
Haddad, Lisa B; Feldacker, Caryl; Jamieson, Denise J; Tweya, Hannock; Cwiak, Carrie; Chaweza, Thomas; Mlundira, Linly; Chiwoko, Jane; Samala, Bernadette; Kachale, Fanny; Bryant, Amy G; Hosseinipour, Mina C; Stuart, Gretchen S; Hoffman, Irving; Phiri, Sam
Programs for integration of family planning into HIV care must recognize current practices and desires among clients to appropriately target and tailor interventions. We sought to evaluate fertility intentions, unintended pregnancy, contraceptive and condom use among a cohort of HIV-infected women seeking family planning services within an antiretroviral therapy (ART) clinic. 200 women completed an interviewer-administered questionnaire during enrollment into a prospective contraceptive study at the Lighthouse Clinic, an HIV/ART clinic in Lilongwe, Malawi, between August and December 2010. Most women (95%) did not desire future pregnancy. Prior reported unintended pregnancy rates were high (69% unplanned and 61% unhappy with timing of last pregnancy). Condom use was inconsistent, even among couples with discordant HIV status, with lack of use often attributed to partner's refusal. Higher education, older age, lower parity and having an HIV negative partner were factors associated with consistent condom usage. High rates of unintended pregnancy among these women underscore the need for integ rating family planning, sexually transmitted infection (STI) prevention, and HIV services. Contraceptive access and use, including condoms, must be improved with specific efforts to enlist partner support. Messages regarding the importance of condom usage in conjunction with more effective modern contraceptive methods for both infection and pregnancy prevention must continue to be reinforced over the course of ongoing ART treatment.
Caperos, José Manuel; Pardo, Antonio
Recent reviews have drawn attention to frequent consistency errors when reporting statistical results. We have reviewed the statistical results reported in 186 articles published in four Spanish psychology journals. Of these articles, 102 contained at least one of the statistics selected for our study: Fisher-F , Student-t and Pearson-c 2 . Out of the 1,212 complete statistics reviewed, 12.2% presented a consistency error, meaning that the reported p-value did not correspond to the reported value of the statistic and its degrees of freedom. In 2.3% of the cases, the correct calculation would have led to a different conclusion than the reported one. In terms of articles, 48% included at least one consistency error, and 17.6% would have to change at least one conclusion. In meta-analytical terms, with a focus on effect size, consistency errors can be considered substantial in 9.5% of the cases. These results imply a need to improve the quality and precision with which statistical results are reported in Spanish psychology journals.
Koenen, K C; Stellman, S D; Dohrenwend, B P; Sommer, J F; Stellman, J M
Self-reports of traumatic events are often used in clinical and epidemiologic studies. Nevertheless, research suggests combat exposure reports may be biased by posttraumatic stress disorder (PTSD) symptom severity, leading to an inflated dose-response relation between combat exposure and PTSD. The authors examined the consistency in combat exposure reports and their relation to PTSD symptoms in Vietnam Veteran American Legionnaires who responded to two mailed surveys (1984, 1998; N = 1,462). Combat exposure reports were highly reliable (test-retest correlation = 0.87). However, changes in exposure reporting were related to changes in PTSD symptoms, specifically reexperiencing symptoms. The effect size of the dose-response relation attributable to changes in reporting was smaller for continuous than categorical measures. Findings are discussed in relation to recent controversies over veterans' combat exposure reports.
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.
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.
Rescorla, Leslie A.; Achenbach, Thomas M.; Ginzburg, Sofia; Ivanova, Masha; Dumenci, Levent; Almqvist, Fredrik; Bathiche, Marie; Bilenberg, Niels; Bird, Hector; Domuta, Anca; Erol, Nese; Fombonne, Eric; Fonseca, Antonio; Frigerio, Alessandra; Kanbayashi, Yasuko; Lambert, Michael C.; Liu, Xianchen; Leung, Patrick; Minaei, Asghar; Roussos, Alexandra; Simsek, Zeynep; Weintraub, Sheila; Weisz, John; Wolanczyk, Tomasz; Zubrick, Stephen R.; Zukauskiene, Rita; Verhulst, Frank
This study compared teachers' ratings of behavioral and emotional problems on the Teacher's Report Form for general population samples in 21 countries (N = 30,957). Correlations between internal consistency coefficients in different countries averaged 0.90. Effects of country on scale scores ranged from 3% to 13%. Gender effects ranged from less…
Full Text Available Behavioral economic demand for addictive substances is commonly assessed via purchase tasks that measure estimated drug consumption at a range of prices. Purchase tasks typically use escalating prices in sequential order, which may influence performance by providing explicit price reference points. This study investigated the consistency of value preferences on two alcohol purchase tasks (APTs that used either a randomized or sequential price order (price range: free to $30 per drink in a sample of ninety-one young adult monthly drinkers. Randomization of prices significantly reduced relative response consistency (p < .01, although absolute consistency was high for both versions (>95%. Self-reported alcohol consumption across prices and indices of demand were highly similar across versions, although a few notable exceptions were found. These results suggest generally high consistency and overlapping performance between randomized and sequential price assessment. Implications for the behavioral economics literature and priorities for future research are discussed.
Rivoirard, Romain; Duplay, Vianney; Oriol, Mathieu; Tinquaut, Fabien; Chauvin, Franck; Magne, Nicolas; Bourmaud, Aurelie
Quality of reporting for Randomized Clinical Trials (RCTs) in oncology was analyzed in several systematic reviews, but, in this setting, there is paucity of data for the outcomes definitions and consistency of reporting for statistical tests in RCTs and Observational Studies (OBS). The objective of this review was to describe those two reporting aspects, for OBS and RCTs in oncology. From a list of 19 medical journals, three were retained for analysis, after a random selection: British Medical Journal (BMJ), Annals of Oncology (AoO) and British Journal of Cancer (BJC). All original articles published between March 2009 and March 2014 were screened. Only studies whose main outcome was accompanied by a corresponding statistical test were included in the analysis. Studies based on censored data were excluded. Primary outcome was to assess quality of reporting for description of primary outcome measure in RCTs and of variables of interest in OBS. A logistic regression was performed to identify covariates of studies potentially associated with concordance of tests between Methods and Results parts. 826 studies were included in the review, and 698 were OBS. Variables were described in Methods section for all OBS studies and primary endpoint was clearly detailed in Methods section for 109 RCTs (85.2%). 295 OBS (42.2%) and 43 RCTs (33.6%) had perfect agreement for reported statistical test between Methods and Results parts. In multivariable analysis, variable "number of included patients in study" was associated with test consistency: aOR (adjusted Odds Ratio) for third group compared to first group was equal to: aOR Grp3 = 0.52 [0.31-0.89] (P value = 0.009). Variables in OBS and primary endpoint in RCTs are reported and described with a high frequency. However, statistical tests consistency between methods and Results sections of OBS is not always noted. Therefore, we encourage authors and peer reviewers to verify consistency of statistical tests in oncology studies.
Mekhora, Keerin; Jalayondeja, Wattana; Jalayondeja, Chutima; Bhuanantanondh, Petcharatana; Dusadiisariyavong, Asadang; Upiriyasakul, Rujiret; Anuraktam, Khajornyod
To develop an online, self-report questionnaire on computer work-related exposure (OSCWE) and to determine the internal consistency, face and content validity of the questionnaire. The online, self-report questionnaire was developed to determine the risk factors related to musculoskeletal disorders in computer users. It comprised five domains: personal, work-related, work environment, physical health and psychosocial factors. The questionnaire's content was validated by an occupational medical doctor and three physical therapy lecturers involved in ergonomic teaching. Twenty-five lay people examined the feasibility of computer-administered and the user-friendly language. The item correlation in each domain was analyzed by the internal consistency (Cronbach's alpha; alpha). The content of the questionnaire was considered congruent with the testing purposes. Eight hundred and thirty-five computer users at the PTT Exploration and Production Public Company Limited registered to the online self-report questionnaire. The internal consistency of the five domains was: personal (alpha = 0.58), work-related (alpha = 0.348), work environment (alpha = 0.72), physical health (alpha = 0.68) and psychosocial factor (alpha = 0.93). The findings suggested that the OSCWE had acceptable internal consistency for work environment and psychosocial factors. The OSCWE is available to use in population-based survey research among computer office workers.
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.
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.
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.
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.
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
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.
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
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
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.
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 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
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
L\\'indice le plus fort de la connaissance du bon mode d\\'emploi du préservatif chez les adolescents et les adolescentes est de les exposer à une démonstration de l\\'emploi du préservatif. Au Burkina-Faso, au Ghana et en Ouganda les adolescents qui ont vu une démonstration du préservatif ont 2 à 5 fois plus la possibilité ...
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.
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…
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 ...
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 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
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.
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.
Full Text Available Abstract Background ICRU 50/62 provides a framework to facilitate the reporting of external beam radiotherapy treatments from different institutions. A predominant role is played by points that represent "the PTV dose". However, for new techniques like Intensity Modulated Radiotherapy (IMRT - especially step and shoot IMRT - it is difficult to define a point whose dose can be called "characteristic" of the PTV dose distribution. Therefore different volume based methods of reporting of the prescribed dose are in use worldwide. Several of them were compared regarding their usability for IMRT and compatibility with the ICRU Reference Point dose for conformal radiotherapy (CRT in this study. Methods The dose distributions of 45 arbitrarily chosen volumes treated by CRT plans and 57 volumes treated by IMRT plans were used for comparison. Some of the IMRT methods distinguish the planning target volume (PTV and its central part PTVx (PTV minus a margin region of × mm. The reporting of dose prescriptions based on mean and median doses together with the dose to 95% of the considered volume (D95 were compared with each other and in respect of a prescription report with the aid of one or several possible ICRU Reference Points. The correlation between all methods was determined using the standard deviation of the ratio of all possible pairs of prescription reports. In addition the effects of boluses and the characteristics of simultaneous integrated boosts (SIB were examined. Results Two types of methods result in a high degree of consistency with the hitherto valid ICRU dose reporting concept: the median dose of the PTV and the mean dose to the central part of the PTV (PTVx. The latter is similar to the CTV, if no nested PTVs are used and no patient model surfaces are involved. A reporting of dose prescription using the CTV mean dose tends to overestimate the plateau doses of the lower dose plateaus of SIB plans. PTVx provides the possibility to approach
Bratengeier, Klaus; Oechsner, Markus; Gainey, Mark; Flentje, Michael
ICRU 50/62 provides a framework to facilitate the reporting of external beam radiotherapy treatments from different institutions. A predominant role is played by points that represent 'the PTV dose'. However, for new techniques like Intensity Modulated Radiotherapy (IMRT) - especially step and shoot IMRT - it is difficult to define a point whose dose can be called 'characteristic' of the PTV dose distribution. Therefore different volume based methods of reporting of the prescribed dose are in use worldwide. Several of them were compared regarding their usability for IMRT and compatibility with the ICRU Reference Point dose for conformal radiotherapy (CRT) in this study. The dose distributions of 45 arbitrarily chosen volumes treated by CRT plans and 57 volumes treated by IMRT plans were used for comparison. Some of the IMRT methods distinguish the planning target volume (PTV) and its central part PTV x (PTV minus a margin region of × mm). The reporting of dose prescriptions based on mean and median doses together with the dose to 95% of the considered volume (D 95 ) were compared with each other and in respect of a prescription report with the aid of one or several possible ICRU Reference Points. The correlation between all methods was determined using the standard deviation of the ratio of all possible pairs of prescription reports. In addition the effects of boluses and the characteristics of simultaneous integrated boosts (SIB) were examined. Two types of methods result in a high degree of consistency with the hitherto valid ICRU dose reporting concept: the median dose of the PTV and the mean dose to the central part of the PTV (PTV x ). The latter is similar to the CTV, if no nested PTVs are used and no patient model surfaces are involved. A reporting of dose prescription using the CTV mean dose tends to overestimate the plateau doses of the lower dose plateaus of SIB plans. PTV x provides the possibility to approach biological effects
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.
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…
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/.
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.
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.
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
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 ...
Crosby, Richard A; Charnigo, Richard J; Salazar, Laura F; Pasternak, Ryan; Terrell, Ivy W; Ricks, JaNelle; Smith, Rachel V; Taylor, Stephanie N
We tested the efficacy of a brief intervention to promote correct and consistent use of condoms among Black male youths attending sexually transmitted infection (STI) clinics in 3 southern US cities. In 2010 to 2012, we screened (n = 1102) and enrolled (n = 702) youths aged 15 to 23 years who identified as Black and reported recent (past 2 months) sexual activity and randomized them to a private, brief, interactive intervention (n = 349) or an attention-equivalent control condition (n = 353). Assessments occurred at baseline and 2 and 6 months after the intervention. At 6 months, with adjustment for age and pretest nonequivalence of the outcome variable, an estimated odds ratio (EOR) of 1.63 (95% confidence interval [CI] = 1.07, 2.49; P = .02) indicated efficacy for correct condom use. An adjusted generalized estimating equations model with both 2- and 6-month condom use variables produced an EOR of 1.49 (95% CI = 1.06, 2.08; P = .02). We did not observe significant effects on chlamydia and gonorrhea incidence. This brief intervention, delivered as part of STI clinical care, could help alleviate the disproportionate STI-HIV burden among young Black men.
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.
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
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
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.
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.
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.
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.
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
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.
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.
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.
Hart, Shelley R; Musci, Rashelle J; Ialongo, Nicholas; Ballard, Elizabeth D; Wilcox, Holly C
Within the context of the recent release of the 2012 National Suicide Prevention Strategy, and as the third leading cause of death for individuals 10- to 24-years-old, suicide prevention is a national priority. A consistently reported and robust risk factor for suicide is a prior suicide attempt; however few studies have investigated the consistency of self-reported lifetime suicide attempts. The goal of this study is to describe the prevalence and characteristics of inconsistent reporting of suicide attempt in a longitudinal cohort of participants annually assessed in 12 waves of data collected from middle school (age 12) to early adulthood (age 22). Among this cohort (n = 678), we compared those who consistently, inconsistently, and never reported a suicide attempt according to demographic and clinical variables. Almost 90% (88.5%) of our sample inconsistently reported a lifetime suicide attempt. Consistent and inconsistent reporters of lifetime suicide attempt did not differ on demographic or clinical variables with the exception of higher rates of lifetime suicidal ideation among consistent reporters (P adolescents. Inconsistent and consistent reporters of suicide attempt differ on few demographic or clinical variables; further prospective research should investigate the reasons for inconsistent reporting as well as the validity and stability of reporting in predicting future suicidal behavior. © 2013 Wiley Periodicals, Inc.
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
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
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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
Soulakova, Julia N; Huang, Huang; Crockett, Lisa J
This study assessed the effect of race/ethnicity on the prevalence of inconsistent reports regarding ever smoking, time since smoking cessation, and age of initiating regular smoking. We used the Tobacco Use Supplement to the Current Population Survey data, which came from a test-retest reliability study, and considered three racial/ethnic subpopulations, Hispanics, Non-Hispanic (NH) Blacks and NH Whites. Initial exploration of highly disagreeing reports of time since smoking cessation and ag...
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
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.
-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 ...
EPA announced the availability of the final report, Land-Use Scenarios: National-Scale Housing-Density Scenarios Consistent with Climate Change Storylines. This report describes the scenarios and models used to generate national-scale housing density scenarios for the con...
Anderson, Daniel; Tindal, Gerald; Alonzo, Julie
We developed alternate forms of a math test for use in both screening students at risk of failure and monitoring their progress over time. In this technical report, we present results of the screener, used in the fall of 2009. The 48-item test was aligned to the National Council of Teachers of Mathematics (NCTM) Curriculum Focal Point Standards…
Joseph J Valadez
Full Text Available A major strategy for preventing transmission of HIV and other STIs is the consistent use of condoms during sexual intercourse. Condom use among youths is particularly important to reduce the number of new cases and the national prevalence. Condom use has been often promoted by the Uganda National AIDS Commission. Although a number of studies have established an association between condom use at one's sexual debut and future condom use, few studies have explored this association over time, and whether the results are generalizable across multiple locations. This multi time point, multi district study assesses the relationship between sexual debut and condom use and consistent use of condoms thereafter. Uganda has used Lot Quality Assurance Sampling surveys since 2003 to monitor district level HIV programs and improve access to HIV health services. This study includes 4518 sexually active youths interviewed at five time points (2003-2010 in up to 23 districts located across Uganda. Using logistic regression, we measured the association of condom use at first sexual intercourse on recent condom usage, controlling for several factors including: age, sex, education, marital status, age at first intercourse, geographical location, and survey year. The odds of condom use at last intercourse, using a condom at last intercourse with a non-regular partner, and consistently using a condom are, respectively, 9.63 (95%WaldCI = 8.03-11.56, 3.48 (95%WaldCI = 2.27-5.33, and 11.12 (95%WaldCI = 8.95-13.81 times more likely for those individuals using condoms during their sexual debut. These values did not decrease by more than 20% when controlling for potential confounders. The results suggest that HIV prevention programs should encourage condom use among youth during sexual debut. Success with this outcome may have a lasting influence on preventing HIV and other STIs later in life.
Davis, Rosemary; Ouma, Joseph; Lwanga, Stephen K.; Moxon, Sarah
A major strategy for preventing transmission of HIV and other STIs is the consistent use of condoms during sexual intercourse. Condom use among youths is particularly important to reduce the number of new cases and the national prevalence. Condom use has been often promoted by the Uganda National AIDS Commission. Although a number of studies have established an association between condom use at one’s sexual debut and future condom use, few studies have explored this association over time, and whether the results are generalizable across multiple locations. This multi time point, multi district study assesses the relationship between sexual debut and condom use and consistent use of condoms thereafter. Uganda has used Lot Quality Assurance Sampling surveys since 2003 to monitor district level HIV programs and improve access to HIV health services. This study includes 4518 sexually active youths interviewed at five time points (2003–2010) in up to 23 districts located across Uganda. Using logistic regression, we measured the association of condom use at first sexual intercourse on recent condom usage, controlling for several factors including: age, sex, education, marital status, age at first intercourse, geographical location, and survey year. The odds of condom use at last intercourse, using a condom at last intercourse with a non-regular partner, and consistently using a condom are, respectively, 9.63 (95%WaldCI = 8.03–11.56), 3.48 (95%WaldCI = 2.27–5.33), and 11.12 (95%WaldCI = 8.95–13.81) times more likely for those individuals using condoms during their sexual debut. These values did not decrease by more than 20% when controlling for potential confounders. The results suggest that HIV prevention programs should encourage condom use among youth during sexual debut. Success with this outcome may have a lasting influence on preventing HIV and other STIs later in life. PMID:24705381
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
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.
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
Critelli, J W; Suire, D M
Two hundred thirty-seven college students involved in heterosexual relationships were surveyed to determine the effects of relationship type and use of forms of contraception other than condoms on condom use. Findings indicated that in the context of a short-term, monogamous relationship, the use of another form of birth control was associated with decreased condom use. In addition, 20% of the participants reported that they had wanted to use a condom for disease prevention on at least one occasion but had decided not to do so because they were using another form of contraception. Implications for preventive health are discussed.
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.
Sanders, Stephanie A; Reece, Michael; Herbenick, Debby; Schick, Vanessa; Dodge, Brian; Fortenberry, J Dennis
Correct and consistent condom use remains the most effective way to reduce sexually transmissible infection/HIV transmission during sex and is a highly effective contraceptive method. Understanding correlates of condom use is vital to public health programs. To explore sociodemographic, event characteristics, and experiential correlates of condom use at last penile-vaginal intercourse (PVI). Survey data were collected from a nationally representative probability sample of adults in the United States as part of the National Survey of Sexual Health and Behavior. Condom use/non-use at most recent PVI was the main outcome. Logistic regression analyses predicted condom use from sociodemographic variables (i.e., age, education, race/ethnicity, sexual orientation, health status, type of relationship with sexual partner) and event characteristics (i.e., location of sexual encounter, prior intercourse experience with partner, whether partner had other sex partners in the 6 months prior to sex with the participant; other contraceptive use, alcohol use, marijuana use, and for men, erection medication use). Logistic regression analyses examined evaluations of the sexual aspects of the experience (pleasure, arousal, erection/lubrication difficulty, participant orgasm, partner orgasm) in light of condom use. Condom-protected PVI was significantly greater among younger people, blacks and Hispanics, and those having PVI with a nonrelationship partner. Statistically adjusting for these differences, condom use was significantly associated with fewer previous intercourse experiences with the partner and not using other forms of contraception. The sexual aspects of experience were evaluated similarly regardless of whether or not a condom was used. Public health programs among youths and minorities may underlie higher condom use rates among these groups. Condom use may be further improved by continuing such programs and also expanding outreach to older persons and whites, suggesting
Sanders, Stephanie A; Crosby, Richard A; Milhausen, Robin R; Graham, Cynthia A; Tirmizi, Amir; Yarber, William L; Beauchamps, Laura; Mena, Leandro
The objective of this study was to investigate women's willingness to experiment with new condoms and lubricants, in order to inform condom promotion in a city with high rates of poverty and HIV. One hundred and seventy-three women (85.9% Black) sexually transmitted infection clinic attendees in Jackson, Mississippi, United States completed a questionnaire assessing willingness to experiment with condoms and lubricants and sexual pleasure and lubrication in relation to last condom use. Most women were willing to: (1) experiment with new types of condoms and lubricants to increase their sexual pleasure, (2) touch/handle these products in the absence of a partner, and (3) suggest experimenting with new condoms and lubricants to a sex partner. Previous positive sexual experiences with lubricant during condom use predicted willingness. The role women may play in male condom use should not be underestimated. Clinicians may benefit women by encouraging them to try new types of condoms and lubricants to find products consistent with sexual pleasure.
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?
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 ...
Huan, L N; Tejani, A M; Egan, G
An increasing amount of recently published literature has implicated outcome reporting bias (ORB) as a major contributor to skewing data in both randomized controlled trials and systematic reviews; however, little is known about the current methods in place to detect ORB. This study aims to gain insight into the detection and management of ORB by biomedical journals. This was a cross-sectional analysis involving standardized questions via email or telephone with the top 30 biomedical journals (2012) ranked by impact factor. The Cochrane Database of Systematic Reviews was excluded leaving 29 journals in the sample. Of 29 journals, 24 (83%) responded to our initial inquiry of which 14 (58%) answered our questions and 10 (42%) declined participation. Five (36%) of the responding journals indicated they had a specific method to detect ORB, whereas 9 (64%) did not have a specific method in place. The prevalence of ORB in the review process seemed to differ with 4 (29%) journals indicating ORB was found commonly, whereas 7 (50%) indicated ORB was uncommon or never detected by their journal previously. The majority (n = 10/14, 72%) of journals were unwilling to report or make discrepancies found in manuscripts available to the public. Although the minority, there were some journals (n = 4/14, 29%) which described thorough methods to detect ORB. Many journals seemed to lack a method with which to detect ORB and its estimated prevalence was much lower than that reported in literature suggesting inadequate detection. There exists a potential for overestimation of treatment effects of interventions and unclear risks. Fortunately, there are journals within this sample which appear to utilize comprehensive methods for detection of ORB, but overall, the data suggest improvements at the biomedical journal level for detecting and minimizing the effect of this bias are needed. © 2014 John Wiley & Sons Ltd.
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.
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.
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
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...
Panos S. Kordoutis
Full Text Available We examined whether ambiance, a qualitative relationship characteristic, predicted condom use in Greek young adults’ dating relationships, along with other objective relationship characteristics, such as relationship duration and coital sex frequency. Ambiance definition was based on the fundamental companionate-passionate love distinction. Participants were 277 Greek university students, 18-25 years old, having an ongoing relationship; they provided their basic demographics and information on their relationship, such as duration and coital sex frequency. They also described their relationship, in terms of passionate and companionate ambiance, using the rating scales of an 11-item ambiance measure. Finally, they indicated whether they had used or not used a condom at first, last intercourse and consistently during the last month. We hypothesized that condoms would be used more frequently at first and last intercourse, and more consistently in relationships with predominantly companionate rather that passionate ambiance. Three logistic regression analyses revealed that ambiance predicted condom use and that condoms were used more frequently at last intercourse and more consistently in relationships of companionate rather than passionate ambiance. Further analyses indicated that ambiance qualified condom use effects of relationship duration and coital sex frequency. It is suggested that companionate ambiance focuses partners on the normative aspect of the relationship, increasing protective behavior, while passionate, on the sexual and intimate, undermining it.
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.
Full Text Available OBJECTIVE: This study aims to determine factors associated with levels of condom use among heterosexual Thai males in sex with regular partners and in sex with casual partners. METHODS: The data used in this study are from the national probability sample of the 2006 National Sexual Behavior Study, the third nationally representative cross-sectional survey in Thailand. A subtotal of 2,281 men were analyzed in the study, including young (18-24 and older (25-59 adults who were residents of rural areas of Thailand, non-Bangkok urban areas, and Bangkok. Two outcomes of interest for this analysis are reported condom use in the past 12 months by males in relationships with the most recent regular and casual partners who were not sex workers. Chi-square statistics, bivariate regressions and the proportional odds regression models are used in the analysis. RESULTS: Condom use for men with their regular partner is revealed to be positively related to education, knowledge of condom effectiveness, and pro-condom strategy, and negatively related to non-professional employment, status of registered marriage, and short relationship duration. Condom use with casual partner is positively determined by education, condom knowledge, non-professional occupation, short relationship duration, and lack of history of paid sex. CONCLUSION: The national survey emphasized the importance of risk perceptions and condom motivations variables in explaining condom use among men in Thailand. These factors include not only education and knowledge of condom effectiveness and pro-condom strategy but also types of partners and their relationship context and characteristics. Program intervention to promote condom use in Thailand in this new era of predominant casual sex rather than sex with sex workers has to take into account more dynamic partner-based strategies than in the past history of the epidemics in Thailand.
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.
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
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.
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.
Roy, Tapash; Anderson, Claire; Evans, Catrin; Rahman, Mohammad Shafiqur; Rahman, Mosiur
The reliable and valid measurement of attitudes towards condom use are essential to assist efforts to design population specific interventions aimed at promoting positive attitude towards, and increased use of condoms. Although several studies, mostly in English speaking western world, have demonstrated the utility of condom attitude scales, very limited culturally relevant condom attitude measures have been developed till to date. We have developed a scale and evaluated its psychometric properties in a sub-sample of rural-to-urban migrant workers in Bangladesh. This paper reports mostly on cross-sectional survey components of a mixed methods sexual health research in Bangladesh. The survey sample (n = 878) comprised rural-to-urban migrant taxi drivers (n = 437) and restaurant workers (n = 441) in Dhaka (aged 18-35 years). The study also involved focus group sessions with same populations to establish the content validity and cultural equivalency of the scale. The current scale was administered with a large sexual health survey questionnaire and consisted of 10 items. Quantitative and qualitative data were assessed with statistical and thematic analysis, respectively, and then presented. The participants found the scale simple and easy to understand and use. The internal consistency (α) of the scale was 0.89 with high construct validity (the first component accounted for about 52% of variance and second component about 20% of the total variance with an Eigen-value for both factors greater than one). The test-retest reliability (repeatability) was also found satisfactory with high inter-item correlations (the majority of the intra-class correlation coefficient values was above 2 and was significant for all items on the scale, p < 0.001). The 2-week repeatability assessed by the Pearson product-moment correlation coefficient was 0.75. The results indicated that Bengali version of the scale have good metric properties for assessing attitudes toward
W. Brad Smith
This article takes a brief chronological look at resource inventory and reporting and links to international influences. It explores events as drivers of more consistent data within the United States and highlights key dates and events in the evolution of inventory policy and practice. From King George to L?Ecole nationale forestiere to the Food and Agriculture...
Chafouleas, Sandra M.; Riley-Tillman, T. Chris; Sassu, Kari A.; LaFrance, Mary J.; Patwa, Shamim S.
In this study, the consistency of on-task data collected across raters using either a Daily Behavior Report Card (DBRC) or systematic direct observation was examined to begin to understand the decision reliability of using DBRCs to monitor student behavior. Results suggested very similar conclusions might be drawn when visually examining data…
Guerreiro, Meg; Alonzo, Julie; Tindal, Gerald
This technical report documents findings from a study of the internal consistency and split-half reliability of the easyCBM© CCSS Reading measures, grades 3-8. Data, drawn from an extant data set gathered in school year 2013-2014, include scores from over 150,000 students' fall and winter benchmark assessments. Findings suggest that the easyCBM©…
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.
disease. Objective: To examine the utility of theory of planned behavior in predicting consistent condom use intention of HIV .... (24-25), making subjective norms as better predictors of intention ..... Organizational Behavior and Human Decision.
Schroder et al., 2003). For example, Schroder et al. (2003) suggested that high-frequency events were less sa- lient, which may cause people to forget...collection methods that may increase reporting accuracy. REFERENCES Allen, S., Meinzen-Derr, J., Kautzman, M., Zulu , I., Trask, S., Fideli, U., et al. (2003
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.
... 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 ...
Nguyen, Anh B; Clark, Trenette T; Hood, Kristina B; Corneille, Maya A; Fitzgerald, Angela Y; Belgrave, Faye Z
African-American women continue to be at high risk for HIV and better prevention efforts are needed. The current paper sought to investigate the relationship between gender roles and condom-related outcomes among African American women. The sample consisted of 398 African-American women, who were administered a survey that contained measures of condom-related outcomes and gender role beliefs. We factor analysed their responses and three domains emerged: caretaking/mindful, interpersonal sensitivity and persistent/active coping. Results indicated that the interpersonal sensitivity domain was a significant predictor of condom use and intention with higher interpersonal sensitivity scores associated with less condom use and intentions. The persistent/active coping domain was a significant predictor of condom negotiation efficacy and condom use with higher scores in this domain associated with more condom negotiation efficacy and use. Results suggest that re-conceptualisations offer a better understanding of underlying traits that may influence condom-related outcomes for this population.
Rijsdijk, L.E.; Bos, A.E.R.; Lie, R.; Ruiter, R.A.C.; Leerlooijer, J.N.; Kok, G.
Background - Comprehensive sex education, including the promotion of consistent condom use, is still an important intervention strategy in tackling unplanned pregnancies, HIV/AIDS and sexually transmitted infections (STIs) among Ugandan adolescents. This study examines predictors of the intention to
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.
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.
Does the position of the Roman Catholic Church on contraception also imply that the usage of condoms by HIV-discordant couples is illicit? A standard argument is to appeal to the doctrine of double effect to condone such usage, but this meets with the objection that there exists an alternative action that brings about the good effect-namely, abstinence. I argue against this objection, because an HIV-discordant couple does not bring about any bad outcome through condom usage-there is no disrespect displayed for the generative function of sex. One might retort that the badness of condom usage consists in thwarting the unitive function of sex. I argue that also this objection cannot be upheld. In conclusion, if there are no in-principle objections against condom usage for HIV-discordant couples, then policies that deny access to condoms to such couples are indefensible. HIV-discordant couples have a right to continue consummating their marriage in a manner that is minimally risky and this right cannot be trumped by utilitarian concerns that the distribution of condoms might increase promiscuity and along with it the HIV infection rate.
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.
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.
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.
-infected women under care at CAISM/UNICAMP and Centro Corsini, both in Campinas. After a screening interview and agreeing to participate, the volunteers received a diary to register their intercourses and correspondent use of male condom (MC. After 30 days, they returned to a training visit when the FC was inserted in a pelvic model, also bringing their diary related to the previous cycle, considered a control cycle. A structured questionnaire was used at 30, 60 and 90 days, also with the respective diary on sexual intercourse and use of MC and FC kept for posterior data entry. c², Fisher's exact, McNemar and Friedman tests were applied statistical analysis of paired samples. RESULTS: there was a predominance of young women, with low schooling, living with their partner. Rate of continuity was 52% after 90 days. The use of FC in half the intercourses for each time period remained stable over the 90-day interval. There was a significant reduction in unprotected intercourses (from 14 to 6%, without use of FC or MC, at the end of the period. The initial difficulties in handling the device were overcome. Serodiscordant couples had more protected intercourses than concordant couples, but the difference did not reach statistical significance. Women reporting consistent previous use of MC had more protected sex using FC. CONCLUSIONS: the offer of the female condom was able to reduce unprotected intercourses in HIV-infected women, which were highly motivated and receptive for the new method.
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:
Wechsberg, Wendee M; Luseno, Winnie K; Kline, Tracy L; Browne, Felicia A; Zule, William A
This article presents the results of a randomized trial in South Africa of an adapted evidence-based Woman-Focused intervention on condom use with primary sex partners. The preliminary findings show that regardless of HIV status, condom negotiation was significantly associated with condom use at the 3- and 6-month follow-ups. By intervention group, significant intervention effects were found at 6-month follow-up for HIV-positive and HIV-unknown status women in the Woman-Focused intervention who were more likely than women in the Standard intervention to report condom use with a primary male partner. Among HIV-positive women, those in the Woman-Focused group and those with greater sexual control were more likely to report condom use at the 6-month follow-up. The findings indicate that gender-based interventions for women may result in increased condom negotiation skills.
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.
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.
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.
The study examined the applicability of the Theory of Reasoned Action to the study of condom use intentions of students at a university in southern Ghana. The data supported the model, explaining 33% of the variance in students' condom use intentions. Subjective norms and the perceived disadvantages of condom use were significant determinants of intention, with the former being more important. Respondents who intended to use condoms consistently ("intenders") and those with no such intentions ("non-intenders") were equally motivated to comply with the wishes of their significant referents (sexual partners, close friends, parents and medical doctors). The critical difference was that "intenders" consistently held a stronger belief than "non-intenders" that their significant referents approved of condom use. Significantly, whereas "intenders" believed that their sexual partners would approve of condom use, the "non-intenders" held the contrary belief that their partners would disapprove of such behavior. This suggests that AIDS education interventions targeting a similar audience like the university students in this study should shift their foci away from individuals alone and instead, focus simultaneously on individuals, their sexual partners and their broader social networks in order to enhance perceptions of peer acceptance of condom use.
Full Text Available Based on qualitative research data, this article exams the meaning of condom among persons engaged in sex work. Sex-work is a specific activity, with a sex service being an object of economic transaction. In order to delineate private sexual relationship and business sexual relationship sex workers rely on a professional code. Abiding to this code is valued positively by the professional group whereas disrespecting it leads to stigmatization of the offender within the group. The basic markers separating professional and private life in a continuum of sexuality are money as a sign and condom as a symbol. Use of condom during the sex-work relation is a symbol of correct approach to work and as such marks the border between professional and unprofessional way for doing the job in addition to marking the border between work and private life. The data show that within this borderline area in real-life situations, complex interactive relationship between sex-workers and their immediate environment leads to discrepancies in the consistency of condom use. The lack of consistent condom is present when a client or type of service is perceived as safe, i.e. carries the meaning of the category "with condom", or when some ambiguous environmental circumstances are present such as influence of the police or pimps, protectors and people related to private life of sex-worker. In the field of sex-work, condom grows from an object of infection prevention into an object that symbolizes professional ethics within sex-work and, in that way, it keeps an atmosphere of a healthy and clean private life for sex-workers.
Conserve, Donaldson F.; Whembolua, Guy-Lucien; Surkan, Pamela J.
Although men have substantial decision-making power regarding condom use, the majority of HIV knowledge and prevention studies in the general Haitian population have been conducted among youth and women. We investigated attitudes towards intimate partner violence, knowledge of and use of condoms among 9,493 men in Haiti using data from the 2012 nationally representative Demographic and Health Survey. Only 36% of HIV-negative and 44% of HIV-positive men reported using a condom the last time th...
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...
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
McLaurin-Jones, TyWanda L.; Lashley, Maudry-Beverley; Marshall, Vanessa J.
Background: Young African American women are disproportionately affected with sexually transmitted infections (STIs) and unintentional pregnancies. Despite adequate knowledge, assertiveness, and negotiation skills, consistent condom use remains low. Aims: We sought to assess the role of pregnancy and STI risk perception in condom decision making…
Azwihangwisi H. Mavhandu-Mudzusi
Full Text Available Background: Millennium Development Goal (MDG number 6, target 6A focuses on halting and reversing the spread of HIV by 2015. South Africa is amongst the 189 countries that are involved in trying to meet the MDGs. In order to try and achieve this goal, South Africa, through its HIV and AIDS, STI and TB strategic plans has adopted the United Nations vision of ‘Zeros’, which include zero new HIV infections by the year 2015. One of the key interventions for achieving this is improvement in access to condoms. Aim: This article reports on perceptions of Vhembe District young adults regarding condom use. Setting: This study was conducted in one of the rural clinics in Vhembe District of the Limpopo Province: South Africa. Methods: A quantitative, cross-sectional design approach was followed. Data were collected using structured questionnaires administered to 372 young adults who came for healthcare services at one of the clinics in Vhembe District. Results: The findings indicated that there is a relationship between positive perceptions toward condom use and actual condom use. People who have positive attitudes toward condoms are also more likely to use them. In contrast, people with a negative attitude towards condoms are less likely to use them during sexual intercourse. Negative attitudes of health care providers were found to be a barrier that prevents sexually active individuals to access condoms in primary health care facilities. Conclusion: With current peceptions towards condom use, Zero new HIV infection will never be achieved. The researcher recommends development of strategies for promoting access and correct use of condoms. Keywords: Condom use, perception, young adults
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.
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 ...
Nasrullah, Muazzam; Oraka, Emeka; Chavez, Pollyanna R; Johnson, Christopher H; DiNenno, Elizabeth
Condom-less sex can increase the risk of acquiring or transmitting HIV. To characterize the prevalence of condom use at the most recent sex act and identify factors associated with use of a condom at the most recent sex act in adults in the United States. Data from the cross-sectional National Survey of Family Growth from cycles 2006 through 2010 and 2011 through 2013 were analyzed for sexually active men and women 18 to 44 years old who reported having sex (vaginal, anal, or oral) with an opposite-sex partner in the past 12 months. HIV-related sexual risk behaviors (SRBs) in the past 12 months included sex with at least four opposite-sex partners; exchanging sex for money or drugs; sex with an injection drug user; sex with an HIV-positive person; sex with a man who previously had sex with a man (women only); sex with a man (men only); or sex with a partner who had sex with other partners. The outcome for this analysis was condom use at the most recent anal or vaginal sex act. Overall prevalence of condom use was 24.8%; only 33.8% of adults with at least one SRB reported the use of a condom. Only 46.4% of unmarried or single men (vs 14.7% married or cohabitating men) and 32.3% unmarried or single women (vs 14.1% married or cohabitating women) with SRBs reported using a condom at the most recent sexual encounter and were less likely to use a condom at the most recent sexual encounter compared with those who did not report SRBs. We did not find a significant relation between using a condom and SRBs in married or cohabitating men and women. Our analysis adds to the literature on how condom use varies by marital status. We measured the use of condoms at the most recent sexual act, which might not reflect an individual's previous behavior of condom use. Nonetheless, condom use at the most recent sexual act has been documented in previous studies as a valid proxy of condom use over time. Continued efforts are needed to promote condom use in heterosexual adults in the
Francois van Loggerenberg
Full Text Available INTRODUCTION: Young women are at disproportionate risk of HIV infection in South Africa. Understanding risk behaviors and factors associated with ability to negotiate safe sex and condom use is likely to be key in curbing the spread of HIV. Traditionally prevention efforts have focused on creating behavioral changes by increasing knowledge about HIV/AIDS. METHODS: This was a cross-sectional analysis from a prospective observational cohort study of 245 women at a high-risk of HIV infection in KwaZulu-Natal, South Africa. RESULTS: Participants demonstrated a high level of HIV/AIDS knowledge. Overall, 60.3% of participants reported condom use. Reported condom use at last sexual encounter varied slightly by partner type (57.0% with steady versus 64.4% with casual partners, and self-perceived ability to choose to use a condom was significantly lower with steady partners compared to casual partners (p<0.01. In multivariate analysis, women who had high school education were more likely to use condoms at their last sex encounter compared to those with only primary school education (RR of 1.36 (95% Confidence Interval (CI 1.06-1.75 and 1.46 (95% CI 1.13-1.88 for grades 8-10 and 11-12, respectively. Those who used condoms as a contraceptive method were twice as likely to use condoms compared to women who did not report using them as a contraceptive method. Greater perceived ability to choose to use condoms was associated with higher self-reported condom use at last encounter, irrespective of partner type (RR = 2.65 (95% CI 2.15-32.5. DISCUSSION: Self-perceived ability to use condoms, level of formal education and condom use as a contraceptive were all significantly associated with self-reported condom use at last sexual encounter. These findings suggest that that gender inequality and access to formal education, as opposed to lack of HIV/AIDS knowledge, prevent safer sexual practices in South Africa.
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.
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 ...
Lachowsky, Nathan J; Saxton, Peter J W; Hughes, Anthony J; Dickson, Nigel P; Milhausen, Robin R; Dewey, Cate E; Summerlee, Alastair J S
Background Condom promotion remains a cornerstone of HIV/STI control, but must be informed by evidence of uptake and address disparities in use. This study sought to determine the prevalence of, and demographic, behavioural and relational factors associated with, condom use during insertive and receptive anal intercourse with casual partners among younger gay, bisexual and other men who have sex with men (YMSM) in New Zealand. The 2006-2011 national HIV behavioural surveillance data for YMSM aged 16-29 years was pooled. Separately for each sexual position, frequent (always/almost always) versus infrequent condom use was regressed onto explanatory variables using manual backward stepwise multivariable logistic regression analysis. Three-quarters of YMSM reported frequent condom use during insertive (76.0%) and receptive (73.8%) anal intercourse. YMSM who were exclusively insertive were more likely to report frequent condom use than versatile YMSM. Factors positively associated with frequent condom use, irrespective of sexual position were: in-person versus web-based recruitment, testing HIV negative versus never testing or testing HIV positive, having no recent sex with women, reporting two to five versus one male sexual partner in the past 6 months, reporting no current regular partner, but if in a regular relationship, reporting a boyfriend-type versus fuckbuddy-type partner, and frequent versus infrequent regular partner condom use. Pacific ethnicity and less formal education were negatively associated with frequent condom use only during receptive anal intercourse. The findings from this study demonstrate that condom norms can be actively established and maintained among YMSM. Condom promotion efforts must increase YMSM's capacity, agency and skills to negotiate condom use, especially for the receptive partner.
Paz-Bailey, Gabriela; Isern Fernandez, Virginia; Morales Miranda, Sonia; Jacobson, Jerry O; Mendoza, Suyapa; Paredes, Mayte A; Danaval, Damien C; Mabey, David; Monterroso, Edgar
We conducted a study among HIV-positive men and women in Honduras to describe demographics, HIV risk behaviors and sexually transmitted infection prevalence, and identify correlates of unsafe sex. Participants were recruited from HIV clinics and nongovernmental organizations in Tegucigalpa and San Pedro Sula, Honduras in a cross-sectional study in 2006. We used audio-assisted computer interviews on demographics; behaviors in the past 12 months, 6 months, and 30 days; and access to care. Assays performed included herpes (HSV-2 Herpes Select), syphilis (rapid plasma reagin [RPR] and Treponema pallidum particle agglutination assay [TPPA]) serology, and other sexually transmitted infections by polymerase chain reaction (PCR). Bivariate and multivariate analyses were conducted to assess variables associated with unprotected sex across all partner types in the past 12 months. Of 810 participants, 400 were from Tegucigalpa and 410 from San Pedro Sula; 367 (45%) were men. Mean age was 37 years (interquartile range: 31-43). Consistent condom use for men and women was below 60% for all partner types. In multivariate analysis, unprotected sex was more likely among women (odds ratio [OR]: 1.9, 95% confidence interval [CI]: 1.2-3.1, P = 0.007), those with HIV diagnoses within the past year (OR: 2.0, 95% CI: 1.1-3.7, P = 0.016), those reporting difficulty accessing condoms (OR: 2.6, 95% CI: 1.4-4.7, P = 0.003), and those reporting discrimination (OR: 1.8, 95% CI: 1.1-3.0, P = 0.016). Programs targeting HIV-positive patients need to address gender-based disparities, improve condom access and use, and help establish a protective legal and policy environment free of stigma and discrimination.
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.
Lippman, Sheri A.; Chinaglia, Magda; Donini, Angela A.; Diaz, Juan; Reingold, Arthur; Kerrigan, Deanna L.
Background Sexually transmitted infection (STI)/HIV prevention programs which do not modify social-structural contexts that contribute to risk of STI/HIV may fail to bring about improvements in health, particularly among groups who experience discrimination and exclusion from public life. We conducted a multi-level intervention with sex workers, including improved clinical care and community mobilizing strategies to modify social-structural factors that shape sexual behavior, in order to improve condom use and reduce incident STI. Methods We followed 420 sex workers participating in the Encontros intervention in Corumbá, Brazil from 2003-2005. We estimated the effect of the intervention on incident chlamydia and gonorrhea infections and condom use using generalized estimating equations and inverse probability weighting by comparing those who actively engaged in the intervention activities (exposed) to those who were less engaged (unexposed). We also determined the association of participation on reported social cohesion and participation in networks. Results Exposed participants had significantly higher odds of reporting consistent condom use with regular clients (OR:1.9, 95%CI:1.1-3.3) and non-significantly increased odds with both new clients (OR:1.6, 0.9-2.8) and nonpaying partners (OR:1.5, 0.9-1.5). The odds of an incident STI were non-significantly reduced for exposed participants compared to unexposed (OR:0.46, 0.2-1.3). Participation was significantly associated with increased perceived cohesion and participation in networks. Conclusion This prospective study provides evidence that multi-level interventions with mobilizing strategies to modify aspects of the social environment can improve condom use, reduce STIs, and increase social cohesion and participation in networks among sex workers. PMID:22337108
Lippman, Sheri A; Chinaglia, Magda; Donini, Angela A; Diaz, Juan; Reingold, Arthur; Kerrigan, Deanna L
Sexually transmitted infection (STI)/HIV prevention programs, which do not modify social structural contexts that contribute to risk of STI/HIV may fail to bring about improvements in health, particularly among groups who experience discrimination and exclusion from public life. We conducted a multilevel intervention with sex workers, including improved clinical care and community-mobilizing strategies to modify social structural factors that shape sexual behavior, to improve condom use and reduce incident STI. We followed 420 sex workers participating in the Encontros intervention in Corumbá, Brazil, between 2003 and 2005. We estimated the effect of the intervention on incident chlamydia and gonorrhea infections and condom use using generalized estimating equations and inverse probability weighting by comparing those who actively engaged in the intervention activities (exposed) with those who were less engaged (unexposed). We also determined the association of participation on reported social cohesion and participation in networks. Exposed participants had significantly higher odds of reporting consistent condom use with regular clients (odds ratio [OR]: 1.9, 95% confidence interval:1.1-3.3) and nonsignificantly increased odds with both new clients (OR: 1.6, 0.9-2.8) and nonpaying partners (OR: 1.5, 0.9-1.5). The odds of an incident STI were nonsignificantly reduced for exposed participants compared with unexposed (OR: 0.46, 0.2-1.3). Participation was significantly associated with increased perceived cohesion and participation in networks. This prospective study provides evidence that multilevel interventions with mobilizing strategies to modify aspects of the social environment can improve condom use, reduce STIs, and increase social cohesion and participation in networks among sex workers.
Full Text Available We create and analyze a mathematical model to understand the impact of condom-use and sexual behavior on the prevalence and spread of Sexually Transmitted Infections (STIs. STIs remain significant public health challenges globally with a high burden of some Sexually Transmitted Diseases (STDs in both developed and undeveloped countries. Although condom-use is known to reduce the transmission of STIs, there are a few quantitative population-based studies on the protective role of condom-use in reducing the incidence of STIs. The number of concurrent partners is correlated with their risk of being infectious by an STI such as chlamydia, gonorrhea, or syphilis. We develop a Susceptible-Infectious-Susceptible (SIS model that stratifies the population based on the number of concurrent partners. The model captures the multi-level heterogeneous mixing through a combination of biased (preferential and random (proportional mixing processes between individuals with distinct risk levels, and accounts for differences in condom-use in the low- and high-risk populations. We use sensitivity analysis to assess the relative impact of high-risk people using condom as a prophylactic intervention to reduce their chance of being infectious, or infecting others. The model predicts the STI prevalence as a function of the number of partners of an individual, and quantifies how this distribution of effective partners changes as a function of condom-use. Our results show that when the mixing is random, then increasing the condom-use in the high-risk population is more effective in reducing the prevalence than when many of the partners of high-risk people have high risk. The model quantifies how the risk of being infected increases for people who have more partners, and the need for high-risk people to consistently use condoms to reduce their risk of infection. Keywords: Mathematical modeling, Sexually transmitted infection (STI, Biased (preferential mixing, Random
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 ...
Wright, Paul J; Sun, Chyng; Steffen, Nicola
Pornography use is becoming more commonplace and may be a modality by which individuals receive sex education. This survey study assessed pornography consumption, perceptions of pornography as a source of sexual information, and condom use in a heterosexual sample of 200 sexually active German adults who were not in monogamous relationships. At the bivariate, overall sample level, there was only a modest association between consuming pornography and a decreased frequency of condom use. However, consistent with the sexual script acquisition, activation, application model ( 3 AM) of sexual media socialization, this association was moderated by differential perceptions of pornography as a source of sexual information. Interaction decomposition revealed that there was no association between pornography consumption and condom use among participants who disagreed that pornography is a source of sexual information. Conversely, pornography consumption was associated with a lower frequency of condom use among participants who agreed that pornography is a source of sexual information. As the perception that pornography is a source of sexual information strengthened, the relationship between pornography consumption and less frequent condom use increased. Gender did not moderate these associations. These findings point toward the importance of fostering a critical reading of pornography through media literacy education.
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.
Lachowsky, N J; Dewey, C E; Dickson, N P; Saxton, P J W; Hughes, A J; Milhausen, R R; Summerlee, A J S
Our objectives were to investigate demographic and behavioural factors associated with condom use and to examine how habitual condom use was across partner types and sexual positions among younger men who have sex with men (YMSM), aged 16-29, surveyed in New Zealand. We analysed the 2006-2011 national HIV behavioural surveillance data from YMSM who reported anal intercourse in four scenarios of partner type and sexual position: casual insertive, casual receptive, regular insertive and regular receptive. For each, respondents' condom use was classified as frequent (always/almost always) or otherwise, with associated factors identified with multivariate mixed-effect logistic regression. Habitual condom use across scenarios was examined using a latent variable technique that estimated the intraclass correlation coefficient (ICC). Frequent condom use was reported for 63.6% of 5153 scenarios reported from 2412 YMSM. Frequent use increased from boyfriend to fuckbuddy to casual partners. Infrequent use was associated with online recruitment, Pacific ethnicity, less education, HIV positivity, sex with women, having ≥20 sexual partners versus 1 and reporting insertive and receptive sexual positions. Frequent condom use was associated with having two to five sexual partners versus one and shorter regular partnerships. The ICC=0.865 indicated highly habitual patterns of use; habitual infrequent condom use was most prevalent with regular partners (53.3%) and habitual frequent condom use was most prevalent with casual partners (70.2%) and for either sexual position (50.5% and 49.1%). Habitual condom use among YMSM highlights the value of early, engaging and sustained condom promotion. Public health should provide better and more compelling condom education, training and promotion for YMSM. 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.
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 ...
This paper proposes that Interface Consistency is an important issue for the development of modular designs. Byproviding a precise specification of component interfaces it becomes possible to check that separately developedcomponents use a common interface in a coherent matter thus avoiding a very...... significant source of design errors. Awide range of interface specifications are possible, the simplest form is a syntactical check of parameter types.However, today it is possible to do more sophisticated forms involving semantic checks....
Roth, Alexis M; Rosenberger, Joshua G; Hensel, Devon J; Wiehe, Sarah E; Fortenberry, J Dennis; Wagner, Karla D
Background Relationship characteristics and day-to-day variation in affective state have been associated with HIV risk behaviour. However, no research has assessed the impact of these factors on event-level condom use among women engaging in transactional sex. Twenty-six women engaging in transactional sex were enrolled in a prospective study of their sexual health. They completed diaries about multi-level predictors of condom use during vaginal sex twice, daily. Over 4 weeks, 18 participants reported 87 paid/traded vaginal intercourse events. Of these, 51.7% were condom protected. The majority of paid/traded events (81.5%) occurred with a non-romantic partner. After controlling for partner type, feeling in love on a given day was associated with higher odds of condom use during paid/traded sexual events, while having sex on the weekend and at night were associated with lower odds of condom use (all P≤0.05). There was a significant interaction between being in love and using condoms during transactional sex (Plove and 40% (4/10) when love was reported. In sexual events with non-romantic partners, the frequency of condom use was 43.8% (14/32) when women did not report love and 59.5% (22/37) when love was reported. Women were less likely to report protected sex with romantic partners and more likely to report protected sex with non-romantic partners when they are in love. Interventions focusing on the link between day-to-day variation in affective state on condom use may help women with risk management across partner types.
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.
Dévieux, Jessy G; Jean-Gilles, Michèle; Rosenberg, Rhonda; Beck-Sagué, Consuelo; Attonito, Jennifer M; Saxena, Anshul; Stein, Judith A
Substance-abusing pregnant and postpartum women are less likely to maintain consistent condom use and drug and alcohol abstinence, which is particularly concerning in high HIV-prevalence areas. Data from 224 pregnant and postpartum women in substance abuse treatment were analyzed to examine effects of history of substance use, child abuse, and mental health problems on current substance use and condom-use barriers. Mediators were depression, relationship power and social support. Most participants (72.9 %) evidenced current depression. Less social support (-0.17, p power (-0.48, p power (0.15, p power limit highest-risk women's ability to negotiate condom use and abstain from substance use, increasing their risk of acute HIV infection and vertical transmission.
Rinaldi-Miles, Anna; Quick, Brian L.; McCloskey, Laura
Objective: This study examined the relationship between three heuristic cues (consistency, liking and social proof) and condom use in casual sex relationships utilising the theory of planned behaviour. Participants: Totally, 388 US college students were surveyed. Method: Three vignettes for each cue primed students to project their willingness to…
... transmitted only by genital fluids (STDs such as gonorrhea, chlamydia, trichomoniasis, and HIV infection) than against infections ... transmitted by genital fluids (STDs such as chlamydia, gonorrhea, and trichomoniasis). Consistent and correct use of latex ...
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.
Lechuga, Julia; Wiebe, John S
The highly influential theory of planned behavior suggests that norms and attitudes predict an important antecedent of behavior: intention. Cross-cultural research suggests that culturally influenced self-construals can be primed and differentially affect behaviors that are influenced by norms and attitudes. The purpose of this experiment was twofold: (1) To investigate whether language functions as a prime for culture in Hispanics, and (2) if so, if norms and attitudes differentially predict condom use intention. Fluent English-Spanish bilingual participants (N = 145) of Mexican descent were randomly assigned to answer questionnaires in English and Spanish. Subjective norms and private evaluations towards condom use were assessed and their relative strength in predicting condom use intention was evaluated. Results suggest that language can prime culture and affect the relative accessibility of culture-relevant norms and self-construals in Hispanics. Moreover, consistent with our expectations, norms and attitudes differentially predicted condom use intention.
Villaran, Manuel V; Bayer, Angela; Konda, Kelika A; Mendoza, Carlos; Quijandria, Hilda; Ampuero, Julia S; Apolaya, Moises; Palacios, Oswaldo; Lescano, Andres G; Vega, Antonio M; Blazes, David L; Kochel, Tadeusz; Montano, Silvia M
The aim of this study was to analyze the rates of condom use among military and police populations in Peru, focusing on differences in use by type of partner. A Knowledge Attitudes and Practices survey was conducted among 6,808 military and police personnel in 18 Peruvian cities between August-September 2006 and September-October 2007. A total of 90.2% of the survey respondents were male; mean age was 37.8 years and 77.9% were married/cohabiting. In all, 99.5% reported having had sex; 89% of the participants had their last sexual contact with their stable partner, 9.7% with a nonstable partner, and 0.8% with a sex worker. Overall, 20.4% used a condom during their most recent sexual contact. Reasons for nonuse of condoms included the following: perception that a condom was not necessary (31.3%) and using another birth control method (26.7%). Prevention efforts against sexually transmitted diseases should focus on strengthening condom use, especially among individuals with nonstable partners.
Doku Paul N
Full Text Available Abstract Background Accurate assessment of self-reports of sexual behaviours is vital to the evaluation of HIV prevention and family planning interventions. This investigation was to determine the cross-cultural suitability of the Condom Use Self Efficacy Scale (CUSES originally developed for American adolescents and young adults by examining the structure and psychometric properties. Method A self-administered cross-sectional survey of a convenient sample of 511 participants from a private university in Ghana with mean age 21.59 years. Result A Principal Component Analysis with varimax rotation identified a 14 item scale with four reliable factors labelled Appropriation (Cronbach alpha = .85, Assertive (Cronbach alpha = .90, Pleasure and Intoxicant (Cronbach alpha = .83, and STDs (Cronbach alpha = .81 that altogether explained 73.72% of the total variance. The scale correlated well with a measure of condom use at past sexual encounter (r = .73, indicating evidence of construct and discriminatory validity. The factor loadings were similar to the original CUSES scale but not identical suggesting relevant cultural variations. Conclusion The 14 item scale (CUSES-G is a reliable and valid instrument for assessing condom use self efficacy. It is culturally appropriate for use among Ghanaian youth to gauge actual condom use and to evaluate interventions meant to increase condom use. Finally, the study cautioned researchers against the use of the original CUSES without validation in African settings and contexts.
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.
Neville, Stephen; Adams, Jeffery; Holdershaw, Judith
The turn of the century has seen an increase in reported cases of sexually transmitted infections including the human immunodeficiency virus, particularly in groups of men who have sex with men. Both internationally and in New Zealand the implementation of social marketing human immunodeficiency virus prevention programmes are identified as appropriate mechanisms to promote condom use in men who have sex with men. This paper presents a review of the literature on research-based social marketing initiatives designed to decrease sexually transmitted infections, including the human immunodeficiency virus, through an increase in condom use by men who have sex with men. Eleven quality assured articles met the inclusion criteria and were consequently included in the review. The review presented here strongly supports the utilisation of behaviourally based social marketing campaigns to increase condom use in men who have sex with men. Nurses are frequently first point of contact for consumers of health services. As such they need to have a sound understanding of not only Get it On!, a New Zealand social marketing campaign designed to promote condom use, but also about existing international campaigns. Nurses should also know about social marketing principles if they are to effect positive changes in condom use and address the complex challenges inherent in tackling increased rates of sexually transmitted infections, including the human immunodeficiency virus.
Yanga Z Zembe
Full Text Available Evidence suggests that multiple concurrent sexual partnering may be a key driver of the high HIV prevalence among young women in South Africa. However, little is known about whether and to what extent women who have multiple sexual partners also engage in other high risk sexual behaviors such as inconsistent condom use. And yet, multiple concurrent sexual partnering is of little epidemiological relevance if all partners in these sexual networks use condoms consistently. This study assesses the prevalence of sexual risk behaviors and HIV, and predictors of inconsistent condom use among women aged 16-24 with multiple sexual partners in a peri-urban setting in South Africa.We used Respondent Driven Sampling, a sampling strategy for hard-to-reach populations to recruit 259 women aged 16-24 in a bio-behavioral cross-sectional survey in the Western Cape province. Estimates of population proportions and 95% confidence intervals (CIs were calculated using the Respondent-Driven Sampling Analysis Tool 5.6 (RDSAT. The primary outcome was inconsistent condom use in the past three months.Young women reported an average of 7 partners in the past 3 months and a high prevalence of sexual risk behaviors: concurrency (87%, transactional sex (91% and age mixing (59%. Having >5 sexual partners in the last 3 months doubled the risk of unprotected sex (OR 2.43, CI 1.39-4.25. HIV prevalence was 4% among 16-19 year olds, increasing threefold (12% at age 20-24.Multiple sexual partnering, where a high number of partners are acquired in a short space of time, is a fertile context for unprotected and risky sexual behavior. The young women featured in this survey present with a constellation of high-risk sexual behaviors that cluster to form a risk syndrome. Carefully tailored repeat bio-behavioral surveillance surveys are recommended for this sub-population.
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.
Glowacka, Marta; Yardley, Lucy; Stone, Nicole; Graham, Cynthia A
Although condoms are effective in reducing the risk of sexually transmitted infections (STIs) and unintended pregnancy, they are still often not used consistently and correctly. Negative impact on sensation and pleasure, ruining the mood, causing problems with maintaining erection, and condom slippage or breakage are some of the reasons given by men explaining why they do not want to use condoms. Although many interventions promoting condom use exist, some of them delivered online are complex and time- and resource-intensive. The Homework Intervention Strategy (eHIS) program, adapted from the existing face-to-face Kinsey Institute Homework Intervention Strategy (KIHIS) program, aims to address these issues by encouraging men to focus on sensation and pleasure when trying different types of condoms and lubricants in a low-pressure situation (on their own, without a partner present). The objectives of this study are to assess the feasibility, acceptability, and users' engagement with the eHIS program, its preliminary effectiveness in increasing condom use frequency and consistency, as well as the feasibility of the program's evaluation approach, including choice of measures and participant recruitment and retaining strategies (primary outcomes). Secondary outcomes include condom use experience, condom use attitudes, condom use self-efficacy, condom use errors and problems, and condom fit-and-feel. All of these will be analyzed in the context of participants' demographics, sexual history, and previous condom use. The study has a pre-post-test, within-subjects design. Men aged 18 to 69 and living in the United Kingdom are recruited through posters, leaflets, social media, and emails. Study participants are asked to complete T1 (baseline) measures before entering the eHIS website. After completing the T1 measures, they can order a free condoms and lubricants kit and have access to the eHIS website for 4 weeks. During that time they are asked to practice using different
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.
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.
Leddy, Anna; Chakravarty, Deepalika; Dladla, Sibongile; de Bruyn, Guy; Darbes, Lynae
Hegemonic masculine norms (HMN), which promote sexual risk-taking among males and the subordination of women, are believed to play a key role in the HIV epidemic among heterosexual couples in South Africa (SA). Sexual communication self-efficacy (SCSE) (i.e., a couple's confidence in their ability to communicate about HIV prevention) may be a key leverage point for increasing HIV prevention behaviors among this population. We interviewed 163 sexually active heterosexual couples in Soweto, SA to investigate the association between SCSE, HMN, and consistent condom use. We collected information on demographics, relationship dynamics, and sexual activity. We utilized the SCSE scale to measure couples' SCSE, and a subscale of the Gender Equitable Men scale to measure HMN among males. We performed bivariate and multivariable analyses to determine the association of consistent condom use with couples' SCSE as well as the male partner's endorsement of HMN. We found that couples with higher SCSE have greater odds of consistent condom use (adjusted odds ratio [AOR] = 1.30, 95% CI: 1.15-1.47). Furthermore, male endorsement of HMN was found to be negatively associated with consistent condom use among couples (AOR = 0.47, 95% CI: 0.24-0.89). Joint HIV serostatus was not significantly associated with the outcome. Future interventions that equip heterosexual couples with sexual communication skills, while simultaneously promoting more gender equitable norms, may increase consistent condom use and thereby reduce the transmission of HIV among this at-risk population.
Brenda Kelly Gonçalves Nunes
Full Text Available This study aimed to estimate the prevalence and factors associated with the use of male condoms in adolescents and young adults from urban settlement areas in a city of central-western Brazil. This is a cross-sectional investigation with 105 adolescents and young students aged 12 to 24 years, which used a structured questionnaire. Of the total number of interviewees, 61 (58.1% had started their sexual life; of these, only 38.3% reported regular condom use. Education over six years (p=0.02, access to sexuality information with parents (p=0.05 and at school (p=0.04 were factors associated with condom use. The results confirm the importance of investing in health policies that invest in working together among healthcare professionals, families and educational institutions, in order to minimize the vulnerability to Sexually Transmitted Infections.
Full Text Available Objectives: Young women are more likely to be infected with HIV globally, in sub-Saharan Africa, and in Cameroon. Despite its clear clinical and public health benefits, condom use among HIV-infected women continues to be low. The objective of this study was to describe the prevalence of inconsistent condom use among HIV-infected women in Cameroon and the factors associated with it. Methods: We conducted a cross-sectional study of HIV-infected young women aged 17–26 years from three semi-urban HIV clinics in the Northwest Region of Cameroon. This study was a subgroup analysis of a previously reported study on inconsistent condom use in HIV-infected and -uninfected youth. Inconsistent condom use was defined as reporting “sometimes” or “never” to questions regarding frequency of condom use. Logistic regression modeling was used to determine factors associated with inconsistent condom use. Results: A total of 84 participants were recruited and submitted completed questionnaires for analysis. Median age was 24 years (interquartile range = 22–25 and the median age at HIV diagnosis was 21 years (interquartile range = 20–23. Fifty percent of the participants reported no prior schooling or only primary school education. Overall, 61/84 (73% reported inconsistent condom use. After adjusting for potential confounders, education to the secondary school level was protective against inconsistent condom use (odds ratio = 0.19; confidence interval: 0.04–0.95, and having ≥2 pregnancies was associated with inconsistent condom use (odds ratio = 7.52; confidence interval: 1.67–34.00. Conclusion: There is a high prevalence of inconsistent condom use among young HIV-infected women in Cameroon, which appears to be associated with lower levels of educational attainment and higher parity. Further larger studies assessing the factors associated with poor condom use in this population are warranted and may inform public health
van Loggerenberg, Francois; Dieter, Alexis A; Sobieszczyk, Magdalena E; Werner, Lise; Grobler, Anneke; Mlisana, Koleka
Young women are at disproportionate risk of HIV infection in South Africa. Understanding risk behaviors and factors associated with ability to negotiate safe sex and condom use is likely to be key in curbing the spread of HIV. Traditionally prevention efforts have focused on creating behavioral changes by increasing knowledge about HIV/AIDS. This was a cross-sectional analysis from a prospective observational cohort study of 245 women at a high-risk of HIV infection in KwaZulu-Natal, South Africa. Participants demonstrated a high level of HIV/AIDS knowledge. Overall, 60.3% of participants reported condom use. Reported condom use at last sexual encounter varied slightly by partner type (57.0% with steady versus 64.4% with casual partners), and self-perceived ability to choose to use a condom was significantly lower with steady partners compared to casual partners (pformal education and condom use as a contraceptive were all significantly associated with self-reported condom use at last sexual encounter. These findings suggest that that gender inequality and access to formal education, as opposed to lack of HIV/AIDS knowledge, prevent safer sexual practices in South Africa.
Aim: This study explores the attitudes of educators working in schools for Deaf and hard-of-hearing pupils in South Africa toward condom education for their pupils. Methods: We conducted a combination of individual in-depth and joint interviews with a total of 27 participants. The sample comprised educators, school psychologists, school nurses and teaching assistants. Results: Results showed that educators were aware of the HIV risk for their pupils and reported the risk of sexual abuse or premature sexual activity as being risk factors for HIV infection. None of the schools had a written condom education policy. Whilst some schools were integrating condom education in existing school curricula, others faced moral or religious dilemmas in doing so. There were differences in attitudes, both amongst schools and amongst educators in the same schools. Conclusions: Given the context of a burgeoning HIV epidemic, it is vital to address adequate condom education in schools.
Conserve, Donaldson F; Whembolua, Guy-Lucien S; Surkan, Pamela J
Although men have substantial decision-making power regarding condom use, the majority of HIV knowledge and prevention studies in the general Haitian population have been conducted among youth and women. We investigated attitudes toward intimate partner violence, knowledge of, and use of condoms among 9493 men in Haiti using data from the 2012 nationally representative Demographic and Health Survey. Only 36% of HIV-negative and 44% of HIV-positive men reported using a condom the last time they had had sex. Logistic regression revealed that believing it was justified for a man to hit or beat his wife if she refuses to have sex with him was associated with a lower odds of condom use. The odds of using a condom during last sex was higher among men who reported knowing condoms can prevent HIV and who had been tested for HIV. Given the low rate of condom use among men in Haiti, these findings suggest that interventions promoting HIV knowledge, HIV testing, and gender-violence prevention among men may also increase condom use. © The Author(s) 2014.
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.
Neville, Stephen; Adams, Jeffery; Moorley, Calvin; Jackson, Debra
To explore men who have sex with men's views about condom use when having anal intercourse. Internationally, health promotion campaigns use behavioural change strategies to support men who have sex with men to always use condoms when having anal sex with other men. The health promotion message given to this group is consistent and explicitly stated that 'use a condom every time for anal sex regardless of relationship status'. Qualitative analysis of data from a cohort of New Zealand men who have sex with men. A total of 960 useable questionnaires were completed: 571 online and 389 in hard copy. Qualitative data were analysed using a thematic data analytic process. Three themes relating to condom use in men who have sex with men were identified. These are as follows: 'Safer sex is good sex', 'Condom use is good but …' and 'I use condoms sometimes'. The range of responses towards condom use for anal sex in men who have sex with men in our sample reveal this as a complex public health issue, with not all men who have sex with men willing to consistently use condoms. It is important that nurses do not assume that all men who have sex with men are willing to use condoms for anal sex, and should create opportunities for men who have sex with men to raise any concerns about the use of condoms. In this way, nurses can assist in providing information that may help men who have sex with men to make decisions that will minimise risk of contracting infections associated with sexual activity. © 2016 John Wiley & Sons Ltd.
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
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.
Thato, Sathja; Hanna, Kathleen M; Rodcumdee, Branom
To translate the 14-item Condom Self-Efficacy Scale (CSES) into Thai and to validate the Thai version of the Condom Self-efficacy Scale (CSES-T) among Thai adolescents and young adults. The CSES was translated using a back-translation technique and validated with a cluster-based sample of 425 participants aged 18 to 22 years from eight randomly selected private vocational schools in Bangkok. Participants completed anonymous self-administered scales. Principal component analysis with varimax rotation was conducted to identify latent factors. Factor analysis indicated three factors: communication, correct use, and consistent use. Items loading on the original CSES also loaded on the same factors of the CSES-T except one item. The Cronbach's alpha coefficients were .85 for the total scale, .70 for consistent use, .79 for correct use, and .80 for communication. Based on psychometric properties, the CSES-T is a valid and reliable tool. It is culturally appropriate for Thai young adults. Thai researchers and health care providers can use the CSES-T to assess adolescents' and young adults' self-efficacy to use condoms as well as to further develop and evaluate interventions to increase condom use.
As access to anti-retroviral therapy (ART) increases in sub-Saharan Africa, fertility and contraception patterns are likely to change. Two hundred HIV-positive women at an ART roll-out site in Zimbabwe responded to a questionnaire on fertility desires and condom use. Ten women (5%) reported planning a pregnancy in the ...
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
A convergence theory for semi-discrete approximations to nonlinear systems of conservation laws is developed. It is shown, by a series of scalar counter-examples, that consistency with the conservation law alone does not guarantee convergence. Instead, a notion of consistency which takes into account both the conservation law and its augmenting entropy condition is introduced. In this context it is concluded that consistency and L(infinity)-stability guarantee for a relevant class of admissible entropy functions, that their entropy production rate belongs to a compact subset of H(loc)sup -1 (x,t). One can now use compensated compactness arguments in order to turn this conclusion into a convergence proof. The current state of the art for these arguments includes the scalar and a wide class of 2 x 2 systems of conservation laws. The general framework of the vanishing viscosity method is studied as an effective way to meet the consistency and L(infinity)-stability requirements. How this method is utilized to enforce consistency and stability for scalar conservation laws is shown. In this context we prove, under the appropriate assumptions, the convergence of finite difference approximations (e.g., the high resolution TVD and UNO methods), finite element approximations (e.g., the Streamline-Diffusion methods) and spectral and pseudospectral approximations (e.g., the Spectral Viscosity methods)
This SBIR report maintains that reliable pretest predictions and efficient certification are suffering from inconsistent structural integrity that is prevalent throughout a project's design maturity...
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
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.
Mullany, Britta; Barlow, Allison; Neault, Nicole; Billy, Trudy; Hastings, Ranelda; Coho-Mescal, Valerie; Lorenzo, Sherilyn; Walkup, John T.
Computer-assisted interviewing techniques have increasingly been used in program and research settings to improve data collection quality and efficiency. Little is known, however, regarding the use of such techniques with American Indian (AI) adolescents in collecting sensitive information. This brief compares the consistency of AI adolescent…
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.
Eileen V Pitpitan
Full Text Available Women in South Africa are at particularly high-risk for HIV infection and are dependent on their male partners' use of condoms for sexual risk reduction. However, many women are afraid to discuss condoms with male partners, placing them at higher risk of HIV infection.To examine the association between fear of condom negotiation with HIV testing and transmission risk behaviors, including alcohol use and sexual risks among South African women.Women (N = 1333 residing in a primarily Xhosa-speaking African township in Cape Town and attending informal alcohol-serving venues (shebeens completed anonymous surveys. Logistic regression was used to test the hypothesis that fear of condom negotiation would be associated with increased risk for HIV.Compared to women who did not fear condom negotiation, those who did were significantly less likely to have been tested for HIV, were more likely to have experienced relationship abuse, and to report more alcohol use and more unprotected sex.For women in South Africa, fear of condom negotiation is related to higher risk of HIV. HIV prevention efforts, including targeted HIV counseling and testing, must directly address gender issues.
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...
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...
Crosby, Richard A; Graham, Cynthia A; Yarber, William L; Sanders, Stephanie A; Milhausen, Robin R; Mena, Leandro
The aim of this study was to construct and test measures of psychosocial mediators that could be used in intervention studies seeking to promote safer sex behavior among young black men who have sex with men (YBMSM). A total of 400 YBMSM, ages 18 to 29 years, were recruited from a clinic for sexually transmitted infection in the southern United States. All men had engaged in penile-anal sex with a man as a "top" in the past 6 months. The men completed an audio-computer-assisted self-interview and provided specimens used for nucleic acid amplification testing to detect Chlamydia and gonorrhea. Four measures were constructed and tested for criterion validity (Safer Sex Communication, Condom Turn-Offs, Condom Pleasure Scale, and a single item assessing frequency of condom use discussions before sexual arousal). With the exception of Safer Sex Communication, all of the measures showed criterion validity for both unprotected anal insertive and unprotected anal receptive sex. With the exception of the Condom Turn-Offs, the 3 other measures were supported by criterion validity for oral sex. Both the Condom Turn-Offs and Condom Pleasure Scale were significantly related to whether or not the men reported multiple partners as a top, but only the Condom Pleasure Scale was associated with reports of multiple partners as a "bottom." Only the Condom Turn-Offs Scale was positively associated with having been diagnosed with either Chlamydia or gonorrhea. Findings provide 3 brief scales and a single item that can be used in intervention studies targeting YBMSM. Perceptions about condoms being a turnoff and about condoms enhancing pleasure showed strong association with sexual risk behaviors.
Gilley, Brian Joseph
HIV/AIDS researchers working among Native Americans have consistently noted resistance to discussions of sexuality and the distribution of condoms. This resistance is inspired by long held values about shame and public discussions of sexuality. Also, American Indians have been reluctant to welcome public discussions of HIV/AIDS and sexuality from external entities, such as governmental agencies. As a result, Native peoples have some of the lowest documented condom use rates. However, innovations in culturally integrating condoms and safe sex messages into Native cultural ideals are proving beneficial. One such innovation is the snag bag, which incorporates popular Native sexual ideology while working within local ideals of shame to distribute condoms and safe sex materials to sexually active young people and adults. Using snag bags as an example, this research proposes that an effective approach to HIV prevention among Native peoples is not cultural sensitivity but cultural integration. That is, HIV prevention strategies must move beyond the empty promise of merely culturally-sensitizing ideas about disease cause. Instead of simply 'translating' HIV/AIDS programming into Native culture, prevention strategies must be integrated by Native peoples into their own disease theories and contemporary culture.
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.
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.
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.
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…
Fioletov, V.; McLinden, C.A.; Kharol, S.K.; Krotkov, N.A.; Li, C.; Joiner, J.; Moran, M.D.; Vet, R.; Visschedijk, A.J.H.; Denier Van Der Gon, H.A.C.
Reported sulfur dioxide (SO2) emissions from US and Canadian sources have declined dramatically since the 1990s as a result of emission control measures. Observations from the Ozone Monitoring Instrument (OMI) on NASA's Aura satellite and ground-based in situ measurements are examined to verify
Correlation between knowledge on transmission and prevention of HIV/STI and proficiency in condom use among male migrants from Africa and Middle East evaluated by a Condom Use Skills score using a wooden penile model.
Zoboli, Fabio; Martinelli, Domenico; Di Stefano, Mariantonietta; Fasano, Massimo; Prato, Rosa; Santantonio, Teresa Antonia; Fiore, Jose' Ramòn
Migrants in Italy are prevalently young adults, with a higher risk of sexual transmitted infections (STI) and HIV infection. Promoting consistent as well as correct use of condoms could reduce failure rate due to their improper use. The aim of our study was to evaluate Condom Use Skills among a migrant population recently landed in Italy, hosted in a government center for asylum seekers. The study sample was composed of 80 male migrants. Sanitary trained interviewers submitted a questionnaire to participants to investigate age, provenience, marital status, educational level and knowledge about transmission and prevention of HIV/STI. Then, we assessed participants' level of condom use skill with the Condom Use Skills (CUS) measure by using a wooden penile model. The interviewer filled in a checklist and assigned 1 point for correct demonstration of each behavior that may prevent condom failure during sex. Participants' median age was 26 years and the sample was composed of 54 migrants from sub-Saharan Africa and 26 from Middle East. Most of them were married, with a lower middle level of education, up to 8 or 5 years. Half of the sample achieved the highest score in the questionnaire and our CUS showed a large number of people with middle high score classes. The Spearman's rho was 0.30, therefore answers to the questionnaire and CUS score appeared correlated (p migrants of the sample. Our study shows that educational level influences the quality of knowledge and awareness about STI/AIDS and contribute to correct condom use. Since the half of participants had a low educational level and linguistic problems, the risk of missing campaigns messages or misunderstanding informative materials increases. Direct observation of condom-application on penile model may offer realistic assessment of application skills in these individuals.
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 ...
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
Blashill, Aaron J.; Gordon, Janna R.; Safren, Steven A.
Previous research has revealed a significant bivariate relationship between anabolic androgenic steroid (AAS) use and reduced condom use among adolescent boys. However, to date, no known studies have explored the psychological mechanisms that may explain this relationship. Thus, the current study sought to examine two possible mediators in the association between AAS and condom use—depressive symptoms and substance use. Data were extracted from a nationally representative sample of U.S. adolescents. Participants were 3,780 U.S. high school boys who responded to self-report items assessing a number of health behaviors, including symptoms of depression, substance use, AAS use, and use of condoms during their most recent act of intercourse. Both depression and substance use were significant mediators in the relationship between AAS and condom use. However, when these effects were contrasted, the indirect effect of substance use was significantly stronger in magnitude than the effect of depression. Although AAS use is associated with sexual risk behaviors among adolescent boys, significant variance in this relationship is accounted for by elevated levels of depression and substance use, with substance use demonstrating a particularly salient pathway. PMID:23718635
East, Leah; Jackson, Debra; O'Brien, Louise; Peters, Kathleen
This paper is a report of a literature review to explore issues influencing condom use in heterosexual adolescents and young people. Sexually transmitted infections (STIs) are a major international health issue and adolescents and young people are particularly vulnerable. Efforts to address the rapid spread of STIs have largely focused on promoting the use of condoms as a protective 'safer sex' measure. However, use of the male condom is still inconsistent and the incidence of STIs continues to increase. A search of the literature using EBSCO Host databases was undertaken in 2006, with a focus on women, young people, condoms and STIs. Papers published in English from 1992 to 2006 were sought. Only research papers are included in this review. Factors impeding decisions to use protection by young people include lack of knowledge about prevalence of STIs, ambiguity around contraception and safer sex practices, and the difficulty faced by young women in particular in negotiating safer sex. The notion of romantic love confounds the assessment of risk and can render young people, particularly young women, ineffective in negotiating safer sex practices. Adolescents and young adults are particularly vulnerable in relation to STIs. There is a need to ensure that accurate messages are delivered about safer sex and contraception to this very vulnerable group. Furthermore, it is important to recognize that romantic love comprises strong emotions that have a role in decision-making and options for reducing personal-health risk during sexual activity.
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.
Konate, M K
In April 1993, a technical assistance contract to measure general condom use, particularly use of the brand name Protector, which has been marketed in Mali since March 1992, was made between the Center of Studies and Research on Population for Development (CERPOD) and the Popular Pharmacy of Mali. In June-July 1991, the SOMARC project and the Malian Institute for Applied Research in Development conducted a baseline survey to determine the condom use rate in Mali before Protector was introduced on the Malian market, so the social marketing project for contraception could be evaluated. It examined knowledge, use, and achievable target level and determined the characteristics of users of the Protector condom. It revealed that more than 90% of both men and women believed birth spacing was a good idea. Men approved of birth spacing for cost-saving reasons, while women approved birth spacing because it allowed mothers time to recuperate between births. Another earlier study in 1987 in Bamako found that 78% of the women already favored birth spacing. 90% of the men in the main cities in Mali knew about condoms. 63% of these men had used them in the past, mainly to prevent sexually transmitted diseases. 30% used them consistently. One hoped that this number was going to grow, since 80% of the men said that they would use condoms in the future. The evaluation of the 1991 social marketing campaign will end in August 1993 and will measure whether it was successful or not. In November 1992, CERPOD followed the framework of a recent baseline survey for an IEC (information, education, and communication) family planning program, operated jointly by the Malian Association for the Protection and Promotion of the Family and Population Communication Services, to measure the effect of the brand name Protector. CERPOD's survey results will be compared with those of the 1993 survey.
Rijsdijk Liesbeth E
Full Text Available Abstract Background Comprehensive sex education, including the promotion of consistent condom use, is still an important intervention strategy in tackling unplanned pregnancies, HIV/AIDS and sexually transmitted infections (STIs among Ugandan adolescents. This study examines predictors of the intention to use a condom and the intention to delay sexual intercourse among secondary school students (aged 12–20 in Uganda. Methods A school-based sample was drawn from 48 secondary schools throughout Uganda. Participants (N = 1978 completed a survey in English measuring beliefs regarding pregnancy, STIs and HIV and AIDS, attitudes, social norms and self-efficacy towards condom use and abstinence/delay, intention to use a condom and intention to delay sexual intercourse. As secondary sexual abstinence is one of the recommended ways for preventing HIV, STIs and unplanned pregnancies among the sexually experienced, participants with and without previous sexual experience were compared. Results For adolescents without sexual experience (virgins, self-efficacy, perceived social norms and attitude towards condom use predicted the intention to use condoms. Among those with sexual experience (non-virgins, only perceived social norm was a significant predictor. The intention to delay sexual intercourse was, however, predicted similarly for both groups, with attitudes, perceived social norm and self-efficacy being significant predictors. Conclusions This study has established relevant predictors of intentions of safe sex among young Ugandans and has shown that the intention to use condoms is motivated by different factors depending on previous sexual experience. A segmented approach to intervention development and implementation is thus recommended.
Decker, Michele R; Miller, Elizabeth; Raj, Anita; Saggurti, Niranjan; Donta, Balaiah; Silverman, Jay G
Commercial sex represents a critical context for HIV transmission within India and elsewhere. Despite research and programmatic attention to commercial sex workers (CSWs), less is known concerning the male CSW clients considered a bridge population for HIV transmission to the general population and thought to drive demand for the sex trafficking of women and girls. The current study assesses the prevalence of past year CSW contact, condom nonuse therein, and associations with demographic characteristics and gendered attitudes among a national sample of Indian men. The nationally representative Indian National Family Health Survey-3 was conducted across all Indian states in 2005-2006; the current sample was limited to 46,961 sexually active men. Analyses calculated the prevalence of past year CSW contact and inconsistent condom use; adjusted logistic regression models were used to evaluate associations of demographic characteristics, sexual entitlement and justification of wife abuse with past year CSW contact, and inconsistent condom use. Approximately 1 in 100 Indian men (0.9%) reported past year CSW contact; over half of such men reported inconsistent condom use with CSWs. CSW contact was most common among men ages 15-24 (3.6%) and never married men (9.9%). Men's CSW contact related to higher levels of sexual entitlement (adjusted odds ratio = 1.64; 95% confidence interval 1.24 to 2.17) and justification of violence against wives (adjusted odds ratio = 1.41; 95% confidence interval: 1.03 to 1.93). Men's past year CSW contact was concentrated among young and unmarried Indian men; condom nonuse with CSWs was common. Traditional gender ideologies seemed to support men's CSW contact, bolstering consideration of this behavior as a gendered form of HIV risk. Findings provide direction for interventions to reduce men's CSW contact in the Indian context by describing high-risk subpopulations and indicating that gender ideologies should be addressed.
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 ...
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.
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
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.
Rhodes, Scott D; Alonzo, Jorge; Mann, Lilli; Song, Eunyoung Y; Tanner, Amanda E; Arellano, Jorge Elias; Rodriguez-Celedon, Rodrigo; Garcia, Manuel; Freeman, Arin; Reboussin, Beth A; Painter, Thomas M
To evaluate the HOLA en Grupos intervention, a Spanish-language small-group behavioral HIV prevention intervention designed to increase condom use and HIV testing among Hispanic/Latino gay, bisexual, and other men who have sex with men. In 2012 to 2015, we recruited and randomized 304 Hispanic/Latino men who have sex with men, aged 18 to 55 years in North Carolina, to the 4-session HOLA en Grupos intervention or an attention-equivalent general health education comparison intervention. Participants completed structured assessments at baseline and 6-month follow-up. Follow-up retention was 100%. At follow-up, relative to comparison participants, HOLA en Grupos participants reported increased consistent condom use during the past 3 months (adjusted odds ratio [AOR] = 4.1; 95% confidence interval [CI] = 2.2, 7.9; P < .001) and HIV testing during the past 6 months (AOR = 13.8; 95% CI = 7.6, 25.3; P < .001). HOLA en Grupos participants also reported increased knowledge of HIV (P < .001) and sexually transmitted infections (P < .001); condom use skills (P < .001), self-efficacy (P < .001), expectancies (P < .001), and intentions (P < .001); sexual communication skills (P < .01); and decreased fatalism (P < .001). The HOLA en Grupos intervention is efficacious for reducing HIV risk behaviors among Hispanic/Latino men who have sex with men.
To identify predictors of HIV testing and condom use in Mozambique. Nationally representative survey data collected in Mozambique in 2009 was analyzed. Logistic regression analysis was used for two outcomes: HIV testing and condom use. Women at a higher risk of HIV were less likely to be tested for HIV than women at a lower risk: compared to married women, HIV testing was lower among never married women (OR = 0.37, CI: 0.25-0.54); compared to women with one lifetime partner, HIV testing was lower among women with four or more lifetime partners (OR = 0.62, CI: 0.47-0.83). Large wealth differentials were observed: compared to the poorest women, HIV testing was higher among the wealthiest women (OR = 3.03, CI: 1.96-4.68). Perceived quality of health services was an important predictor of HIV testing: HIV testing was higher among women who rated health services as being of very good quality (OR = 2.12, CI: 1.49-3.00). Type of sexual partner was the strongest predictor of condom use: condom use was higher among men who reported last sex with a girlfriend (OR = 9.75, CI: 6.81-13.97) or a casual partner (OR = 11.05, CI: 7.21-16.94). Being tested for HIV during the last two years was the only programmatic variable that predicted condom use. Interestingly, being tested for HIV more than two years ago was not associated with condom use. Frequent mass media exposure was neither associated with HIV testing nor with condom use. The focus of HIV testing should shift from married women (routinely tested during antenatal care visits) to unmarried women and women with multiple sexual partners. Financial barriers to HIV testing appear to be substantial. Since HIV testing is done without a fee being charged, these barriers are presumably related to the cost of transportation to static health facilities. Mechanisms should be developed to cover the cost of transportation to health facilities. Substantially increasing community-based counseling is one way of reducing the cost of
Full Text Available Abstract Background To identify predictors of HIV testing and condom use in Mozambique. Methods Nationally representative survey data collected in Mozambique in 2009 was analyzed. Logistic regression analysis was used for two outcomes: HIV testing and condom use. Results Women at a higher risk of HIV were less likely to be tested for HIV than women at a lower risk: compared to married women, HIV testing was lower among never married women (OR = 0.37, CI: 0.25-0.54; compared to women with one lifetime partner, HIV testing was lower among women with four or more lifetime partners (OR = 0.62, CI: 0.47-0.83. Large wealth differentials were observed: compared to the poorest women, HIV testing was higher among the wealthiest women (OR = 3.03, CI: 1.96-4.68. Perceived quality of health services was an important predictor of HIV testing: HIV testing was higher among women who rated health services as being of very good quality (OR = 2.12, CI: 1.49-3.00. Type of sexual partner was the strongest predictor of condom use: condom use was higher among men who reported last sex with a girlfriend (OR = 9.75, CI: 6.81-13.97 or a casual partner (OR = 11.05, CI: 7.21-16.94. Being tested for HIV during the last two years was the only programmatic variable that predicted condom use. Interestingly, being tested for HIV more than two years ago was not associated with condom use. Frequent mass media exposure was neither associated with HIV testing nor with condom use. Conclusions The focus of HIV testing should shift from married women (routinely tested during antenatal care visits to unmarried women and women with multiple sexual partners. Financial barriers to HIV testing appear to be substantial. Since HIV testing is done without a fee being charged, these barriers are presumably related to the cost of transportation to static health facilities. Mechanisms should be developed to cover the cost of transportation to health facilities
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.
Rodriguez-Llanes, Jose M; Guha-Sapir, Debarati; Schlüter, Benjamin-Samuel; Hicks, Madelyn Hsiao-Rei
Evidence of use of toxic gas chemical weapons in the Syrian war has been reported by governmental and non-governmental international organizations since the war started in March 2011. To date, the profiles of victims of the largest chemical attacks in Syria remain unknown. In this study, we used descriptive epidemiological analysis to describe demographic characteristics of victims of the largest chemical weapons attacks in the Syrian war. We analysed conflict-related, direct deaths from chemical weapons recorded in non-government-controlled areas by the Violation Documentation Center, occurring from March 18, 2011 to April 10, 2017, with complete information on the victim's date and place of death, cause and demographic group. 'Major' chemical weapons events were defined as events causing ten or more direct deaths. As of April 10, 2017, a total of 1206 direct deaths meeting inclusion criteria were recorded in the dataset from all chemical weapons attacks regardless of size. Five major chemical weapons attacks caused 1084 of these documented deaths. Civilians comprised the majority ( n = 1058, 97.6%) of direct deaths from major chemical weapons attacks in Syria and combatants comprised a minority of 2.4% ( n = 26). In the first three major chemical weapons attacks, which occurred in 2013, children comprised 13%-14% of direct deaths, ranging in numbers from 2 deaths among 14 to 117 deaths among 923. Children comprised higher proportions of direct deaths in later major chemical weapons attacks, forming 21% ( n = 7) of 33 deaths in the 2016 major attack and 34.8% ( n = 32) of 92 deaths in the 2017 major attack. Our finding of an extreme disparity in direct deaths from major chemical weapons attacks in Syria, with 97.6% of victims being civilians and only 2.4% being combatants provides evidence that major chemical weapons attacks were indiscriminate or targeted civilians directly; both violations of International Humanitarian Law (IHL). Identifying and
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.
Full Text Available Abstract Background Although some studies in Tanzania have addressed the question of sexuality and STIs among adolescents, mostly those aged 15 - 19 years, evidence on how multiple sexual partners influence condom use among 10 - 19 year-olds is limited. This study attempts to bridge this gap by testing a hypothesis that sexual relationships with multiple partners in the age group 10 - 19 years spurs condom use during sex in four districts in Tanzania. Methods Secondary analysis was performed using data from the Adolescents Module of the cross-sectional household survey on Maternal, Newborn and Child Health (MNCH that was done in Kigoma, Kilombero, Rufiji and Ulanga districts, Tanzania in 2008. A total of 612 adolescents resulting from a random sample of 1200 households participated in this study. Pearson Chi-Square was used as a test of association between multiple sexual partners and condom use. Multivariate logistic regression model was fitted to the data to assess the effect of multiple sexual partners on condom use, having adjusted for potential confounding variables. STATA (10 statistical software was used to carry out this process at 5% two-sided significance level. Results Of the 612 adolescents interviewed, 23.4% reported being sexually active and 42.0% of these reported having had multiple (> 1 sexual partners in the last 12 months. The overall prevalence of condom use among them was 39.2%. The proportion using a condom at the last sexual intercourse was higher among those who knew that they can get a condom if they want than those who did not. No evidence of association was found between multiple sexual partners and condom use (OR = 0.77, 95% CI = 0.35 - 1.67, P = 0.504. With younger adolescents (10 - 14 years being a reference, condom use was associated with age group (15 - 19: OR = 3.69, 95% CI = 1.21 - 11.25, P = 0.022 and district of residence (Kigoma: OR = 7.45, 95% CI = 1.79 - 31.06, P = 0.006; Kilombero: OR = 8.89, 95% CI = 2
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.
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
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.
Jamner, M S; Wolitski, R J; Corby, N H
To evaluate the impact of the Long Beach AIDS Community Demonstration Project, a community-based HIV-prevention intervention incorporating principles from the Transtheoretical model in its design and evaluation. Repeated cross-sectional sampling with matched intervention and comparison communities. Neighborhoods in Long Beach, California, having a high prevalence of drug abuse and prostitution. 3081 injecting drug users who were sexually active and/or shared injection equipment. Trained peer volunteers distributed fliers featuring role model stories targeted to the population's stage of change. Fliers were packaged with bleaching kits and/or condoms. Primary outcome measures were exposure to the intervention, condom carrying, and stage of change for disinfecting injection equipment with bleach and for using condoms with main and other partners. Toward the end of the study, 77% of injection drug users in the intervention area reported being exposed to the intervention. In the intervention area, rates of condom carrying increased from 10 to 27% (p project exposure had higher stage-of-change scores for using condoms with a main partner (p Project intervention for reaching injecting drug users in the community and for motivating the adoption of risk-reducing practices.
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.
van der Straten, Ariane; Moore, Jie; Napierala, Sue; Clouse, Kate; Mauck, Christine; Hammond, Nii; Padian, Nancy
We examined the use and acceptability of a combination product (diaphragm and gel) compared to a single product (gel) during a 6-month safety trial in Zimbabwe. Women were randomized to the use of a diaphragm with gel or the use of gel alone, in addition to male condoms. Ever use and use of study product on the last act of sexual intercourse were assessed monthly by Audio Computer-Assisted Self-Interviewing. Acceptability, correct use and consistent use (use at every sexual act during the previous 3 months) were measured on the last visit by face-to-face interview. Predictors of consistent use were examined using multivariate logistic regression analyses. In this sample of 117 sexually active, monogamous, contracepting women, rates of consistent use were similar in both groups (59.7% for combination method vs. 56.4% for gel alone). Product acceptability was high, but was not independently associated with consistent use. Independent predictors of consistent use included age [adjusted odds ratio (AOR)=1.08; 95% confidence interval (95% CI)=1.01-1.16], consistent condom use (AOR=3.85; 95% CI=1.54-9.63) and having a partner who approves of product use (AOR=2.66; 95% CI=1.10-6.39). Despite high reported acceptability and few problems with the products, the participants reported only moderate product adherence levels. Consistent use of condoms and consistent use of products were strongly associated. If observed in other studies, this may bias the estimation of product effectiveness in future trials of female-controlled methods.
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 ...
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.
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.
Crosby, Richard A.; Mena, Leandro; Geter, Angelica
This study determined whether YBMSM endorsing serosorting are less likely to use condoms. A questionnaire assessed men’s attitudes towards serosorting with a three-item scale; various sexual risk behaviors were measured using a 90-day recall period. Favorable attitudes toward serosorting were associated with a greater likelihood of condomless sex as a top (P<.001) and as a bottom (P<.001), as well as a lower likelihood of using condoms with main partners (P=.003). Findings suggest that YBMSM having favorable attitudes toward serosorting may be more likely to report condomless sex than their counterparts without favorable attitudes. PMID:26433647
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 ...
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.
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 ...
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.
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.
Dr Oboro VO
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.
Gupta, Mukesh [URS Professional Solutions LLC, Aiken, SC (United States); Niemi, Belinda [Washington River Protection Solutions, LLC, Richland, WA (United States); Paik, Ingle [Washington River Protection Solutions, LLC, Richland, WA (United States)
In 2012, One System Nuclear Safety performed a comparison of the safety bases for the Tank Farms Operations Contractor (TOC) and Hanford Tank Waste Treatment and Immobilization Plant (WTP) (RPP-RPT-53222 / 24590-WTP-RPT-MGT-12-018, “One System Report of Comparative Evaluation of Safety Bases for Hanford Waste Treatment and Immobilization Plant Project and Tank Operations Contract”), and identified 25 recommendations that required further evaluation for consensus disposition. This report documents ten NSSC approved consistent methodologies and guides and the results of the additional evaluation process using a new set of evaluation criteria developed for the evaluation of the new methodologies.
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.
Saxton, Peter J W; Dickson, Nigel P; Hughes, Anthony J
Over the last decade, annual HIV diagnoses among men who have sex with men (MSM) in New Zealand increased, then stabilised in 2006 and have not increased further. The aim was to examine trends in behaviours in order to better understand this pattern and inform community-based prevention. From 2002 to 2011, we conducted five repeat cross-sectional behavioural surveillance surveys among MSM at community locations in Auckland (fair day, gay bars, sex-on-site venues; n=6091). Participation was anonymous and self-completed. Recruitment methods were consistent at each round. Overall, the samples became more ethnically diverse and less gay community attached over time. Condom use during anal intercourse was stable across three partnering contexts (casual, current regular fuckbuddy, current regular boyfriend), with a drop among casual contacts in 2011 only. In the 6 months prior to surveys, there was a gradual decline over time in the proportion reporting >20 male partners, an increase in acquiring partners from the internet and increases in engagement in anal intercourse in some partnering contexts. HIV testing in the 12 months prior to surveys rose from 35.1% in 2002 to 50.4% in 2011, mostly from 2008. This first indepth examination of trends in HIV-related behaviours among five consecutive large and diverse samples of MSM in New Zealand does not suggest condom use is declining. However, subtle changes in sexual networks and partnering may be altering the epidemic determinants in this population and increasing exposure.
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.
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.
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.
Andrew, Benjamin J; Mullan, Barbara A; de Wit, John B F; Monds, Lauren A; Todd, Jemma; Kothe, Emily J
The aim of this meta-analysis was to explore whether the constructs in the theory of planned behaviour (TPB; i.e., attitude, subjective norm, perceived behavioural control, intention) explain condom use behaviour among men who have sex with men (MSM). Electronic databases were searched for studies that measured TPB variables and MSM condom use. Correlations were meta-analysed using a random effects model and path analyses. Moderation analyses were conducted for the time frame of the behavioural measure used (retrospective versus prospective). Attitude, subjective norm and perceived behavioural control accounted for 24.0 % of the variance in condom use intention and were all significant correlates. Intention and PBC accounted for 12.4 % of the variance in condom use behaviour. However, after taking intention into account, PBC was no longer significantly associated with condom use. The strength of construct relationships did not differ between retrospective and prospective behavioural assessments. The medium to large effect sizes of the relationships between the constructs in the TPB, which are consistent with previous meta-analyses with different behaviours or target groups, suggest that the TPB is also a useful model for explaining condom use behaviour among MSM. However, the research in this area is rather small, and greater clarity over moderating factors can only be achieved when the literature expands.
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.
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/
Scholey, A B; Owen, L; Gates, J; Rodgers, J; Buchanan, T; Ling, J; Heffernan, T; Swan, P; Stough, C; Parrott, A C
Our group has conducted several Internet investigations into the biobehavioural effects of self-reported recreational use of MDMA (3,4-methylenedioxymethamphetamine or Ecstasy) and other psychosocial drugs. Here we report a new study examining the relationship between self-reported Ecstasy use and traces of MDMA found in hair samples. In a laboratory setting, 49 undergraduate volunteers performed an Internet-based assessment which included mood scales and the University of East London Drug Use Questionnaire, which asks for history and current drug use. They also provided a hair sample for determination of exposure to MDMA over the previous month. Self-report of Ecstasy use and presence in hair samples were consistent (p happiness and higher self-reported stress. Self-reported Ecstasy use, but not presence in hair, was also associated with decreased tension. Different psychoactive drugs can influence long-term mood and cognition in complex and dynamically interactive ways. Here we have shown a good correspondence between self-report and objective assessment of exposure to MDMA. These data suggest that the Internet has potentially high utility as a useful medium to complement traditional laboratory studies into the sequelae of recreational drug use. Copyright © 2010 S. Karger AG, Basel.
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.
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.
Peterson, John L.; Bakeman, Roger
The association between perceptions about condom use among one's peers, beliefs about new HIV treatments, and HIV sexual risk behavior was examined in a large urban sample ( N = 454) of gay and bisexual men in the Southeast. Results partially confirmed the hypothesis that men who endorsed new HIV treatment beliefs would report lower norms for…
Milleliri, Jean-Marie; Krentel, Alison; Rey, Jean-Loup
The authors report the evaluation of the impact of a comic book about condom use distributed to Gabonese high school students in Libreville and Lambarene in 1999. This evaluation was conducted through a self-administered questionnaire completed by 954 students in 11 high schools immediately before distribution of a comic book about condoms and by 771 students 15-30 days afterwards. The anonymous questionnaire contained multiple-choice and open questions about knowledge, attitudes and practices. During the second survey (same schools and same classes), the questions tested knowledge about AIDS and about the stories in the book. The student populations who responded to the two questionnaires were homogeneous for sex, age, school class, and province of residence. Knowledge about the modes of HIV/AIDS contamination improved substantially between the two questionnaires, with knowledge about the mother-child transmission pathway increasing from 47% to 75% of responders. At the same time, and without any significant difference by sex, class or province, individual adhesion to the role of the condom as a means of prevention against AIDS progressed from 64% to 95%. The students questioned wanted AIDS prevention information to be better integrated into their curriculum and, in particular, they wanted educational activities in this area in their school, either by their teachers or in special information areas. Thus, the 48-page comic book by young Gabonese artists was perceived as a good method of condom education for the young (75%) and as an excellent method for inducing awareness about it among them (89%). The book's contents had been absorbed, and the students found that the stories and the message were well matched. Moreover, the extension of the readership beyond the initial distribution at the first evaluation (7.5 readers reported per copy) showed that the messages in the book spread well beyond the student group.
Fladseth, Kristin; Gafos, Mitzy; Newell, Marie Louise; McGrath, Nuala
Critical to preventing the spread of HIV is promoting condom use among HIV-positive individuals. Previous studies suggest that gender norms (social and cultural constructions of the ways that women and men are expected to behave) may be an important determinant of condom use. However, the relationship has not been evaluated among HIV-positive women and men in South Africa. We examined gender norms and condom use at last sex among 550 partnerships reported by 530 sexually-active HIV-positive women (372) and men (158) who had sought care, but not yet initiated antiretroviral therapy in a high HIV-prevalence rural setting in KwaZulu-Natal, South Africa between January 2009 and March 2011. Participants enrolled in the cohort study completed a baseline questionnaire that detailed their socio-demographic characteristics, socio-economic circumstances, religion, HIV testing history and disclosure of HIV status, stigma, social capital, gender norms and self-efficacy. Gender norms did not statistically differ between women and men (p = 0.18). Overall, condoms were used at last sex in 58% of partnerships. Although participants disclosed their HIV status in 66% of the partnerships, 60% did not have knowledge of their partner’s HIV status. In multivariable logistic regression, run separately for each sex, women younger than 26 years with more equitable gender norms were significantly more likely to have used a condom at last sex than those of the same age group with inequitable gender norms (OR = 8.88, 95% CI 2.95–26.75); the association between condom use and gender norms among women aged 26+ years and men of all ages was not statistically significant. Strategies to address gender inequity should be integrated into positive prevention interventions, particularly for younger women, and supported by efforts at a societal level to decrease gender inequality. PMID:25853870
Fladseth, Kristin; Gafos, Mitzy; Newell, Marie Louise; McGrath, Nuala
Critical to preventing the spread of HIV is promoting condom use among HIV-positive individuals. Previous studies suggest that gender norms (social and cultural constructions of the ways that women and men are expected to behave) may be an important determinant of condom use. However, the relationship has not been evaluated among HIV-positive women and men in South Africa. We examined gender norms and condom use at last sex among 550 partnerships reported by 530 sexually-active HIV-positive women (372) and men (158) who had sought care, but not yet initiated antiretroviral therapy in a high HIV-prevalence rural setting in KwaZulu-Natal, South Africa between January 2009 and March 2011. Participants enrolled in the cohort study completed a baseline questionnaire that detailed their socio-demographic characteristics, socio-economic circumstances, religion, HIV testing history and disclosure of HIV status, stigma, social capital, gender norms and self-efficacy. Gender norms did not statistically differ between women and men (p = 0.18). Overall, condoms were used at last sex in 58% of partnerships. Although participants disclosed their HIV status in 66% of the partnerships, 60% did not have knowledge of their partner's HIV status. In multivariable logistic regression, run separately for each sex, women younger than 26 years with more equitable gender norms were significantly more likely to have used a condom at last sex than those of the same age group with inequitable gender norms (OR = 8.88, 95% CI 2.95-26.75); the association between condom use and gender norms among women aged 26+ years and men of all ages was not statistically significant. Strategies to address gender inequity should be integrated into positive prevention interventions, particularly for younger women, and supported by efforts at a societal level to decrease gender inequality.
Full Text Available Critical to preventing the spread of HIV is promoting condom use among HIV-positive individuals. Previous studies suggest that gender norms (social and cultural constructions of the ways that women and men are expected to behave may be an important determinant of condom use. However, the relationship has not been evaluated among HIV-positive women and men in South Africa. We examined gender norms and condom use at last sex among 550 partnerships reported by 530 sexually-active HIV-positive women (372 and men (158 who had sought care, but not yet initiated antiretroviral therapy in a high HIV-prevalence rural setting in KwaZulu-Natal, South Africa between January 2009 and March 2011. Participants enrolled in the cohort study completed a baseline questionnaire that detailed their socio-demographic characteristics, socio-economic circumstances, religion, HIV testing history and disclosure of HIV status, stigma, social capital, gender norms and self-efficacy. Gender norms did not statistically differ between women and men (p = 0.18. Overall, condoms were used at last sex in 58% of partnerships. Although participants disclosed their HIV status in 66% of the partnerships, 60% did not have knowledge of their partner's HIV status. In multivariable logistic regression, run separately for each sex, women younger than 26 years with more equitable gender norms were significantly more likely to have used a condom at last sex than those of the same age group with inequitable gender norms (OR = 8.88, 95% CI 2.95-26.75; the association between condom use and gender norms among women aged 26+ years and men of all ages was not statistically significant. Strategies to address gender inequity should be integrated into positive prevention interventions, particularly for younger women, and supported by efforts at a societal level to decrease gender inequality.
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
Background Fostering adolescents’ communication on sexuality issues with their parents and other significant adults is often assumed to be an important component of intervention programmes aimed at promoting healthy adolescent sexual practices. However, there are few studies describing the relationship between such communication and sexual practices, particularly in sub-Saharan Africa. This study examined the relationships between adolescents’ communication with significant adults and their condom use in three sites in this region. Methods Data stem from a multi-site randomized controlled trial of a school-based HIV prevention intervention implemented in Cape Town and Mankweng, South Africa and Dar es Salaam, Tanzania. Only data from comparison schools were used. The design is therefore a prospective panel study with three waves of data collections. Data were collected in 2004 from 6,251 participants in 40 schools. Associations between adolescents’ communication with adults about sexuality issues and their use of condoms were analysed cross-sectionally using analysis of variance, as well as prospectively using multiple ordinal logistic regression analysis. Results Cross-sectional analyses showed that consistent condom users had significantly higher mean scores on communication (across topics and communication partners) than both occasional users and never-users, who had the lowest scores. After controlling for condom use at the first data collection occasion in each model as well as for possible confounders, communication scores significantly predicted consistent condom use prospectively in all three ordinal logistic regression models (Model R2 = .23 to .31). Conclusion The findings are consistent with the assertion that communication on sexuality issues between adolescents and significant adults results in safer sexual practices, as reflected by condom use, among in-school adolescents. The associations between communication variables and condom use might
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.
Huneeus, Andrea; Deardorff, Julianna; Lahiff, Maureen; Guendelman, Sylvia
Although condom use in adolescence is related to higher lifetime educational attainment, the association between primary education (from kindergarten to eighth grade) and adolescent sexual behavior is not well understood. This study examined the association between type of school in which primary education was completed-public, charter, or private-and condom use at sexual debut among Chilean adolescents. Drawing on the 2009 Chilean National Youth Survey, a population-based sample of general community youth aged 15 to 29 years, we conducted a study of the 4217 participants who reported onset of sexual activity during adolescence. Bivariate and multple logistic regression was used to examine the relationship between type of primary school attended (60.1% public, 30.3% charter, and 9.6% private) and condom use at sexual debut while controlling for sociodemographic characteristics and sexual behavior. Compared with students who completed their primary education in private or charter schools, students who completed their primary education in public schools had 1.85 (95% confidence interval, 1.12-3.04) and 1.67 (95% confidence interval, 1.26-2.23) higher odds, respectively, of not using condoms at sexual debut. Odds were similar for students living in urban settings, whereas there were too few students attending private schools in rural areas to allow meaningful estimates. Independent of household income, primary schooling is associated with sexual health behaviors among Chilean adolescents living in urban areas and can serve as a target for public health interventions designed to prevent sexually transmitted infections in adolescence.
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.
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.
Rizwan, S A; Kant, S; Goswami, K; Rai, S K; Misra, P
Migrant workers constitute an important risk group for Human Immunodeficiency Virus/Acquired Immuno-Deficiency Syndrome transmission in India. Alcohol consumption before sexual intercourse has been postulated to influence condom use practices. This study aimed to assess this association with regard to non-spousal sexual encounters among male migrant workers in northern India. A cross-sectional facility-based survey was conducted in 2011. Male migrant workers aged ≥18 years, who were born outside Haryana, who had moved to the current location after 15 years of age,had worked in the current factory for at least 1 year, who were willing to participate and were able to give written, informed consent were included in the study. A consecutive sampling was performed. Descriptive, bivariate and multiple logistic regression analyses were carried out. A total of 162 participants reported having experienced non-spousal sexual encounters in the last 1 year. The proportion of men who reported not having used a condom at their last non-spousal sexual encounter was 59.3%, and 78.4% of the men reported having consumed alcohol in the last 1 year. About 48.1% of men reported having consumed alcohol before their last non-spousal sexual encounter. Men who consumed alcohol were three times more likely to not use a condom at their last non-spousal sexual encounter (OR = 3.1, 95% CI: 1.5-6.4). This association persisted even after adjusting for relevant confounders. Alcohol consumption had a negative influence on condom use during non-spousal sexual encounter among male migrant workers. An integrated approach to promote condom use and reduce alcohol consumption among migrant men needs to be undertaken through targeted intervention strategies.
Trijsburg, Laura; Geelen, Anouk; Hollman, Peter Ch; Hulshof, Paul Jm; Feskens, Edith Jm; Van't Veer, Pieter; Boshuizen, Hendriek C; de Vries, Jeanne Hm
As misreporting, mostly under-reporting, of dietary intake is a generally known problem in nutritional research, we aimed to analyse the association between selected determinants and the extent of misreporting by the duplicate portion method (DP), 24 h recall (24hR) and FFQ by linear regression analysis using the biomarker values as unbiased estimates. For each individual, two DP, two 24hR, two FFQ and two 24 h urinary biomarkers were collected within 1·5 years. Also, for sixty-nine individuals one or two doubly labelled water measurements were obtained. The associations of basic determinants (BMI, gender, age and level of education) with misreporting of energy, protein and K intake of the DP, 24hR and FFQ were evaluated using linear regression analysis. Additionally, associations between other determinants, such as physical activity and smoking habits, and misreporting were investigated. The Netherlands. One hundred and ninety-seven individuals aged 20-70 years. Higher BMI was associated with under-reporting of dietary intake assessed by the different dietary assessment methods for energy, protein and K, except for K by DP. Men tended to under-report protein by the DP, FFQ and 24hR, and persons of older age under-reported K but only by the 24hR and FFQ. When adjusted for the basic determinants, the other determinants did not show a consistent association with misreporting of energy or nutrients and by the different dietary assessment methods. As BMI was the only consistent determinant of misreporting, we conclude that BMI should always be taken into account when assessing and correcting dietary intake.
Kreps, David M; Ramey, Garey
Sequential equilibria comprise consistent beliefs and a sequentially ra tional strategy profile. Consistent beliefs are limits of Bayes ratio nal beliefs for sequences of strategies that approach the equilibrium strategy. Beliefs are structurally consistent if they are rationaliz ed by some single conjecture concerning opponents' strategies. Consis tent beliefs are not necessarily structurally consistent, notwithstan ding a claim by Kreps and Robert Wilson (1982). Moreover, the spirit of stru...
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
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
Process Analytical Technology for High Shear Wet Granulation: Wet Mass Consistency Reported by In-Line Drag Flow Force Sensor Is Consistent With Powder Rheology Measured by At-Line FT4 Powder Rheometer.
Narang, Ajit S; Sheverev, Valery; Freeman, Tim; Both, Douglas; Stepaniuk, Vadim; Delancy, Michael; Millington-Smith, Doug; Macias, Kevin; Subramanian, Ganeshkumar
Drag flow force (DFF) sensor that measures the force exerted by wet mass in a granulator on a thin cylindrical probe was shown as a promising process analytical technology for real-time in-line high-resolution monitoring of wet mass consistency during high shear wet granulation. Our previous studies indicated that this process analytical technology tool could be correlated to granulation end point established independently through drug product critical quality attributes. In this study, the measurements of flow force by a DFF sensor, taken during wet granulation of 3 placebo formulations with different binder content, are compared with concurrent at line FT4 Powder Rheometer characterization of wet granules collected at different time points of the processing. The wet mass consistency measured by the DFF sensor correlated well with the granulation's resistance to flow and interparticulate interactions as measured by FT4 Powder Rheometer. This indicated that the force pulse magnitude measured by the DFF sensor was indicative of fundamental material properties (e.g., shear viscosity and granule size/density), as they were changing during the granulation process. These studies indicate that DFF sensor can be a valuable tool for wet granulation formulation and process development and scale up, as well as for routine monitoring and control during manufacturing. Copyright © 2016. Published by Elsevier Inc.
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.
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.
Full Text Available The data from Board of Health in Surakarta City, on 8 September 2005, from 155 commercial sex worker woman had blood examined, there were 7 persons positive in HIV. One of factor affecting the high infection HIV/AIDS in women commercial sex worker was low use of condom. Aims of this research was to know factor-factor associated with didn’t use of condom and social aspect negotiations about using condom (education, economics status, working experience, devilling place, occupation, ethnic, religious, and income. This research is qualitative research using guided group discussion technique, in-depth interview, and participatory observation. Subject for this research were 30 persons, consist of 25 commercial sex worker, 3 guest, 1 room owner, and 1 parent. Independent variables in this research are social economics characteristic, demography and community characteristics. Dependent variables as PPSK capability in condom using negotiating to prevent sexually transmitted disease and HIV/AIDS. Commonly, despite knowing that everyone, including themselves, is vulnerable to AIDS infection, the respondents ignore asking the guest/partners for condom use. Most of them don’t ask for condom use due to their fear of either being the target of the guest anger and bad words, or losing money from them. Women commercial sex worker Silir in using condom and prevent sexual transmitted disease had free education from Board of Health in Surakarta City. In the street prostitutes are low support from peer, room owner, hotel owner, or guest about using condom for women commercial sex worker in illegal place, caused women commercial sex worker in the street more potential and high risk to spread sexual transmitted diseases than they were operated in Silir. The low capability of the street prostitutes for negotiating condom use with the guest customers results from: misperception on "safe-sex" behavior for seeking "help", economic and psychology pressure, free and
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.
Heeren, G Anita; Mandeya, Andrew; Jemmott, John B; Chiruka, Raymond T; Marange, C Show; Batidzirai, Jesca M; Gwaze, Arnold R; Tyler, Joanne C; Hsu, Janet
The prevalence of HIV in sub-Saharan Africa is the highest in the world. Young people, including university students, are at risk. Many sexually active young people have multiple partners, but little is known about how university students who have multiple partners differ from those who do not. This study examined such differences among randomly selected first-year students at a university in the Eastern Cape Province, South Africa, who completed a confidential questionnaire via audio computer-assisted self-interviewing. Of 201 participants, 93 (46.3%) reported sexual intercourse in the previous 3 months. Of those, 52 (55.91%) reported sexual intercourse with more than one partner in the past 3 months. Controlling for gender, students who reported multiple partners were younger at first coitus, had a greater number of lifetime coital partners, and reported more frequent coitus and unprotected coitus but a lower proportion of condom-protected coital acts in the past 3 months than did those reporting only one partner. However, those reporting multiple partners and one partner did not differ in religiosity, drinking problems, or victimization by childhood sexual abuse. HIV/sexually transmitted disease risk reduction interventions must address unprotected coitus and failure to use condoms among university students reporting multiple partners.
Rasberry, Catherine N; Condron, D Susanne; Lesesne, Catherine A; Adkins, Susan Hocevar; Sheremenko, Ganna; Kroupa, Elizabeth
With HIV and sexually transmitted disease (STD) rates disproportionately high among adolescent sexual minority males (ASMM), it is important to understand how school-based sexual health education may relate to sexual risk-related behavior among this population. This analysis explores reported HIV/AIDS- and condom-related education and sexual risk-related behaviors among ASMM and their adolescent non-sexual-minority male (non-ASMM) peers. Students (n = 11,681) from seven Florida high schools completed paper-and-pencil questionnaires. A matched analytic sample of ASMM and non-ASMM students was created by using propensity score-matching techniques (n = 572). Logistic regressions controlling for individual and school characteristics examined reporting having been taught about AIDS or HIV in school, having been taught in school about using condoms, condom use at last sex, HIV/STD testing, and associations between these variables. Compared with matched non-ASMM peers, ASMM students were less likely to report having been taught about AIDS or HIV in school (odds ratio [OR] = 0.58, P = 0.04) and having used a condom at last sex (OR = 0.39, P condoms. Among non-ASMM, reporting having been taught in school about using condoms was associated with a greater likelihood of condom use at last sex (OR = 4.78, P education and differential associations between condom-related education and condom use in ASMM and non-ASMM suggest that sexual health education in schools may not be resonating with ASMM and non-ASMM in the same way.
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.
Conners, Erin E; Swanson, Kate; Morales-Miranda, Sonia; Fernández Casanueva, Carmen; Mercer, Valerie J; Brouwer, Kimberly C
This study assessed correlates of inconsistent condom use with casual partners and the prevalence of sexual risk behaviors and STIs in the Mexico/Guatemala border region using a sample of 392 migrants (303 men, 85 women) who reported current substance use or problem drinking. We ran separate univariate logistic regression models for men and women, and multivariate logistic regression models for men only. Prevalence of syphilis was 1.2% among women and 2.3% among men; HIV prevalence was 2.4% among women and 1.3% among men. Inconsistent condom use with casual partners was higher in women with greater education and lower among women who sold sex. In men, less access to free condoms, drug use with sexual partners, and drug use before sex were independently associated with inconsistent condom use with casual partners. Sexual and substance use risk behaviors were common, and HIV/STI prevention efforts should target both genders and expand beyond most-at risk populations.
Full Text Available Background: Disabled adolescents are at a critical time in their psychosocial and sexual development.Aim: This study explores the attitudes of educators working in schools for Deaf and hard-of-hearing pupils in South Africa toward condom education for their pupils.Methods: We conducted a combination of individual in-depth and joint interviews with a total of 27 participants. The sample comprised educators, school psychologists, school nurses and teaching assistants.Results: Results showed that educators were aware of the HIV risk for their pupils and reported the risk of sexual abuse or premature sexual activity as being risk factors for HIV infection. None of the schools had a written condom education policy. Whilst some schools were integrating condom education in existing school curricula, others faced moral or religious dilemmas in doing so. There were differences in attitudes, both amongst schools and amongst educators in the same schools.Conclusions: Given the context of a burgeoning HIV epidemic, it is vital to address adequate condom education in schools.
Full Text Available The social skills rating system (SSRS is used to assess social skills and competence in children and adolescents. While its characteristics based on United States samples (US are published, corresponding Australian figures are unavailable. Using a 4-week retest design, we examined the internal consistency, retest reliability and measurement error (ME of the SSRS secondary student form (SSF in a sample of Year 7 students (N = 187, from five randomly selected public schools in Perth, western Australia. Internal consistency (IC of the total scale and most subscale scores (except empathy on the frequency rating scale was adequate to permit independent use. On the importance rating scale, most IC estimates for girls fell below the benchmark. Test-retest estimates of the total scale and subscales were insufficient to permit reliable use. ME of the total scale score (frequency rating for boys was equivalent to the US estimate, while that for girls was lower than the US error. ME of the total scale score (importance rating was larger than the error using the frequency rating scale. The study finding supports the idea of using multiple informants (e.g. teacher and parent reports, not just student as recommended in the manual. Future research needs to substantiate the clinical meaningfulness of the MEs calculated in this study by corroborating them against the respective Minimum Clinically Important Difference (MCID.
Vaz, Sharmila; Parsons, Richard; Passmore, Anne Elizabeth; Andreou, Pantelis; Falkmer, Torbjörn
The social skills rating system (SSRS) is used to assess social skills and competence in children and adolescents. While its characteristics based on United States samples (US) are published, corresponding Australian figures are unavailable. Using a 4-week retest design, we examined the internal consistency, retest reliability and measurement error (ME) of the SSRS secondary student form (SSF) in a sample of Year 7 students (N = 187), from five randomly selected public schools in Perth, western Australia. Internal consistency (IC) of the total scale and most subscale scores (except empathy) on the frequency rating scale was adequate to permit independent use. On the importance rating scale, most IC estimates for girls fell below the benchmark. Test-retest estimates of the total scale and subscales were insufficient to permit reliable use. ME of the total scale score (frequency rating) for boys was equivalent to the US estimate, while that for girls was lower than the US error. ME of the total scale score (importance rating) was larger than the error using the frequency rating scale. The study finding supports the idea of using multiple informants (e.g. teacher and parent reports), not just student as recommended in the manual. Future research needs to substantiate the clinical meaningfulness of the MEs calculated in this study by corroborating them against the respective Minimum Clinically Important Difference (MCID).
Nyoni, Joyce E; Ross, Michael W
Although studies have been conducted in neighboring countries, there are no published data on men who have sex with men (MSM) in mainland Tanzania. We report on a respondent-driven sampling study of 271 MSM in Dar es Salaam, Tanzania. The sample covered a wide range of educational attainment and employment, median age was 24, and all respondents had heard of HIV/AIDS, mostly through public media. Those satisfied with media information on HIV were younger, had lower education, and had obtained their information from health facilities. Over two-thirds believed that having one faithful partner and using condoms would protect against HIV: nevertheless, more than two-thirds were worried about HIV infection. Two-thirds had had a relationship with a woman, one-third in the past year. Predictors of non-use of condoms for anal sex with last casual partner were younger age, not being worried about HIV infection, and agreeing to have sex even if a condom was refused. There was no significance in proportion using a condom with last casual (43%) and last regular (49%) partner. Most partners (MSM knew a median of 10 other MSM) were met in bars, music halls, and in the home/local environment, and 70% of MSM described their sexual position as "bottom." Sixty percent reported having an HIV test and the great majority was comfortable discussing condoms with partners and friends: half would refuse to have sex if condoms were not agreed to. These data suggest a significant "gay" community in Dar es Salaam with relatively accurate HIV information but moderate condom use, HIV testing and ability to refuse unsafe sex. There is clearly scope for targeted HIV prevention programs in the MSM community in Tanzania.
... ACOG Barrier Methods of Birth Control: Spermicide, Condom, Sponge, Diaphragm, and Cervical Cap Home For Patients Search ... Format Barrier Methods of Birth Control: Spermicide, Condom, Sponge, Diaphragm, and Cervical Cap Contraception What are barrier ...
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…