A workplace intervention program and the increase in HIV knowledge, perceived accessibility and use of condoms among young factory workers in Thailand.

PubMed

Chamratrithirong, Aphichat; Ford, Kathleen; Punpuing, Sureeporn; Prasartkul, Pramote

2017-12-01

Vulnerability to Human Immunodeficiency Virus (HIV) infection among factory workers is a global problem. This study investigated the effectiveness of an intervention to increase AIDS knowledge, perceived accessibility to condoms and condom use among young factory workers in Thailand. The intervention was a workplace program designed to engage the private sector in HIV prevention. A cross-sectional survey conducted in 2008 to measure program outcomes in factories in Thailand was used in this study. The workplace intervention included the development of policies for management of HIV-positive employees, training sessions for managers and workers, and distribution of educational materials and condoms. A multi-level analysis was used to investigate the effect of HIV/AIDS prevention program components at the workplace on HIV/AIDS knowledge, perceived accessibility to condoms and condom use with regular sexual partners among 699 young factory workers (aged 18-24 years), controlling for their individual socio-demographic characteristics. Interventions related to the management and services component including workplace AIDS policy formulation, condom services programs and behavioral change campaigns were found to be significantly related to increased AIDS knowledge, perceived accessibility to condoms and condom use with regular partners. The effect of the HIV/AIDS training for managers, peer leaders and workers was positive but not statistically significant. With some revision of program components, scaling up of workplace interventions and the engagement of the private sector in HIV prevention should be seriously considered.

Condoms and Coca-Cola.

PubMed

Townsend, S

1992-01-01

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.

Condom availability in the schools: lessons from the courtroom.

PubMed

Mahler, K

1996-01-01

The Massachusetts Supreme Judicial Court unanimously supported the condom availability program of the Falmouth School District. The program allows students in grades 7-12 full access to condoms without prior parental consent. Before the junior high students can receive counseling, however, they must first undergo counseling. Like the high school students (who have access to counseling, but do not require it before receiving condoms), junior high school students also have access to informational pamphlets. The court rejected the parents' claims that the program infringed on their rights as parents since students are free to decline to participate in the program and the parents are free to tell their children not to participate. In January 1996, the US Supreme Court refused to review this case and provided no comment or recorded dissent. On the other hand, in 1993, the New York appellate court, in a 3-2 decision, found that the condom availability program of New York City public schools coerced parents to surrender their rights to raise their children without undue interference from the state. When New York City later offered parents an opt-out, fewer than 1% of parents of high school students selected it. A clear history of legal precedent supports a minor's right to consent to the receipt of medical services related to sexuality and reproductive health. There is currently a challenge to the condom availability program in the Philadelphia public schools, which offers an opt-out provision for parents who do not want their children to participate in the program. The challenge revolves around the supposition that parental consent is needed for some medical services, in this case provision of condoms. What makes this case unique is that parents who support the condom program are parties in the lawsuit. The unpredictability of school districts and local governing bodies do not guarantee the success of implementing comprehensive school-based AIDS education programs. Some parents and conservative groups will continue to fight condom availability programs.

Correlates of Condom Use among Chinese College Students in Hunan Province

ERIC Educational Resources Information Center

Xiao, Zhiwen

2012-01-01

A cross-sectional survey was conducted to test an integrated model of condom use with a sample of 490 sexually active Chinese college students. A number of variables in the integrated model were predictors of condom use, explaining 33.4% of the variance in use. Partner communication was the strongest predictors (beta = 0.317, SE = 0.038, p less…

The reach and impact of social marketing and reproductive health communication campaigns in Zambia

PubMed Central

Van Rossem, Ronan; Meekers, Dominique

2007-01-01

Background Like many sub-Saharan African countries, Zambia is dealing with major health issues, including HIV/AIDS, family planning, and reproductive health. To address reproductive health problems and the HIV/AIDS epidemic in Zambia, several social marketing and health communication programs focusing on reproductive and HIV/AIDS prevention programs are being implemented. This paper describes the reach of these programs and assesses their impact on condom use. Methods This paper assesses the reach of selected radio and television programs about family planning and HIV/AIDS and of communications about the socially marketed Maximum condoms in Zambia, as well as their impact on condom use, using data from the 2001–2002 Zambia Demographic and Health Survey. To control for self-selection and endogeneity, we use a two-stage regression model to estimate the effect of program exposure on the behavioural outcomes. Results Those who were exposed to radio and television programs about family planning and HIV/AIDS were more likely to have ever used a condom (OR = 1.16 for men and 1.06 for women). Men highly exposed to Maximum condoms social marketing communication were more likely than those with low exposure to the program to have ever used a condom (OR = 1.48), and to have used a condom at their last sexual intercourse (OR = 1.23). Conclusion Findings suggest that the reproductive health and social marketing campaigns in Zambia reached a large portion of the population and had a significant impact on condom use. The results suggest that future reproductive health communication campaigns that invest in radio programming may be more effective than those investing in television programming, and that future campaigns should seek to increase their impact among women, perhaps by focusing on the specific constrains that prevent females from using condoms. PMID:18088437

Understanding gender differences in condom use self-efficacy among youth in urban Cameroon.

PubMed

Meekers, Dominique; Klein, Megan

2002-02-01

The aim of this study was to understand gender differences in components of condom use self-efficacy to inform the design of effective reproductive health interventions for youth. Data stem from a July to August 2000 reproductive health survey among youth aged 15-24. Gender differentials in self-efficacy are analyzed using logistic regression. Perceived ability to discuss and negotiate condom use is high for both sexes. Women are less likely than men to know correct condom use (58% vs. 80%, p<.01) but are more likely to be shy buying condoms (67% vs. 50%, p<.01). Prior experience buying and using condoms, parental support, and condom promotion affect perceived ability to correctly use condoms and shyness buying condoms. Programs aiming to increase self-efficacy in condom use should focus on increasing confidence in youth's ability to buy condoms and to use them correctly, especially for young women. There is a need for programs that publicize and/or increase access to youth-friendly outlets and increase the acceptability of young women buying condoms.

The impact of condom availability [correction of distribution] in Seattle schools on sexual behavior and condom use.

PubMed Central

Kirby, D; Brener, N D; Brown, N L; Peterfreund, N; Hillard, P; Harrist, R

1999-01-01

OBJECTIVES: Ten Seattle high schools made condoms available through vending machines, baskets in school clinics, or both. This study measured the number of condoms that students obtained and subsequent changes in sexual behavior and condom use. METHODS: Schoolwide surveys were administered in spring 1993 and in spring 1995, before and during the condom availability program. These data were compared with data from nationally representative surveys administered at the same time. RESULTS: Seattle students obtained an average of 4.6 condoms per year, the vast majority from baskets and very few from vending machines. Relative to the national samples, the percentage of Seattle students who had ever had sex remained stable after the program began; current sexual activity decreased significantly; and the percentage of sexually experienced students who used a condom the last time they had sex decreased significantly, particularly in the 5 schools with baskets of condoms in clinics. CONCLUSIONS: Making condoms available in Seattle schools enabled students to obtain relatively large numbers of condoms but did not lead to increases in either sexual activity or condom use. PMID:9949746

Condom distribution in Bali: assuring supply meets demand.

PubMed

Merati, T P

1994-01-01

Hundreds of thousands of tourists visit Bali each year, many of whom pay to have sex with local residents. Kuta, one of Bali's major tourist resort towns, has manifested an higher demand for condoms than other studied areas in Indonesia. Such demand is laudable in the context of a growing HIV/AIDS epidemic, but demand must encounter supply to be worthwhile. The Citra Usadha Indonesia Foundation (YCUI) has been conducting outreach education in Kuta and other areas of Bali since February 1992. Over that time, outreach workers have found that street youths' and prostitutes' main sources for condoms, pharmacies, supermarkets, and YCUI outreach workers, are either closed or potentially unavailable at night, when most sexual transactions occur. Pharmacies and supermarkets close at 10 pm. YCUI therefore initiated a six-month condom distribution program in 1994 to encourage the approximately 150 street vendors working in Kuta to sell condoms. Street vendors who enrolled in the program were provided with a monthly supply of 30 free condoms for the period of six months and invited to sell them to the public at whatever price the market set. Concurrently, YCUI promoted condom sales and increased awareness of the new condom source through social marketing techniques and their network of outreach workers. After six months, 122 vendors had participated in the program selling 10,255 condoms. Vendors were able to sell more and more condoms as the program progressed. A final evaluation will be conducted October 1994 to determine how many vendors still sell condoms now that the free supplies have been discontinued.

Evaluation of two school-based HIV prevention interventions in the border city of Tijuana, Mexico.

PubMed

Martinez-Donate, Ana P; Hovell, Melbourne F; Zellner, Jennifer; Sipan, Carol L; Blumberg, Elaine J; Carrizosa, Claudia

2004-08-01

This research project examined the individual and combined effectiveness of an HIV prevention workshop and a free condom distribution program in four high schools in Tijuana, Mexico. Adolescents (N = 320) completed baseline measures on sexual practices and theoretical correlates and participated in a two-part study. In Study 1, students were randomly assigned to an HIV prevention workshop or a control condition, with a 3-month follow-up assessment. Results indicate three significant workshop benefits regarding HIV transmission by altering sexual initiation, access to condoms, and traditional beliefs regarding condoms. In Study 2, we set up a condom distribution program at two of the participating schools, and students completed a 6-month follow-up assessment. Results indicate that exposure to the workshop followed by access to the condom distribution program yielded two beneficial results for reducing HIV transmission: moderating sexual initiation and increasing condom acquisition. Access to the condom distribution program alone had no effects on behavioral and psychosocial correlates of HIV transmission. We discuss implications of these results.

Participation in Counseling Programs: High-Risk Participants Are Reluctant to Accept HIV-Prevention Counseling

PubMed Central

Earl, Allison; Albarracín, Dolores; Durantini, Marta R.; Gunnoe, Joann B.; Leeper, Josh; Levitt, Justin H.

2013-01-01

HIV-prevention intervention effectiveness depends on understanding whether clients with highest need for HIV-prevention counseling accept it. With this objective, a field study with a high-risk community sample from the southeastern United States (N = 350) investigated whether initial knowledge about HIV, motivation to use condoms, condom-use-relevant behavioral skills, and prior condom use correlate with subsequent acceptance of an HIV-prevention counseling session. Ironically, participants with high (vs. low) motivation to use condoms, high (vs. low) condom-use-relevant behavioral skills, and high (vs. low) prior condom use were more likely to accept the HIV-prevention counseling. Moreover, the influence of motivation to use condoms, condom-use-relevant behavioral skills, and prior condom use on acceptance of the counseling was mediated by expectations that the counseling session would be useful. Methods to reduce barriers to recruitment of clients for counseling programs are discussed. PMID:19634960

Feasibility and Preliminary Effectiveness of the Homework Intervention Strategy (eHIS) Program to Enhance Male Condom Use: Research Protocol.

PubMed

Glowacka, Marta; Yardley, Lucy; Stone, Nicole; Graham, Cynthia A

2018-01-02

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 types of condoms and lubricants on their own in a no-pressure situation. Following T1, participants are asked to complete the T2 and T3 measures at 4 and 10 weeks, respectively. Data collection for the study is completed. Data analysis is in progress and is expected to be completed by February 2018. This brief, home-based, self-guided program may lead to increased consistent and correct condom use. Online delivery can make the program an easily accessible and low-cost health promotion intervention, which has the potential to reach a wide and diverse audience. If results of the current study show the program's feasibility and preliminary effectiveness in changing condom use related outcomes, a larger scale randomized controlled trial (RCT) will be conducted. Research Registry: researchregistry2325; http://www.researchregistry.com/browse-the-registry.html# home/registrationdetails/58da6cad1d7ab0314337d076/ (Archived by WebCite at http://www.webcitation.org/6vXs6S9XW). ©Marta Glowacka, Lucy Yardley, Nicole Stone, Cynthia A Graham. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 02.01.2018.

Pregnancy prevention and condom use practices among HIV-infected women on antiretroviral therapy seeking family planning in Lilongwe, Malawi.

PubMed

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

2015-01-01

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.

Condom use and self-efficacy among female sex workers with steady partners in China.

PubMed

Zhao, R; Wang, B; Fang, X; Li, X; Stanton, B

2008-08-01

This study attempted to determine the association of self-efficacy with condom-use practice and to explore reasons of not using condoms among female sex workers (FSWs) with steady partners in China. Data from 309 establishment-based FSWs with steady partners in one Chinese county were collected through a cross-sectional study. Consistent condom use with steady partners was lower than with clients in entertainment establishments. Condom-use self-efficacy was positively associated with condom-use communication and condom-use frequency with clients but not with steady partners. It was positively associated with condom-use intention and skill with clients and steady partners. However, it was not associated with appropriate use of condoms. Significant differences of reasons about not using condom were also observed between the two partner types. The results may represent an important challenge to STD and HIV intervention programs aimed at achieving consistent condom use in FSWs. Health workers should focus on psychosocial factors affecting inconsistent condom use among FSWs with steady partners in China. In addition, intervention programs that can promote FSWs' self-efficacy through condom-use skill training will still be necessary.

The impact of condom prices on sales in social marketing programs.

PubMed

Harvey, P D

1994-01-01

The issue of pricing contraceptives in family planning programs is becoming more and more important. What is the relationship between consumer prices and demand, and how can we strike the correct balance between the two? This report examines the correlation between consumer prices for condoms, expressed as a percentage of per-capita gross national product, and per-capita sales of condoms in 24 social marketing programs. The correlation that emerges is strong and negative: Even when the data are controlled for age of program and other independent variables, there is a clear negative correlation between prices and contraceptive sales in these programs. The conclusion is clear that condom prices must be set very low--well below the equivalent of 1 percent of per-capita gross national product for a year's supply--in order to achieve satisfactory prevalence for condoms in either a family-planning or an AIDS-prevention context.

Alcohol abuse and other factors associated with risky sexual behaviors among adolescent students from the poorest areas in Costa Rica.

PubMed

Rios-Zertuche, Diego; Cuchilla, Jose; Zúñiga-Brenes, Paola; Hernández, Bernardo; Jara, Patricia; Mokdad, Ali H; Iriarte, Emma

2017-03-01

We applied the Integrative Model of Behavioral Prediction to analyze factors associated with risky sexual behaviors for adolescent students living in the poorest segments in Costa Rica. We used data from a school-based knowledge, attitudes, and behaviors survey from the poorest districts of Costa Rica, collected for Salud Mesoamerica Initiative. We analyzed responses of 919 male and female students (12-19 years old) to determine factors associated with sexual intercourse and condom use. One of every four students reported being sexually active. Students that reported being sexually active were more likely to consume excessive alcohol (OR 3.04 [95 % CI 1.94-4.79]). While 88.0 % [95 % CI 73.5-95.1] of sexually active adolescents said they would use a condom the next time they have sex, only 53.1 % [95 % CI 39.3-66.5] reported condom use the last time. Non-condom-users felt purchasing condoms was uncomfortable (OR 0.34 [95 % CI 0.12-0.93]). Poor adolescents in Costa Rica begin sexual activities early and undertake behaviors that increase their risk for unwanted pregnancies and sexually transmitted infections. We found the urgent need to address alcohol abuse, and recognize gender differences in youth health programs.

A family planning program that pays for itself.

PubMed

1987-07-01

In Japan, the condom is the method of choice of 82% of all contraceptive users. The Japan Family Planning Association covers about 3% of the total condom market through a well-organized social marketing scheme. Mobile guidance teams, equipped with a vehicle, supply contraceptives to health centers, independent midwives, and maternity hospitals in 17 prefectures and collect payment for condoms distributed after their previous visit. As an incentive, organizations and health institutions receive a commission for the condoms they supply. Japan's largest condom manufacturer provides supplies to the Family Planning Association at a very low price. The contraceptive social marketing program pays for its own promotion, and the Family Planning Association is able to support its other activities from the income it earns. The program was designed to complement rather than compete with commercial marketing channels such as pharmacies, which supply 60% of the 660 million condoms purchased in Japan each year.

Condom provision and education in Minnesota public schools: a telephone survey of parents.

PubMed

Eisenberg, Marla E; Bernat, Debra H; Bearinger, Linda H; Resnick, Michael D

2009-09-01

Increasing correct and consistent condom use among sexually active adolescents continues to be a critical public health goal, with schools serving as key agents for achieving this goal through sexuality education and condom use provision. This research aims to describe the views of parents regarding school-based condom distribution and education programs, and examines how these views differ across demographic groups. Parents of school-age children in Minnesota were surveyed in telephone interviews (N = 1605; 63% participation) regarding their beliefs about condom availability and education. Chi-square tests of significance were used to detect differences in agreement with each statement for 10 demographic and personal characteristics. A majority of respondents held supportive views about condom availability and education programs. Strongest support centered on statements in the survey about teenagers needing information about condoms (86%) and showing actual condoms during classroom lessons (77%). Approximately two thirds of the parents agreed that school-based instruction about condoms should be "allowed" at the high school level (65%), and one fifth (21%) believed that this type of education should be "required." Support for condom availability and education programs differed significantly according to certain personal characteristics, with less supportive views from self-identified Born Again Christians and politically conservative parents. Public discourse regarding school-based sexuality education should include the viewpoints of parents of school-aged children as key stakeholders. Parents' perspectives provide unique and critical insights that school administrators and educators should consider as they develop educational and programmatic offerings regarding condoms.

Factors associated with parent support for condom education and availability.

PubMed

AugsJoost, Brett; Jerman, Petra; Deardorff, Julianna; Harley, Kim; Constantine, Norman A

2014-04-01

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.

Condom Use: Slippage, Breakage, and Steps for Proper Use among Adolescents in Alternative School Settings

ERIC Educational Resources Information Center

Coyle, Karin K.; Franks, Heather M.; Glassman, Jill R.; Stanoff, Nicole M.

2012-01-01

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…

Correlates of Condom-use Self-efficacy on the EPPM-based Integrated Model among Chinese College Students.

PubMed

Jin, Shan Shan; Bu, Kai; Chen, Fang Fang; Xu, Hui Fang; Li, Yi; Zhao, Dong Hui; Xu, Fang; Li, Jing Yan; Han, Meng Jie; Wang, Ning; Wang, Lu

2017-02-01

To explore the predictors of condom-use self-efficacy in Chinese college students according to the extended parallel process model (EPPM)-based integrated model. A total of 3,081 college students were anonymously surveyed through self-administered questionnaires in Guangzhou and Harbin, China. A structural equation model was applied to assess the integrated model. Among the participants, 1,387 (46.7%) were male, 1,586 (53.3%) were female, and the average age was 18.6 years. The final integrated model was acceptable. Apart from the direct effect (r = 0.23), perceived severity had two indirect effects on condom-use self-efficacy through the attitude to HIV education (r = 0.40) and intention to engage in premarital sex (r = -0.16), respectively. However, the perceived susceptibility mediated through the intention to engage in premarital sex (intent-to-premarital-sex) had a poor indirect impact on condom-use self-efficacy (total effect was -0.06). Furthermore, attitude toward HIV health education (r = 0.49) and intent-to-premarital-sex (r = -0.31) had a strong direct effect on condom-use self-efficacy. In addition, male students perceived higher susceptibility, stronger intent-to-premarital-sex, and lower condom-use self-efficacy than female students. The integrated model may be used to assess the determinants of condom-use self-efficacy among Chinese college students. Future research should focus on raising the severity perception, HIV-risk-reduction motivation, and the premarital abstinence intention among college students. Furthermore, considering the gender differences observed in the present survey, single-sex HIV education is required in school-based HIV/sex intervention. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

Are Female Sex Workers Able to Negotiate Condom Use with Male Clients? The Case of Mobile FSWs in Four High HIV Prevalence States of India

PubMed Central

Bharat, Shalini; Mahapatra, Bidhubhusan; Roy, Suchismita; Saggurti, Niranjan

2013-01-01

Introduction Condom promotion among female sex workers (FSWs) is a key intervention in India’s National AIDS Control Program. However, there is limited understanding of how FSWs negotiate condom use with male clients, particularly in the context of their mobility for sex work. The objective of this study is to examine the factors associated with the mobile FSWs’ ability to refuse unsafe sex and successfully negotiate condom use with unwilling male clients. Methods Data for 5498 mobile FSWs from a cross-sectional survey conducted in 22 districts of four states in southern India were analyzed. Questions assessed FSWs’ ability to refuse clients unprotected sex, convince unwilling clients for condom use and negotiate condom use in a new location. Logistic regression models were constructed to examine the association between socio-demographics, economic vulnerability, sex work practice, and program exposure and condom negotiation ability. Results A majority of FSWs (60%) reported the ability to refuse clients for unprotected sex, but less than one-fifth reported the ability to successfully convince an unwilling client to use a condom or to negotiate condom use in a new site. Younger and older mobile FSWs compared to those who were in the middle age group, those with longer sex work experience, with an income source other than sex work, with program exposure and who purchased condoms for use, reported the ability to refuse unprotected sex, to successfully negotiate condom use with unwilling clients and to do so at new sites. Conclusion FSWs need to be empowered to not only refuse unprotected sex but also to be able to motivate and convince unwilling clients for condom use, including those in new locations. In addition to focusing on condom promotion, interventions must address the factors that impact FSWs’ ability to negotiate condom use. PMID:23840806

Country watch: Nicaragua.

PubMed

Pauw, J

1999-01-01

The Association of Workers for Education, Health and Social Integration (TESIS) works with commercial sex workers to control HIV and sexually transmitted diseases in Nicaragua through free condom distribution and education. Education includes group work, individual counseling, and demonstrations of correct condom use. Condoms are also distributed to the motels frequented by commercial sex workers. When the Condom Social Marketing (CSM) project in Central America started, it sold condoms of the same quality as the ones offered by TESIS; thus the condom donors reduced their donations, and in turn, TESIS lost its normal quota for free condom distribution. Because of this situation, TESIS dealt with a condom promotion scheme at a lower cost for the poorest women. Condom quality did not deteriorate as products only came with simpler packaging. TESIS fills the gap which CSM missed.

The Effects of School-Based Condom Availability Programs (CAPs) on Condom Acquisition, Use and Sexual Behavior: A Systematic Review.

PubMed

Wang, Timothy; Lurie, Mark; Govindasamy, Darshini; Mathews, Catherine

2018-01-01

We conducted a systematic review to assess the impact of school-based condom availability programs (CAPs) on condom acquisition, use and sexual behavior. We searched PubMed to identify English-language studies evaluating school-based CAPs that reported process (i.e. number of condoms distributed or used) and sexual behavior measures. We identified nine studies that met our inclusion criteria, with the majority conducted in the United States of America. We judged most studies to have medium risk of bias. Most studies showed that school-based CAPs increased the odds of students obtaining condoms (odds ratios (ORs) for individual studies ranged between 1.81 and 20.28), and reporting condom use (OR 1.36-3.2). Three studies showed that school-based CAPs positively influenced sexual behavior, while no studies reported increase in sexual activity. Findings suggest that school-based CAPs may be an effective strategy for improving condom coverage and promoting positive sexual behaviors.

A pilot test of a self-guided, home-based intervention to improve condom-related sexual experiences, attitudes, and behaviors among young women.

PubMed

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

2018-07-01

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.

A Condom Distribution Program for Adolescents: The Findings of a Feasibility Study.

ERIC Educational Resources Information Center

Arnold, Charles B.; Cogswell, Betty E.

This paper describes a family planning service for adolescent males in an inner-city area. The program utilized the distribution of free condoms through local commercial outlets (barber shops, grocery stores, pool hall, restaurant). The proprietors agreed to distribute condoms in the target area which included approximately 3,000 males aged 12-26…

Implementation and Evaluation of a Condom Availability Program on a College Campus: Lessons from the Field

ERIC Educational Resources Information Center

Eastman-Mueller, Heather P.; Gomez-Scott, Jessica R.; Jung, Ae-Kyung; Oswalt, Sara B.; Hagglund, Kristofer

2016-01-01

The U.S. Centers for Disease Control and Prevention advocate access to condoms as a critical sexual health prevention strategy. The purpose of this article is to discuss the implementation and evaluation of a condom availability program using dispensing machines in residence halls at a Midwestern U.S. university. Undergraduate students (N = 337)…

The impact on condom use of the "100% Jeune" social marketing program in Cameroon.

PubMed

Meekers, Dominique; Agha, Sohail; Klein, Megan

2005-06-01

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.

Condom use and the popular press in Nigeria.

PubMed

Renne, E P

1993-04-01

The increased acceptability and use of condoms by men in southwestern Nigeria is reflected in joking references to condoms in the comic-style popular press. Yet these references display an ambivalence about condoms that is mirrored in survey data and in interviews regarding condom use by rural Ekiti Yoruba men. This ambivalence, which is often couched in terms of health, has implications for the acceptance of government-sponsored HIV/AIDS-related educational programs. Because of the irreverence of comic-style newspapers and the 'unofficial' nature of their authority which coincides with popular attitudes about health programs, they have a credibility that could be useful in educating adolescents about sexually-transmitted diseases and HIV/AIDS.

Factors Associated with Parent Support for Condom Education and Availability

ERIC Educational Resources Information Center

AugsJoost, Brett; Jerman, Petra; Deardorff, Julianna; Harley, Kim; Constantine, Norman A.

2014-01-01

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…

Condom negotiation strategies as a mediator of the relationship between self-efficacy and condom use.

PubMed

French, Sabine Elizabeth; Holland, Kathryn J

2013-01-01

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.

Urban African-American males' perceptions of condom use, gender and power, and HIV/STD prevention program.

PubMed Central

Kennedy, Stephen B.; Nolen, Sherry; Applewhite, Jeffrey; Waiter, Elizabeth

2007-01-01

The overall goal of the research project was to develop, administer and assess a brief male-focused condom promotion program for inner-city young adult African-American males. To achieve that goal, we conducted a formative study consisting of both quantitative and qualitative research methods. For the qualitative component, which was guided by the relevant tenets of the social cognitive theory and the stages of change model, a series of focus group discussions was conducted among the target population based upon a thematic topic guide that covered three broad areas: young men's perceptions of condom use relative to pregnancy and HIV/sexually transmitted disease (STD) prevention, gender-based issues surrounding condom use, and potential guidelines for the development of customized condom promotion programs. Those focus group discussions were audiotaped and the transcribed data summarized and analyzed based on those thematic topics. The findings revealed that respondents were more likely to assume that they know the risk behaviors of their sexual partners, more likely to consider pregnancy as a socially desirable outcome, more likely to control condom use within relationship dynamics and sexual contexts, and also more likely to provide suggestions on suitable components for program development. The implications and limitations of those findings from this qualitative component of the project are herein described, including potential recommendations for program development. PMID:18229776

Increasing condom use and declining STI prevalence in high-risk MSM and TGs: evaluation of a large-scale prevention program in Tamil Nadu, India.

PubMed

Subramanian, Thilakavathi; Ramakrishnan, Lakshmi; Aridoss, Santhakumar; Goswami, Prabuddhagopal; Kanguswami, Boopathi; Shajan, Mathew; Adhikary, Rajat; Purushothaman, Girish Kumar Chethrapilly; Ramamoorthy, Senthil Kumar; Chinnaswamy, Eswaramurthy; Veeramani, Ilaya Bharathy; Paranjape, Ramesh Shivram

2013-09-17

This paper presents an evaluation of Avahan, a large scale HIV prevention program that was implemented using peer-mediated strategies, condom distribution and sexually transmitted infection (STI) clinical services among high-risk men who have sex with men (HR-MSM) and male to female transgender persons (TGs) in six high-prevalence state of Tamil Nadu, in southern India. Two rounds of large scale cross-sectional bio-behavioural surveys among HR-MSM and TGs and routine program monitoring data were used to assess changes in program coverage, condom use and prevalence of STIs (including HIV) and their association to program exposure. The Avahan program for HR-MSM and TGs in Tamil Nadu was significantly scaled up and contacts by peer educators reached 77 percent of the estimated denominator by the end of the program's fourth year. Exposure to the program increased between the two rounds of surveys for both HR-MSM (from 66 percent to 90 percent; AOR = 4.6; p < 0.001) and TGs (from 74.5 percent to 83 percent; AOR = 1.82; p < 0.06). There was an increase in consistent condom use by HR-MSM with their regular male partners (from 33 percent to 46 percent; AOR = 1.9; p < 0.01). Last time condom use with paying male partners (up from 81 percent to 94 percent; AOR = 3.6; p < 0.001) also showed an increase. Among TGs, the increase in condom use with casual male partners (18 percent to 52 percent; AOR = 1.8; p < 0.27) was not significant, and last time condom use declined significantly with paying male partners (93 percent to 80 percent; AOR = 0.32; p < 0.015). Syphilis declined significantly among both HR-MSM (14.3 percent to 6.8 percent; AOR = 0.37; p < 0.001) and TGs (16.6 percent to 4.2 percent; AOR = 0.34; p < 0.012), while change in HIV prevalence was not found to be significant for HR-MSM (9.7 percent to 10.9 percent) and TGs (12 percent to 9.8 percent). For both groups, change in condom use with commercial and non-commercial partners was found to be strongly linked with exposure to the Avahan program. The Avahan program for HR-MSM and TGs in Tamil Nadu achieved a high coverage, resulting in improved condom use by HR-MSM with their regular and commercial male partners. Declining STI prevalence and stable HIV prevalence reflect the positive effects of the prevention strategy. Outcomes from the program logic model indiacte the effectiveness of the program for HR-MSM and TGs in Tamil Nadu.

Gender differences in determinants of condom use among HIV clients in Uganda.

PubMed

Walusaga, Happy Annet; Kyohangirwe, Rossette; Wagner, Glenn J

2012-11-01

Little research has examined gender differences in reporting of condom use, which is the goal of our analysis. A baseline study was conducted in two urban clinics and we examined data from sexually active clients entering HIV care who enrolled in a prospective longitudinal cohort study. The primary outcome was consistent condom use and determinant variables were demographics, physical health and immune status, economic well-being, relationship characteristics, psychosocial functioning, and self-efficacy. Of 280 participants, 129 were males and 151 females, and 41.7% had at least some secondary education; 60.7% did not always use condoms. Nearly half (48.1%) of men reported always using condoms compared to 31.8% of females. In bivariate analyses, men who consistently use condoms were more likely to be working, have a primary partner who was HIV negative, to have disclosed their HIV status to their primary partner, and to have higher general self-efficacy and condom use self-efficacy compared to men who did not always use condoms. Higher general self-efficacy and condom use self-efficacy were the only variables associated with reported consistent condom use among women. In regression analysis, working in the last 7 days, general self efficacy, and condom use self-efficacy were associated with consistent condom use among men. These findings reveal low rates of consistent condom use among people living with HIV, and a gender difference with men more likely to report consistent condom use. These data suggest the need for gender sensitive prevention programs and strategies, including programs that can provide women with greater control and self-efficacy regarding use of protective methods.

Condom use increasing.

PubMed

Finger, W R

1998-01-01

Condom use is central to the prevention of AIDS among people at risk for contracting HIV. As such, condom use is increasing dramatically even though many men say that they do not like using them. Condom sales through social marketing campaigns have increased dramatically in some countries, where tens of millions of condoms are sold annually. For example, during the period 1991-96, annual social marketing sales increased about five-fold in Ethiopia to 21 million, and nine-fold in Brazil to 27 million. These sales reflect the success of condom social marketing campaigns in making condoms accessible and largely affordable. There is also a greater general awareness of AIDS than there used to be, and communication campaigns have shown that condoms are an effective solution. More condoms still need to be used in the ongoing struggle against HIV/AIDS. The author discusses the factors which affect the limited acceptance of condoms, condom use outside of marriage, social marketing, and family planning programs.

Social marketing: making condoms available to communities. An interview with Duncan Earle.

PubMed

1994-05-01

This document presents an interview in which AIDSCAP private-sector officer Duncan Earle discusses how condom social marketing contributes to AIDS prevention efforts. Condom social marketing uses commercial marketing techniques to promote condom use by making them more accessible and affordable. Thus, condoms are sold where people can purchase them without embarrassment (often by street hawkers) or where they may be needed in impulsive situations (in bars, hotels, and nightclubs). Social marketing relies on such marketing techniques as identifying wholesalers, assisting wholesalers with sales, creating point-of-purchase advertising, and developing attractive packaging. Prices are based on rough formulas derived from per capita gross national product and the prices people are willing to pay for such products as matches, cigarettes, candy, and aspirin. Quality is assured if the condoms are obtained through the US Agency for International Development's procurement system. Samples of condoms obtained from other sources are submitted for quality testing. The success of social marketing programs can be determined by examining sales and resupply. Cost effectiveness is determined by the cost of delivering 100 condoms (1 couple-year of protection). While social marketing would be more cost effective without expenditures on advertising, it would be less effective overall. Some barriers that must be overcome to market condoms include laws outlawing the sale or advertising of condoms, duties and customs' surcharges on imported condoms (which, in some cases, increase the cost 33%), and religious objections to contraception. As well as selling condoms, social marketing programs educate people about AIDS using any kind of media available.

Female condom importance acknowledged in HIV prevention.

PubMed

1996-12-09

The Female Health Co. (FHC), London, United Kingdom, has signed a three-year agreement with the Joint United Nations Program on HIV/AIDS (UNAIDS) to provide a global public sector price for the female condom to 193 affiliated countries. An adjunct education and social marketing program, supported by UNAIDS, will be launched. High rates of acceptance have been shown previously when the female condom has been introduced with an effective educational approach. Negotiations between FHC and UNAIDS began in September 1996; 80 of 193 countries, upon inquiry, have already identified a requirement for over 7 million female condoms in 1997. UNAIDS estimates that nearly 50% of new human immunodeficiency virus (HIV) infections are in women; the female condom is the only woman-controlled product providing protection against sexually transmitted diseases (STDs), including HIV and acquired immunodeficiency syndrome (AIDS). Studies have indicated that the number of unprotected sex acts decreases when the female condom is available. Dr. Peter Piot (UNAIDS) states that the female condom is important in those cultures and situations where women have limited control over sexual decisions. Dr. Mary Ann Leeper (FHC) states that the company is committed to making the female condom available in developing countries.

Putting the C Back into the ABCs: A Multi-Year, Multi-Region Investigation of Condom Use by Ugandan Youths 2003–2010

PubMed Central

Davis, Rosemary; Ouma, Joseph; Lwanga, Stephen K.; Moxon, Sarah

2014-01-01

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

Putting the C back into the ABCs: a multi-year, multi-region investigation of condom use by Ugandan youths 2003-2010.

PubMed

Valadez, Joseph J; Jeffery, Caroline; Davis, Rosemary; Ouma, Joseph; Lwanga, Stephen K; Moxon, Sarah

2014-01-01

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.

Evidence-based HIV pilot program for Chinese college students: Differences by gender.

PubMed

Tung, Wei-Chen; Serratt, Teresa D; Lu, Minggen

2015-06-01

This study explored gender differences in the effectiveness of the translated VOICES (Video Opportunities for Condom Education and Safer Sex) intervention on the condom use intention, perceived benefits and barriers to condom use, condom use self-efficacy, and HIV/AIDS knowledge among Chinese students in a US university. We utilized a pretest/post-test quasi-experimental design and recruited 67 Chinese students at the local university. Participants viewed a 20-min video with Chinese subtitles, attended one 25-min small group discussion and condom interactive educational activity. Female participants showed significantly greater mean scores of perceived benefits and condom use self-efficacy, in comparison with male participants. Female participants also reported significantly higher scores than male participants in five of the perceived benefits items and one self-efficacy item. These study results provide important information for developing more differentiated intervention strategies specific to gender for HIV and STI education programs. © 2014 Wiley Publishing Asia Pty Ltd.

Safer sex negotiation and its association with condom use among clients of female sex workers in Bangladesh.

PubMed

Kamal, S M Mostafa; Hassan, Che Hashim; Salikon, Roslan Hj

2015-03-01

This study examines safer sex negotiation and its association with condom use among clients of female sex workers (FSWs) in Bangladesh. Data were collected from 484 FSWs living in Dhaka city following a convenient sampling procedure. Overall, 47% of the clients were suggested to use condom during last sexual intercourse and 21% did so. Both bivariate and multivariable binary logistic regression analyses yielded significantly increased risk of negotiation for safer sex with clients among FSWs with higher education. The power bargaining significantly (P < .001) increased the risk of condom use by 2.15 times (95% confidence interval = 1.28-3.59). The odds of condom use were significantly higher among the FSWs with higher education, unmarried, hotel-based, and among those with higher level of HIV/AIDS-related knowledge. The Bangladeshi FSWs have little control over their profession. HIV prevention programs should aim to encourage FSWs through information, education, and communication program to insist on condom use among clients. © 2013 APJPH.

NGO participation boosts condom sales in Haiti.

PubMed

Dadian, M J

1997-01-01

An estimated 10% of Haiti's urban population and 4% of the rural population is infected with HIV. As recent as a few years ago, few commercial sales outlets for condoms existed in Haiti, even in the cities. Now, however, Pante condoms are accessible to Haitians at all hours of the day even in remote areas of the country. Pante is the brand name of the condom that Population Services International (PSI) introduced in Haiti in 1990, and began packaging, promoting, and selling a year later through a condom social marketing (CSM) program funded by the AIDS Control and Prevention (AIDSCAP) Project. The CSM program allows Pante to be sold at 10% of the cost of commercial condoms. Even in the context of political instability and economic crisis which followed the overthrow of Haiti's elected government in 1991, monthly sales of Pante during 1991-95 increased from an average of 3000 to more than 400,000, and more than 16 million units were sold over the 4-year period.

21 CFR 801.435 - User labeling for latex condoms.

Code of Federal Regulations, 2010 CFR

2010-04-01

... products are formed from latex films. (b) Data show that the material integrity of latex condoms degrade... required by paragraph (c) of this section, and initially delivered for introduction into interstate...

Increasing condom use and declining STI prevalence in high-risk MSM and TGs: evaluation of a large-scale prevention program in Tamil Nadu, India

PubMed Central

2013-01-01

Background This paper presents an evaluation of Avahan, a large scale HIV prevention program that was implemented using peer-mediated strategies, condom distribution and sexually transmitted infection (STI) clinical services among high-risk men who have sex with men (HR-MSM) and male to female transgender persons (TGs) in six high-prevalence state of Tamil Nadu, in southern India. Methods Two rounds of large scale cross-sectional bio-behavioural surveys among HR-MSM and TGs and routine program monitoring data were used to assess changes in program coverage, condom use and prevalence of STIs (including HIV) and their association to program exposure. Results The Avahan program for HR-MSM and TGs in Tamil Nadu was significantly scaled up and contacts by peer educators reached 77 percent of the estimated denominator by the end of the program’s fourth year. Exposure to the program increased between the two rounds of surveys for both HR-MSM (from 66 percent to 90 percent; AOR = 4.6; p < 0.001) and TGs (from 74.5 percent to 83 percent; AOR = 1.82; p < 0.06). There was an increase in consistent condom use by HR-MSM with their regular male partners (from 33 percent to 46 percent; AOR = 1.9; p < 0.01). Last time condom use with paying male partners (up from 81 percent to 94 percent; AOR = 3.6; p < 0.001) also showed an increase. Among TGs, the increase in condom use with casual male partners (18 percent to 52 percent; AOR = 1.8; p < 0.27) was not significant, and last time condom use declined significantly with paying male partners (93 percent to 80 percent; AOR = 0.32; p < 0.015). Syphilis declined significantly among both HR-MSM (14.3 percent to 6.8 percent; AOR = 0.37; p < 0.001) and TGs (16.6 percent to 4.2 percent; AOR = 0.34; p < 0.012), while change in HIV prevalence was not found to be significant for HR-MSM (9.7 percent to 10.9 percent) and TGs (12 percent to 9.8 percent). For both groups, change in condom use with commercial and non-commercial partners was found to be strongly linked with exposure to the Avahan program. Conclusion The Avahan program for HR-MSM and TGs in Tamil Nadu achieved a high coverage, resulting in improved condom use by HR-MSM with their regular and commercial male partners. Declining STI prevalence and stable HIV prevalence reflect the positive effects of the prevention strategy. Outcomes from the program logic model indiacte the effectiveness of the program for HR-MSM and TGs in Tamil Nadu. PMID:24044766

Protection vs. protectionism?

PubMed

Dadian, M J

1997-06-01

Condom social marketing (CSM) programs have been successful in Rwanda and Haiti because they make it possible to sell condoms at prices even low-income people can afford. In Haiti, a packet of 3 Pante condoms costs US$0.06, about the same amount as a packet of 4 Prudence condoms in Rwanda. Less expensive condoms translate into higher condom sales, greater condom use, and a lower degree of HIV transmission. Fewer infections mean funding for AIDS prevention and care can be diverted to other health needs, fewer workers become sick and drop out of the economy, and fewer orphaned children become wards of the state. A major factor which allows such low prices in Haiti and Rwanda is the absence of taxes and tariffs on imported condoms, which comprise the bulk of socially marketed condoms. Botswana, Tanzania, and Bangladesh also do not collect duties on foreign condoms. Some countries, however, impose considerable taxes upon imported condoms. Malaysia, a major condom manufacturer and exporter, imposes a 25% tax upon imported condoms, while Brazil charges condom importers a 10% import duty and all condom marketers an 18% circulation tax. Condom prices in Brazil are among the highest in the world. Even subsidized socially marketed condoms are too expensive for many to buy consistently. Brazil's tariffs together with condom testing regulations and legal expenses impede the sale of subsidized condoms in the country. Efforts are underway to get the Brazilian government to eliminate taxes on imported condoms.

Impact of an advertising campaign on condom use in urban Pakistan.

PubMed

Agha, Sohail; Meekers, Dominique

2010-12-01

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.

Condom deserts: geographical disparities in condom availability and their relationship with rates of sexually transmitted infections.

PubMed

Shacham, Enbal; Nelson, Erik J; Schulte, Lauren; Bloomfield, Mark; Murphy, Ryan

2016-05-01

Identifying predictors that contribute to geographical disparities in sexually transmitted infections (STIs) is necessary. This study assesses the spatial relationship between condom availability to locations of STIs in order to better understand these geographical disparities. We conducted a condom availability audit among potential condom-selling establishments. New gonorrhoea and chlamydia cases in 2011 (n=6034) and HIV infection cases from 2006 to 2011 (n=565) were collected by census tract in St Louis, Missouri. 829 potential condom-selling establishments participated in the condom availability audit in St Louis City; 242 of which sold condoms. A negative linear relationship exists between condom vendors and cases of gonorrhoea and chlamydia, after adjusting for concentrated disadvantage and free condom locations. Higher concentrated disadvantage, higher proportions of convenience vendors and free locations were associated with higher rates of HIV. This study was conducted to provide evidence that lack of condom availability is associated with STI rates, and likely is an integral component to influencing the subjective norms surrounding condom use and STI rates. Condom distribution interventions may be addressing availability needs and social norms, yet are more likely to be effective when placed in locations with the highest STI rates. 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/

HIV prevention among male clients of female sex workers in Kaolack, Senegal: results of a peer education program.

PubMed

Leonard, L; Ndiaye, I; Kapadia, A; Eisen, G; Diop, O; Mboup, S; Kanki, P

2000-02-01

This article reports the results of a peer-led HIV prevention education and condom promotion program among transport workers in Kaolack, Senegal. As part of a 2-year longitudinal follow-up study, changes in men's AIDS-related knowledge, sexual behavior, condom use, and perceived barriers to condom use were evaluated by self-reports obtained from a systematic sample of transport workers interviewed before and after intervention. In addition to men's self-reports, preintervention and postintervention data on men's sexual and condom use behavior were gathered from a sample of licensed, commercial sex workers, who cited transport workers as their primary source of clients. Significant increases in men's HIV-related knowledge, previous use of condoms (from 30.4% to 53.5%), and consistent condom use with regular sex partners were documented over the study period, as were significant declines in perceived barriers to condom use. Though men reported significantly fewer sexual encounters with casual and commercial partners at follow-up compared to baseline, these data were unreliable. Women's postintervention reports indicate that a greater proportion of clients (including, but not limited to transport workers) "always" agree to use condoms (p < .01) compared with baseline and that fewer men offer more money for unprotected sex (p < .01). However, women also report taking greater initiative in the mechanics of condom use (supplying the condom, putting it on, and taking it off) than they did prior to the intervention, and significantly (p < .05) fewer women think that most of their clients know how to use a condom. The findings indicate that the peer-mediated intervention had a positive impact on several important outcomes measured and suggest that HIV prevention efforts need to focus on male client groups despite the logistical and methodological challenges.

Perceived family support regarding condom use and condom use among secondary school female students in Limbe urban city of Cameroon.

PubMed

Tarkang, Elvis E

2014-02-18

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 more condom use at least once, than those who disagreed (X2 = 8.755; df = 3; p = 0.033). Significant associations between perceptions of family support for condom use and condom use were established in this study. This finding suggests that regardless of the sexual communication patterns within the family, techniques that increase the occurrence of parent and female student's discussion concerning condoms and HIV/AIDS will prove useful in preventing HIV/AIDS among female students in Limbe Urban City of Cameroon.

Engaging community businesses in human immunodeficiency virus prevention: a feasibility study.

PubMed

Rovniak, Liza S; Hovell, Melbourne F; Hofstetter, C Richard; Blumberg, Elaine J; Sipan, Carol L; Batista, Marcia F; Martinez-Donate, Ana P; Mulvihill, Mary M; Ayala, Guadalupe X

2010-01-01

To explore the feasibility of engaging community businesses in human immunodeficiency virus (HIV) prevention. Randomly selected business owners/managers were asked to display discreetly wrapped condoms and brochures, both of which were provided free-of-charge for 3 months. Assessments were conducted at baseline, mid-program, and post-program. Customer feedback was obtained through an online survey. Participants were selected from a San Diego, California neighborhood with a high rate of acquired immune deficiency syndrome. Fifty-one business owners/managers who represented 10 retail categories, and 52 customers. Participation rates, descriptive characteristics, number of condoms and brochures distributed, customer feedback, business owners'/managers' program satisfaction, and business owners'/managers' willingness to provide future support for HIV prevention were measured. Kruskal-Wallis, Mann-Whitney U, Fisher's exact, and McNemar's tests were used to analyze data. The 20 business owners/managers (39%) who agreed to distribute condoms and brochures reported fewer years in business and more employees than those who agreed only to distribute brochures (20%) or who refused to participate (41%; p < .05). Bars were the easiest of ten retail categories to recruit. Businesses with more employees and customers distributed more condoms and brochures (p < .05). More than 90% of customers supported distributing condoms and brochures in businesses, and 96% of business owners/managers described their program experience as positive. Businesses are willing to distribute condoms and brochures to prevent HIV. Policies to increase business participation in HIV prevention should be developed and tested.

Zaire program expands to cover high-risk groups in two cities.

PubMed

1989-01-01

This article announces the expansion of Zaire's social marketing program for condoms to high-risk groups in the cities of Goma and Matadi. The program will use proven marketing techniques from Kinshasha, printed materials, and direct marketing to retail outlets, emphasizing hotels, bars, and other areas frequented by prostitutes, migrants, and other travelers. In addition to retail outlets such as pharmacies, 50 taxis will be tested as additional retail sources for Prudence condoms. Once under way, this effort could reach as many as 96,000 people/day. 5 new AIDS information spots are being televised, and an anti-AIDS song and jingle are on the air. Condom social marketing representatives report a 357% increase in condom sales through March, 1989, over 1988, and that products are now available in 85% of Kinshasha pharmacies. Medical center coverage has increased to 14 from 9 zones, while products reach 11 additional cities and 5 interior provinces.

Predictors of consistent condom use among Chinese female sex workers: an application of the protection motivation theory.

PubMed

Zhang, Liying; Li, Xiaoming; Zhou, Yuejiao; Lin, Danhua; Su, Shaobing; Zhang, Chen; Stanton, Bonita

2015-01-01

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.

The Impact of Cultural Context on Brazilian Adolescents' Sexual Practices

ERIC Educational Resources Information Center

Levinson, Ruth Andrea; Sadigursky, Clesia; Erchak, Gerald M.

2004-01-01

AIDS prevention research has demonstrated that theoretically driven HIV prevention programs can be tailored to specific cultures. Further, condom self-efficacy and contraceptive self-efficacy scales have been tested in the U.S. and been shown to predict condom and contraceptive use. Results of condom and contraceptive self-efficacy studies have…

The effects of condom choice on self-reported condom use among men in Ghana, Kenya and South Africa: a randomized trial.

PubMed

Weaver, Mark A; Joanis, Carol; Toroitich-Ruto, Cathy; Parker, Warren; Gyamenah, Nana A; Rinaldi, Anne; Omungo, Zablon; Steiner, Markus J

2011-09-01

Male condoms are readily available and affordable in many settings, but risky sexual acts still go unprotected. This unblinded randomized trial, conducted in Ghana, Kenya and South Africa, was designed to assess the impact of providing a choice of condoms on self-reported use and uptake over 6 months. We enrolled 1,274 men. The mean subject-specific proportion of protected acts with all partners increased from baseline to 6 months by 0.07 in the control group compared to 0.03 in the choice group (p=.025). The observed results were largely consistent across all three countries. In the choice group, men clearly preferred one condom type over the others, and this preference was consistent across all three countries. Providing one type of male condom in public sector programs appears justified. Programs should not focus on the number of brands available, but should encourage effective promotion and consistent and correct use of available brands. Copyright © 2011 Elsevier Inc. All rights reserved.

The effect of exposure to a condom script on attitudes toward condoms.

PubMed

Kyes, K B; Brown, I S; Pollack, R H

1991-01-01

The effect of reading an erotic script that described condom placement on attitudes toward condom use was investigated in 102 male and 108 female US university students. It was hypothesized that, when integrated into an erotic script, condom use would become viewed as a pleasurable activity rather than just a means of avoiding pregnancy or disease. Controls received identical scripts except that the use of condoms was omitted or received no stories. Subjects who read the erotic accounts exhibited a positive change from pretest to posttest in attitudes toward condom use, but there was no difference in this outcome between condom story and no-condom erotic story conditions. In women, but not men, a high level of arousal induced by the script was associated with negative attitudes toward condoms, suggesting that males and females may require different reading materials. Given the finding, at least in women, of an inverse relationship between explicit eroticism/sexual arousal and condom attitude scores, a 2nd experiment involving less explicit stories written by college students was conducted. Here, 100 men and 100 women students received erotic stories that either featured or did not include condom use. Again, males who read stories incorporating condom placement held more positive attitudes toward condom use than same-sex controls, but women were not affected by the manipulation. For women, a positive attitude toward condom use was associated only with history of sexual activity. Helpful would be the preparation of erotic scripts that appeal to both sexes given the demonstrated effectiveness of this social learning technique with the male subjects in both experiments.

Two horses of a different color: CSM in Thailand and Colombia.

PubMed

1985-01-01

The Colombian Association for Family Welfare (PROFAMILIA) and Indonesia's Community Development Association (PDA) operate social marketing projects which might more appropriately be called social sales projects. Unlike other social marketing projects, these 2 projects seek profits from their contraceptive sales. The profits are then used to subsidize other programs operated by these 2 nonprofit organizations. Indonesia's PDA initiated its sales project in 1974. It operates both an urban contraceptive retail sales (CRS) program and a rural community-based distribution sales (CBD) program. The CRS program sells 3 types of condoms, which it delivers directly to the 1750 retailers involved in the program. The condoms sell for US$.03-US$.07, somewhat more than condoms sold in most social marketing projects. The CBD project covers 10,200 villages in 157 of Indonesia's 620 districts. Each village has a CBD volunteer who sells oral contraceptives (OCs) and condoms and also promotes family planning and rural development. The program sells Norinyl, Ovostat, and Eugynon for US$.19-US$.30/cycle. PDA runs other profit-making projects. For example, it sells promotional T-shirts and calendars at its vasectomy clinics and through its CBD program. PDA also established the taxable Population and Development Corporation, which engages in marketing activities. Profits from the corporation are channeled back to PDA. PROFAMILIA also operates both an urban sales program and a rural community-based distribution program. In the urban program, condoms are sold at normal retail prices and OCs at prices 30% below retail prices. The profits derived form the urban sales are used to subsidize the rural project. In 1981, the urban program began selling 6 noncontraceptive products, e.g., distilled water and disposable diapers. Currently, the program sells only distilled water, as the other products failed to yield a profit. A table provides sales information for both the PDA and PROFAMILIA programs.

Condom-associated erection problems: behavioural responses and attributions in young, heterosexual men

PubMed Central

Hill, Brandon J.; Sanders, Stephanie A.; Crosby, Richard A.; Ingelhart, Kara N.; Janssen, Erick

2015-01-01

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. Methods 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. Results 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. Conclusions 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. PMID:26166025

Engaging Community Businesses in HIV Prevention: A Feasibility Study

PubMed Central

Rovniak, Liza S.; Hovell, Melbourne F.; Hofstetter, C. Richard; Blumberg, Elaine J.; Sipan, Carol L.; Batista, Marcia F.; Martinez-Donate, Ana P.; Mulvihill, Mary M.; Ayala, Guadalupe X.

2009-01-01

Purpose To explore the feasibility of engaging community businesses in HIV prevention. Design Randomly selected business owners/managers were asked to display discreetly wrapped condoms and brochures provided free-of-charge for 3 months. Assessments were conducted at baseline, mid-, and post-program. Customer feedback was obtained through an online survey. Setting San Diego, California neighborhood with a high rate of AIDS. Subjects Fifty-one business owners/managers representing 10 retail categories, and 52 customers. Measures Participation rates, descriptive characteristics, number of condoms and brochures distributed, customer feedback, business owners'/managers' program satisfaction and willingness to provide future support for HIV prevention. Analysis Kruskal-Wallis, Mann-Whitney U, Fisher's exact, and McNemar's tests were used to analyze data. Results The 20 business owners/managers (39%) who agreed to distribute condoms and brochures reported fewer years in business and more employees than those who agreed only to distribute brochures (20%) or refused to participate (41%), p <.05. Bars were the easiest of ten retail categories to recruit. Businesses with more employees and customers distributed more condoms and brochures, p < .05. More than 90% of customers supported distributing condoms and brochures in businesses and 96% of business owners/managers described their program experience as “positive.” Conclusion Businesses are willing to distribute condoms and brochures to prevent HIV. Policies to increase business participation in HIV prevention should be developed and tested. PMID:20465150

Female Condom Skill and Attitude: Results from a NIDA Clinical Trials Network Gender-specific HIV Risk Reduction Study

PubMed Central

Campbell, Aimee N. C.; Tross, Susan; Hu, Mei-Chen; Pavlicova, Martina; Kenney, Jennifer; Nunes, Edward V.

2011-01-01

The female condom is effective in reducing unprotected sexual acts; however it remains underutilized in the U.S. This study examined whether a 5-session HIV prevention intervention (Safer Sex Skills Building (SSB)), including presentation, discussion, and practice with female condoms, improved female condom skills and attitude among women in outpatient substance abuse treatment. Mixed-effects modeling was used to test the effect of SSB on skills and attitude over 3- and 6-month post treatment among 515 randomized women. SSB was significantly associated with increases in skills and attitude, and the female condom demonstration session was primarily responsible for skills improvement. Attitude was a partial mediator of the intervention effect in reducing unprotected sex. Findings emphasize the utility of integrating female condom messages targeting proximal behavioral outcomes into HIV prevention. The study supports the use of female condom skill instruction via brief, hands-on exercises, as well as further research to enhance attitudinal change to reduce sexual risk. PMID:21861607

HIV/AIDS Prevention among the Male Population: Results of a Peer Education Program for Taxicab and Tricycle Drivers in the Philippines

ERIC Educational Resources Information Center

Morisky, Donald E.; Nguyen, Chrystene; Ang, Alfonso; Tiglao, Teodora V.

2005-01-01

This study assesses the results of a 2-year community-based peer education program aimed at increasing HIV/AIDS knowledge, attitudes toward condoms, and condom use behavior among taxicab and tricycle drivers in the Philippines. Pretest, posttest, and follow-up data were collected throughout the educational intervention program. The results of the…

[Attitudes and knowledge towards condom use among adolescents and young adults in Southern Italy].

PubMed

Starace, F; Minaci, F; Semmola, A; Nespoli, M; Palumbo, F

1997-06-01

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.

Examining the applicability of the IMB model in predicting condom use among sexually active secondary school students in Mbarara, Uganda

PubMed Central

Ybarra, Michele L.; Korchmaros, Josephine; Kiwanuka, Julius; Bangsberg, David R.; Bull, Sheana

2012-01-01

We tested the applicability of the IMB model in predicting condom use among sexually active secondary school students in Mbarara, Uganda. Three hundred and ninety adolescents across five secondary schools completed a self-report survey about their health and sexual experiences. Based upon results from structural equation modeling, the IMB model partially predicts condom use. Condom use was directly predicted by HIV prevention information and behavioral skills regarding having and using condoms. It was indirectly predicted (through behavioral skills regarding having and using condoms) by behavioral intentions regarding using condoms and talking to one‘s partner about safer sex. Aspects of one‘s first sexual experience (i.e., age at first sex, having discussed using condoms with first sex partner, willingness at first sex) are hugely influential of current condom use; this is especially true for discussing condoms with one‘s first partner. Findings highlight the importance of providing clear and comprehensive condom use training in HIV prevention programs aimed at Ugandan adolescents. They also underscore the importance of targeting abstinent youth before they become sexually active to positively affect their HIV preventive behavior at their first sexual experience. PMID:22350827

Variables influencing condom use in a cohort of gay and bisexual men.

PubMed

Valdiserri, R O; Lyter, D; Leviton, L C; Callahan, C M; Kingsley, L A; Rinaldo, C R

1988-07-01

Nine hundred fifty-five of 1,384 (69 per cent) gay and bisexual men enrolled in a prospective study of the natural history of human immunodeficiency virus (HIV) infection who reported engaging in anal intercourse in the past six months were surveyed about condom use practices for both insertive (IAI) and receptive anal intercourse (RAI). The following results were obtained: 23 per cent of the men reported that they always used condoms for IAI and 21 per cent for RAI; 32 per cent sometimes used condoms for IAI; 28 per cent sometimes used condoms for RAI; 45 per cent never used condoms for IAI; and 50 per cent never used condoms for RAI. Multiple logistic regression analysis revealed that the following variables were associated with both insertive and receptive condom use: condom acceptability; a history of multiple and/or anonymous partners in the past six months, and the number of partners with whom one is "high" (drugs/alcohol) during sex. Knowledge of positive HIV serostatus was more strongly associated with receptive than with insertive use. Condom use is a relatively complex health-related behavior, and condom promotion programs should not limit themselves to stressing the dangers of unprotected intercourse.

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.

PubMed

Ramanathan, Shreena; Deshpande, Sucheta; Gautam, Abhishek; Pardeshi, Dilip B; Ramakrishnan, Lakshmi; Goswami, Prabuddhagopal; Adhikary, Rajatashuvra; George, Bitra; Paranjape, Ramesh S; Mainkar, Mandar M

2014-08-03

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 behaviours with male sexual partners. Syphilis prevalence declined; however HIV prevalence did not change and is still a major concern. Continued strengthening of core programmatic strategies are needed to effectively improve condom use with all partner types and to help bring sustained reductions in HIV risk in HR-MSM/TG and its onward transmission.

Measuring the effectiveness of contraceptive marketing programs: Preethi in Sri Lanka.

PubMed

Davies, J; Louis, T D

1977-04-01

The Preethi marketing program resulted in sales of more than 11 million condoms during its first 33 months, multiplying Sri Lanka's annual per capita condom use by a factor of five. Estimates for 1974 show 144,000 new acceptors (8% of married women of reproductive age), totaling 50,000 couple-years of protection. It is also estimated that more than half of the nation's 1.8 million couples of childbearing age were educated about the function of a condom. Unit costs were low for this new, nationwide program: about US $2.00 for each new acceptor; 6.00 dollars for each couple-year of protection; and 0.09 dollars for each couple educated. The program's success suggests that a social marketing approach can advance family planning at a relatively low cost.

Preventing syndemic Zika virus, HIV/STIs and unintended pregnancy: dual method use and consistent condom use among Brazilian women in marital and civil unions.

PubMed

Tsuyuki, Kiyomi; Gipson, Jessica D; Barbosa, Regina Maria; Urada, Lianne A; Morisky, Donald E

2017-12-12

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.

Heavy Sexual Content Versus Safer Sex Content: A Content Analysis of the Entertainment Education Drama Shuga.

PubMed

Booker, Nancy Achieng'; Miller, Ann Neville; Ngure, Peter

2016-12-01

Extremely popular with Kenyan youth, the entertainment-education drama Shuga was designed with specific goals of promoting condom use, single versus multiple sexual partners, and destigmatization of HIV. Almost as soon as it aired, however, it generated controversy due to its extensive sexual themes and relatively explicit portrayal of sexual issues. To determine how safer sex, antistigma messages, and overall sexual content were integrated into Shuga, we conducted a content analysis. Results indicated that condom use and HIV destigmatization messages were frequently and clearly communicated. Negative consequences for risky sexual behavior were communicated over the course of the entire series. Messages about multiple concurrent partnerships were not evident. In addition, in terms of scenes per hour of programming, Shuga had 10.3 times the amount of sexual content overall, 8.2 times the amount of sexual talk, 17.8 times the amount of sexual behavior, and 9.4 times the amount of sexual intercourse as found in previous analysis of U.S. entertainment programming. Research is needed to determine how these factors may interact to influence adolescent viewers of entertainment education dramas.

“It’s a Different Condom, Let’s See How It Works”: Young Men’s Reactions to and Experiences of Female Condom Use During an Intervention Trial in South Africa

PubMed Central

Masvawure, Tsitsi B.; Mantell, Joanne E.; Mabude, Zonke; Ngoloyi, Claudia; Milford, Cecilia; Beksinska, Mags; Smit, Jennifer A.

2013-01-01

Although male partner cooperation is often essential for successful use of the female condom, only a few studies have directly assessed men’s experiences of using the device. We examined barriers to and facilitators of female condom use via qualitative in-depth interviews with 38 young men (18 to 28 years) in South Africa whose partners, all university students, were enrolled in a female condom intervention trial. In all, 21 men used the female condom; the remaining 17 did not attempt use. The main facilitators to female condom use were convenience of use for men, curiosity to see how female condoms compared to male condoms, enhanced sexual sensation, and perceptions of better safety and comfort of the device compared to male condoms. The main barriers were men’s limited familiarity with the device, insertion difficulties, and men’s concerns about loss of control over sexual encounters. We recommend that human immunodeficiency virus (HIV) prevention and condom promotion programs around the world target men directly for education on female condoms and that they also work with couples jointly around issues of safer-sex communication and negotiation. PMID:24053638

Determinants of demand for condoms to prevent HIV infections among barmaids and guesthouse workers in two districts, Tanzania.

PubMed

Mubyazi, Godfrey M; Exavery, Amon; Tenu, Filemoni; Massaga, Julius J; Rugemalila, Jovitha; Malebo, Hamisi M; Wiketye, Victor; Makundi, Emmanuel A; Ikingura, Joyce K; Mushi, Adiel K; Malekia, Sia E; Mziray, Abubakary; Ogondiek, John W; Kahwa, Amos; Kafuye, Mwanaidi M; Malecela, Mwelecele N

2015-11-02

Condoms are scientifically recommended as potential products for preventing infections attributable to human immuno-deficiency viruses (HIV). However, evidence on factors leading to their inadequate use in developing countries is still scanty. This paper reports an exploratory study of factors constraining condoms use in Tanzania from the perspectives of barmaids, guest-house workers and retailers. Data were collected in two districts-Mpwapwa in Dodoma Region and Mbeya Rural in Mbeya Region-between October and December 2011, using structured interviews with 238 individuals including barmaids, guesthouse workers and 145 retailers. Data analysis was performed using STATA 11 software. Awareness about condoms was high among all study groups. Male condoms were more popular and available than female ones. A considerable proportion of the barmaids and guesthouses were disappointed with condoms being promoted and distributed to young children and disliked condom use during sexual intercourse. Accessibility of condoms was reported as being lowered by condom prices, shortage of information concerning their availability; short supply of condoms; some people shying away to be watched by children or adult people while purchasing condoms; retailers' using bad languages to condom customers; occasionally condom shops/kiosks found closed when they are urgently needed; and prevailing social perception of condoms to have low/no protective efficacy. Regression analysis of data from barmaids and guesthouse-workers indicated variations in the degree of condom acceptability and methods used to promote condoms among respondents with different demographic characteristics. A combination of psychosocial and economic factors was found contributing to lower the demand for and actual use of condoms in study communities. Concerted measures for promoting condom use need to address the demand challenges and making operational research an integral element of monitoring and evaluation of the launched interventions, hence widening the evidence for informed policy decisions.

Beyond the Syndemic: Condom Negotiation and Use among Women Experiencing Partner Violence

PubMed Central

Peasant, Courtney; Sullivan, Tami P.; Weiss, Nicole H.; Martinez, Isabel; Meyer, Jaimie P.

2016-01-01

Background HIV and sexually transmitted infections (STIs) disproportionately affect women who experience intimate partner violence (IPV). Objective 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. Methods 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 significantly correlated, indicating a syndemic. Results 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]). Conclusions 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. PMID:27590004

Beyond the syndemic: condom negotiation and use among women experiencing partner violence.

PubMed

Peasant, Courtney; Sullivan, Tami P; Weiss, Nicole H; Martinez, Isabel; Meyer, Jaimie P

2017-04-01

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.

Social marketing in a rural African district.

PubMed

Kipp, W; Kabwa, P; Mwesigye, B

1992-01-01

21 focus group discussions were held in 5 locations of Kabarole district, Uganda, with 200 male and female participants to assess the demand for and acceptability of condoms in the region. The discussions were also held to obtain information related to the design of products and motivational materials, and included people believed to engage in high-risk sex, lower-risk members of the general population, and shop owners. Condoms and condom use are strongly desired within this population, with participants expressing interest in high-quality products of uniform size which are continuously available at convenient outlets. Moreover, shop and pharmacy owners were more than willing to display subtle messages about condoms and advertise their availability. The main barriers to use were low female acceptance, unavailability, societal attitudes, high cost, and the inability to buy condoms at night when shops are closed. Feedback led to the development of the logo of a man holding a spear and a shield and the adoption of the brand name Engabu, Rutooro terminology for a wooden shield. Comparatively stronger, yet sensitive, brown condoms were eventually packaged in dark brown wrappings in groups of 5. Vendors are offered the packets of 5 condoms for US$0.06, which they are expected t sell at US$0.08; owners expressed the preference for slot-box distribution containers. In addition, people in the sales network were all trained so they could explain proper condom use to clients. A post-study assessment found people content with the product and its presentation, so the social marketing program was officially launched in September, 1992. Condoms were sold heavily in the 1st few weeks of the program despite the lack of media and newspaper coverage per national government condom policy. Knowledge of the availability of condoms will instead be spread through counseling and health education sessions, seminars, and informal talks.

Effect of Couples Counselling on Reported HIV Risk Behaviour among HIV Serodiscordant Couples by ART Use, HIV Status and Gender in Rural Uganda

PubMed Central

King, Rachel; Min, Jeong; Birungi, Josephine; Nyonyintono, Maureen; Muldoon, Katherine A.; Khanakwa, Sarah; Kaleebu, Pontiano; Moore, David M.

2015-01-01

Background We examined several measures of self-reported HIV risk behaviour in mutually disclosed sero-discordant couples over time to see if a couples counselling intervention was associated with changes in these behaviors. Methods We analysed data from a prospective cohort study of HIV sero-discordant couples in Jinja, Uganda collected between June 2009 and December 2011. Participants received couples counselling, at 3-monthly intervals. We examined trends in reported condom-use, number of concurrent sexual partners, knowledge of HIV serostatus of concurrent partners and condom use of concurrent partners using Generalized Estimating Equation models, comparing responses at study enrollment with responses at six, 12 18 and 24 months of follow-up. Results A total of 586 couples were enrolled and the female member was HIV positive in 255 (44%) of them. The median age for female participants was 35 years and 42 years for men. Reported condom use at last sex with spouse increased over time (p<0.001) with the largest increases found among couples where the positive participant never received ART during the study(an increase from 68.8% at enrollment to 97.1% at 24 months). Male participants reported reductions in the number of concurrent sexual partners (p<0.001), increase in the knowledge of the HIV serostatus of these partners (p = 0.001) and a trend towards improved condom-use among non-primary partners (p = 0.070). Reported reduced risky behaviors did not wane over the study period. Conclusion Couples counselling resulted in increased condom use among all participants and among men the intervention resulted in reductions in risk behaviour with concurrent sexual partners. Routine counselling for serodiscordant couples should be integrated in routine ART care programs. PMID:26384103

Guatemala social marketing program.

PubMed

1987-01-01

The Guatemala Social Marketing Program reported 1986 increases after social marketing promotion in the sales of Panther and Scudo condoms, Perla oral contraceptives, and Lirio vaginal foaming tablets. Sale of Panther condoms was highest in February; all the other products peaked in June and July. Sales fell in December due to Christmas holidays. Sale patterns are illustrated graphically for all 4 products.

Reducing HIV Risk among Transgender Women in Thailand: A Quasi-Experimental Evaluation of the Sisters Program

PubMed Central

Pawa, Duangta; Firestone, Rebecca; Ratchasi, Sindh; Dowling, Olivia; Jittakoat, Yaowalak; Duke, Alex; Mundy, Gary

2013-01-01

Transgender women are particularly at risk of HIV infection, but little evidence exists on effective HIV prevention strategies with this population. We evaluated whether Sisters, a peer-led program for transgender women, could reduce HIV risks in Pattaya, Thailand. The study used time-location sampling to recruit 308 transgender women in Pattaya into a behavioral survey in 2011. Coarsened exact matching was used to create statistically equivalent groups of program participants and non-participants, based on factors influencing likelihood of program participation. Using multivariable logistic regression, we estimated effects of any program participation and participation by delivery channel on: condom use at last sex; consistent condom and condom/water-based lubricant use in the past 3 months with commercial, casual, and regular partners; and receipt of HIV testing in the past 6 months. Program coverage reached 75% of the population. In a matched sub-sample (n = 238), participation in outreach was associated with consistent condom/water-based lubricant use with commercial partners (AOR 3.22, 95% CI 1.64–6.31). Attendance at the Sisters drop-in center was associated with receiving an HIV test (AOR 2.58, 95% CI 1.47–4.52). Dedicated transgender-friendly programs are effective at reducing HIV risks and require expansion to better serve this key population and improve HIV prevention strategies. PMID:24204750

Social and structural factors increase inconsistent condom use by sex workers' one-time and regular clients in Northern Uganda.

PubMed

Duff, Putu; Birungi, Josephine; Dobrer, Sabina; Akello, Monika; Muzaaya, Godfrey; Shannon, Kate

2018-06-01

While sex workers (SWs) bear the brunt of the epidemic in Uganda, there remains a dearth of empirical research on the structural drivers of HIV prevention among SWs. This study examined the drivers of inconsistent condom use by one-time and regular clients of young women SWs in Gulu, Northern Uganda. Data were drawn from the Gulu Sexual Health Study, a cross-sectional study of young SWs, aged 14 years and older (2011-2012). SWs were recruited using peer/SW-led outreach, in partnership with The AIDS Support Organization and other CBOs. Multivariable logistic regression was used to examine the correlates of inconsistent condom use by one-time and regular clients. In total, 84.5% of the 381 SWs servicing regular clients and 76.8% of the 393 SWs servicing one-time clients reported inconsistent client condom use. In multivariable analysis, physical/sexual violence by clients (AOR = 5.39; 95%CI 3.05-9.49), low sexual control by workers (measured by the validated Pulweritz scale) (AOR = 2.86; 95%CI 1.47-5.58), alcohol/drug use while working (AOR = 1.98; 95%CI 1.17-3.35) and migration to Gulu for sex work (AOR = 1.73; 95%CI 0.95-3.14) were positively correlated with inconsistent condom use by one-time clients. Correlates of inconsistent condom use by regular clients included: low sexual control by workers (AOR = 4.63; 95%CI 2.32-9.23); physical/sexual violence by clients (AOR = 3.48; 95%CI 1.85-6.53); police harassment (AOR = 2.57; 95%CI 1.17-5.65); and being a single mother (AOR = 2.07; 95%CI 1.09-3.93). Structural and interpersonal factors strongly influence inconsistent condom use by clients, with violence by clients and police, low sexual control by workers, migration and single-parenthood all linked to non-condom use. There is a need for peer-led structural interventions that improve access to occupational health and safety standards (e.g., violence prevention and alcohol/drug harm reduction policies/programming). Shifts away from the current punitive approaches towards SWs are integral to the success of such interventions, as they continue to undermine HIV prevention efforts.

USING THE THEORY OF PLANNED BEHAVIOR TO DETERMINE THE CONDOM USE BEHAVIOR AMONG COLLEGE STUDENTS

PubMed Central

Asare, Matthew

2015-01-01

The study utilized the Theory of Planned Behavior (TPB) to determine condom use behavior among college students. A total of 218 college students with mean age of 20.9 years old participated in the study. A 32- item cross-sectional survey was administered among the participants. The constructs of attitude towards behavior, perceived behavioral control, and subjective norm (p<0.001) significantly predicted intention to use condoms and they accounted for 64% of the variance. Behavioral intention significantly predicted condom use and it accounted for 15% of the variance. The TPB could be used to guide programs in promoting condom use among college students. PMID:26512197

Condom use peer norms and self-efficacy as mediators between community engagement and condom use among Chinese men who have sex with men.

PubMed

Li, Haochu; Xue, Li; Tucker, Joseph D; Wei, Chongyi; Durvasula, Maya; Hu, Wenqi; Kang, Dianming; Liao, Meizhen; Tang, Weiming; Ma, Wei

2017-08-07

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.

"Being faithful" in a sexual relationship: perceptions of Tanzanian adolescents in the context of HIV and pregnancy prevention.

PubMed

Baumgartner, Joy Noel; Lugina, Helen; Johnson, Laura; Nyamhanga, Tumaini

2010-09-01

Little is known about what adolescents think about faithfulness and partner reduction for HIV prevention (the "B" in the ABC HIV prevention behavior change strategy), including how they understand its implementation within relationships. In addition, because adolescents face the twin threats of HIV and unintended pregnancy, it is important to understand how adolescents may integrate their thinking on pregnancy prevention if they are using faithfulness or partner reduction as their HIV prevention strategy. This study gathered evidence by conducting 20 focus group discussions (FGDs) with 158 adolescents, aged 14-20. The FGDs were stratified by sex, age, current school attendance, rural or urban residence, and marital status. Results showed that the vast majority of groups felt that "B" messages are important and relevant for unmarried (as well as married) youth to hear for HIV prevention, but the messages need to be explicit (e.g., "being faithful means having only one tested sexual partner at a time"). Faithful relationships are perceived as ideal in terms of romantic expectations and HIV prevention, but were considered unrealistic if the relationship had a power imbalance. Adolescents acknowledged the risks of multiple partners and a few recognized that concurrent partnerships are riskier than serial partnerships. Condoms were given as the primary method for pregnancy prevention among youth, yet faithfulness was usually seen as precluding condom use and many youth considered condom use as evidence of a lack of faithfulness. Overall, adolescents recognized that practicing fidelity is complex. Young people need life skills education for how to establish and maintain faithful relationships with one tested partner and how to integrate condom use for pregnancy prevention within that relationship. Programs also need to more explicitly address the issues of trust and repeat HIV testing within "faithful" relationships which is an uncomfortable but necessary reality for many adolescents.

Safer choices: reducing teen pregnancy, HIV, and STDs.

PubMed Central

Coyle, K.; Basen-Engquist, K.; Kirby, D.; Parcel, G.; Banspach, S.; Collins, J.; Baumler, E.; Carvajal, S.; Harrist, R.

2001-01-01

OBJECTIVES: This study evaluated the long-term effectiveness of Safer Choices, a theory-based, multi-component educational program designed to reduce sexual risk behaviors and increase protective behaviors in preventing HIV, other STDs, and pregnancy among high school students. METHODS: The study used a randomized controlled trial involving 20 high schools in California and Texas. A cohort of 3869 ninth-grade students was tracked for 31 months from fall semester 1993 (baseline) to spring semester 1996 (31-month follow-up). Data were collected using self-report surveys administered by trained data collectors. Response rate at 31-month follow-up was 79%. RESULTS: Safer Choices had its greatest effect on measures involving condom use. The program reduced the frequency of intercourse without a condom during the three months prior to the survey, reduced the number of sexual partners with whom students had intercourse without a condom, and increased use of condoms and other protection against pregnancy at last intercourse. Safer Choices also improved 7 of 13 psychosocial variables, many related to condom use, but did not have a significant effect upon rates of sexual initiation. CONCLUSIONS: The Safer Choices program was effective in reducing important risk behaviors for HIV, other STDs, and pregnancy and in enhancing most psychosocial determinants of such behavior. PMID:11889277

Use of spermicide and impact of prophylactic condom use among sex workers in Santa Fe de Bogota, Colombia.

PubMed

Farr, G; Acosta Castro, L A; DiSantostefano, R; Claassen, E; Olguin, F

1996-01-01

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 condom. However, these same women usually used the study spermicide as an alternate prophylaxis.

Female condom becomes available nationwide.

PubMed

1995-01-01

Between May 1993 and August 1994, only family planning and sexually transmitted disease (STD) clinics had the female condom available. The manufacturer is using a print and educational campaign to market the female condom. The print campaigns provide a toll-free number for consumers and health care providers. The educational component consists of community outreach programs for public health, family planning clinics, and university health centers. The single-use soft polyurethane sheath has a flexible ring at the closed end, which is used to insert the condom and holds it over the cervix. A flexible ring is at the outer end; it holds the condom over the labia. The female condom is prelubricated and comes with a bottle of lubricant. Adding extra lubricant on the penis or the inside of the condom can prevent invagination of the outer ring, the penis entering the vagina instead of the condom, or the condom riding the penis. The 1-year failure rate is 25% for average use and 5.1% for perfect use. Correct and consistent use determines the female condom's ability to protect against STDs and HIV. The female condom helps women protect themselves against pregnancy and STDs/HIV when their male partner refuses to use a latex condom. Since it is visible outside the vagina, some women might still find it difficult to negotiate its use. Drawbacks of the female condom are that it is cumbersome and challenges our traditional gender roles and ideas about sexuality. Education addressing how women feel about themselves, their sexuality, and their relationships is needed to increase female condom use and acceptance. Some couples prefer the female condom over the male condom because it is roomier and because the polyurethane creates a better sensation than latex.

Condom-Insistence Conflict in Women’s Alcohol-Involved Sexual Encounters with a New Male Partner

PubMed Central

Bryan, Amanda E. B.; Norris, Jeanette; Abdallah, Devon Alisa; Zawacki, Tina; Morrison, Diane M.; George, William H.; Davis, Kelly C.; Danube, Cinnamon L.; Stappenbeck, Cynthia A.

2017-01-01

First-time sexual intercourse with a new male partner, relative to other sexual encounters, is associated with heightened risk to women for contracting sexually transmitted infections. Little is known, however, about women’s condom-related decision-making processes during these first-time sexual encounters. In the present study, we surveyed a community sample of 179 women aged 18–30 about their alcohol consumption, desire to use a condom, perception of their partner’s desire to use a condom, condom-insistence conflict, and condom-decision abdication and use during their most recent alcohol-involved first-time sexual encounter with a new partner. With structural equation modeling we tested a cognitive mediation model with various configurations of alcohol effects on abdication and condom use (direct, indirect, moderator). A moderated mediation model fit the data best. Women experienced elevated condom-insistence conflict when they wanted to use a condom and perceived their partner did not; conflict, in turn, was associated with higher likelihood of abdication and lower likelihood of condom use. Higher alcohol intoxication attenuated the associations of desire to use a condom, and perceived partner’s desire to use a condom, with conflict. Results support an alcohol myopia-conflict inhibition-reduction model and emphasize the importance of sex education programs that teach young women not only about condom-related assertiveness and the effects of alcohol, but also prepare them to respond to experiences of conflict that arise during sexual encounters. PMID:29720782

The potential impact and cost of focusing HIV prevention on young women and men: A modeling analysis in western Kenya.

PubMed

Alsallaq, Ramzi A; Buttolph, Jasmine; Cleland, Charles M; Hallett, Timothy; Inwani, Irene; Agot, Kawango; Kurth, Ann E

2017-01-01

We compared the impact and costs of HIV prevention strategies focusing on youth (15-24 year-old persons) versus on adults (15+ year-old persons), in a high-HIV burden context of a large generalized epidemic. Compartmental age-structured mathematical model of HIV transmission in Nyanza, Kenya. The interventions focused on youth were high coverage HIV testing (80% of youth), treatment at diagnosis (TasP, i.e., immediate start of antiretroviral therapy [ART]) and 10% increased condom usage for HIV-positive diagnosed youth, male circumcision for HIV-negative young men, pre-exposure prophylaxis (PrEP) for high-risk HIV-negative females (ages 20-24 years), and cash transfer for in-school HIV-negative girls (ages 15-19 years). Permutations of these were compared to adult-focused HIV testing coverage with condoms and TasP. The youth-focused strategy with ART treatment at diagnosis and condom use without adding interventions for HIV-negative youth performed better than the adult-focused strategy with adult testing reaching 50-60% coverage and TasP/condoms. Over the long term, the youth-focused strategy approached the performance of 70% adult testing and TasP/condoms. When high coverage male circumcision also is added to the youth-focused strategy, the combined intervention outperformed the adult-focused strategy with 70% testing, for at least 35 years by averting 94,000 more infections, averting 5.0 million more disability-adjusted life years (DALYs), and saving US$46.0 million over this period. The addition of prevention interventions beyond circumcision to the youth-focused strategy would be more beneficial if HIV care costs are high, or when program delivery costs are relatively high for programs encompassing HIV testing coverage exceeding 70%, TasP and condoms to HIV-infected adults compared to combination prevention programs among youth. For at least the next three decades, focusing in high burden settings on high coverage HIV testing, ART treatment upon diagnosis, condoms and male circumcision among youth may outperform adult-focused ART treatment upon diagnosis programs, unless the adult testing coverage in these programs reaches very high levels (>70% of all adults reached) at similar program costs. Our results indicate the potential importance of age-targeting for HIV prevention in the current era of 'test and start, ending AIDS' goals to ameliorate the HIV epidemic globally.

Understanding Female Condom Use and Negotiation Among Young Women in Cape Town, South Africa.

PubMed

Martin, Julia; de Lora, Patsy; Rochat, Roger; Andes, Karen L

2016-03-01

In most countries, female condoms are not widely available and uptake has been slow. More information is needed on how women and men successfully negotiate female condom use. In-depth interviews were conducted at two sites in Cape Town, South Africa, with 14 women and 13 men who had used female condoms. A structured interview guide was used to elicit information on how women negotiate female condom use, and how male partners negotiate or respond to negotiations of female condom use. Thematic analysis was used to identify key patterns in the data. Participants reported that female condoms are easier for women to negotiate than male condoms, largely because the method is understood to be under a woman's control. The main barrier to use was lack of familiarity with the method; strong negative reactions from partners were not a major barrier. Personal comfort and tensions with partners usually improved after first use. Some male respondents preferred the method because it shifts responsibility for condom use from men to women. Findings suggest that female condoms empower women to initiate barrier method use, and that programs designed to educate potential users about female condoms and familiarize them with the method may be useful. That some men preferred female condoms because they wanted women to take responsibility for condom use is cause for concern, and suggests that counseling efforts should be directed toward men as well as women, and should include a discussion of gender dynamics and responsibility that emphasizes condom use as a choice that couples make together.

Condom social marketing program to prevent HIV/AIDS in post-conflict Liberia.

PubMed

Harris, A O; Jubwe, S; Kennedy, S B; Taylor, C H; Martin, R B; Bee, E M; Perry, O S; Massaquoi, M T; Woods, D V; Barbu, E M

2011-08-01

Youths in sub-Saharan Africa (SSA) account for a large burden of the global HIV/STI crises. As such, strategies directed at promoting behavioral modifications would be critical to reducing the prevalence of risky sexual behaviors among high risk adolescents in post-conflict environments. This study describes a condom promotion strategy to prevent HIV/STIs among highly vulnerable urban youth in a post-conflict, resource-constrained environment via the provision of both male and female condoms to nontraditional venues like music and photo shops, ice cream parlors, money exchange centers and beauty salons. Community members in the designated catchment areas volunteered their services and the use of their small businesses to support this endeavor. In this paper, we describe the condom promotion strategy and its implications within the context of a community-based participatory social marketing program to prevent risky sexual behaviors among highly vulnerable urban youth in a post-conflict country. We postulate that this approach may likely increase condom use among urban youth in Monrovia, the capital city of Liberia.

Prevention as policy: how Thailand reduced STD and HIV transmission.

PubMed

Hanenberg, R; Rojanapithayakorn, W

1996-05-01

In 1989, in response to growing HIV seroprevalences among intravenous drug users and low-fee commercial sex workers in northern Chiang Mai, the Government of Thailand launched a massive expansion of its HIV/AIDS Prevention and Control Program. The most ambitious, innovative aspect of this effort was the 100% Condom Program established in 1991 to enforce universal condom use in all commercial sex establishments. Every sex worker is presented with a box of 100 condoms or more when she reports for a regular sexually transmitted disease (STD) checkup at a government clinic. When health officials visit commercial sex establishments, they take along boxes of condoms. Strong pressure, often from the police, is placed on brothel owners who fail to support the campaign. By 1994, over 90% of commercial sex acts were protected by condoms and the number of men presenting to government clinics for STD treatment dropped by 90% from 1989 to 1995. Moreover, the number of commercial sex workers has declined by 25% since 1989. Models of the AIDS epidemic indicate that Thai health authorities should continue to focus on commercial sex for the control of HIV.

Sri Lanka drops leading condom.

PubMed

1984-01-01

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. Panther sales increased from, 38,000 condoms in the 1st quarter of 1983 to 462,000 in the same period of 1984. The project is intensifying its market coverage by increasing the number of sales divisions from 5 to 7 to help maintain sales momentum for the new product.

Uganda: condoms provoke an AIDS storm.

PubMed

Tebere, R

1991-03-01

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.

Quasi-experimental evaluation of a national primary school HIV intervention in Kenya.

PubMed

Maticka-Tyndale, Eleanor; Wildish, Janet; Gichuru, Mary

2007-05-01

This study examined the impact of a primary-school HIV education initiative on the knowledge, self-efficacy and sexual and condom use activities of upper primary-school pupils in Kenya. A quasi-experimental mixed qualitative-quantitative pre- and 18-month post-design using 40 intervention and 40 matched control schools demonstrated significant program impact on targeted objectives of (1) adequate program delivery and, for standard 6 and 7 pupils (ages 11-16 years), (2) increased HIV-related knowledge; (3) increased communication with parents and teachers about HIV and sexuality; (4) increased assistance to fellow pupils to avoid sexual activity; (5) increased self-efficacy related to abstinence and condom use; (6) decreased exposure to HIV through delayed first intercourse, decreased sexual activity and increased condom. Results support the conclusions that the existing infrastructure is adequate for national roll-out of the program; that the program has its most beneficial effect on sexually inexperienced youth and should therefore be implemented with the youngest age groups possible; and that gains are gender specific, with boys reporting increased condom use while girls are more likely to decrease or delay sexual activity. Based on these results, the program began national roll-out to all primary schools in 2005. By June 2006, the program was operating in 11,000 of the country's nearly 19,000 schools.

Social marketing of condoms (female, too) gets going (again). Zimbabwe.

PubMed

Winter, J

1997-04-01

More than 10% of Zimbabwe's population is thought to be infected with HIV. Protector condoms, marketed by Johnson and Johnson (Zimbabwe), have been available in Zimbabwe for several years, but supplies often ran out due to contractual difficulties with the US Agency for International Development (USAID). Population Services International (PSI), with the financial support of Britain's Overseas Development Administration (ODA) and USAID, has relaunched the condom social marketing program in Zimbabwe and will also introduce female condoms for the first time in May. Selling for about Z$1 (US$0.09) each, the subsidized male condoms will be marketed in places where the public sector cannot go, such as gas stations, supermarkets, convenience grocery stores in high-density suburbs, beer halls, and night clubs. Approximately 5 million condoms are expected to be sold in 1997, although most condoms will still be supplied free of charge through the public sector. The female condoms will be priced at Z$3 each. PSI hopes to sell 40,000 per year, while another 400,000 will be given away in hospitals, family planning clinics, and other public health services.

Heterosexual men's attitudes toward the female condom.

PubMed

Seal, D W; Ehrhardt, A A

1999-04-01

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.

HIV/AIDS Prevention Among the Male Population: Results of a Peer Education Program for Taxicab and Tricycle Drivers in the Philippines

PubMed Central

Morisky, Donald E.; Nguyen, Chrystene; Ang, Alfonso; Tiglao, Teodora V.

2011-01-01

This study assesses the results of a 2-year community-based peer education program aimed at increasing HIV/AIDS knowledge, attitudes toward condoms, and condom use behavior among taxicab and tricycle drivers in the Philippines. Pretest, posttest, and follow-up data were collected throughout the educational intervention program. The results of the repeated measures analysis of variance (ANOVA) indicate a significant change on knowledge about HIV/AIDS from baseline to posttest and from posttest to follow-up (F = 449.27, df = 2, p < .001). There was also a significant change on attitudes about condom use from baseline to posttest and from posttest to follow-up (F = 425.19, df = 2, p = 0.001), and a significant effect on condom use behavior with commercial sex workers from baseline to posttest and follow-up (F = 428.31, df = 2, p = .001). The peer-mediated intervention was found to be an effective means of HIV/AIDS prevention among taxi and tricycle drivers in the Philippines. PMID:15642754

Country watch: Pakistan.

PubMed

Toll, K; Agha, S

1999-01-01

In Pakistan, which has a high fertility rate, affordable prices of condoms and family planning services attract low-income residents. This was shown by the two projects: the condom distribution scheme and the family planning franchise. A condom social marketing (CSM) program started by Population Services International (PSI) increased contraceptive use in urban areas and sold low-priced condoms. However, in 1991 the price doubled in order to recover the costs, which resulted in a decline in sales. Thus, in 1995 PSI and Social Marketing Pakistan franchised the Green Star project that aimed to raise the quality of private sector family planning clinics serving low-income women and to increase the availability and use of female-controlled contraception. By 1996, the CSM project was selling over 80 million condoms annually.

Predictors of sexual risk behaviors among adolescent mothers in a human immunodeficiency virus prevention program.

PubMed

Koniak-Griffin, Deborah; Stein, Judith A

2006-03-01

The purpose of this study was to determine the following: (1) whether adolescent mothers in a human immunodeficiency virus (HIV) prevention program had significantly greater perceived self-efficacy and perceived behavioral control to use condoms, and more favorable outcome expectancies and subjective norms regarding condom use than those in a health education control group, 3 months after intervention; and (2) the impact of the 3-month postintervention theoretical variables on intentions to use condoms at 3 months and sexual risk behaviors at 6 months. Structural equation modeling with latent variables was used to assess the influence of theoretical variables and treatment condition using data from 496 participants (78% Latinas, 18% African-Americans) who completed questionnaires at baseline and at 3- and 6-month follow-up evaluations. Substantial improvements were shown by both groups, with a slight advantage for the HIV prevention group, on all theoretical variables between pretest and the follow-up evaluations. In the predictive model, the intervention group reported significantly fewer sex partners. By using intentions to use condoms as a mediator, greater self-efficacy, hedonistic beliefs, positive subjective norms, and less unprotected sex predicted intentions to use condoms, which, in turn, predicted less unprotected sex. Lower subjective norms modestly predicted multiple partners. Significant indirect paths mediated through intentions to use condoms were observed. These data support a relationship among several constructs from social cognitive theory and the theory of reasoned action, and subsequent sexual risk behaviors. HIV-prevention programs for adolescent mothers should be designed to include these theoretical constructs and to address contextual factors influencing their lives.

Bridges crossed yesterday, peaks to be conquered tomorrow. AIDS and the condom.

PubMed

Mouli, V C

1992-07-01

The experiences of the condom promotion campaign in Zambia are recounted since AIDS public education began in 1987. The initial challenges were to make condoms an acceptable option, to legitimize public promotion, to expand access, to obtain the highest level approval, and to avoid offending the religious community. The 1st major publication was the production of a booklet on AIDS information for secondary school students, which advocated abstinence before marriage and condom use for those already sexually active. A public debate ensued. A truce was reached in December 1989, and religious groups withdrew their attacks on the promotion of condoms by health workers, continued their encouragement of condom use within their congregations. The Ministry of Health also received the endorsement from top political leadership, and a public campaign was launched. Posters and leaflets were distributed to high risk groups and in bars and taverns through Ministry of Health workers and National AIDS Prevention and Control Program (NAPSP) workers. Access through hospitals and clinics was improved and a knowledge, attitudes, and practices survey was conducted in September 1990. A brochure about what health workers should know about condoms was and continues to be distributed to health personnel. By 1990 it became clear that the subject of condoms was no longer taboo, e.g., the leading national daily newspaper ran articles based on 2 booklets about AIDS and sexually transmitted diseases without a public outcry. Mistakes can be made, however. In another African country in 1991, a newspaper printed the message that the Bible saves souls and the condom saves people and the religious community vehemently protested. Another survey in May 1990 produced findings from 10 focus groups which identified the association between condom use and promiscuity. The challenges ahead are to promote condom use for effective AIDS and sexually transmitted disease prevention and to link use with responsibility and manliness, and users with sensible and responsible people. Public access needs to be improved. Programs need to be planned carefully, implemented effectively, and evaluated honestly.

Relationship of condom strength to failure during use.

PubMed

1980-10-01

Less-than-ideal environmental conditions, especially in developing countries with tropical or desert climates, prolonged storage times because of unpredictable supply and distribution, and inexperience with warehousing and logistics causing haphazard turnover of stocks can accelerate deterioration of condoms and render them unsuitable for use. As condom strength standards have never been related directly to failure during use, a Program for the Introduction and Adaptation of Contraceptive Technology (PIACT) study, in collaboration with Planned Parenthood of Seattle-King County, Washington, was conducted to determine the actual relationship between condom strength and failure during use (see July 1980 issue of Contraception). The study found that: 1) air burst test parameters can effectively and sensitively measure changes in condom strength; 2) condoms produced by Western industrial standards exceed by a wide margin the minimum strength required for effective use; and 3) stored condoms should not necessarily be thrown out if they are uniform in strength, even though they fall below accepted standards for new condoms. The study also brought out the issue of condom packaging. The potent deteriorating effect of ultraviolet light on condoms is well-known, and it is therefore suggested that condoms be packaged in foil or opaque laminates on both sides. A separate study requested by the U.S. Agency for International Development investigating the relationship between the 2 tests for condom strength (air burst standards as used in the PIACT study and tensile strength measurements) showed that air burst data and tensile strength parameters closely reflected the same characteristics, thus providing support for the use of air burst strength measurements for predicting useful life of stored condoms.

Assessing effects of a media campaign on HIV/AIDS awareness and prevention in Nigeria: results from the VISION Project.

PubMed

Keating, Joseph; Meekers, Dominique; Adewuyi, Alfred

2006-05-03

In response to the growing HIV epidemic in Nigeria, the U.S. Agency for International Development (USAID) initiated the VISION Project, which aimed to increase use of family planning, child survival, and HIV/AIDS services. The VISION Project used a mass-media campaign that focused on reproductive health and HIV/AIDS prevention. This paper assesses to what extent program exposure translates into increased awareness and prevention of HIV/AIDS. This analysis is based on data from the 2002 and 2004 Nigeria (Bauchi, Enugu, and Oyo) Family Planning and Reproductive Health Surveys, which were conducted among adults living in the VISION Project areas. To correct for endogeneity, two-stage logistic regression is used to investigate the effect of program exposure on 1) discussion of HIV/AIDS with a partner, 2) awareness that consistent condom use reduces HIV risk, and 3) condom use at last intercourse. Exposure to the VISION mass media campaign was high: 59%, 47%, and 24% were exposed to at least 1 VISION radio, printed advertisement, or TV program about reproductive health, respectively. The differences in outcome variables between 2002 baseline data and the 2004 follow-up data were small. However, those with high program exposure were almost one and a half (Odds Ratio [O.R.] = 1.47, 95% Confidence Interval [C.I.] 1.01-2.16) times more likely than those with no exposure to have discussed HIV/AIDS with a partner. Those with high program exposure were over twice (O.R. = 2.20, C.I. 1.49-3.25) as likely as those with low exposure to know that condom use can reduce risk of HIV infection. Program exposure had no effect on condom use at last sex. The VISION Project reached a large portion of the population and exposure to mass media programs about reproductive health and HIV prevention topics can help increase HIV/AIDS awareness. Programs that target rural populations, females, and unmarried individuals, and disseminate information on where to obtain condoms, are needed to reduce barriers to condom use. Improvements in HIV/AIDS prevention behaviour are likely to require that these programmatic efforts be continued, scaled up, done in conjunction with other interventions, and targeted towards individuals with specific socio-demographic characteristics.

21 CFR 801.435 - User labeling for latex condoms.

Code of Federal Regulations, 2014 CFR

2014-04-01

... this section. If the data from tests following real time storage described in paragraph (d)(3) of this... data based upon real time storage and testing and have such storage and testing data available for... products are formed from latex films. (b) Data show that the material integrity of latex condoms degrade...

21 CFR 801.435 - User labeling for latex condoms.

Code of Federal Regulations, 2011 CFR

2011-04-01

... this section. If the data from tests following real time storage described in paragraph (d)(3) of this... data based upon real time storage and testing and have such storage and testing data available for... products are formed from latex films. (b) Data show that the material integrity of latex condoms degrade...

21 CFR 801.435 - User labeling for latex condoms.

Code of Federal Regulations, 2012 CFR

2012-04-01

... this section. If the data from tests following real time storage described in paragraph (d)(3) of this... data based upon real time storage and testing and have such storage and testing data available for... products are formed from latex films. (b) Data show that the material integrity of latex condoms degrade...

21 CFR 801.435 - User labeling for latex condoms.

Code of Federal Regulations, 2013 CFR

2013-04-01

... this section. If the data from tests following real time storage described in paragraph (d)(3) of this... data based upon real time storage and testing and have such storage and testing data available for... products are formed from latex films. (b) Data show that the material integrity of latex condoms degrade...

Preventing HIV transmission in Chinese internal migrants: a behavioral approach.

PubMed

Liu, Xiaona; Erasmus, Vicki; Sun, Xinying; Cai, Rui; Shi, Yuhui; Richardus, Jan Hendrik

2014-01-01

This study is a step towards a behavioral intervention to prevent HIV transmission among Chinese internal migrants. To explore important and changeable determinants of condom use and inspect effective and feasible methods to increase condom use for the target population, we conducted a three-round web-based Delphi study among a panel of 62 experts between October 2012 and March 2013. The panelists were purposely selected using a stepwise procedure to represent topic-related areas of expertise. The response rate per round ranges from 21% to 81%. The panelists identified 19 possible determinants of condom use and reported 16 intervention methods they considered successful. They agreed that attitude towards condom use was the most important and changeable determinant, while applying behavioral theory, increasing sexual education and condom access, performing worksite health promotion, detecting risk factors, and working closely with relevant organizations and the government were effective and feasible methods to increase condom use among internal migrants in China. In conclusion, results of this study highlight the importance of attitude in changing condom use and underscore the need to apply behavior theory and integrate multiple educational approaches for developing behavioral HIV prevention interventions targeting internal migrants in China.

Condom Use With a Casual Partner: What Distinguishes College Students' Use When Intoxicated?

PubMed Central

Abbey, Antonia; Parkhill, Michele R.; Buck, Philip O.; Saenz, Christopher

2015-01-01

Determining alcohol's precise role in sexual risk taking has proven to be an elusive goal. Past research has produced mixed results, depending on characteristics of individuals, their partners, and the situation, as well as how the link between alcohol consumption and sexual behavior was assessed. In this study, cross-sectional predictors of the frequency of condom use were examined for 298 heterosexual college students at a large urban university. In hierarchical multiple regression analyses that controlled for frequency of condom use when sober, alcohol expectancies regarding sexual risk taking and self-efficacy regarding condom use when intoxicated were significant predictors of frequency of condom use when intoxicated. These findings highlight the importance of targeting beliefs about alcohol's disinhibiting effects in STD- and HIV-prevention programs. PMID:17385957

Understanding the Relationship Between Female Sex Workers and Their Intimate Partners: Lessons and Initial Findings From Participatory Research in North Karnataka, South India.

PubMed

Bhattacharjee, Parinita; Campbell, Linda; Thalinja, Raghavendra; Nair, Sapna; Doddamane, Mahesh; Ramanaik, Satyanarayana; Isac, Shajy; Beattie, Tara S

2018-04-01

While traditional HIV prevention programs with female sex workers (FSWs) in Karnataka, India, have focused on reducing HIV transmission between FSWs and clients through increased condom use, these programs have not fully addressed the transmission risk between FSWs and their nonpaying intimate partners (IPs). Condom use is infrequent and violence is recurrent in these relationships: Furthermore, there is little evidence on the precise nature of FSW-IP relationships. Our study addresses this knowledge gap to inform HIV programs targeted at FSWs. A series of workshops, using participatory tools, was held to explore FSW-IP relationships; 31 FSWs and 37 IPs participated. Three aspects of FSW-IP relationships were examined: how FSWs and IPs understand and interpret their relationships, factors influencing condom use, and the role of violence and its consequences. FSWs wish to be perceived as their IPs' wives, while IPs expect their FSW partners to accept their dominance in the relationship. Nonuse of condoms signals fidelity and elevates the status of the relationship almost to that of marriage, which helps FSWs enter the category of "good" (married) women. Tolerating and accepting violence in these relationships is normative, as in other marital relationships; IPs justify violence as necessary to establish and maintain their power within the relationship. Both FSWs and IPs value their relationships despite the high degree of risk posed by low condom use and high levels of violence. Implications for program design include addressing current norms around masculinity and gender roles, and improving communication within relationships.

Contextual influences on safer sex negotiation among female sex workers (FSWs) in Hong Kong: the role of non-governmental organizations (NGOs), FSWs' managers, and clients.

PubMed

Cheng, Shannon S Y; Mak, Winnie W S

2010-05-01

Despite social-cognitive interventions to increase safer sex awareness, condom use among female sex workers (FSWs) continued to be inconsistent. To account for the possible influences of contextual factors that may hinder or promote FSWs' safer sex negotiation and condom use, the present study examined the effects of non-governmental organizations (NGOs), FSWs' managers, and clients on FSWs' negotiation efficacy and condom-use efficacy, and the effects of efficacy on condom use. One hundred and nineteen FSWs in Hong Kong completed a questionnaire that focused on their perceived influences of NGOs, managers, and clients toward safer sex negotiation and condom use. Hierarchical regression results showed that whereas NGOs' influence and clients' support were positively related to negotiation self-efficacy, managers' pressure, and clients' pressure were negatively related to negotiation self-efficacy. Managers' pressure was negatively related to condom-use self-efficacy. Logistic regression results showed that FSWs with high condom-use self-efficacy was 24 times more likely to use condom in the previous six months than their counterparts. The present study indicated the importance of social contexts in affecting FSWs' safer sex negotiation and condom-use self-efficacy. Implications on preventive programs for FSWs, managers, and clients were discussed.

Trends and determinants of condom use in Uganda.

PubMed

De Coninck, Zaake; Marrone, Gaetano

2012-01-01

Documenting trends in condom use and exploring factors associated with their utilization are important for broadening the information base for the design of HIV intervention programs. This paper aims to document Uganda's nationwide trends in condom use from 1995 to 2006 and seeks to understand some of the socio-demographic variables that may be associated with their use, using Uganda Demographic Health Surveys (UDHSs). Data from UDHSs conducted in 1995, 2000/2001 and 2006 were analyzed. Socio-demographic variables as well as 'survey year' were selected to assess their interaction with condom use. Multivariate regression analyses were performed. Odds ratios and confidence intervals were computed. Socio-demographic factors such as being male and living in an urban setting were significantly associated with an increased likelihood of reported use of condoms. All results indicated a far greater increase in condom use between 1995 and 2000/2001 than between 2000/2001 and 2006. Policies need to intensify condom use campaigns especially among women and rural populations. The wane in increase in condom use between 2000/2001 and 2006 may be due to the large-scale influx of antiretrovirals (starting in 2004) which may be lowering the anxiety associated with the social construct of HIV/AIDS.

Estimating the Prevalence and Predictors of Incorrect Condom Use Among Sexually Active Adults in Kenya: Results From a Nationally Representative Survey.

PubMed

Grasso, Michael A; Schwarcz, Sandra; Galbraith, Jennifer S; Musyoki, Helgar; Kambona, Caroline; Kellogg, Timothy A

2016-02-01

Condom use continues to be an important primary prevention tool to reduce the acquisition and transmission of HIV and other sexually transmitted infections. However, incorrect use of condoms can reduce their effectiveness. Using data from a 2012 nationally representative cross-sectional household survey conducted in Kenya, we analyzed a subpopulation of sexually active adults and estimated the percent that used condoms incorrectly during sex, and the type of condom errors. We used multivariable logistic regression to determine variables to be independently associated with incorrect condom use. Among 13,720 adolescents and adults, 8014 were sexually active in the previous 3 months (60.3%; 95% confidence interval [CI], 59.0-61.7). Among those who used a condom with a sex partner, 20% (95% CI, 17.4-22.6) experienced at least one instance of incorrect condom use in the previous 3 months. Of incorrect condom users, condom breakage or leakage was the most common error (52%; 95% CI, 44.5-59.6). Factors found to be associated with incorrect condom use were multiple sexual partnerships in the past 12 months (2 partners: adjusted odds ratio [aOR], 1.5; 95% CI, 1.0-2.0; P = 0.03; ≥3: aOR, 2.3; 95% CI, 1.5-3.5; P < 0.01) and reporting symptoms of a sexually transmitted infection (aOR, 2.8; 95% CI, 1.8-4.3; P < 0.01). Incorrect condom use is frequent among sexually active Kenyans and this may translate into substantial HIV transmission. Further understanding of the dynamics of condom use and misuse, in the broader context of other prevention strategies, will aid program planners in the delivery of appropriate interventions aimed at limiting such errors.

Determinants of condom use among junior high school students in a minority, inner-city school district.

PubMed

DiClemente, R J; Durbin, M; Siegel, D; Krasnovsky, F; Lazarus, N; Comacho, T

1992-02-01

Condoms reduce the risk of human immunodeficiency virus (HIV) transmission; however, their use among adolescents has been inconsistent. Little is known about factors which motivate consistent condom use, particularly among younger adolescents. In a study designed to identify such factors, 1899 inner-city junior high school students were surveyed. In June 1988, students completed an anonymous self-report questionnaire assessing HIV-related knowledge, attitudes, and behaviors. Among sexually active students (N = 403), logistic regression analysis evaluated the influence of demographic, psychosocial, and behavioral factors on frequency of condom use. Respondents who believe condoms are effective in preventing HIV transmission were 2.2 times more likely to report using condoms consistently during sexual intercourse; those with low perceived costs associated with condom use were 1.9 times more likely to be consistent users. Number of lifetime sexual partners was inversely related to frequency of condom use. Respondents with a history of three or more sex partners were half as likely to use condoms consistently. Factors not associated with consistent condom use include age, age at sexual debut, ethnicity, HIV knowledge, perceived efficacy to avoid HIV infection, and alcohol and drug use. School- and community-based HIV prevention programs will have to go beyond the didactic transfer of factual information and include more interactive teaching strategies to improve adolescents' attitudes toward condoms are self-efficacy to increase condom use and to counter negative peer influences and adolescents' perceptions of invulnerability. Physicians are an underutilized source of HIV prevention information. They have an important role in counseling adolescents about effective HIV-prevention methods and dispelling misperceptions which hinder consistent condom use.

The dynamics of condom use with regular and casual partners: analysis of the 2006 National Sexual Behavior Survey of Thailand.

PubMed

Chamratrithirong, Aphichat; Kaiser, Paulina

2012-01-01

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. 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. 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. 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.

Can AIDS prevention move to sufficient scale?

PubMed

Slutkin, G

1993-05-01

Much has been learned about which AIDS prevention interventions are effective and what an AIDS prevention program should look like. It is also clear that important program issues must be worked out at the country level if effective interventions are to be had. Programs with successful interventions and approaches in most countries, however, have yet to be implemented on a sufficiently large scale. While some national programs are beginning to use proven interventions and are moving toward implementing full-scale national AIDS programs, most AIDS prevention programs do not incorporate condom marketing, are not using mass media and advertising in a well-programmed way, do not have peer projects to reach most at-risk populations, and do not have systems in place to diagnose and treat persons with sexually transmitted diseases (STD). Far more planning and resources for AIDS prevention are needed from national and international public and private sectors. International efforts by the World Health Organization (WHO), UNICEF, UNDP, UNESCO, UNFPA, and the World Bank have increased markedly over the past few years. Bilaterally, the US, Sweden, United Kingdom, Canada, Netherlands, Norway, Denmark, Japan, Germany, France, and other countries are contributing to WHO/GPA and to direct bilateral AIDS prevention activities. USAID happens to be the largest single contributor to WHO/GPA and is also the largest bilateral program with its $168 millions AIDSCAP funded over 5 years. AIDSCAP integrates condom distribution and marketing, STD prevention and control, behavioral change and communication strategies through person-to-person and mass media approaches, and strong evaluation components. AIDSCAP can help fulfill the need to demonstrate that programs can be developed on a country-wide level by showing how behavior can be changed in a broad geographical area.

PROFAM expands Mexican family planning clinics.

PubMed

1983-01-01

Mexico's private, nonprofit social marketing company, known as PROFAM, intends to expand its family planning clinics to marginal urban areas. The clinics are part of PROFAM's push to diversify social marketing outlets for contraceptive products and other birth control methods. PROFAM expects to establish 3 new clinics, possibly including a pregnancy test laboratory, a small 1-doctor clinic, and a large clinic housing an operating room. 1 clinic will be located outside the Mexico City area, the program's traditional boundaries. The company currently runs 2 small clinics and a pregnancy testing laboratory in Ciudad Netzahualcoyti, a community of 3.5 million on Mexico City's outskirts. PROFAM recently obtaine d government approval to sell condoms in food stores, which should increase distribtuion and sales. Currently, the company sells over 1 million high quality, lubricated condoms each month, accounting for over half of the Mexican market. Distribution covers 85% of the country's drugstore. Program setbacks occurred in 1981, when the Mexican government cancelled PROFAM's sales permits for all contraceptive products except condoms. Cancelled products included an oral contraceptive and 3 vaginal spermicides. These 4 products had provided nearly 100,000 couple years of protection in 1979 and an estimated 120,000 CYP 1980. During 1979 and 1980, condoms provided about 27,000 and 60,000 CYP, respectively. PROFAM had relied heavily on the pill and spermicides because its early studies showed condoms had a negative image in Mexico, due largely to the product's association with extramarital affairs. To counter this, PROFAM launched a widespread, free product sampling program in 1979, along with a continuing educational and advertising drive. Subsequent consumer surveys revealed a marked increase in product acceptance, with PROFAM's condom becoming the most widely known brand available in Mexico.

AIDS epidemic in Malawi: shaking cultural foundations.

PubMed

Chirwa, I

1993-05-01

Many young men and women in Malawi are infected with HIV and dying from AIDS. The head of the Malawi AIDS Control Program estimates that as many as 10% of all adults in the country may be infected with HIV, with the rate being higher in urban areas. While more than 90% of the population is now aware of the existence of AIDS and its dangers, changes in behavior have not taken place and HIV continues to spread. Early campaigns attempted to generate condom use through peer educators among bar girls, truck drivers, and STD patients. Many men state, however, that they prefer to have sex without condoms because it is more exciting. Others cite alcohol consumption, ignorance of the dangers of HIV infection, and/or a fear of suggesting mistrust in a partner as reasons for not using condoms. Many women also find it difficult to negotiate condom use among reluctant men. Making condoms readily accessible and giving them a positive image may help increase their rate of use; the opposition of some religious groups must be thwarted and the distribution system needs to be improved to realize these ends. Condoms are provided to Malawi free of charge by the US Agency of International Development. Supplies are then either distributed free through health centers and bars or sold in shops. The failure of free condoms to be readily available in rural areas where 90% of the population resides, however, poses concern. Finally, training programs, counseling, anonymous HIV testing centers, and peer educators are among some of the interventions being made against AIDS in Malawi.

Evaluation of the reach and impact of the 100% Jeune youth social marketing program in Cameroon: findings from three cross-sectional surveys.

PubMed

Plautz, Andrea; Meekers, Dominique

2007-02-26

The 100% Jeune youth social marketing program in Cameroon aims to address the high STI/HIV prevalence rates and the high levels of unwanted pregnancy. This study evaluates the 100% Jeune program, analyzing its reach and impact on condom use, level of sexual activity, and predictors of condom use. This analysis uses data from three waves of the Cameroon Adolescent Reproductive Health Survey, implemented at 18-month intervals between 2000 and 2003. The sample is restricted to unmarried youth aged 15-24; sample sizes are 1,956 youth in 2000, 3,237 in 2002, and 3,370 in 2003. Logistic regression analyses determine trends in reproductive health behavior and their predictors, as well as estimate the effect of program exposure on these variables. All regression analyses control for differences in sample characteristics. A comparison of trends over the 36-month study period shows that substantial positive changes occurred among youth. Results of dose response analyses indicate that some of these positive changes in condom use and predictors of use can be attributed to the 100% Jeune youth social marketing program. The program contributed to substantial increases in condom use, including consistent use with regular partners among youth of both sexes. Among males, it also contributed to consistent use with casual partners. While condom use increased with both regular and casual partners, levels of use are higher with the latter. Observed secular trends indicate that factors besides the 100% Jeune program also contributed to the observed improvements. Despite efforts to promote abstinence, the 100% Jeune program had no effect on levels of sexual activity or number of sexual partners. Likewise, there is no evidence that reproductive health programs for youth lead to increased sexual activity. Results show that 100% Jeune successfully used a variety of mass media and interpersonal communication channels to reach a high proportion of youth throughout the intervention period. In a context in which a variety of governmental and nongovernmental partners are increasing youth-focused reproductive health programming, the 100% Jeune program reached a higher proportion of youth than did other programs. Collective efforts of multiple organizations over time can lead to improvements in adolescent reproductive health. Resources should be allocated to identify and understand predictors of abstinence and partner reduction to inform future programming decisions.

Evaluation of the reach and impact of the 100% Jeune youth social marketing program in Cameroon: findings from three cross-sectional surveys

PubMed Central

Plautz, Andrea; Meekers, Dominique

2007-01-01

Background The 100% Jeune youth social marketing program in Cameroon aims to address the high STI/HIV prevalence rates and the high levels of unwanted pregnancy. This study evaluates the 100% Jeune program, analyzing its reach and impact on condom use, level of sexual activity, and predictors of condom use. Methods This analysis uses data from three waves of the Cameroon Adolescent Reproductive Health Survey, implemented at 18-month intervals between 2000 and 2003. The sample is restricted to unmarried youth aged 15–24; sample sizes are 1,956 youth in 2000, 3,237 in 2002, and 3,370 in 2003. Logistic regression analyses determine trends in reproductive health behavior and their predictors, as well as estimate the effect of program exposure on these variables. All regression analyses control for differences in sample characteristics. Results A comparison of trends over the 36-month study period shows that substantial positive changes occurred among youth. Results of dose response analyses indicate that some of these positive changes in condom use and predictors of use can be attributed to the 100% Jeune youth social marketing program. The program contributed to substantial increases in condom use, including consistent use with regular partners among youth of both sexes. Among males, it also contributed to consistent use with casual partners. While condom use increased with both regular and casual partners, levels of use are higher with the latter. Observed secular trends indicate that factors besides the 100% Jeune program also contributed to the observed improvements. Despite efforts to promote abstinence, the 100% Jeune program had no effect on levels of sexual activity or number of sexual partners. Likewise, there is no evidence that reproductive health programs for youth lead to increased sexual activity. Conclusion Results show that 100% Jeune successfully used a variety of mass media and interpersonal communication channels to reach a high proportion of youth throughout the intervention period. In a context in which a variety of governmental and nongovernmental partners are increasing youth-focused reproductive health programming, the 100% Jeune program reached a higher proportion of youth than did other programs. Collective efforts of multiple organizations over time can lead to improvements in adolescent reproductive health. Resources should be allocated to identify and understand predictors of abstinence and partner reduction to inform future programming decisions. PMID:17324289

Factors related to condom use behavior among club-working women in South Korea: importance of subjective norms and customer-related attitudes.

PubMed

Jeong, Heon-Jae; Jo, Heui-Sug; Jung, Su-Mi; Lee, Ja-young

2014-03-01

The primary aim of this study was to understand factors associated with condom use behavior among club-working women and identify the most influential factors to be addressed in future health programs. A total of 158 club-working women were surveyed from 3 midsize cities in South Korea from July to September 2004. Survey questionnaires were developed based on the theory of planned behavior. A total of 7 distinct themes emerged: Health aspects, Customer related, Pleasure related, Finance related, Societal norm, Occupational norm, and Perceived control. The results indicated that the Customer-related theme, Societal norm, and Occupational norm were statistically significant factors affecting condom use. On the other hand, self-related factors such as health, pleasure, and finance are not significantly related to the condom use behavior of club-working women in South Korea, suggesting that the currently used knowledge-focused education programs may not be sufficient for this population.

Interim outcomes for a community-based program to prevent perinatal HIV transmission.

PubMed

Santelli, J S; Celentano, D D; Rozsenich, C; Crump, A D; Davis, M V; Polacsek, M; Augustyn, M; Rolf, J; McAlister, A L; Burwell, L

1995-06-01

The AIDS Prevention for Pediatric Life Enrichment (APPLE) project is a community-based program to prevent perinatal HIV infection by preventing infection in women. One project component tested a primary prevention model developed from principles of cognitive social learning theory which used street outreach and community-targeted small media materials to increase the use of condoms. Formative research was used to explore community perceptions about HIV/AIDS and to design media materials. Program evaluation employed a two-community, time series, quasi-experimental design. Annual street surveys samples individuals in areas where they were likely to encounter outreach workers. Baseline surveys found substantial pre-programmatic behavior change. After two years considerable APPLE name recognition (40%), contact with media materials (63%), and contact with outreach workers (36%) were found and norms reflecting social acceptability of condoms were more positive among women in the intervention community. Condom use at last sexual encounter rose in both communities but was significantly higher in the intervention community. Condom use also was higher among women who reported exposure to either small media or small media plus street outreach. Other self-reported HIV-prevention behaviors did not show change in the initial period.

Predictors of Sexual Risk Reduction Among Mexican Female Sex Workers Enrolled in a Behavioral Intervention Study

PubMed Central

Strathdee, Steffanie A.; Mausbach, Brent; Lozada, Remedios; Staines-Orozco, Hugo; Semple, Shirley J.; Abramovitz, Daniela; Fraga-Vallejo, Miguel; de la Torre, Adela; Amaro, Hortensia; Martínez-Mendizábal, Gustavo; Magis-Rodríguez, Carlos; Patterson, Thomas L.

2009-01-01

Objective We recently showed efficacy of an intervention to increase condom use among female sex workers (FSWs) in Tijuana and Ciudad Juarez, situated on the Mexico–United States border. We determined whether increases in condom use were predicted by social cognitive theory and injection drug user status among women randomized to this intervention. Methods Four hundred nine HIV-negative FSWs aged ≥18 years having unprotected sex with clients within the prior 2 months received a brief individual counseling session integrating motivational interviewing and principles of behavior change (ie, HIV knowledge, self-efficacy for using condoms, and outcome expectancies). Results Increases in self-efficacy scores were associated with increases in percent condom use (P = 0.008), whereas outcome expectancies were not. Female sex workers who inject drugs (FSW-IDUs) increased condom use with clients but not to the same extent as other FSWs (P = 0.09). Change in HIV knowledge was positively associated with change in percent condom use among FSW-IDUs (P = 0.03) but not noninjection drug users. Conclusions Increases in self-efficacy significantly predicted increased condom use among FSWs, consistent with social cognitive theory. Increased HIV knowledge was also important among FSW-IDUs, but their changes in condom use were modest. Enhanced interventions for FSW-IDUs are needed, taking into account realities of substance use during sexual transactions that can compromise safer sex negotiation. PMID:19384101

Consequences of sexual decisions: the perceptions of rural adolescents.

PubMed

Duerst, B L; Keller, M L; Mockrud, P; Zimmerman, J

1997-01-01

The purpose of this study was to examine the content of adolescent thinking about the consequences of choosing abstinence, sexual intercourse with a condom, and unprotected intercourse. Consequences for the relationship and for each partner's thoughts and feelings were explored. Participants were 116 high school students living in a rural area of a midwestern state; their average age was 16 years. They completed a series of open-ended questions about possible outcomes to a scenario involving sexual decision making. Content analysis of responses revealed that about half of the participants associated abstinence with positive consequences; however, it was also associated with insecurity and the possibility of losing the relationship. Sexual intercourse with a condom was viewed as an indication of caring and responsibility and was associated with positive outcomes for the relationship. Identified consequences of unprotected intercourse were almost entirely negative. Some differences in perceived consequences were influenced by the gender of the partner. Integration of these findings into programs designed to prevent sexual risk-taking is discussed.

Risky Sexual Behaviors among Female Youth in Tiss Abay, a Semi-Urban Area of the Amhara Region, Ethiopia

PubMed Central

Tadesse, Gojjam; Yakob, Bereket

2015-01-01

Background Little is known about sexual risks and associated factors about female youths in semi-urban areas of Ethiopia. This study aimed to describe the nature and magnitude of risky sexual behaviors, and the socio-demographic and behavioral determinants among female youths in Tiss Abay, a semi-urban area on the outskirts of Bahir Dar City of the Amhara Region in northern Ethiopia. Methods A cross-sectional census type study was conducted among female youths who were unmarried and aged 15–29 years in September 2011. Results 711 female youths participated in the study, with the mean age of initiation of sex of 78.6% being16.73±2.53 years. Only 52(9.3%) used condom during the first sex. Within the last 12 months, 509(71.6%) had sexual intercourse and 278(54.6%) had two or more sex partners, and 316(62.1%) did not use condom during their last sex. Sex under the influence of substances was reported by 350(68.8%), and a third of the recent sexes were against the will of participants. One or more risky sexual practices were reported by 503(70.3%) participants, including: multiple sexual partnerships, inconsistently using or not using condoms, sex under the influence of alcohol and/or sex immediately after watching pornography. Age group, current marital status, drinking homemade alcohol, chewing ‘khat’, watching pornography and using any form of stimulant substances were the predictors of risky sexual behavior. Watching pornography before sex and sex for transaction were the predicators of not using condom during most recent sex. Conclusions Risky sexual behaviors were very common among the female youths in Tiss Abay. Initiation of context-based interventions, such as raising awareness about the risks, safer sex practices, condom promotion and integration of gender issues in the programs are recommended. PMID:25738508

Risky sexual behaviors among female youth in Tiss Abay, a semi-urban area of the Amhara Region, Ethiopia.

PubMed

Tadesse, Gojjam; Yakob, Bereket

2015-01-01

Little is known about sexual risks and associated factors about female youths in semi-urban areas of Ethiopia. This study aimed to describe the nature and magnitude of risky sexual behaviors, and the socio-demographic and behavioral determinants among female youths in Tiss Abay, a semi-urban area on the outskirts of Bahir Dar City of the Amhara Region in northern Ethiopia. A cross-sectional census type study was conducted among female youths who were unmarried and aged 15-29 years in September 2011. 711 female youths participated in the study, with the mean age of initiation of sex of 78.6% being16.73±2.53 years. Only 52(9.3%) used condom during the first sex. Within the last 12 months, 509(71.6%) had sexual intercourse and 278(54.6%) had two or more sex partners, and 316(62.1%) did not use condom during their last sex. Sex under the influence of substances was reported by 350(68.8%), and a third of the recent sexes were against the will of participants. One or more risky sexual practices were reported by 503(70.3%) participants, including: multiple sexual partnerships, inconsistently using or not using condoms, sex under the influence of alcohol and/or sex immediately after watching pornography. Age group, current marital status, drinking homemade alcohol, chewing 'khat', watching pornography and using any form of stimulant substances were the predictors of risky sexual behavior. Watching pornography before sex and sex for transaction were the predicators of not using condom during most recent sex. Risky sexual behaviors were very common among the female youths in Tiss Abay. Initiation of context-based interventions, such as raising awareness about the risks, safer sex practices, condom promotion and integration of gender issues in the programs are recommended.

Condom use with a casual partner: what distinguishes college students' use when intoxicated?

PubMed

Abbey, Antonia; Parkhill, Michele R; Buck, Philip O; Saenz, Christopher

2007-03-01

Determining alcohol's precise role in sexual risk taking has proven to be an elusive goal. Past research has produced mixed results, depending on characteristics of individuals, their partners, and the situation, as well as how the link between alcohol consumption and sexual behavior was assessed. In this study, cross-sectional predictors of the frequency of condom use were examined for 298 heterosexual college students at a large urban university. In hierarchical multiple regression analyses that controlled for frequency of condom use when sober, alcohol expectancies regarding sexual risk taking and self-efficacy regarding condom use when intoxicated were significant predictors of frequency of condom use when intoxicated. These findings highlight the importance of targeting beliefs about alcohol's disinhibiting effects in STD- and HIV-prevention programs. (c) 2007 APA, all rights reserved.

Substance use and other risk factors for unprotected sex: results from an event-based study of homeless youth.

PubMed

Tucker, Joan S; Ryan, Gery W; Golinelli, Daniela; Ewing, Brett; Wenzel, Suzanne L; Kennedy, David P; Green, Harold D; Zhou, Annie

2012-08-01

This study used an event-based approach to understand condom use in a probability sample of 309 homeless youth recruited from service and street sites in Los Angeles County. Condom use was significantly less likely when hard drug use preceded sex, the relationship was serious, the partners talked about "pulling out", or sex occurred in a non-private place (and marginally less likely when heavier drinking preceded sex, or the partnership was monogamous or abusive). Condom use was significantly more likely when the youth held positive condom attitudes or were concerned about pregnancy, the partners talked about condom use, and the partners met up by chance. This study extends previous work by simultaneously examining a broad range of individual, relationship, and contexual factors that may play a role in condom use. Results identify a number of actionable targets for programs aimed at reducing HIV/STI transmission and pregnancy risk among homeless youth.

Substance Use and Other Risk Factors for Unprotected Sex: Results From An Event-Based Study of Homeless Youth

PubMed Central

Tucker, Joan S.; Ryan, Gery W.; Golinelli, Daniela; Munjas, Brett; Wenzel, Suzanne L.; Kennedy, David P.; Green, Harold D.; Zhou, Annie

2011-01-01

This study used an event-based approach to understand condom use in a probability sample of 309 homeless youth recruited from service and street sites in Los Angeles County. Condom use was significantly less likely when hard drug use preceded sex, the relationship was serious, the partners talked about “pulling out”, or sex occurred in a non-private place (and marginally less likely when heavier drinking preceded sex, or the partnership was monogamous or abusive). Condom use was significantly more likely when the youth held positive condom attitudes or were concerned about pregnancy, the partners talked about condom use, and the partners met up by chance. This study extends previous work by simultaneously examining a broad range of individual, relationship, and contexual factors that may play a role in condom use. Results identify a number of actionable targets for programs aimed at reducing HIV/STI transmission and pregnancy risk among homeless youth. PMID:21932093

Taking Be Proud! Be Responsible! to the Suburbs: A Replication Study

PubMed Central

Borawski, Elaine A.; Trapl, Erika S.; Adams-Tufts, Kimberly; Hayman, Laura L.; Goodwin, Meredith A.; Lovegreen, Loren D.

2011-01-01

CONTEXT An important phase of HIV prevention research is replicating successful interventions with different groups and in different settings. METHODS Be Proud! Be Responsible!, a successful intervention originally targeting black urban males and carried out in nonschool settings, was presented in health classes at urban and suburban schools with diverse student bodies. A group-randomized intervention study, which included 1,357 ninth and 10th graders from 10 paired schools in a Midwestern metropolitan area, was conducted in 2000–2002. Half the schools received the intervention, and half received a general health promotion program. Students’ reports of their sexual behavior and selected cognitive mediators were analyzed immediately following the programs and four and 12 months later. RESULTS Compared with students who received the control curriculum, students exposed to the intervention reported significantly greater knowledge of HIV, other STDs and condoms; greater confidence in their ability to control sexual impulses, to use condoms and to negotiate the use of condoms; and stronger intentions to use condoms. Stratified analyses revealed that the strongest intervention impacts were on knowledge and efficacy among males and students attending suburban schools. The intervention had no impact on sexual initiation, frequency of intercourse or condom use. CONCLUSIONS Schools are a logical and viable setting for the dissemination and acquisition of information about HIV, including prevention strategies. However, the behavioral impact of an intervention may not be easily transferable when the program is taught outside a carefully controlled, nonschool setting. PMID:19291124

Variations in condom use by locale: a comparison of mobile Chinese female sex workers in Hong Kong and mainland China.

PubMed

Lau, Joseph T F; Tsui, H Y; Ho, Shara P Y

2007-12-01

The present study investigated the prevalence of HIV and HIV-related behaviors and perceptions among 336 female sex workers (FSW) traveling from mainland China to work in Hong Kong. None of the participants tested HIV positive. Of the participants, 13.2% and 26.8%, respectively, would have unprotected sex with a client in Hong Kong or in mainland China if they liked the client; 16.7% and 21.7%, respectively, would have unprotected sex with a client in Hong Kong and in mainland China if he paid more. Of the participants, 98.5% used condoms in the last episode of sex work in Hong Kong and 78.1% were consistent condom users in Hong Kong in the last month. Yet, among those who previously worked as FSW in mainland China (n = 141), only 28.6% used condoms consistently in mainland China in the last year; 60% of those who used condoms inconsistently while in mainland China became consistent condom users in Hong Kong. Among those who did not use condoms in mainland China, willingness to have unprotected sex with a client who was liked by the FSW was a strong predictor for consistent condom use in Hong Kong (OR = 18.67, p < .001). Among those who were consistent condom users in Hong Kong, the same variable predicted inconsistent condom use while in mainland China (OR = 14.02, p < .05). Condom use behaviors change when FSW are working in different social contexts and behavioral changes are possible. Education programs should take socio-contextual factors into account.

Social marketing campaign swaps condoms for bottle tops.

PubMed

1993-01-01

PSI, a non-profit organization based in the United States, uses private sector condom marketing programs to provide condoms to developing countries at low cost to help stem the spread of AIDS. PSI started promoting condoms in the CAR in November 1991. 150,000 Prudence brand condoms were sold in the 1st month. The price for a pack of 4 was far below that charged by private pharmacies. PSI turned to a collaborative venture with Societe Centrafricaine des Boissons (SCB), a local drinks manufacturer. In a joint campaign in April 1992, 4 packs of condoms were exchanged for 5 tops from SCB bottles. At markets and bars promotional items were given away during condom demonstration contests. SCB bought all the condoms from PSI and financed all the publicity. Similar promotion launched the improved Prudence Plus condom in December. Cumulative sales of Prudence and Plus condoms in the CAR now exceed 1 million. Another marketing idea was to commission a textile company called UCATEX to design a fabric based on the Prudence logo. 1600 lengths of cotton cloth were printed and sold. There was also Operation Taxi Bus. PSI's team broadcast twice on the taxi association's weekly radio show about AIDS prevention, the importance of condoms, and the Prudence brand. Then, every morning for a week, PSI promoters put stickers on as many taxis as possible. Every driver agreeing to display a sticker was entitled to receive 2 packets of Prudence for personal use. The 450 taxis with stickers now in a city of 500,000 are an effective promotion network. In order to prevent a gap in supply before PSI receives its long-term funding from a US donor, The World Health Organization recently bought 500,000 Prudence condoms for PSI to distribute.

Efficacy of theory-based HIV behavioral prevention among rural-to-urban migrants in China: a randomized controlled trial.

PubMed

Li, Xiaoming; Lin, Danhua; Wang, Bo; Du, Hongfei; Tam, Cheuk Chi; Stanton, Bonita

2014-08-01

Our objective was to evaluate the efficacy of a cultural adaptation of a social cognitive theory-based HIV behavioral prevention program among young rural-to-urban migrants in China. The intervention design and assessment were guided by the Protection Motivation Theory (PMT). The intervention was evaluated through a randomized controlled trial with 6-month and 12-month follow-ups. The primary behavioral outcome was the use of condoms. Other outcome measures include HIV knowledge, condom use knowledge, HIV-related perceptions (PMT constructs), and intention to use condom. The mixed-effects regression models for condom use with regular partners indicated that overall frequency of condom use, condom use in last three sexual acts and proper condom use increased over time for the participants but the increases were significantly greater among the intervention group than the control group at 6-month and 12-month follow-ups. The mixed-effects models for HIV-related perceptions indicated that extrinsic rewards, intrinsic rewards, and response costs decreased while vulnerability, severity, response efficacy, and self-efficacy increased over time for the intervention group. The increases in HIV knowledge, condom use knowledge, and intention to use condom were also significantly greater among the intervention group than the control group. The data in the current study suggested efficacy of a social cognitive theory-based behavioral intervention in increasing condom use among young migrants in China. The intervention also increased protective perceptions and decreased risk perception posited by the theory (i.e., PMT).

Conversation and compliance: role of interpersonal discussion and social norms in public communication campaigns.

PubMed

Frank, Lauren B; Chatterjee, Joyee S; Chaudhuri, Sonal T; Lapsansky, Charlotte; Bhanot, Anurudra; Murphy, Sheila T

2012-01-01

This study explores the role of interpersonal discussion and social norms in a public health campaign, the BBC Condom Normalization Campaign, designed to promote conversation and change the public perception of condom use in India. Drawing upon the integrative model of behavioral prediction, attitudes, self-efficacy, subjective norms, and descriptive norms were predicted to relate to behavioral intentions to use condoms. It is important to note that the valence of discussion was hypothesized to relate to each of these more proximal predictors. The authors used structural equation modeling to test the model on 3 separate samples of Indian men between the ages of 15 and 49 years: (a) high-risk men who had sex with nonspouses; (b) low-risk, sexually inactive, unmarried men; and (c) low-risk, monogamous, married men. Results were similar for low- and high-risk audiences, with valence of discussion about condoms predicting condom-related attitudes, self-efficacy, and subjective and descriptive social norms with respect to condom use, which, in turn, predicted behavioral intent to use condoms. These findings underscore the need to take not only the frequency but also the valence of interpersonal discussion into account when assessing the effect of health campaigns. Implications for theory and design of future public communication campaigns are explored.

The culture of condoms: culturally grounded variables and their association with attitudes to condoms.

PubMed

Liddell, Christine; Giles, Melanie; Rae, Gordon

2008-05-01

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.

Attitudes toward condom education amongst educators for Deaf and hard-of-hearing adolescents in South Africa.

PubMed

Mall, Sumaya; Swartz, Leslie

2014-08-13

Disabled adolescents are at a critical time in their psychosocial and sexual development. 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. 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 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. Given the context of a burgeoning HIV epidemic, it is vital to address adequate condom education in schools.

Are condom-promotion interventions reaching internal migrants in China? Integrated evidence from two cross-sectional surveys.

PubMed

Liu, Xiaona; Erasmus, Vicki; van Genugten, Lenneke; Sun, Xinying; Tan, Jingguang; Richardus, Jan Hendrik

2016-09-01

Behavioral interventions containing behavior change techniques (BCTs) that do not reach the target populations sufficiently will fail to accomplish their desired outcome. To guide sexually transmitted infection prevention policy for internal migrants in China, this study examines the extent to which BCTs aiming at increasing condom use reach the migrants and investigates the preference of the target population for these techniques among 364 migrants and 44 healthcare workers (HCWs) in Shenzhen, China. The results show that condom-promotion techniques that had been offered by HCWs to internal migrants reached a limited proportion of the population (range of reach ratio: 17.6-55.0%), although there appears to be a good match between what is offered and what is preferred by Chinese internal migrants regarding condom-promotion techniques (rank difference ≤ 1). Our findings highlight the need to increase the reach of condom-promotion techniques among Chinese internal migrants, and suggest techniques that are likely to reach the target population and match their preferred health education approaches.

Exposure of natural rubber to personal lubricants--swelling and stress relaxation as potential indicators of reduced seal integrity of non-lubricated male condoms.

PubMed

Sarkar Das, Srilekha; Coburn, James C; Tack, Charles; Schwerin, Matthew R; Richardson, D Coleman

2014-07-01

Male condoms act as mechanical barriers to prevent passage of body fluids. For effective use of condoms the mechanical seal is also expected to remain intact under reasonable use conditions, including with personal lubricants. Absorption of low molecular weight lubricant components into the material of male condoms may initiate material changes leading to swelling and stress relaxation of the polymer network chains that could affect performance of the sealing function of the device. Swelling indicates both a rubber-solvent interaction and stress relaxation, the latter of which may indicate and/or result in a reduced seal pressure in the current context. Swelling and stress relaxation of natural rubber latex condoms were assessed in a laboratory model in the presence of silicone-, glycol-, and water-based lubricants. Within 15 minutes, significant swelling (≥6 %) and stress reduction (≥12 %) of condoms were observed with 2 out of 4 silicone-based lubricants tested, but neither was observed with glycol- or water-based lubricants tested. Under a given strain, reduction in stress was prominent during the swelling processes, but not after the process was complete. Lubricant induced swelling and stress relaxation may loosen the circumferential stress responsible for the mechanical seal. Swelling and stress relaxation behavior of latex condoms in the presence of personal lubricants may be useful tests to identify lubricant-rooted changes in condom-materials. For non-lubricated latex condoms, material characteristics--which are relevant to failure--may change in the presence of a few silicone-based personal lubricants. These changes may in turn induce a loss of condom seal during use, specifically at low strain conditions. Published by Elsevier Inc.

Assessing the potential of the Woman's Condom for vaginal drug delivery

PubMed Central

Kramzer, Lindsay F.; Cohen, Jessica; Schubert, Jesse; Dezzutti, Charlene S.; Moncla, Bernard J.; Friend, David; Rohan, Lisa C.

2015-01-01

Background The Woman's Condom is a new female condom that uses a dissolvable polyvinyl alcohol (PVA) capsule to simplify vaginal insertion. This preclinical study assessed the feasibility to incorporate an antiviral drug, UC781, into the Woman's Condom capsule, offering a unique drug delivery platform. Study Design UC781 capsules were fabricated using methods from the development of the Woman's Condom capsules as well as those used in vaginal film development. Capsules were characterized to evaluate physical/chemical attributes, Lactobacillus compatibility, in vitro safety and bioactivity, and condom compatibility. Results Two UC781 capsule platforms were assessed. Capsule masses (mg; mean ± SD) for platforms 1 and 2 were 116.50 ± 18.22 and 93.80 ± 8.49, respectively. Thicknesses were 0.0034 ± 0.0004 in and 0.0033 ± 0.0004 in. Disintegration times were 11 ± 3 sec and 5 ± 1 sec. Puncture strengths were 21.72 ± 3.30 N and 4.02 ± 0.83 N. Water content measured 6.98 ± 1.17 % and 7.04 ± 1.92 %. UC781 content was 0.59 ± 0.05 mg and 0.77 ± 0.11 mg. Both platforms retained in vitro bioactivity and were non-toxic to TZM-bl cells and Lactobacillus. Short-term storage of UC781 capsules with the Woman's Condom pouch did not decrease condom mechanical integrity. Conclusions UC781 was loaded into a polymeric capsule similar to that of the Woman's Condom product. This study highlights the potential use of the Woman's Condom as a platform for vaginal delivery of drugs relevant to sexual/reproductive health, including those for short or long-acting HIV prevention. PMID:25998936

Color It Real: A Program to Increase Condom Use and Reduce Substance Abuse and Perceived Stress.

PubMed

Zellner, Tiffany; Trotter, Jennie; Lenoir, Shelia; Walston, Kelvin; Men-Na'a, L'dia; Henry-Akintobi, Tabia; Miller, Assia

2015-12-22

Few interventions have targeted perceived stress as a co-occurring construct central to substance use and subsequent HIV/AIDS risk reduction among African American urban young adults. The Color It Real Program was a seven session, weekly administered age-specific and culturally-tailored intervention designed to provide substance abuse and HIV education and reduce perceived stress among African Americans ages 18 to 24 in Atlanta, GA. Effectiveness was assessed through a quasi-experimental study design that consisted of intervention (n = 122) and comparison (n = 70) groups completing a pre- and post-intervention survey. A series of Analysis of Variance (ANOVA) tests were used to assess pre- to post-intervention changes between study groups. For intervention participants, perceived stress levels were significantly reduced by the end of the intervention (t(70) = 2.38, p = 0.020), condom use at last sexual encounter significantly increased (F = 4.43, p = 0.0360), intervention participants were significantly less likely to drink five or more alcoholic drinks in one sitting (F = 5.10, p = 0.0245), and to use clean needles when injecting the drug (F = 36.99, p = 0.0001). This study is among the first of its kind to incorporate stress management as an integral approach to HIV/SA prevention. The program has implications for the design of other community-based, holistic approaches to addressing substance use and risky behaviors for young adults.

Determinants of condom breakage among female sex workers in Karnataka, India.

PubMed

Bradley, Janet; Rajaram, S; Alary, Michel; Isac, Shajy; Washington, Reynold; Moses, Stephen; Ramesh, B M

2011-12-29

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 condom use. More research is also needed on what specific situational parameters might be important in predisposing women to condom breakage.

Violence, condom breakage, and HIV infection among female sex workers in Benin, West Africa.

PubMed

Tounkara, Fatoumata K; Diabaté, Souleymane; Guédou, Fernand A; Ahoussinou, Clément; Kintin, Frédéric; Zannou, Djimon M; Kpatchavi, Adolphe; Bédard, Emmanuelle; Bietra, Raphaël; Alary, Michel

2014-05-01

To examine the relationship between violence, condom breakage, and HIV prevalence among female sex workers (FSWs). Data were obtained from the 2012 cross-sectional integrated biological and behavioral survey conducted in Benin. Multivariable log-binomial regression was used to estimate the adjusted prevalence ratios of HIV infection and condom breakage in relation to violence toward FSWs. A score was created to examine the relationship between the number of violence types reported and HIV infection. Among the 981 women who provided a blood sample, HIV prevalence was 20.4%. During the last month, 17.2%, 13.5%, and 33.5% of them had experienced physical, sexual, and psychological violence, respectively. In addition, 15.9% reported at least 1 condom breakage during the previous week. There was a significant association between all types of violence and HIV prevalence. The adjusted prevalence ratios of HIV were 1.45 (95% confidence interval [95% CI], 1.05-2.00), 1.42 (95% CI, 1.02-1.98), and 1.41 (95% CI, 1.08-1.41) among those who had ever experienced physical, sexual, and psychological violence, respectively. HIV prevalence increased with the violence score (P = 0.002, test for trend), and physical and sexual violence were independently associated with condom breakage (P = 0.010 and P = 0.003, respectively). The results show that violence is associated with a higher HIV prevalence among FSWs and that condom breakage is a potential mediator for this association. Longitudinal studies designed to analyze this relationship and specific interventions integrated to current HIV prevention strategies are needed to reduce the burden of violence among FSWs.

Violence, condom breakage and HIV infection among female sex workers in Benin, West Africa

PubMed Central

Tounkara, Fatoumata K.; Diabaté, Souleymane; Guédou, Fernand A.; Ahoussinou, Clément; Kintin, Frédéric; Zannou, Djimon M.; Kpatchavi, Adolphe; Bédard, Emmanuelle; Bietra, Raphaël; Alary, Michel

2014-01-01

Objective To examine the relationship between violence, condom breakage and HIV prevalence among female sex workers (FSWs). Methods Data were obtained from the 2012 cross-sectional integrated biological and behavioural survey conducted in Benin. Multivariable log-binomial regression was used to estimate the adjusted prevalence ratios (APRs) of HIV infection and condom breakage in relation to violence towards FSWs. A score was created to examine the relationship between the number of violence types reported and HIV infection. Results Among the 981 women who provided a blood sample, HIV prevalence was 20.4%. During the last month, 17.2%, 13.5% and 33.5% of them had experienced physical, sexual and psychological violence, respectively. In addition, 15.9% reported at least one condom breakage during the previous week. There was a significant association between all types of violence and HIV prevalence. The APRs of HIV were 1.45 (95% confidence interval [95%CI]: 1.05 – 2.00), 1.42 (95%CI: 1.02 – 1.98), and 1.41 (95%CI: 1.08 – 1.41) among those who had ever experienced physical, sexual and psychological violence, respectively. HIV prevalence increased with the violence score (p=0.002, test for trend), and physical and sexual violence were independently associated with condom breakage (p values 0.010 and 0.003, respectively). Conclusion The results show that violence is associated with a higher HIV prevalence among FSWs and that condom breakage is a potential mediator for this association. Longitudinal studies designed to analyse this relationship and specific interventions integrated to current HIV prevention strategies are needed to reduce the burden of violence among FSWs. PMID:24722385

Promoting positive condom use experiences among young black MSM: a randomized controlled trial of a brief, clinic-based intervention.

PubMed

Crosby, Richard A; Mena, Leandro; Smith, Rachel Vickers

2018-06-01

The aim of this study is to determine, among young Black men who have sex with men (YBMSM), the 12-month efficacy of a single-session, clinic-based intervention promoting condom use to enhance sexual pleasure (purpose 1) and the use of condoms from the start-to-finish of anal sex (purpose 2). A pre-test, post-test randomized controlled trial was conducted, using a 12-month period of follow-up observation, in STI clinics. Data from 394 YBMSM completing baseline and 12-month follow-up assessments were analyzed. The experimental condition comprised a one-to-one, interactive program (Focus on the Future) designed for tailored delivery. Regarding study purpose 1, in an age-adjusted linear regression model for 277 HIV-uninfected men, there was a significant effect of the intervention (Beta=0.13, P =0.036) relative to more favorable sexual experiences when using condoms. Regarding study purpose 2, in an adjusted logistic regression model, for HIV-uninfected men, there was a significant effect of the intervention (AOR=0.54, P =0.048) relative to using condoms from start-to-finish of anal sex. Significant effects for HIV-infected men were not observed. A small, but non-significant, effect was observed relative to men's self-report of always using condoms. This single-session program may be a valuable counseling tool for use in conjunction with pre-exposure prophylaxis-related care for HIV-uninfected YBMSM.

Awareness of HIV results in increased condom sales.

PubMed

1994-12-19

India's government reports a campaign against HIV increased condom sales by 4% in 1994. New Delhi reported a sale of more than 1 billion condoms in 1993-94 after a sharp decline of 8% in 1993, the Times of India said. Increasing awareness of HIV accounted for the growth in the condom market, said an official of Hindustan Latex Ltd. "Men in India do not use condoms for contraception," the company's executive director Daolly Frances said. "They leave that burden to women." The total market sale of condoms for 1994 was 1.1 billion items, almost the same number distributed free of charge under the government's family welfare program. "It is encouraging but still far below the market potential," the chairman of the condom-making company said. The WHO (World Health Organization) has identified India as one of the countries that will witness the greatest explosion of HIV cases in the coming years. According to WHO figures, incidence of HIV in Asia has increased 5 times in the last 3 years from 0.5 million in 1991 to more than 2.5 million cases at present. "The figure is expected to quadruple by the year 2000 to over ten million infections," regional director of WHO for Southeast Asia Uton Muchtar Rafei said on the World AIDS Day December 1, 1994. Official records say there are 885 full-blown AIDS cases in India, with 1.6 million people testing positive for HIV. But non-government organizations place the figure much higher. India's Health Organization said India will have up to 30 million HIV cases by the year 2000. "The epidemic has now moved from sex workers and their clients to housewives and newborn babies," said I.S. Gilhada, secretary-general of Indian Health Organization. A government survey among Bombay's sex workers has shown 52% tested positive for HIV. Despite a $100 million World Bank-WHO funded AIDS control program, reports suggest a gross misuse of government's free condoms distribution scheme. full text

Self-efficacy for AIDS preventive behaviors among tenth grade students.

PubMed

Kasen, S; Vaughan, R D; Walter, H J

1992-01-01

To guide acquired immunodeficiency syndrome (AIDS) prevention program planning, 181 tenth grade students residing in or near an AIDS epicenter completed a survey measuring past year involvement in sexual intercourse and condom use, beliefs about self-efficacy for AIDS preventive behaviors, and beliefs about susceptibility to and severity of AIDS, and outcome efficacy of AIDS preventive actions. A degree of uncertainty existed for all areas of self-efficacy surveyed: refusing sexual intercourse under a variety of circumstances, questioning sex partners about past risky behaviors, and correct and consistent condom use. Students were most uncertain of their ability to refuse sex with a desirable partner, under pressure, or after drinking alcohol or using marijuana; to purchase condoms, or use them consistently after drinking alcohol or using marijuana; and to question partners about past homosexual history. Those students with lower self-efficacy for refusing sex were twice as likely to have had sexual intercourse. Similarly, those students with lower self-efficacy for correct, consistent condom use were five times less likely to have used condoms consistently. These associations remained even after adjusting for the influence of other AIDS-related beliefs. Implications of these findings focus on exploiting the link between self-efficacy and behavior by building a prevention program that emphasizes skills-building rather than the traditional knowledge-only approach.

Sexually transmitted diseases and condom use among female freelance and brothel-based sex workers in Singapore.

PubMed

Wong, M L; Chan, R K; Chua, W L; Wee, S

1999-11-01

Most studies in Asia exclude freelance female sex workers because of difficulties in access and the illegality of their work. Data are lacking on their risk behaviors. To compare sexually transmitted disease (STD) rates, condom use, and health screening behavior between freelance and brothel-based sex workers in Singapore. This is a cross-sectional survey of 111 free-lance sex workers arrested from November 1996 to March 1997 for illicit prostitution and 333 randomly selected brothel-based sex workers. All were tested for STDs. STDs were significantly more prevalent among freelance than brothel-based sex workers (34.8% vs. 24.0%). Inconsistent condom use was significantly higher among freelance than brothel-based sex workers and was significantly associated with younger age, decreasing number of clients, and perception of non-condom use among peers. Educational programs to promote condom use should target freelance sex workers and their clients.

A 1-year follow-up evaluation of a sexual-health education program for Spanish adolescents compared with a well-established program.

PubMed

Morales, Alexandra; Espada, José P; Orgilés, Mireia

2016-02-01

Competencies for adolescents with a healthy sexuality (COMPAS) is the only school-based sexual health promotion program in Spain that has been found to be as effective as an evidence-based intervention (¡Cuídate!) in the short term. This study's aim was to compare data from a 12-month follow-up evaluation on the effects of COMPAS on adolescents' sexual risks (knowledge, attitudes, perceived norms, sexual risk perception and intentions) and sexual behaviours (age of the first sex, consistent condom use and multiple partners) with an evidence-based intervention (¡Cuídate!) and a control group. Eighteen schools from five provinces of Spain were randomly assigned to one of three conditions: COMPAS, ¡Cuídate! and a control group. The adolescents (N = 1563; 34% attrition) were evaluated 1 week before and after the program, and 1 year post-program implementation. We found that the COMPAS program was as effective as ¡Cuídate!, the evidence-based program, in increasing the adolescents' knowledge about sexually transmitted infections and in fostering favourable attitudes about condom use and people living with HIV/AIDS. COMPAS was more effective than ¡Cuídate! in increasing the adolescents' perceptions of their peer's consistent condom use and the age delay of their first vaginal intercourse. However, it was less effective in maintaining the adolescents' intentions to use condoms and in delaying the age of their first oral sex experience. COMPAS was as effective as ¡Cuídate! in reducing sexual risk among adolescents. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Condom use self-efficacy and HIV risk practices among men who use the internet to find male partners for unprotected sex.

PubMed

Klein, Hugh

2014-05-01

This research examines the levels of condom use self-efficacy in a population of men who have sex with men who are at great risk for contracting/transmitting HIV. It focuses on the relationship between condom use self-efficacy and risk involvement, and examines the factors associated with greater/lower levels of condom use self-efficacy. The data come from a national sample of men, randomly chosen, who used any of 16 websites specifically to identify other men with whom they could engage in unprotected sex. Data were collected between January 2008 and May 2009 from 332 men, via telephone interviews. Multivariate analyses and structural equation modeling were used to test a conceptual model based on syndemics theory. Overall levels of condom use self-efficacy were fairly high, and self-efficacy was related inversely to involvement in HIV risk practices. Six factors were found to be indicative of levels of condom use self-efficacy: the number of drug problems experienced, sexual role identity as a "bottom," not caring about the HIV serostatus of potential sex partners, experiencing childhood maltreatment, having confidence in HIV-related information provided in other men's online profiles, and level of HIV knowledge. Condom use self-efficacy plays an integral role in HIV risk practices among high-risk men who have sex with men. This is true despite the fact that, overall, condom use self-efficacy levels were fairly high in this population.

The Dynamics of Condom Use with Regular and Casual Partners: Analysis of the 2006 National Sexual Behavior Survey of Thailand

PubMed Central

Chamratrithirong, Aphichat; Kaiser, Paulina

2012-01-01

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. PMID:22860047

"It's some kind of women's empowerment": the ambiguity of the female condom as a marker of female empowerment.

PubMed

Kaler, A

2001-03-01

The female condom is the latest in a series of sexual and reproductive technologies to be imported into the third world, following the contraceptive pill, the Depo-Provera injection, the latex male condom, and others. It is an example of "traveling technology", which accrues different meanings and connotations in the different settings into which it is introduced in its journey through the circuits of international technological diffusion, from the headquarters of international NGOs and bilateral aid programs, through the bureaucracies of national ministries of health to the communities in urban and rural settings where the condoms are distributed. The female condom almost always carries connotations of women's empowerment, and the possibility of greater sexual autonomy for women. This association is a result of the female condom being the first new "post-Cairo" technology, the diffusion of which was spurred by the consensus reached at the 1994 International Conference on Population and Development in Cairo, at which the need to promote women's empowerment was moved to the center of international family planning and population movements. However, I demonstrate that "empowerment" is an ambiguous term, interpreted in different ways in different contexts. I illustrate this through interviews conducted in 1998 and 1999 with stakeholders in the female condom in Cape Town, Nairobi, and in rural western Kenya. These stakeholders range from directors of US-based development programs to heads of national AIDS-prevention efforts to community-based distributors and primary health care nurses at the village level. I argue that three different notions of empowerment are being articulated with respect to the female condom--two which correspond to Maxine Molyneux's typology of strategic and practical gender interests, and a third in which women's empowerment is conceived of as something which diminished the power of men. I argue further that the disjunctures between these three different notions of what "empowerment" means will pose a challenge for people at all levels which are seeking to make the female condom more widely accessible to women at risk of HIV/AIDS.

Predictors of frequency of condom use and attitudes among sexually active female military personnel in Nigeria

PubMed Central

Essien, E James; Mgbere, Osaro; Monjok, Emmanuel; Ekong, Ernest; Abughosh, Susan; Holstad, Marcia M

2010-01-01

Background Despite awareness of condom efficacy, in protecting against both human immunodeficiency virus/sexually transmitted diseases (HIV/STDs) and unintended pregnancy; some females find it difficult to use or permit condom use consistently because of the power imbalances or other dynamics operating in their relationships with males. The purpose of this study was to determine the factors that predict the frequency of condom use and attitudes among sexually active female military personnel in Nigeria. Methods This study used a cross-sectional design in which a total of 346 responses were obtained from consenting female military personnel in two cantonments in Southwestern Nigeria between 2006 and 2008. The study instrument was designed to assess HIV/acquired immunodeficiency syndrome (AIDS) knowledge (HAK), HIV risk behaviors (HRB), alcohol and drug use, condom attitudes and barriers (CAS) condom use self-efficacy (CUS) and social support to condom use (SSC). The sociodemographic characteristics of participants were also captured. Univariate analysis and multivariable logistic regression were used for modeling the predictors of condom use. Results The results showed that 63% of the respondents reported using condoms always, 26% sometimes used condoms and 11% never used condoms during a sexual encounter in the past three months. Univariate analysis revealed that significant associations existed between CAB (P < 0.05), HRB (P < 0.01) and SSC (P < 0.01) with the frequency of condom use. The following sociodemographic variables: age, marital status, number of children, employment status and type of sexual relationship were also significantly (P ≤ 0.05) associated with consistent condom use in the study group. Multivariate analysis indicated that marital status, type of relationship and CAB were the only significant predictors (r2 = 0.37; P ≤ 0.05) of condom use behaviors after adjusting for all other factors in the model. Conclusions Findings indicate that consistent condom use could be enhanced through gender-specific intervention programs that incorporate the predictor variables identified. These are likely to be successful in decreasing sexual risk behaviors in the subpopulation. PMID:22096387

Assessing the potential of the Woman's Condom for vaginal drug delivery.

PubMed

Kramzer, Lindsay F; Cohen, Jessica; Schubert, Jesse; Dezzutti, Charlene S; Moncla, Bernard J; Friend, David; Rohan, Lisa C

2015-09-01

The Woman's Condom is a new female condom that uses a dissolvable polyvinyl alcohol capsule to simplify vaginal insertion. This preclinical study assessed the feasibility to incorporate an antiviral drug, UC781, into the Woman's Condom capsule, offering a unique drug delivery platform. UC781 capsules were fabricated using methods from the development of the Woman's Condom capsules as well as those used in vaginal film development. Capsules were characterized to evaluate physical/chemical attributes, Lactobacillus compatibility, in vitro safety and bioactivity, and condom compatibility. Two UC781 capsule platforms were assessed. Capsule masses (mg; mean±SD) for platforms 1 and 2 were 116.50±18.22 and 93.80±8.49, respectively. Thicknesses were 0.0034±0.0004 in and 0.0033±0.0004 in. Disintegration times were 11±3 s and 5±1 s. Puncture strengths were 21.72±3.30 N and 4.02±0.83 N. Water content measured 6.98±1.17% and 7.04±1.92%. UC781 content was 0.59±0.05 mg and 0.77±0.11 mg. Both platforms retained in vitro bioactivity and were nontoxic to TZM-bl cells and Lactobacillus. Short-term storage of UC781 capsules with the Woman's Condom pouch did not decrease condom mechanical integrity. UC781 was loaded into a polymeric capsule similar to that of the Woman's Condom product. This study highlights the potential use of the Woman's Condom as a platform for vaginal delivery of drugs relevant to sexual/reproductive health, including those for short- or long-acting HIV prevention. We determined the proof-of-concept feasibility of incorporation of an HIV-preventative microbicide into the Woman's Condom capsule. This study highlights various in vitro physical and chemical evaluations as well as bioactivity and safety assessments necessary for vaginal product development related to female sexual and reproductive health. Copyright © 2015 Elsevier Inc. All rights reserved.

Consistent condom use and its correlates among female sex workers at hair salons: a cross-sectional study in Zhejiang province, China.

PubMed

Ma, Qiaoqin; Jiang, Jianmin; Pan, Xiaohong; Cai, Gaofen; Wang, Hui; Zhou, Xin; Jiang, Tingting; Chen, Lin

2017-11-28

This study investigated condom use among female sex workers (FSWs) at hair salons during commercial sexual interactions over 1 month. We explored the associations of such use with various sexual behaviours, HIV/STI risk perception and related knowledge, self-efficacy regarding condom use, exposure to behavioural interventions, and other factors. This type of information has not been reported in China and is critical for designing and modifying programs aimed at preventing HIV/STI transmission in this group of FSWs and their clients. Our data were derived from a large cross-sectional study conducted among low-tier FSWs in 21 counties within Zhejiang province, China. Data were collected from September to November 2013.Bivariable and multiple logistic regression analyses were used to identify factors associated with self-reported consistent condom use among FSWs working at hair salons. Of 1682 FSWs working at hair salons, 50.5% consistently used condom with clients during the previous month. Multivariable analysis revealed that condom use for commercial sex, consistent vaginal douching after commercial sex, adopting contraceptive measures, high scores on perceived self-efficacy regarding condom use, and exposure to interventions were associated with self-reported consistent condom use; early initiation of commercial sex, experiences with oral sex, rarely/sometimes/often using oral contraceptives, and having seen a doctor were associated with not using condoms. Commercial sex is not effectively protected, and behavioural interventions targeting FSWs should take into account the various factors that are correlated to condom use.

A social cognitive-based model for condom use among college students.

PubMed

Dilorio, C; Dudley, W N; Soet, J; Watkins, J; Maibach, E

2000-01-01

Social cognitive theory has been used extensively to explain health behaviors. Although the influence of one construct in this model-self-efficacy-has been well established, the role of other social cognitive constructs has not received as much attention in human immunodeficiency virus (HIV) prevention research. More complete understanding of how social cognitive constructs operate together to explain condom use behaviors would be useful in developing HIV and sexually transmitted disease (STD) prevention programs for college students. The primary aim of this study was to test a social cognitive-based model of condom use behaviors among college students. Data were collected from a sample of college students attending six different colleges and universities. Participants were 18 to 25 years of age, single, and sexually active. For the sample of 1,380 participants, the mean age was 20.6 years (SD = 1.76). Most participants reported having had vaginal intercourse (95.8%) and oral sex (86.5%); 16% reported anal sex. Self-efficacy was related directly to condom use behaviors and indirectly through its effect on outcome expectancies. As predicted, self-efficacy was related to anxiety, but anxiety was not related to condom use. Substance use during sexual encounters was related to outcome expectancies but not to condom use as predicted. Overall, the findings lend support to a condom use model based on social cognitive theory and provide implications for HIV interventions. Interventions that focus on self-efficacy are more likely to reduce anxiety related to condom use, increase positive perceptions about condoms, and increase the likelihood of adopting condom use behaviors.

Understanding Failure of Condom Use Intention among Adolescents: Completing an Intensive Preventive Intervention

ERIC Educational Resources Information Center

Bauman, Laurie J.; Karasz, Alison; Hamilton, Adaoha

2007-01-01

Although interventions based on cognitive theories can reduce rates of unsafe sexual behavior in adolescents, effect sizes remain small. This study was a qualitative investigation of inner-city adolescents' intentions to use condoms following participation in an intensive safer sex program. In-depth interviews with 26 adolescents were analyzed…

A Daily Diary Analysis of Condom Breakage and Slippage During Vaginal Sex or Anal Sex Among Adolescent Women.

PubMed

Hensel, Devon J; Selby, Sarah; Tanner, Amanda E; Fortenberry, J Dennis

2016-09-01

Adolescent women are disproportionately impacted by the adverse outcomes associated with sexual activity, including sexually transmitted infections (STI). Condoms as a means of prevention relies on use that is free of usage failure, including breakage and/or slippage. This study examined the daily prevalence of and predictors of condom breakage and/or slippage during vaginal sex and during anal sex among adolescent women. Adolescent women (N = 387; 14 to 17 years) were recruited from primary care clinics for a longitudinal cohort study of STIs and sexual behavior. Data were daily partner-specific sexual diaries. Random intercept mixed-effects logistic regression was used to estimate the fixed effect of each predictor on condom breakage/slippage during vaginal or during anal sex (Stata, 13.0), adjusting model coefficients for the correlation between repeated within-participant diary entries. Condom slippage and/or breakage varied across sexual behaviors and was associated with individual-specific (eg, age and sexual interest) and partner-specific factors (eg, negativity). Recent behavioral factors (eg, experiencing slippage and/or breakage in the past week) were the strongest predictors of current condom slippage and/or breakage during vaginal or anal sex. Factors associated with young women's condom breakage/slippage during vaginal or during anal sex should be integrated as part of STI prevention efforts and should be assessed as part of ongoing routine clinical care.

Influence of attitudes on the intention to use condoms in Quebec sexually active male adolescents.

PubMed

Nguyen, M N; Saucier, J F; Pica, L A

1994-05-01

The purpose of this study was to determine the influence of attitudes and other variables on the intention to use condoms in sexually active male adolescents. The survey was conducted from April to June 1989 on a sample of 433 sexually active boys aged 12-19 years registered in secondary schools in Laval, Quebec. Information on condoms provided by parents, peers, school, or media had no positive effect on male adolescents' intention to use condoms. Having a favorable attitude towards contraceptive responsibility, however, was significantly associated with the outcome variable. Endorsement of this responsibility seemed short-lived being replaced by the birth control pill in older adolescents. The study also found that in younger adolescents, intention to use condoms was significantly associated with supportive parental attitudes. The results of this study highlight the importance of developing strategies to encourage sexually active male adolescents to assume greater responsibility for using condoms, and suggest that in order for programs to be effective, STD and acquired immunodeficiency syndrome prevention should be done at younger ages while encouraging parents to take a greater role in sex education.

Correlates of Mandrax use and condom beliefs in preventing sexually transmitted infections among a cohort of South African prison inmates

PubMed Central

Stephens, Torrance T.; Gardner, Darius; Jones, Keena; Sifunda, Sibusiso; Braithwaite, Ronald; Smith, Selina E.

2016-01-01

Background This study was designed to identify the extent to which self-reported Mandrax use impacts condom-use beliefs amongst South African prison inmates. Methods 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. Results 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 (p<0.01); 2) condoms work well to prevent the spread of HIV (p<0.02). Both factors were also inversely related to Mandrax use. Conclusion 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. PMID:26316220

Investing in communities: evaluating the added value of community mobilization on HIV prevention outcomes among FSWs in India.

PubMed

Kuhlmann, Anne Sebert; Galavotti, Christine; Hastings, Philip; Narayanan, Pradeep; Saggurti, Niranjan

2014-04-01

Community mobilization often requires greater time and resource investments than typical interventions, yet few evaluations exist to justify these investments. We evaluated the added benefit of community mobilization on HIV prevention outcomes among female sex workers (FSWs) using a composite measure of volunteer participation in program committees by FSWs. After adjusting for treatment propensity, we used multilevel structural equation modeling (MSEM) to test our program theory. We hypothesized that stronger community mobilization would be associated with increased levels of consistent condom use and with increased levels of perceived fairness, mediated by psychosocial processes. Community mobilization had an indirect effect on consistent condom use mediated through social cohesion and an indirect effect on perceived fairness mediated by collective efficacy. Our results suggest higher levels of community mobilization help improve condom use and reduce perceived discrimination beyond the effects of the core HIV intervention program. We recommend further testing of this model.

A Randomized Trial to Evaluate the Efficacy of a Web-Based HIV Behavioral Intervention for High-Risk African American Women.

PubMed

Billings, Douglas W; Leaf, Samantha L; Spencer, Joy; Crenshaw, Terrlynn; Brockington, Sheila; Dalal, Reeshad S

2015-07-01

The aim of this study was to develop and test a cost-effective, scalable HIV behavioral intervention for African American women. Eighty-three African American women were recruited from a community health center and randomly assigned to either the web-based Safe Sistah program or to a delayed HIV education control condition. The primary outcome was self-reported condom use. Secondary measures assessed other aspects of the gender-focused training included in Safe Sistah. Participants completed self-report assessments prior to randomization, 1- and 4-months after their program experience. Across the entire study period, women in the experimental condition significantly increased their condom use relative to controls (F = 5.126, p = 0.027). Significant effects were also found for sexual communication, sex refusal, condom use after alcohol consumption, and HIV prevention knowledge. These findings indicate that this web-based program could be an important component in reducing the HIV disparities among African American women.

Retailers in social program strategy: the case of family planning.

PubMed

Black, T R; Farley, J U

1977-01-01

The provision of contraceptive agents and devices through hospitals and clinics is not a cost-efficient procedure, therefore the distribution through retailers in a preexisting network is an attractive prospect. To really distribute contraceptives, e.g., birth control pills, the retailer would have to be trained in a format of questions. Two studies of retail marketing were conducted, one in Jamaica for condoms and one in Kenya where a subsidized marketing program for condoms was started in rural areas. More urban shops, which were larger in size, carried condoms than rural shops. Retailers in both areas were completely oriented to their immediate vicinity. Their concerns were with volume and with aggregate demand both before and after subsidized programs. The distribution system requires the additional support of advertising and marketing, but since the structure is in place it can be used with relatively little capital outlay. Research of retailers' attitudes and perceptions is inexpensive and often indicates customer preference and local market conditions.

Determinants of condom breakage among female sex workers in Karnataka, India

PubMed Central

2011-01-01

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 < 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). 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 might be important in predisposing women to condom breakage. PMID:22376237

Development of a scale for attitude toward condom use for migrant workers in India.

PubMed

Talukdar, Arunansu; Bal, Runa; Sanyal, Debasis; Roy, Krishnendu; Talukdar, Payel Sengupta

2008-02-01

The propaganda for the use of condoms remains one of the mainstay for prevention of human immunodeficiency virus (HIV) transmission. In spite of the proven efficacy of condom, some moral, social and psychological obstacles are still prevalent, hindering the use of condoms. The study tried to construct a short condom-attitude scale for use among the migrant workers, a major bridge population in India. The study was conducted among the male migrant workers who were 18-49 years old, sexually active and had heard about condoms and were engaged in nonformal jobs. We recruited 234 and 280 candidates for Phase 1 and Phase 2 respectively. Ten items from the original 40-item Brown's ATC (attitude towards condom) scale were selected in Phase 1. After analysis of Phase 1 results, using principal component analysis six items were found appropriate for measuring attitude towards condom use. These six items were then administered in another group in Phase 2. Utilizing Pearson's correlations, scale items were examined in terms of their mean response scores and the correlation matrix between items. Cornbach's alpha and construct validity were also assessed for the entire sample. Study subjects were categorized as condom users and nonusers. The scale structure was explored by analyzing response scores with respect to the items, using principal component analysis followed by varimax rotation analysis. Principal component analysis revealed that the first factor accounted for 71% of the variance, with eigenvalue greater than one. Eigenvalues of the second factor was less than one. Application of screen test suggests only one factor was dominant. Mean score of six items among condom users was 20.45 and that among nonusers was 16.67, which was statistically significant (P<0.01). Cornbach's alpha coefficient was 0.92. This tailor-made attitude-toward-condom-use scale, targeted for most vulnerable people in India, can be included in any rapid survey for assessing the existing beliefs and attitudes toward condoms and also for evaluating efficacy of an intervention program.

Social Influence and Individual Risk Factors of HIV Unsafe Sex among Female Entertainment Workers in China

PubMed Central

Yang, Xiushi; Xia, Guomei; Li, Xiaoming; Latkin, Carl; Celentano, David

2010-01-01

Female entertainment workers in China are at increased sexual risk of HIV, but causes of their unprotected sex remain poorly understood. We develop a model that integrates information-motivation-behavioral skills (IMB) with social influences and test the model in a venue-based sample of 732 female entertainment workers in Shanghai. Most IMB and social influence measures are statistically significant in bivariate relationships to condom use; only HIV prevention motivation and behavioral self-efficacy remain significant in the multiple regressions. Self-efficacy in condom use is the most proximate correlate, mediating the relationship between information and motivation and condom use. Both peer and venue supports are important, but their influences over condom use are indirect and mediated through prevention motivation and/or self-efficacy. Behavioral intervention is urgently needed and should take a multi-level approach, emphasizing behavioral skills training and promoting a supportive social/working environment. PMID:20166789

An interactive multimedia program to prevent HIV transmission in men with intellectual disability.

PubMed

Wells, Jennifer; Clark, Khaya; Sarno, Karen

2014-05-01

The efficacy of a computer-based interactive multimedia HIV/AIDS prevention program for men with intellectual disability (ID) was examined using a quasi-experimental within-subjects design. Thirty-seven men with mild to moderate intellectual disability evaluated the program. The pretest and posttest instruments assessed HIV/AIDS knowledge (high-risk fluids, HIV transmission, and condom facts) and condom application skills. All outcome measures showed statistically significant gains from pretest to posttest, with medium to large effect sizes. In addition, a second study was conducted with twelve service providers who work with men with ID. Service providers reviewed the HIV/AIDS prevention program, completed a demographics questionnaire, and a program satisfaction survey. Overall, service providers rated the program highly on several outcome measures (stimulation, relevance, and usability).

Associations of sexually transmitted infections with condom problems among young men who have sex with men.

PubMed

Mustanski, Brian; Ryan, Daniel T; Garofalo, Robert

2014-07-01

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.

Incorporating AIDS prevention activities into a family planning organization in Colombia.

PubMed

Vernon, R; Ojeda, G; Murad, R

1990-01-01

Three AIDS prevention activities were incorporated into the services offered by PROFAMILIA in two operations research projects. The activities included: (1) informative talks given both to the general public and to members of target groups by PROFAMILIA's community marketing (CM) program field workers (or instructors); (2) the establishment of condom distribution posts in meeting places of target groups; and (3) mass-media information campaigns on AIDS prevention. Community-based distributors were able to successfully provide information on AIDS to their regular audiences as well as to deliver information and condoms to special target groups without negatively affecting family planning information/education/communication activities and contraceptive sales. A radio campaign that promoted condom use for AIDS prevention did not affect public perceptions about the condom and did not jeopardize PROFAMILIA's image.

A multilevel analysis of gatekeeper characteristics and consistent condom use among establishment-based female sex workers in Guangxi, China.

PubMed

Li, Qing; Li, Xiaoming; Stanton, Bonita; Fang, Xiaoyi; Zhao, Ran

2010-11-01

Multilevel analytical techniques are being applied in condom use research to ensure the validity of investigation on environmental/structural influences and clustered data from venue-based sampling. The literature contains reports of consistent associations between perceived gatekeeper support and condom use among entertainment establishment-based female sex workers (FSWs) in Guangxi, China. However, the clustering inherent in the data (FSWs being clustered within establishment) has not been accounted in most of the analyses. We used multilevel analyses to examine perceived features of gatekeepers and individual correlates of consistent condom use among FSWs and to validate the findings in the existing literature. We analyzed cross-sectional data from 318 FSWs from 29 entertainment establishments in Guangxi, China in 2004, with a minimum of 5 FSWs per establishment. The Hierarchical Linear Models program with Laplace estimation was used to estimate the parameters in models containing random effects and binary outcomes. About 11.6% of women reported consistent condom use with clients. The intraclass correlation coefficient indicated 18.5% of the variance in condom use could be attributed to their similarity between FSWs within the same establishments. Women's perceived gatekeeper support and education remained positively associated with condom use (P < 0.05), after controlling for other individual characteristics and clustering. After adjusting for data clustering, perceived gatekeeper support remains associated with consistent condom use with clients among FSWs in China. The results imply that combined interventions to intervene both gatekeepers and individual FSW may effectively promote consistent condom use.

A Multilevel Analysis of Gatekeeper Characteristics and Consistent Condom Use Among Establishment-Based Female Sex Workers in Guangxi, China

PubMed Central

Li, Qing; Li, Xiaoming; Stanton, Bonita; Fang, Xiaoyi; Zhao, Ran

2010-01-01

Background Multilevel analytical techniques are being applied in condom use research to ensure the validity of investigation on environmental/structural influences and clustered data from venue-based sampling. The literature contains reports of consistent associations between perceived gatekeeper support and condom use among entertainments establishment-based female sex workers (FSWs) in Guangxi, China. However, the clustering inherent in the data (FSWs being clustered within establishment) has not been accounted in most of the analyses. We used multilevel analyses to examine perceived features of gatekeepers and individual correlates of consistent condom use among FSWs and to validate the findings in the existing literature. Methods We analyzed cross-sectional data from 318 FSWs from 29 entertainment establishments in Guangxi, China in 2004, with a minimum of 5 FSWs per establishment. The Hierarchical Linear Models program with Laplace estimation was used to estimate the parameters in models containing random effects and binary outcomes. Results About 11.6% of women reported consistent condom use with clients. The intraclass correlation coefficient indicated 18.5% of the variance in condom use could be attributed to their similarity between FSWs within the same establishments. Women’s perceived gatekeeper support and education remained positively associated with condom use (P < 0.05), after controlling for other individual characteristics and clustering. Conclusions After adjusting for data clustering, perceived gatekeeper support remains associated with consistent condom use with clients among FSWs in China. The results imply that combined interventions to intervene both gatekeepers and individual FSW may effectively promote consistent condom use. PMID:20539262

Modelling the effects of condom use and antiretroviral therapy in controlling HIV/AIDS among heterosexuals, homosexuals and bisexuals.

PubMed

Malunguza, Noble; Mushayabasa, Steady; Chiyaka, Christinah; Mukandavire, Zindoga

2010-09-01

A deterministic compartmental sex-structured HIV/AIDS model for assessing the effects of homosexuals and bisexuals in heterosexual settings in which homosexuality and bisexuality issues have remained taboo is presented. We extend the model to focus on the effects of condom use as a single strategy approach in HIV prevention in the absence of any other intervention strategies. Initially, we model the use of male condoms, followed by incorporating the use of both the female and male condoms. The model includes two primary factors in condom use to control HIV which are condom efficacy and compliance. Reproductive numbers for these models are computed and compared to assess the effectiveness of male and female condom use in a community. We also extend the basic model to consider the effects of antiretroviral therapy as a single strategy. The results from the study show that condoms can reduce the number of secondary infectives and thus can slow the development of the HIV/AIDS epidemic. Further, we note from the study that treatment of AIDS patients may enlarge the epidemic when the treatment drugs are not 100% effective and when treated AIDS patients indulge in risky sexual behaviour. Thus, the treatment with amelioration of AIDS patients should be accompanied with intense public health educational programs, which are capable of changing the attitude of treated AIDS patients towards safe sex. It is also shown from the study that the use of condoms in settings with the treatment may help in reducing the number of secondary infections thus slowing the epidemic.

Protective Parenting, Relationship Power Equity, and Condom Use Among Rural African American Emerging Adult Women

PubMed Central

Kogan, Steven M.; Simons, Leslie G.; Chen, Yifu; Burwell, Stephanie; Brody, Gene H.

2012-01-01

Sexually transmitted infections disproportionately affect African Americans, particularly young women. The influence of a set of interrelated protective parenting processes—instrumental and emotional support, sexual risk communication, and encouragement of goals for employment or education—on emerging adult women was examined. Parenting was hypothesized to affect consistent condom use through its association with women’s reports of power equity in their intimate relationships. Hypotheses were tested with 135 sexually active women 18 to 21 years of age living in rural southern communities. Structural equation modeling indicated that (a) parenting processes predicted women’s self-reported relationship power equity and consistent condom use, and (b) relationship power equity predicted consistent condom use. Limited support emerged for a mediational role of relationship power equity in explaining the influence of parenting on consistent condom use. Parental involvement and young women’s establishment of personal control in their intimate relationships are important goals for sexual risk reduction programs. PMID:23729949

Predicting Condom Use Using the Information-Motivation-Behavioral Skills (IMB) Model: A Multivariate Latent Growth Curve Analysis

PubMed Central

Senn, Theresa E.; Scott-Sheldon, Lori A. J.; Vanable, Peter A.; Carey, Michael P.

2011-01-01

Background The Information-Motivation-Behavioral Skills (IMB) model often guides sexual risk reduction programs even though no studies have examined covariation in the theory’s constructs in a dynamic fashion with longitudinal data. Purpose Using new developments in latent growth modeling, we explore how changes in information, motivation, and behavioral skills over 9 months relate to changes in condom use among STD clinic patients. Methods Participants (N = 1281, 50% female, 66% African American) completed measures of IMB constructs at three time points. We used parallel process latent growth modeling to examine associations among intercepts and slopes of IMB constructs. Results Initial levels of motivation, behavioral skills, and condom use were all positively associated, with behavioral skills partially mediating associations between motivation and condom use. Changes over time in behavioral skills positively related to changes in condom use. Conclusions Results support the key role of behavioral skills in sexual risk reduction, suggesting these skills should be targeted in HIV prevention interventions. PMID:21638196

Relationship Factors and Condom Use Among Women with a History of Intimate Partner Violence.

PubMed

McGrane Minton, Heather A; Mittal, Mona; Elder, Heather; Carey, Michael P

2016-01-01

Women who experience intimate partner violence (IPV) are at increased risk for HIV infection. To further the understanding of the dyadic factors that impact condom use among women, we investigated the impact of three relationship factors (i.e., power, fear, and dependence) on the association between HIV-related information, motivation, and behavioral skills [constructs from the information-motivation-behavioral skills (IMB) model] and condom use among abused women. Data from 133 urban, low-income women recruited from several community-based agencies (e.g., domestic violence agencies, women's health organizations, hospitals, Department of Health and Human Services, and Family Court) showed that these women experienced high levels of IPV and that relationship power, fear of abuse, and partner dependence were all associated with condom use. Multivariable models revealed that fear of abuse and partner dependence moderated the association between IMB constructs and condom use but relationship power did not. Results highlight the critical need to incorporate strategies to address relationship factors in HIV prevention programs with abused women.

Sexual behavior and attitude toward condoms among unmarried in-school and out-of-school adolescents in a high-HIV prevalence region in Ghana.

PubMed

Sallar, Anthony M

Among adolescents in Africa and in the rest of the world, unprotected sexual intercourse is the primary cause of HIV transmission. There is limited information on population based study of adolescents who are not-in-school. A quantitative and qualitative study was conducted among adolescents aged 10-19 (n = 483, mean age = 16.6) in the Ashanti region of Ghana on sexual behavior, condom use, and peer norms regarding sexuality. Age of sexual debut was younger for those in-school. However, out-of-school adolescents were more likely to ever have sexual intercourse (72.2% vs. 27.8%) and use condoms (83.6% vs. 16.4%) compared to their in-school counterparts. Religious affiliation was associated with being less sexually active. Statistically significant differences occurred for condom use and increased sexual activity with age. There is the need for programs to increase condom use. Adolescents in Ghana represent a vulnerable population and concerted efforts must be made to reach them.

Genital Tract Infections, Bacterial Vaginosis, HIV, and Reproductive Health Issues among Lima-Based Clandestine Female Sex Workers

PubMed Central

Perla, M. E.; Ghee, Annette E.; Sánchez, Sixto; McClelland, R. Scott; Fitzpatrick, Annette L.; Suárez-Ognio, Luis; Lama, Javier R.; Sánchez, Jorge

2012-01-01

Sociodemographic and behavioral characteristics of 212 Peruvian female sex workers (FSWs) were analyzed. The association between genital tract infections (GTIs) and risk factors by multivariate analysis was evaluated. Eighty-eight percent of FSWs were diagnosed with at least one GTI (HSV-2 80.1%, BV 44.8%, candidiasis 9.9%, syphilis seropositivity 9.4%, Trichomonas vaginalis 2.4%, HIV seropositivity 2.4%). Reported condom use with clients was nearly universal (98.3%), but infrequent with husband/regular partners (7.3%). In multivariate analysis BV was negatively associated with more consistent condom use (PRR = 0.63, 95% CI, 0.42–0.96). Many had not visited a Sexually Transmitted Infection (STI) clinic or been tested for HIV in the past year (40.6%, 47.1%, resp.). Nonclient contraceptive use was low (57%) and induced abortion was common (68%). High GTI burden and abortions suggest that a services-access gap persists among marginalized FSWs. Continued health outreach programs and integrating family planning and reproductive health services into existing STI clinic services are recommended. PMID:22811592

Color It Real: A Program to Increase Condom Use and Reduce Substance Abuse and Perceived Stress

PubMed Central

Zellner, Tiffany; Trotter, Jennie; Lenoir, Shelia; Walston, Kelvin; Men-Na’a, L’dia; Henry-Akintobi, Tabia; Miller, Assia

2015-01-01

Few interventions have targeted perceived stress as a co-occurring construct central to substance use and subsequent HIV/AIDS risk reduction among African American urban young adults. The Color It Real Program was a seven session, weekly administered age-specific and culturally-tailored intervention designed to provide substance abuse and HIV education and reduce perceived stress among African Americans ages 18 to 24 in Atlanta, GA. Effectiveness was assessed through a quasi-experimental study design that consisted of intervention (n = 122) and comparison (n = 70) groups completing a pre- and post-intervention survey. A series of Analysis of Variance (ANOVA) tests were used to assess pre- to post-intervention changes between study groups. For intervention participants, perceived stress levels were significantly reduced by the end of the intervention (t(70) = 2.38, p = 0.020), condom use at last sexual encounter significantly increased (F = 4.43, p = 0.0360), intervention participants were significantly less likely to drink five or more alcoholic drinks in one sitting (F = 5.10, p = 0.0245), and to use clean needles when injecting the drug (F = 36.99, p = 0.0001). This study is among the first of its kind to incorporate stress management as an integral approach to HIV/SA prevention. The program has implications for the design of other community-based, holistic approaches to addressing substance use and risky behaviors for young adults. PMID:26703653

Exploring the population-level impact of antiretroviral treatment: the influence of baseline intervention context.

PubMed

Mishra, Sharmistha; Mountain, Elisa; Pickles, Michael; Vickerman, Peter; Shastri, Suresh; Gilks, Charles; Dhingra, Nandini K; Washington, Reynold; Becker, Marissa L; Blanchard, James F; Alary, Michel; Boily, Marie-Claude

2014-01-01

To compare the potential population-level impact of expanding antiretroviral treatment (ART) in HIV epidemics concentrated among female sex workers (FSWs) and clients, with and without existing condom-based FSW interventions. Mathematical model of heterosexual HIV transmission in south India. We simulated HIV epidemics in three districts to assess the 10-year impact of existing ART programs (ART eligibility at CD4 cell count ≤350) beyond that achieved with high condom use, and the incremental benefit of expanding ART by either increasing ART eligibility, improving access to care, or prioritizing ART expansion to FSWs/clients. Impact was estimated in the total population (including FSWs and clients). In the presence of existing condom-based interventions, existing ART programs (medium-to-good coverage) were predicted to avert 11-28% of remaining HIV infections between 2014 and 2024. Increasing eligibility to all risk groups prevented an incremental 1-15% over existing ART programs, compared with 29-53% when maximizing access to all risk groups. If there was no condom-based intervention, and only poor ART coverage, then expanding ART prevented a larger absolute number but a smaller relative fraction of HIV infections for every additional person-year of ART. Across districts and baseline interventions, for every additional person-year of treatment, prioritizing access to FSWs was most efficient (and resource saving), followed by prioritizing access to FSWs and clients. The relative and absolute benefit of ART expansion depends on baseline condom use, ART coverage, and epidemic size. In south India, maximizing FSWs' access to care, followed by maximizing clients' access are the most efficient ways to expand ART for HIV prevention, across baseline intervention context.

Strategies to prevent HIV transmission among heterosexual African-American men

PubMed Central

Essien, Ekere J; Meshack, Angela F; Peters, Ronald J; Ogungbade, Gbadebo O; Osemene, Nora I

2005-01-01

Background As part of qualitative research for developing a culturally sensitive and developmentally appropriate videotape-based HIV prevention intervention for heterosexual African- American men, six focus groups were conducted with thirty African-American men to determine their perceptions of AIDS as a threat to the African-American community, characteristics of past situations that have placed African Americans at risk for HIV infection, their personal high risk behaviors, and suggestions on how HIV intervention videotapes could be produced to achieve maximum levels of interest among African-American men in HIV training programs. Methods The groups took place at a low-income housing project in Houston, Texas, a major epicenter for HIV/AIDS. Each group was audiotaped, transcribed, and analyzed using theme and domain analysis. Results The results revealed that low-income African-American men perceive HIV/AIDS as a threat to their community and they have placed themselves at risk of HIV infection based on unsafe sex practices, substance abuse, and lack of knowledge. They also cite lack of income to purchase condoms as a barrier to safe sex practice. They believe that HIV training programs should address these risk factors and that videotapes developed for prevention should offer a sensationalized look at the effects of HIV/AIDS on affected persons. They further believe that programs should be held in African-American communities and should include condoms to facilitate reduction of risk behaviors. Conclusions The results indicate that the respondents taking part in this study believe that HIV and AIDS are continued threats to the African-American community because of sexual risk taking behavior, that is, failure to use condoms. Further, African-American men are having sex without condoms when having sex with women often when they are under the influence of alcohol or other mind-altering substances and they are having sex with men while incarcerated and become infected and once released resume unprotected sexual relations with women. According to the men, substance abuse is an important part of the problem of HIV in the African-American community. This is in keeping with research that shows that drug use, especially crack cocaine, is linked to sexual risk taking among African Americans and to increased likelihood of becoming infected with other sexually transmitted diseases (STDs) including HIV. Thus, interventions for men should address condom use, condom availability, skills for using condoms, eroticizing condoms and substance abuse prevention. Men in the present study also strongly recommended that HIV/AIDS videotaped messages should include footage of the sensational effects of the disease. PMID:15638937

Strategies to prevent HIV transmission among heterosexual African-American men.

PubMed

Essien, Ekere J; Meshack, Angela F; Peters, Ronald J; Ogungbade, Gbadebo O; Osemene, Nora I

2005-01-07

As part of qualitative research for developing a culturally sensitive and developmentally appropriate videotape-based HIV prevention intervention for heterosexual African- American men, six focus groups were conducted with thirty African-American men to determine their perceptions of AIDS as a threat to the African-American community, characteristics of past situations that have placed African Americans at risk for HIV infection, their personal high risk behaviors, and suggestions on how HIV intervention videotapes could be produced to achieve maximum levels of interest among African-American men in HIV training programs. The groups took place at a low-income housing project in Houston, Texas, a major epicenter for HIV/AIDS. Each group was audiotaped, transcribed, and analyzed using theme and domain analysis. The results revealed that low-income African-American men perceive HIV/AIDS as a threat to their community and they have placed themselves at risk of HIV infection based on unsafe sex practices, substance abuse, and lack of knowledge. They also cite lack of income to purchase condoms as a barrier to safe sex practice. They believe that HIV training programs should address these risk factors and that videotapes developed for prevention should offer a sensationalized look at the effects of HIV/AIDS on affected persons. They further believe that programs should be held in African-American communities and should include condoms to facilitate reduction of risk behaviors. The results indicate that the respondents taking part in this study believe that HIV and AIDS are continued threats to the African-American community because of sexual risk taking behavior, that is, failure to use condoms. Further, African-American men are having sex without condoms when having sex with women often when they are under the influence of alcohol or other mind-altering substances and they are having sex with men while incarcerated and become infected and once released resume unprotected sexual relations with women. According to the men, substance abuse is an important part of the problem of HIV in the African-American community. This is in keeping with research that shows that drug use, especially crack cocaine, is linked to sexual risk taking among African Americans and to increased likelihood of becoming infected with other sexually transmitted diseases (STDs) including HIV. Thus, interventions for men should address condom use, condom availability, skills for using condoms, eroticizing condoms and substance abuse prevention. Men in the present study also strongly recommended that HIV/AIDS videotaped messages should include footage of the sensational effects of the disease.

The use of theory based semistructured elicitation questionnaires: formative research for CDC's Prevention Marketing Initiative.

PubMed Central

Middlestadt, S E; Bhattacharyya, K; Rosenbaum, J; Fishbein, M; Shepherd, M

1996-01-01

Through one of its many HIV prevention programs, the Prevention Marketing Initiative, the Centers for Disease Control and Prevention promotes a multifaceted strategy for preventing the sexual transmission of HIV/AIDS among people less than 25 years of age. The Prevention Marketing Initiative is an application of marketing and consumer-oriented technologies that rely heavily on behavioral research and behavior change theories to bring the behavioral and social sciences to bear on practical program planning decisions. One objective of the Prevention Marketing Initiative is to encourage consistent and correct condom use among sexually active young adults. Qualitative formative research is being conducted in several segments of the population of heterosexually active, unmarried young adults between 18 and 25 using a semistructured elicitation procedure to identify and understand underlying behavioral determinants of consistent condom use. The purpose of this paper is to illustrate the use of this type of qualitative research methodology in designing effective theory-based behavior change interventions. Issues of research design and data collection and analysis are discussed. To illustrate the methodology, results of content analyses of selected responses to open-ended questions on consistent condom use are presented by gender (male, female), ethnic group (white, African American), and consistency of condom use (always, sometimes). This type of formative research can be applied immediately to designing programs and is invaluable for valid and relevant larger-scale quantitative research. PMID:8862153

The use of theory based semistructured elicitation questionnaires: formative research for CDC's Prevention Marketing Initiative.

PubMed

Middlestadt, S E; Bhattacharyya, K; Rosenbaum, J; Fishbein, M; Shepherd, M

1996-01-01

Through one of its many HIV prevention programs, the Prevention Marketing Initiative, the Centers for Disease Control and Prevention promotes a multifaceted strategy for preventing the sexual transmission of HIV/AIDS among people less than 25 years of age. The Prevention Marketing Initiative is an application of marketing and consumer-oriented technologies that rely heavily on behavioral research and behavior change theories to bring the behavioral and social sciences to bear on practical program planning decisions. One objective of the Prevention Marketing Initiative is to encourage consistent and correct condom use among sexually active young adults. Qualitative formative research is being conducted in several segments of the population of heterosexually active, unmarried young adults between 18 and 25 using a semistructured elicitation procedure to identify and understand underlying behavioral determinants of consistent condom use. The purpose of this paper is to illustrate the use of this type of qualitative research methodology in designing effective theory-based behavior change interventions. Issues of research design and data collection and analysis are discussed. To illustrate the methodology, results of content analyses of selected responses to open-ended questions on consistent condom use are presented by gender (male, female), ethnic group (white, African American), and consistency of condom use (always, sometimes). This type of formative research can be applied immediately to designing programs and is invaluable for valid and relevant larger-scale quantitative research.

A Daily Diary Analysis of Condom Breakage and Slippage during Vaginal Sex or Anal Sex among Adolescent Women

PubMed Central

Hensel, Devon J.; Selby, Sarah; Tanner, Amanda E.; Fortenberry, J. Dennis

2016-01-01

Background Adolescent women Adolescent women are disproportionately impacted by the adverse outcomes associated with sexual activity, including sexually transmitted infections (STI). Condoms as a means of prevention relies upon use that is free of usage failure, including breakage and/or slippage. This study examined the daily prevalence of and predictors of condom breakage and/or slippage during vaginal sex and during anal sex among adolescent women. Methods Adolescent women (N=387; 14 to 17 years) were recruited from primary care clinics for a longitudinal cohort study of STIs and sexual behavior. Data were daily partner-specific sexual diaries. Random intercept mixed effects logistic regression was used to estimate the fixed effect of each predictor on condom breakage/slippage during vaginal or during anal sex (Stata, 13.0), adjusting model coefficients for the correlation between repeated within-participant diary entries. Results Condom slippage and/or breakage varied across sexual behaviors and was associated with individual-specific (e.g., age and sexual interest) and partner-specific factors (e.g., negativity). Recent behavioral factors (e.g., experiencing slippage and/or breakage in the past week) were the strongest predictors of current condom slippage and/or breakage during vaginal or anal sex Conclusion Factors associated with young women’s condom breakage/slippage during vaginal or during anal sex should be integrated as part of STI prevention efforts, and should be assessed as part of ongoing routine clinical care. PMID:27513377

Addressing a Critical Gap in U.S. National Teen Pregnancy Prevention Programs: The Acceptability and Feasibility of Father-Based Sexual and Reproductive Health Interventions for Latino Adolescent Males.

PubMed

Guilamo-Ramos, Vincent; Bowman, Alex S; Santa Maria, Diane; Kabemba, Francesca; Geronimo, Yoyce

2018-03-01

The purpose of the research was to examine the feasibility and acceptability of a father-based sexual and reproductive health intervention designed to reduce sexual and reproductive (SRH) disparities and increase correct and consistent condom use among Latino adolescent males. The current study conducted in-depth semi-structured interviews with Latino father-son dyads (N=30) designed to elicit perspectives on communication regarding sex and condom use. In addition, the interview protocol included father-son preferences regarding paternal involvement in condom instruction and perceived obstacles and advantages of father direct involvement in education efforts designed to increase correct and consistent condom use among their adolescent sons. Three independent coders conducted both vertical and horizontal analyses of the data to identify emergent themes and reach theoretical saturation. The main findings from this study suggest that Latino fathers can be impactful in shaping Latino adolescent male sexual decision-making and correct and consistent condom use. However, our data highlight that while both feasible and acceptable, Latino fathers identify needing additional support in how best to communicate and seek opportunities to master their own knowledge and skills regarding condom use and effective communication with their adolescent sons about sex. Latino father-based interventions represent an acceptable and feasible option for building upon the recent success of U.S. national efforts to reduce teen pregnancy rates and STI disparities among Latino youth. However, there exists a need for father-based programs that will support Latino fathers in best educating their sons about condom use and better addressing their SRH. Ongoing national efforts to reduce Latino teen SRH disparities warrant the consideration of father-son interventions for Latino adolescent males in the United States. Copyright © 2018. Published by Elsevier Inc.

Latino Youths’ Sexual Values and Condom Negotiation Strategies

PubMed Central

Deardorff, Julianna; Tschann, Jeanne M.; Flores, Elena; de Groat, Cynthia L.; Steinberg, Julia R.; Ozer, Emily J.

2013-01-01

CONTEXT Young Latinos in the United States are at high risk for STDs and are less likely than other youth to use condoms. To our knowledge, no studies have examined the relationship between sexual values and condom negotiation strategies among young Latinos. METHODS Cross-sectional data collected in 2003–2006 from 571 Latino women and men aged 16–22 in the San Francisco Bay Area were used to examine associations between sexual values (e.g., considering sexual talk disrespectful or female virginity important) and use of strategies to engender or avoid condom use. Linear regression analyses were used to identify such associations while adjusting for potential covariates and gender interactions. RESULTS Among women, sexual comfort and comfort with sexual communication were positively associated with frequency of direct communication to foster condom use; the importance of premarital virginity and levels of sexual self-acceptance was positively associated with expressing dislike of condoms to avoid using them; and levels of sexual self-acceptance were negatively associated with expressing dislike of condoms to avoid using them. Moreover, the degrees to which women considered sexual talk disrespectful and female virginity important were positively associated with the frequency with which they shared risk information as a condom use strategy. Among both sexes, the importance that respondents placed on premarital female virginity was negatively associated with use of direct communication strategies. CONCLUSION Researchers designing interventions to influence Latino youths’ sexual decision making and behaviors should consider including program components that address sexual values. PMID:24165307

Latino youths' sexual values and condom negotiation strategies.

PubMed

Deardorff, Julianna; Tschann, Jeanne M; Flores, Elena; de Groat, Cynthia L; Steinberg, Julia R; Ozer, Emily J

2013-12-01

Young Latinos in the United States are at high risk for STDs and are less likely than other youth to use condoms. To our knowledge, no studies have examined the relationship between sexual values and condom negotiation strategies among young Latinos. Cross-sectional data collected in 2003-2006 from 571 Latino women and men aged 16-22 in the San Francisco Bay Area were used to examine associations between sexual values (e.g., considering sexual talk disrespectful or female virginity important) and use of strategies to engender or avoid condom use. Linear regression analyses were used to identify such associations while adjusting for potential covariates and gender interactions. Among women, sexual comfort and comfort with sexual communication were positively associated with frequency of direct communication to foster condom use; the importance of female premarital virginity and levels of sexual self-acceptance were positively associated with expressing dislike of condoms to avoid using them; and levels of sexual self-acceptance were negatively associated with expressing dislike of condoms to avoid using them. Moreover, the degrees to which women considered sexual talk disrespectful and female virginity important were positively associated with the frequency with which they shared risk information as a condom use strategy. Among both sexes, the importance that respondents placed on premarital female virginity was negatively associated with use of direct communication strategies. Researchers designing interventions to influence Latino youths' sexual decision making and behaviors should consider including program components that address sexual values. Copyright © 2013 by the Guttmacher Institute.

Predictors of reported condom use in central Harlem youth as conceptualized by the health belief model.

PubMed

Laraque, D; McLean, D E; Brown-Peterside, P; Ashton, D; Diamond, B

1997-11-01

To examine the relationship of reported condom use to specific sociodemographics, psychosocial variables, and perceptions of and motivations for condom use as conceptualized by the Health Belief Model. This study performed a cross-sectional survey of 557 adolescents enrolled in a hospital-based pregnancy prevention program in an urban community hospital (Harlem Hospital). Multiple logistic regression analysis examined the combined relationship of the significant psychosocial variables to consistent condom use. Males were less likely than females to report teen-parent conflict and depression and more likely to report support for birth control, participation in community activities, and favorable attitudes toward delaying parenthood. Consistent with the Health Belief Model adjusting for age, the strongest predictors of consistent condom use were partner preference for condoms, perceived benefit of avoidance of pregnancy, male gender, and support for birth control (usually by a parent). The data on this urban, predominantly African-American sample of adolescents suggest the importance of the influences on specific motivations to use protection--that is, the wish to avoid pregnancy, human immunodeficiency virus/acquired immunodeficiency syndrome, and sexually transmitted diseases, although the mechanisms are still unclear. In addition, gender and the modifying effects of parental and partner support of the use of protection strongly influence the reported use of condoms by adolescents. These factors (in addition to psychosocial factors such as depression) may be important in planning interventions to increase condom use by sexually active teens.

Wanted: new condom suppliers for USAID (foreign companies need not apply).

PubMed

1992-01-01

The US Agency for International Development (USAID) could have expanded its family planning service budget by 10% had it purchased condoms from foreign manufacturers. In 1991, USAID purchased more than 633 million condoms at 5.3 cents/condom, or $7.63/gross. The United Nations Population Fund (UNFPA) and the International Planned Parenthood Federation (IPPF), however, buy condoms from Korean manufacturers at an approximate cost of 1.7 cents/condom, or $2.50/gross. Had USAID followed suit, more than $22 million would have been saved to be better spent on expanding family planning and AIDS prevention programs in developing countries. The Australian company Ansell supplies 90% of USAID's condoms from its Alabama offices. Alabama Senator Howell Heflin and Ansell representatives have effectively lobbied to make sure that USAID adheres to a policy of buying only American-made products. While the Federal Procurement Act strongly encourages USAID to favor American products, federal law does not bar purchases of products manufactured overseas. USAID also pays considerably more for IUDs than other international agencies. UNFPA and IPPF agree with critics who say that USAID has a responsibility to purchase condoms from less expensive overseas suppliers. In so doing, USAID would maximize the use of American tax dollars while expanding the agency's mission in developing countries. The perceived need to protect a few dozen jobs in Alabama pales next to the potential of sparing hundreds of thousands of lives in Africa.

Moderating Effects of Sexual Orientation and Gender Characteristic on Condom Use Intentions Among Boys' Senior High School Students in Taiwan: An Exploration Based on the Theory of Planned Behavior.

PubMed

Cheng, Chien-Mu; Huang, Jiun-Hau

2017-10-27

This study examined condom use intentions among adolescent boys in relation to the constructs of the Theory of Planned Behavior (TPB): attitude toward the behavior (ATB), subjective norm (SN), and perceived behavioral control (PBC). The potential moderating effects of sexual orientation and gender characteristic (masculine/feminine) were also explored. Anonymous survey data were collected from 929 students enrolled in a boys' senior high school in Taiwan (response rate: 89.9%). Multivariate logistic regression analyses found higher condom use intentions linked to more positive ATB (adjusted odds ratio [AOR] = 8.09) and supportive SN (AOR = 2.73), as well as high PBC under facilitating conditions (AOR = 2.04). Notably, nonheterosexual boys perceiving supportive SN (AOR = 0.23) or high support for condom use from teachers and health educators (AOR = 0.10 and 0.26, respectively) had lower condom use intentions than their heterosexual peers. By contrast, relatively feminine boys perceiving supportive SN (AOR = 2.06) or high support from close friends (AOR = 2.18) had higher condom use intentions than their masculine counterparts. In conclusion, ATB and SN were strongly linked to condom use intentions; PBC was significant only under facilitating conditions. Sexual orientation and gender characteristic had important moderating effects. These empirical findings could inform tailored health education programs to increase condom use intentions in the male student population.

[Happy birthday, Number One] World AIDS Day 1995].

PubMed

1995-12-01

December 1995 was the first anniversary of the arrival of the condom brand Number One in Cambodia. In one year these condoms have seen great success. More than 4 million Number One condoms have been sold. PSI (the distributor of Number One), the newspaper Cambodge Soir, and all the patrons of this special AIDS edition offer their best wishes to all the Cambodian people for the year to come. In 1996, in addition to promoting the use of Number One condoms to prevent AIDS and to promote birth spacing, PSI will lead other operations for all teachers in the country. PSI will equally continue to distribute the education kit that aims to inform primary pupils and secondary students about AIDS. Pursuing this same objective, educational broadcasts will also be featured on radio. PSI, with all those who support its program, wish to thank the loyal clients of Number One by offering them a condom for more pleasure and protection. If you have not yet tried Number One, take advantage then of this opportunity to have sexual relations without risks. PSI hopes that you will then continue to use Number One. Number One is available throughout Cambodia at a cost of 200 riels for four quality condoms.

Efficacy of an HIV Prevention Program Among Female Adolescents Experiencing Gender-Based Violence

PubMed Central

Wingood, Gina M.; DiClemente, Ralph J.; Harrington, Kathy F.; Lang, Delia L.; Davies, Susan L.; Hook, Edward W.; Oh, M. Kim; Hardin, James W.

2006-01-01

Objectives. We examined the efficacy of an HIV prevention intervention among African American female adolescents reporting a history of gender-based violence. Methods. In this analysis of a subgroup of participants involved in a randomized controlled trial, consistent condom use, psychosocial mediators associated with HIV-preventive behaviors, and presence of sexually transmitted diseases were assessed at 6- and 12-month follow-ups. The intervention emphasized ethnic and gender pride, HIV knowledge, condom attitudes, healthy relationships, communication, and condom use skills. Results. Relative to the comparison condition, participants randomized to the intervention reported using condoms more consistently, had fewer episodes of unprotected vaginal sex, engaged in a greater proportion of protected intercourse acts, were more likely to have used a condom during their most recent intercourse, were less likely to have a new sexual partner, were less likely to have a sexually transmitted disease, and demonstrated more proficient condom skills. Conclusions. Given the substantial prevalence of gender-based violence among female adolescents and the associations observed between gender-based violence, HIV risk, and HIV infection, it is essential that HIV interventions involving young women address partner violence. PMID:16670238

Couple-focused human immunodeficiency virus prevention for young Latino parents: randomized clinical trial of efficacy and sustainability.

PubMed

Koniak-Griffin, Deborah; Lesser, Janna; Takayanagi, Sumiko; Cumberland, William G

2011-04-01

To evaluate the efficacy and sustainability of a couple-focused human immunodeficiency virus (HIV) prevention intervention in reducing unprotected sex and increasing intent to use condoms and knowledge about AIDS. Randomized controlled trial. Urban community settings in Southern California. Primarily Latino couples (168 couples; 336 individuals) who were aged 14 to 25 years, English or Spanish speaking, and coparenting a child at least 3 months of age. A 12-hour theory-based, couple-focused HIV prevention program culturally tailored for young Latino parents, with emphasis on family protection, skill building, and issues related to gender and power. The 1½-hour control condition provided basic HIV-AIDS information. Primary outcome measures included self-report of condom use during the past 3 months; secondary, intent to use condoms and knowledge about AIDS. The HIV prevention intervention reduced the proportion of unprotected sex episodes (odds ratio, 0.87 per month from baseline to 6 months; 95% confidence interval [CI], 0.82-0.93) and increased intent to use condoms (slope increase, 0.20; 95% CI, 0.04-0.37) at the 6-month follow-up; however, these effects were not sustained at 12 months. Knowledge about AIDS was increased in both groups from baseline to 6 months (slope estimate, 0.57; 95% CI, 0.47-0.67) and was maintained in the intervention group only through 12 months. Female participants in both groups had higher intent to use condoms and knowledge about AIDS than male participants (P ≤ .01). The couple-focused HIV prevention intervention reduced risky sexual behaviors and improved intent to use condoms among young Latino parents at the 6-month evaluation. A maintenance program is needed to improve the sustainability of effects over time.

Attitudes about AIDS education and condom availability among parents of high school students in New York City: a focus group approach.

PubMed

Rafferty, Y; Radosh, A

1997-02-01

This paper describes parents' views of the New York City Public High School's AIDS Education and Condom Availability Program. It presents findings from 12 focus groups with 81 parents of students at six representative high schools. Focus groups were conducted as part of an independent, comprehensive 3-year evaluation of the program, consisting of both qualitative and quantitative components. Participants were mostly supportive of the program, citing intense concern about AIDS among adolescents, fear that teenagers do not adequately perceive themselves as being vulnerable, and personal experiences with infected relatives and friends. Implications of these findings for program development are discussed and recommendations for social policy changes are presented.

Sexual Assertiveness Skills and Sexual Decision-Making in Adolescent Girls: Randomized Controlled Trial of an Online Program.

PubMed

Widman, Laura; Golin, Carol E; Kamke, Kristyn; Burnette, Jeni L; Prinstein, Mitchell J

2018-01-01

To evaluate the efficacy of an interactive, Web-based sexual health program (Health Education and Relationship Training [HEART]) for developing sexual assertiveness skills and enhancing sexual decision-making in adolescent girls. Participants were 222 tenth-grade girls (mean age = 15.2; 38% White, 29% Hispanic, 25% Black) in the Southeastern United States who were randomized in fall 2015 to the HEART intervention or an attention-matched control. We assessed participants at pretest, immediate posttest, and 4-month follow-up. Both groups had similar demographic and sexual behavior characteristics at pretest. At immediate posttest, girls who completed the HEART program demonstrated better sexual assertiveness skills measured with a behavioral task, higher self-reported assertiveness, intentions to communicate about sexual health, knowledge regarding HIV and other sexually transmitted diseases (STDs), safer sex norms and attitudes, and condom self-efficacy compared with the control condition. At 4-month follow-up, group differences remained in knowledge regarding HIV and other STDs, condom attitudes, and condom self-efficacy. This brief online sexual health program can improve short-term outcomes among adolescent girls and offers an exciting new option in the growing array of digital health interventions available to youths. NCT02579135.

Sociocultural and behavioral contexts of condom use in heterosexual married couples in India: challenges to the HIV prevention program.

PubMed

Bhattacharya, Gauri

2004-02-01

This article examines sociocultural expectations of sexual behavior and the reasons why not using condoms may be logical to married heterosexual couples in India. Married women who report monogamous sexual relationships with their husbands are a high-risk group for HIV infection in India. Based on the public health model and a population-based perspective on HIV infection prevention, this article illustrates the underlying mechanisms that link the role of women in society, holistic health beliefs, and cultural beliefs about the transmission of HIV with the precursors to nonuse of condoms. The author concludes that promoting condom use requires an emphasis on family health, not only as contraceptives. Challenges for reducing the social stigma and developing a comprehensive policy on HIV prevention and AIDS treatment and care are discussed.

Structural Determinants of Inconsistent Condom Use with Clients Among Migrant Sex Workers: Findings of Longitudinal Research in an Urban Canadian Setting

PubMed Central

Sou, Julie; Shannon, Kate; Li, Jane; Nguyen, Paul; Strathdee, Steffanie; Shoveller, Jean; Goldenberg, Shira M.

2015-01-01

Background 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. Methods Questionnaire and HIV/STI testing data from a longitudinal cohort, AESHA, were collected from 2010–2013. Logistic regression using generalized estimating equations (GEE) was used to model correlates of inconsistent condom use by clients among international migrant sex workers over a 3-year study period. Results Of 685 participants, analyses were restricted to 182 (27%) international migrants who primarily originated from China. In multivariate GEE 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 parlours) (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. Conclusions 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 three 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. PMID:25970307

Structural determinants of inconsistent condom use with clients among migrant sex workers: findings of longitudinal research in an urban canadian setting.

PubMed

Sou, Julie; Shannon, Kate; Li, Jane; Nguyen, Paul; Strathdee, Steffanie A; Shoveller, Jean; Goldenberg, Shira M

2015-06-01

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.

Condom use and prevalence of syphilis and HIV among female sex workers in Andhra Pradesh, India - following a large-scale HIV prevention intervention.

PubMed

Rachakulla, Hari Kumar; Kodavalla, Venkaiah; Rajkumar, Hemalatha; Prasad, S P V; Kallam, Srinivasan; Goswami, Prabuddhagopal; Dale, Jayesh; Adhikary, Rajatashuvra; Paranjape, Ramesh; Brahmam, G N V

2011-12-29

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. 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. 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 were small. 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.

Sociocultural and Behavioral Contexts of Condom Use in Heterosexual Married Couples in India: Challenges to the HIV Prevention Program

ERIC Educational Resources Information Center

Bhattacharya, Gauri

2004-01-01

This article examines sociocultural expectations of sexual behavior and the reasons why not using condoms may be logical to married heterosexual couples in India. Married women who report monogamous sexual relationships with their husbands are a high-risk group for HIV infection in India. Based on the public health model and a population-based…

The Mediating Role of Partner Communication Frequency on Condom Use Among African-American Adolescent Females Participating in an HIV Prevention Intervention

PubMed Central

Sales, Jessica M.; Lang, Delia L.; DiClemente, Ralph J.; Latham, Teaniese P; Wingood, Gina M.; Hardin, James W.; Rose, Eve S.

2011-01-01

Objective Although effective HIV prevention interventions have been developed for adolescents, few interventions have explored whether components of the intervention are responsible for the observed changes in behaviors post-intervention. This study examined the mediating role of partner communication frequency on African-American adolescent females’ condom use post-participation in a demonstrated efficacious HIV risk-reduction intervention. Main Outcome Measures Percent condom use in the past 60 days and consistent condom use in the past 6o days across the 12-month follow-up period. Design As part of a randomized controlled trial of African-American adolescent females (N=715), 15-21 years, seeking sexual health services, completed a computerized interview at baseline (prior to intervention) and again 6- and 12-month follow-up post-intervention participation. The interview assessed adolescents’ sexual behavior and partner communication skills, among other variables, at each time point. Using generalized estimating equation (GEE) techniques, both logistic and linear regression models were employed to test mediation over the 12-month follow-up period. Additional tests were conducted to assess the significance of the mediated models. Results Mediation analyses observed that partner communication frequency was a significant partial mediator of both proportion condom-protected sex acts (p =.001) and consistent condom use (p = .001). Conclusion Partner communication frequency, an integral component of this HIV intervention, significantly increased as a function of participating in the intervention partially explaining the change in condom use observed 12-months post-intervention. Understanding what intervention components are associated with behavior change is important for future intervention development. PMID:21843001

Social marketing of condoms in India.

PubMed

Thapa, S; Prasad, C V; Rao, P H; Severy, L J; Rao, S R

1994-01-01

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.

Impact of an HIV prevention intervention on condom use among long distance truckers in India.

PubMed

Juneja, Sachin; Rao Tirumalasetti, Vasudha; Mishra, Ram Manohar; Sethu, Shekhar; Singh, Indra Ramyash

2013-03-01

This paper examines the impact of three components of an HIV prevention program (mid-media, interpersonal communication, and project-run clinics) on consistent condom use by long distance truckers with paid and non-paid female partners in India. Data from 2,723 long distance truckers were analyzed using the propensity score matching approach. Based on utilization of services, the following categories of intervention exposure were derived: no exposure, exposure only to mid-media, exposure only to mid-media and interpersonal communication, exposure only to mid-media and project-run clinics, and exposure to all three intervention components. Compared to those who were not exposed to any intervention, exposure to mid-media alone increased consistent condom use with paid female partners by about ten percent. Exposure to mid-media and visits to project-run clinics increased consistent condom use with non-paid female partners by 26 %. These findings suggest that mid-media events and clinics were the most effective package of services to increase consistent condom use among the long distance truckers.

Correlates of Correct Condom Use Among High-Risk African American Men Attending an Urban STD Clinic in the South

PubMed Central

Crosby, Richard; DiClemente, Ralph J.; Yarber, William L.

2011-01-01

The purpose of this cross-sectional study was to assess prevalence and correlates of correct condom use among high-risk African American men attending a publicly-funded sexually transmitted disease (STD) clinic. Men 18 through 29 years of age and newly diagnosed with a sexually transmitted disease were further assessed for study eligibility. Of 296 meeting eligibility criteria, 271 agreed to participate thereby yielding a participation rate of 91.5%. Correct use, assessed by an index, was reported by 38%. Correct use was associated with having sex with 3 or fewer female sex partners (AOR=3.1), being in an exclusive relationship (AOR=3.2), not indicating problems with the fit or feel of condoms (AOR=2.9), and not being drunk/high while using condoms (AOR=2.6). The correct use of condoms among young African American men newly diagnosed with an STD may be a function of situational factors. These factors could potentially be addressed in the context of clinic-based behavioral intervention programs. PMID:21297891

Relationship Factors and Condom Use among Women with a History of Intimate Partner Violence

PubMed Central

McGrane Minton, Heather A.; Mittal, Mona; Elder, Heather; Carey, Michael P.

2016-01-01

Women who experience intimate partner violence (IPV) are at increased risk for HIV infection. To further the understanding of the dyadic factors that impact condom use among women, we investigated the impact of three relationship factors (i.e., power, fear, and dependence) on the association between HIV-related information, motivation, and behavioral skills [constructs from the Information-Motivation-Behavioral Skills (IMB) model] and condom use among abused women. Data from 133 urban, low-income women recruited from several community-based agencies (e.g., domestic violence agencies, women’s health organizations, hospitals, Department of Health and Human Services, and Family Court) showed that these women experienced high levels of IPV and that relationship power, fear of abuse, and partner dependence were all associated with condom use. Multivariable models revealed that fear of abuse and partner dependence moderated that association between IMB constructs and condom use but relationship power did not. Results highlight the critical need to incorporate strategies to address relationship factors in HIV prevention programs with abused women. PMID:26354519

An AIDS risk reduction program for Dutch drug users: an intervention mapping approach to planning.

PubMed

van Empelen, Pepijn; Kok, Gerjo; Schaalma, Herman P; Bartholomew, L Kay

2003-10-01

This article presents the development of a theory- and evidence-based AIDS prevention program targeting Dutch drug users and aimed at promoting condom use. The emphasis is on the development of the program using a five-step intervention development protocol called intervention mapping (IM). Preceding Step 1 of the IM process, an assessment of the HIV problem among drug users was conducted. The product of IM Step 1 was a series of program objectives specifying what drug users should learn in order to use condoms consistently. In Step 2, theoretical methods for influencing the most important determinants were chosen and translated into practical strategies that fit the program objectives. The main strategy chosen was behavioral journalism. In Step 3, leaflets with role-model stories based on authentic interviews with drug users were developed and pilot tested. Finally, the need for cooperation with program users is discussed in IM Steps 4 and 5.

Condom use among unmarried students in a Hispanic-serving university.

PubMed

Kim, Sunny; De La Rosa, Mario; Trepka, Mary Jo; Kelley, Megan

2007-10-01

This study compares the prevalence of risky sexual behavior between unmarried Hispanic and non-Hispanic students in southern Florida and assesses the role of substance use in risky sexual behavior. Among 815 unmarried respondents, approximately 35% had two or more sexual partners within the past 12 months. Compared with non-Hispanic White students, Hispanic students were less likely to engage in unprotected sex under the influence of alcohol (25% vs. 16%) but also less likely to have been tested for HIV infection (55% vs. 43%). The percentage of students using a condom during their last sexual encounter was 8% (oral), 35% (anal), and 50% (vaginal). For both Hispanic and non-Hispanic students, condom use was low regardless of smoking, heavy alcohol consumption, and marijuana use. From the problem behavior theory perspective, condom use and substance use may have different behavioral origins. These findings can help target and guide the development of prevention programs in university settings.

Condoms for sexually transmissible infection prevention: politics versus science.

PubMed

Mindel, Adrian; Sawleshwarkar, Shailendra

2008-03-01

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.

The association between stress, coping, and sexual risk behaviors over 24 months among African-American female adolescents.

PubMed

Hulland, Erin N; Brown, Jennifer L; Swartzendruber, Andrea L; Sales, Jessica M; Rose, Eve S; DiClemente, Ralph J

2015-01-01

Heightened psychosocial stress coupled with maladaptive coping may be associated with greater sexual risk engagement. This study examined the association between stress levels and coping strategy use as predictors of sexual risk behavior engagement over 24 months among African-American adolescent females (N = 701; M = 17.6 years) enrolled in an STI/HIV risk-reduction intervention program. Participants completed audio computer assisted self-interview (ACASI) measures of global stress, interpersonal stress, coping strategy use, and sexual behaviors prior to intervention participation. Follow-up ACASI assessments were conducted at 6, 12, 18, and 24 months post-intervention. Generalized estimated equation models examined associations between baseline stress levels and coping strategy use as predictors of condom use (past 90 days, last sex) and multiple partners during follow-up. Global stress and individual coping strategy usage were not associated with differences in condom use. Higher interpersonal stress was associated with lower proportion condom use (p = .018), inconsistent condom use (p = .011), and not using a condom at last sex (p = .002). There were no significant associations between stress levels, coping strategy use, and multiple partners. Future research should explore mechanisms that may underlie the association between elevated interpersonal stress and decreased condom use among this population.

Gender differences in condom use prediction with Theory of Reasoned Action and Planned Behaviour: the role of self-efficacy and control.

PubMed

Muñoz-Silva, A; Sánchez-García, M; Nunes, C; Martins, A

2007-10-01

There is much evidence that demonstrates that programs and interventions based on the theoretical models of the Theory of Reasoned Action (TRA) and the Theory of Planned Behaviour (TPB) have been effective in the prevention of the sexual transmission of HIV. The objective of this work is to compare the effectiveness of both models in the prediction of condom use, distinguishing two components inside the variable Perceived Behavioural Control of the TPB model: self-efficacy and control. The perspective of gender differences is also added. The study was carried out in a sample of 601 Portuguese and Spanish university students. The results show that the females have a higher average in all the TPB variables than males, except in the frequency of condom use: females request the use of condoms less frequently than males. On the other hand, for both females and males the TPB model predicts better condom-use intention than the TRA. However there are no differences between the two models in relation to the prediction of condom-use behaviour. For prediction of intention, the most outstanding variable among females is attitude, while among males they are subjective norm and self-efficacy. Finally, we analyze the implications of these data from a theoretical and practical point of view.

Exposure to a community-level HIV prevention intervention: who gets the message.

PubMed

Walls, C T; Lauby, J; Lavelle, K; Derby, T; Bond, L

1998-08-01

As part of the evaluation of a community-level HIV prevention program for women, this study examined predictors of exposure to print media and community outreach and assessed the relationship between exposure to the intervention and condom use behavior. Data from interviews with 479 women randomly selected from the intervention community in 1995 and 1996 were examined. Analysis of demographic and risk characteristics were conducted to identify predictors of exposure to the project's HIV prevention messages. Additionally, logistic regression analyses were conducted to examine the effects of intervention exposure on condom use, controlling for factors related to exposure. The results revealed that the print media campaign reached the largest number of women. However, women at highest risk did not have high rates of exposure to print media, but had greater exposure to outreach. Exposure to print media had an effect on increased communication with a main partner about condom use, but was not significantly related to condom use last time had sex. There were no significant main effects for exposure to outreach on condom use behavior. An important finding of this analysis was that each intervention strategy was successful in reaching a different portion of the target population and that exposure had differential effects on the condom use behavior of particular segments of the target population.

Decision Processes about Condom Use among Shelter-Homeless LGBT Youth in Manhattan

PubMed Central

Ream, Geoffrey L.; Barnhart, Kate F.; Lotz, Kevin V.

2012-01-01

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

The association between stress, coping, and sexual risk behaviors over 24-months among African American female adolescents

PubMed Central

Hulland, Erin N.; Brown, Jennifer L.; Swartzendruber, Andrea L.; Sales, Jessica M.; Rose, Eve S.; DiClemente, Ralph J.

2014-01-01

Heightened psychosocial stress coupled with maladaptive coping may be associated with greater sexual risk engagement. This study examined the association between stress levels and coping strategy use as predictors of sexual risk behavior engagement over 24 months among African American adolescent females (N = 701; M = 17.6 years) enrolled in an STI/HIV risk-reduction intervention program. Participants completed audio computer assisted self-interview (ACASI) measures of global stress, interpersonal stress, coping strategy use, and sexual behaviors prior to intervention participation. Follow-up ACASI assessments were conducted at 6-, 12-, 18-, and 24-months post-intervention. Generalized estimated equation models examined associations between baseline stress levels and coping strategy use as predictors of condom use (past 90 days, last sex) and multiple partners during follow-up. Global stress and individual coping strategy usage were not associated with differences in condom use. Higher interpersonal stress was associated with lower proportion condom use (p=0.018), inconsistent condom use (p=0.011), and not using a condom at last sex (p=0.002). There were no significant associations between stress levels, coping strategy use, and multiple partners. Future research should explore mechanisms that may underlie the association between elevated interpersonal stress and decreased condom use among this population. PMID:25159332

Sexual behavior and HIV transmission risk of Ugandan adults taking antiretroviral therapy: 3 year follow-up.

PubMed

Apondi, Rose; Bunnell, Rebecca; Ekwaru, John Paul; Moore, David; Bechange, Stevens; Khana, Kenneth; King, Rachel; Campbell, James; Tappero, Jordan; Mermin, Jonathan

2011-06-19

Long-term impact of antiretroviral therapy (ART) on sexual HIV-transmission risk in Africa is unknown. We assessed sexual behavior changes and estimated HIV transmission from HIV-infected adults on ART in Uganda. Between 2003 and 2007, we enrolled and followed ART-naive HIV-infected adults in a home-based AIDS program with annual counseling and testing for cohabitating partners, participant transmission risk-reduction plans, condom distribution and prevention support for cohabitating discordant couples. We assessed participants' HIV plasma viral load and partner-specific sexual behaviors. We defined risky sex as intercourse with inconsistent/no condom use with HIV-negative or unknown serostatus partners in previous 3 months. We compared rates using Poisson regression models, estimated transmission risk using established viral load-specific transmission estimates, and documented sero-conversion rates among HIV-discordant couples. Of 928 participants, 755 (81%) had 36 months data: 94 (10%) died and 79 (9%) missing data. Sexual activity increased from 28% (baseline) to 41% [36 months (P < 0.001)]. Of sexually active participants, 22% reported risky sex at baseline, 8% at 6 months (P < 0.001), and 14% at 36 months (P = 0.018). Median viral load among those reporting risky sex was 122,500 [interquartile range (IQR) 45 100-353 000] copies/ml pre-ART at baseline and undetectable at follow-up. One sero-conversion occurred among 62 cohabitating sero-discordant partners (0.5 sero-conversions/100 person-years). At 36 months, consistent condom use was 74% with discordant partners, 55% with unknown and 46% with concordant partners. Estimated HIV transmission risk reduced 91%, from 47.3 to 4.2/1000 person-years. Despite increased sexual activity among HIV-infected Ugandans over 3 years on ART, risky sex and estimated risk of HIV transmission remained lower than baseline levels. Integrated prevention programs could reduce HIV transmission in Africa.

Community mobilization, empowerment and HIV prevention among female sex workers in south India.

PubMed

Blanchard, Andrea K; Mohan, Haranahalli Lakkappa; Shahmanesh, Maryam; Prakash, Ravi; Isac, Shajy; Ramesh, Banadakoppa Manjappa; Bhattacharjee, Parinita; Gurnani, Vandana; Moses, Stephen; Blanchard, James F

2013-03-16

While community mobilization has been widely endorsed as an important component of HIV prevention among vulnerable populations such as female sex workers (FSWs), there is uncertainty as to the mechanism through which it impacts upon HIV risk. We explored the hypothesis that individual and collective empowerment of FSW is an outcome of community mobilization, and we examined the means through which HIV risk and vulnerability reduction as well as personal and social transformation are achieved. This study was conducted in five districts in south India, where community mobilization programs are implemented as part of the Avahan program (India AIDS Initiative) of the Bill & Melinda Gates Foundation. We used a theoretically derived "integrated empowerment framework" to conduct a secondary analysis of a representative behavioural tracking survey conducted among 1,750 FSWs. We explored the associations between involvement with community mobilization programs, self-reported empowerment (defined as three domains including power within to represent self-esteem and confidence, power with as a measure of collective identity and solidarity, and power over as access to social entitlements, which were created using Principal Components analysis), and outcomes of HIV risk reduction and social transformation. In multivariate analysis, we found that engagement with HIV programs and community mobilization activities was associated with the domains of empowerment. Power within and power with were positively associated with more program contact (p < .01 and p < .001 respectively). These measures of empowerment were also associated with outcomes of "personal transformation" in terms of self-efficacy for condom and health service use (p < .001). Collective empowerment (power with others) was most strongly associated with "social transformation" variables including higher autonomy and reduced violence and coercion, particularly in districts with programs of longer duration (p < .05). Condom use with clients was associated with power with others (p < .001), while power within was associated with more condom use with regular partners (p < .01) and higher service utilization (p < .05). These findings support the hypothesis that community mobilization has benefits for empowering FSWs both individually and collectively. HIV prevention is strengthened by improving their ability to address different psycho-social and community-level sources of their vulnerability. Future challenges include the need to develop social, political and legal contexts that support community mobilization of FSWs, and to prospectively measure the impact of combined community-level interventions on measures of empowerment as a means to HIV prevention.

Community mobilization, empowerment and HIV prevention among female sex workers in south India

PubMed Central

2013-01-01

Background While community mobilization has been widely endorsed as an important component of HIV prevention among vulnerable populations such as female sex workers (FSWs), there is uncertainty as to the mechanism through which it impacts upon HIV risk. We explored the hypothesis that individual and collective empowerment of FSW is an outcome of community mobilization, and we examined the means through which HIV risk and vulnerability reduction as well as personal and social transformation are achieved. Methods This study was conducted in five districts in south India, where community mobilization programs are implemented as part of the Avahan program (India AIDS Initiative) of the Bill & Melinda Gates Foundation. We used a theoretically derived “integrated empowerment framework” to conduct a secondary analysis of a representative behavioural tracking survey conducted among 1,750 FSWs. We explored the associations between involvement with community mobilization programs, self-reported empowerment (defined as three domains including power within to represent self-esteem and confidence, power with as a measure of collective identity and solidarity, and power over as access to social entitlements, which were created using Principal Components analysis), and outcomes of HIV risk reduction and social transformation. Results In multivariate analysis, we found that engagement with HIV programs and community mobilization activities was associated with the domains of empowerment. Power within and power with were positively associated with more program contact (p < .01 and p < .001 respectively). These measures of empowerment were also associated with outcomes of “personal transformation” in terms of self-efficacy for condom and health service use (p < .001). Collective empowerment (power with others) was most strongly associated with “social transformation” variables including higher autonomy and reduced violence and coercion, particularly in districts with programs of longer duration (p < .05). Condom use with clients was associated with power with others (p < .001), while power within was associated with more condom use with regular partners (p < .01) and higher service utilization (p < .05). Conclusion These findings support the hypothesis that community mobilization has benefits for empowering FSWs both individually and collectively. HIV prevention is strengthened by improving their ability to address different psycho-social and community-level sources of their vulnerability. Future challenges include the need to develop social, political and legal contexts that support community mobilization of FSWs, and to prospectively measure the impact of combined community-level interventions on measures of empowerment as a means to HIV prevention. PMID:23496972

Impact of an intervention on HIV, sexually transmitted diseases, and condom use among sex workers in Bombay, India.

PubMed

Bhave, G; Lindan, C P; Hudes, E S; Desai, S; Wagle, U; Tripathi, S P; Mandel, J S

1995-07-01

To develop and test an HIV intervention targeting sex workers and madams in the brothels of Bombay. In a controlled intervention trial, with measurements before and after the intervention, 334 sex workers and 20 madams were recruited from an intervention site, and 207 and 17, respectively, from a similar control site, both in red-light areas of Bombay. All sex workers were tested for antibodies to HIV and syphilis, and for hepatitis B surface antigen. Information on sexual practices, condom use and knowledge of HIV was collected by interviewer-administered questionnaire. All subjects in the intervention group underwent a 6-month program of educational videos, small group discussions and pictorial educational materials; free condoms were also distributed. The blood tests and the questionnaire were readministered to all subjects at both sites immediately after the intervention. Both groups were followed for approximately 1 year. The baseline level of knowledge about HIV and experience with condoms was extremely low among both sex workers and madams. The baseline prevalence of HIV antibodies was 47% in the intervention group and 41% in the control group (P = 0.17). The incidence densities for HIV and sexually transmitted diseases were significantly different in the two groups (all P < 0.005): 0.05 and 0.16 per person-year of follow-up for HIV, 0.08 and 0.22 per person-year for antibodies to syphilis, and 0.04 and 0.12 per person-year for hepatitis B surface antigen in the intervention and control women, respectively. Following the intervention, women reported increased levels of condom use, and some (41%) said they were willing to refuse clients who wouldn't use them. However, both the sex workers and the madams were concerned about losing business if condom use was insisted upon. Both HIV prevalence and incidence are alarmingly high among female sex workers in Bombay. Successful interventions can be developed for these women, and even a partial increase in condom use may decrease the transmission of HIV and sexually transmitted diseases. Intervention programs of longer duration that target madams and clients and make condoms easily available are urgently needed at multiple sites in red-light areas.

STD / AIDS prevention: new challenges for family planning programs.

PubMed

Williamson, N; Townsend, S

1991-12-01

Family planning (FP) professionals and programs are increasingly called upon to respond to increasing rates of sexually transmitted diseases (STD) and AIDS. While structural and ideological readjustment to meet these demands may seem problematic for some programs, the AIDS epidemic allows the opportunity for programs to expand into preventive health activities. Dr. Nancy Williamson, Director of Family Health International's Division of Program Evaluation and 1 of the authors of the World Health Organization's guidelines on family planning and AIDS, responds to questions most frequently posed by FP providers considering the need for and process of FP program restructuring. She holds that programmatic expansion for the prevention of HIV infection enhances the capability to provide good contraceptive services. FP programs are not expected to abandon their central missions of preventing unwanted pregnancies, but to engage in both the prevention of STD infection and unwanted pregnancies where possible. Sharing responsible sex behavior and the condom as common means of prevention, these 2 missions are far from mutually exclusive. The AIDS epidemic has impacted upon FP programs in a number of ways. Increased demand for condoms has been observed in countries with high levels of HIV seropositivity, greater concern has been placed upon counseling and sterile procedures, view have been altered to accept this dual role of contraception, and universal precautions for the protection of both client and workers from infection are of greater importance. Promoting the consistent use of condoms for the prevention of STDs has proved more challenging than promoting for contraceptive uses. Gaining the legitimacy of condoms among married couples while they are also promoted among high-risk groups also remains difficult. On other issues, promoting the routine use of 2 temporary methods is not recommended, questions must be posed to determine clients' risk status for infection, counseling and services should be provided to those HIV+, and alternative funding sources may need to be sought for FP program expansion. Arguments for and against such expansion are discussed. Most of sub-Saharan Africa, the Caribbean, and Thailand are in most serious need of programmatic changes, India and most of Central and South American need some changes, and other areas would benefit from minor changes. Dr. Williamson finally considers how programs should be modified, changes made thus far by programs, and suggests what programs may do to enhance their capability to provide contraceptive services.

Review of HIV Vulnerability and Condom Use in Central and Eastern Europe

PubMed Central

Amirkhanian, Yuri A.

2015-01-01

The epidemiological trend of increasing HIV incidence rates due to sexual transmission in Central and Eastern Europe has been documented. The current review analyzed research articles that report on a wide spectrum of vulnerable populations from this world region. Studies of injection drug users, commercial sex workers, men who have sex with men, adolescents and young adults all reported inconsistent condom use. However, these patterns varied across populations and geographic areas. Populations in former Soviet countries—most affected by HIV—also often appeared to have lower condom use rates. Intensified, comprehensive, and locally-tailored measures to curb sexual HIV transmission are urgently needed. Social development programs need to incorporate HIV prevention. PMID:22348631

Behavior change communication and mobile populations: the evaluation of a cross-border HIV/AIDS communication strategy amongst migrants from Swaziland.

PubMed

Silvestre, Eva; Weiner, Renay; Hutchinson, Paul

2016-01-01

This study investigates the effect of being exposed to the Soul City Southern Africa Regional OneLove campaign, a behavior change communication program, on sexual behavior and condom use among a mobile population in Swaziland. Data for this study come from a nationally representative sample of 845 individuals who reported traveling to neighboring countries for at least two weeks at any time in the previous two years. Respondents were asked about exposure to the campaign through television, radio, booklets, posters, and advertisements both in Swaziland and in the other countries where they had traveled in the previous two years. Odds ratios were used to estimate the relationships between the HIV/AIDS outcomes of interest and program exposure for the full sample as well as separately for males and females. The program had no effect on reducing known risky behaviors such as having multiple sexual partners. However, men exposed in Swaziland only (AOR = 3.4, CI 1.2-9.4) and in Swaziland and another country (AOR = 2.8, CI 1.0-7.7) were more likely to report using a condom at last sex. In the full sample, those exposed in Swaziland were more likely to report using a condom at last sex (AOR = 2.6, CI 1.3-5.3) and a condom at last sex with a regular partner (AOR = 2.3, CI 1.1-4.8). Men who reported multiple sexual partnerships and who were exposed in Swaziland and another country were nine times as likely to report condom at last sex than men with no exposure. Respondents exposed in Swaziland and another country were more likely to have been tested for HIV; this was true for the total population (AOR = 2.9, CI 1.1-7.9) and for men separately (AOR = 3.3, CI 1.1-10.1). These findings provide support for more regional HIV prevention programs in Southern Africa as a way to increase positive behaviors among mobile populations.

A randomized controlled trial to increase information, motivation, and behavioral skills in Ugandan adolescents

PubMed Central

Ybarra, Michele L.; Korchmaros, Josephine D.; Prescott, Tonya L.; Birungi, Ruth

2015-01-01

Background One in twenty-five Ugandan adolescents is HIV positive. Purpose Examine the impact of an Internet-based HIV prevention program on Information-Motivation-Behavior Skills Model-related constructs. Methods Three hundred and sixty-six sexually experienced and inexperienced students 12-18+ years-old in Mbarara, Uganda were randomly assigned to: the five-lesson CyberSenga program or treatment-as-usual. Half of the intervention participants were further randomized to a booster session. Assessments were collected at three and six months post-baseline. Results Participants’ HIV-related information improved over time at a greater rate for the intervention groups compared to the control group. Motivation for condom use changed to a greater degree over time for the intervention group – especially those in the intervention+booster group - compared to the control group. Behavioral skills for condom use, and motivation and behavioral skills for abstinence were statistically similar over time for both groups. Conclusions CyberSenga improves HIV preventive information and motivation to use condoms. PMID:25633626

Awareness, acceptability, and use of female condoms among university students in Nigeria: implications for STI/HIV prevention.

PubMed

Tobin-West, Charles I; Maduka, Omosivie; Onyekwere, Victor N; Tella, Adedayo O

2014-01-01

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.

A cross-sectional study to evaluate factors related to condom use with commercial sexual partners in workers from Ecuadorian companies.

PubMed

Cabezas, María C; Fornasini, Marco; Dardenne, Nadia; Barmettler, David; Borja, Teresa; Albert, Adelin

2015-09-04

Unprotected intercourse with sex workers is one of the major risk factors for HIV infection. Consistent condom use is a prerequisite to lower the incidence of HIV. We assessed the prevalence of condom use and its determinants among company workers engaged with commercial sexual partners in Ecuador. The study was based on a random sample of 115 companies and 1,732 workers stratified by province and working sector and utilized the "Behavioral Surveillance Surveys - Adult questionnaire" developed by Family Health International. Of the 1,561 sexually active workers, 311 (19.9%) reported having intercourse with sex workers. Among them 25.9% did not use a condom at the last sexual intercourse. As for condom use frequency over the last 12 months, 29/208 (13.9%) reported never, 23 (11.1%) sometimes, 24 (11.5%) almost every time and 132 (63.5%) every time. Factors adversely affecting condom use frequency over the last 12 months were female gender (OR = 4.56, 95% CI: 1.45-14.4), older age (OR = 1.07, 95% CI: 1.03-1.10), low educational level (OR = 4.69, 95% CI: 1.95-11.3) and married workers living with spouse (OR = 7.66, 95 % CI: 3.08-19.1). By contrast, factors such as age at first sexual intercourse, job category, HIV transmission and prevention measure knowledge, single workers, previous exposure to HIV intervention programs and having a casual sexual partner were not affecting condom use frequency. When considering condom use during the last sexual intercourse or during the past 12 months with commercial sexual partners, results were similar. Workers with low education, older age, female gender and those married living with their spouse should be targeted for specific educational interventions.

Sexual Decision-Making in HIV-Positive Men Who Have Sex with Men: How Moral Concerns and Sexual Motives Guide Intended Condom Use with Steady and Casual Sex Partners

PubMed Central

Hospers, Harm J.; van Empelen, Pepijn; Breukelen, Gerard van; Kok, Gerjo

2007-01-01

Determinants of intended condom use with steady and casual sex partners were examined among Dutch HIV-positive men who have sex with men (MSM) (N = 296). Given the proposition that safer sex behavior among HIV-positive people is a form of prosocial behavior, the present study extended the general framework of the Theory of Planned Behavior with Schwartz’s norm-activation theory and tested the assumption that personal norms would mediate the effects of other psychosocial factors on intended condom use for anal sex. In addition, it was hypothesized that, depending on the context in which sex occurs, specific motives for unprotected anal sex may have a negative influence on intended condom use and, as such, undermine a prosocial tendency to practice safer sex. Therefore, we also investigated the influence of sexual motives for unprotected anal sex on intended condom use with steady and casual sex partners. Results indicated that the Theory of Planned Behavior adequately predicted condom use intentions (for casual sex partners and steady sex partners, the explained variance was 52% and 53%, respectively). However, our proposed model of sexual decision-making significantly improved the prediction of behavioral intentions. For steady and casual sex partners, the assumption of the mediating role of personal norms on condom use intention was confirmed empirically. Additionally, sexual motives for unprotected anal sex exerted, as expected, a direct, negative effect on condom use intention with casual sex partners. The implications of the findings for future research and the development of HIV-prevention programs for HIV-positive MSM are discussed. PMID:17333328

Client and Provider Perspectives on New HIV Prevention Tools for MSM in the Americas

PubMed Central

Lippman, Sheri A.; Koester, Kimberly A.; Amico, K. Rivet; Lama, Javier R.; Martinez Fernandes, Nilo; Gonzales, Pedro; Grinsztejn, Beatriz; Liu, Al; Buchbinder, Susan; Koblin, Beryl A.

2015-01-01

Men who have sex with men (MSM) in the Americas require targeted, combination HIV prevention approaches. We solicited client and provider perspectives on emerging prevention interventions including HIV pre-exposure prophylaxis (PrEP) and HIV self-tests through focus groups and in-depth interviews with 130 MSM and 41 providers across four sites: New York, San Francisco, Lima, and Rio de Janeiro. Among the MSM participants, we identified three prevention typologies: non-condom users, inconsistent condom users, and consistent condom users. Northern and Southern MSM differed in the variety of harm reduction strategies utilized: where U.S. MSM relied on condom use as well as disclosure and seroadaptive behaviors for prevention, condom use without disclosure or serostatus discussions was the norm in South America. Interest in new prevention technologies was shaped by the social context. U.S. MSM preferences differed by typology, such that non-condom users were interested in taking PrEP and using home HIV tests. MSM in Brazil, regardless of typology, were interested in exploring new prevention options. MSM in Peru demonstrated moderate interest but were less comfortable with adopting new strategies. MSM and providers’ opinions differed substantially with respect to new prevention options. Across sites, most providers were reticent to engage with new prevention options, though some NGO-based providers were more supportive of exploring new prevention tools. Both clients and providers will need to be engaged in developing integrated prevention strategies for MSM. PMID:25826246

Client and provider perspectives on new HIV prevention tools for MSM in the Americas.

PubMed

Lippman, Sheri A; Koester, Kimberly A; Amico, K Rivet; Lama, Javier R; Martinez Fernandes, Nilo; Gonzales, Pedro; Grinsztejn, Beatriz; Liu, Al; Buchbinder, Susan; Koblin, Beryl A

2015-01-01

Men who have sex with men (MSM) in the Americas require targeted, combination HIV prevention approaches. We solicited client and provider perspectives on emerging prevention interventions including HIV pre-exposure prophylaxis (PrEP) and HIV self-tests through focus groups and in-depth interviews with 130 MSM and 41 providers across four sites: New York, San Francisco, Lima, and Rio de Janeiro. Among the MSM participants, we identified three prevention typologies: non-condom users, inconsistent condom users, and consistent condom users. Northern and Southern MSM differed in the variety of harm reduction strategies utilized: where U.S. MSM relied on condom use as well as disclosure and seroadaptive behaviors for prevention, condom use without disclosure or serostatus discussions was the norm in South America. Interest in new prevention technologies was shaped by the social context. U.S. MSM preferences differed by typology, such that non-condom users were interested in taking PrEP and using home HIV tests. MSM in Brazil, regardless of typology, were interested in exploring new prevention options. MSM in Peru demonstrated moderate interest but were less comfortable with adopting new strategies. MSM and providers' opinions differed substantially with respect to new prevention options. Across sites, most providers were reticent to engage with new prevention options, though some NGO-based providers were more supportive of exploring new prevention tools. Both clients and providers will need to be engaged in developing integrated prevention strategies for MSM.

Risk reduction and perceived collective efficacy and community support among female sex workers in Tamil Nadu and Maharashtra, India: the importance of context.

PubMed

Guha, Mohua; Baschieri, Angela; Bharat, Shalini; Bhatnagar, Tarun; Sane, Suvarna Sanjay; Godbole, Sheela V; S, Saravanamurthy P; Mainkar, Mandar Keshav; Williams, Joseph; Collumbien, Martine

2012-10-01

Empowering sex workers to mobilise and influence the structural context that obstructs risk reduction efforts is now seen an essential component of successful HIV prevention programmes. However, success depends on local programme environments and history. The authors analysed data from the Integrated Behavioural and Biological Assessment Round I cross-sectional survey among female sex workers in Tamil Nadu and Maharashtra. The authors used propensity score matching to estimate the impact of participation in intervention activities on reduction of risk (consistent condom use) and vulnerability (perceived collective efficacy and community support). Background levels of risk and vulnerability as well as intervention impact varied widely across the different settings. The effect size ATT of attending meetings/trainings on consistent condom use was as high as 21% in Tamil Nadu (outside of Chennai) where overall use was lowest at 51%. Overall, levels of perceived collective efficacy were low at the time of the survey; perceived community support was high in Tamil Nadu and especially in Chennai (93%) contrasting with 33% in Mumbai. Consistent with previous research, the context of Mumbai seems least conducive to vulnerability reduction, yet self-help groups had a significant impact on consistent condom use (ATT=10%) and were significantly associated with higher collective efficacy (ATT=31%). Significant risk reduction can be achieved by large-scale female sex worker interventions, but the impact depends on the history of programming, the complexity of the context in which sex work happens and pre-existing levels of support sex workers perceive from their peers.

New Campaign in Thailand.

PubMed

Phelan, B J

1975-02-09

A program run by Community-Based Family Planning Services in rural Banglamoong, Thailand, is completing its first year of family planning efforts with considerable success. Under the program, district leaders such as the police chief, doctor, school prinicipal and pharmacist, are approached and asked to recommend village inhabitants to serve as distributors of birth control pills and condoms and as referral agents for people desiring IUD insertion and sterilization. These people, who receive 5 cents for every pill or condom sale, act as salemen with a simple message, "Too many children make you poor." The fact that they are members of the community and convenient to the inhabitants has made the program more successful than some programs at the district and national level. In addition, the volunteers have formed the nucleus of a broad-based paramedical corps trained to recognize signs of certain deseases.

Extensive advertising. Turkey.

PubMed

Yaser, Y

1993-12-01

The Turkish Family Health and Planning Foundation set out with the support of the US Agency for International Development in 1988 to develop a contraceptive social marketing program. It was designed to increase the availability and use of condoms and low-dose pills, while maximizing the participation of the private sector. The program would build a market using existing infrastructure; collaborate and participate with 4 major pharmaceutical companies; use all commercial products and nothing donated; and negotiate for commercial product prices without subsidy. Full cost recovery and self-sufficient operation was projected to be realized by the 4th year of sales. The OK condom brand was created for the program and marketed through television, open air advertisements, gifts, and sponsorship from mid-1991. 4.46 million units were sold over the period May-December 1991 and 5.76 million over January-November 1992; these figures were 127% and 115% above sales targets, respectively. The OK brand dominated the market of everusers with 41.1% having employed the brand. Data suggest that the condoms are effectively being used by the urban and comparatively poor segments of society. Sales volumes were so robust that the commercial sector expanded the product line on its own to offer OK Extra.

A qualitative exploration of sexual risk and HIV testing behaviors among men who have sex with men in Beirut, Lebanon.

PubMed

Wagner, Glenn J; Aunon, Frances M; Kaplan, Rachel L; Rana, Yashodhara; Khouri, Danielle; Tohme, Johnny; Mokhbat, Jacques

2012-01-01

Men who have sex with men (MSM) may account for most new HIV infections in Lebanon, yet little is known about the factors that influence sexual risk behavior and HIV testing in this population. Qualitative interviews were conducted with 31 MSM living in Beirut, and content analysis was used to identify emergent themes. Mean age of the participants was 28.4 years, and all identified as either gay (77%) or bisexual (23%). Half reported not using condoms consistently and one quarter had not been HIV-tested. Many described not using condoms with a regular partner in the context of a meaningful relationship, mutual HIV testing, and a desire to not use condoms, suggesting that trust, commitment and intimacy play a role in condom use decisions. Condoms were more likely to be used with casual partners, partners believed to be HIV-positive, and with partners met online where men found it easier to candidly discuss HIV risk. Fear of infection motivated many to get HIV tested and use condoms, but such affect also led some to avoid HIV testing in fear of disease and social stigma if found to be infected. Respondents who were very comfortable with their sexual orientation and who had disclosed their sexuality to family and parents tended to be more likely to use condoms consistently and be tested for HIV. These findings indicate that similar factors influence the condom use and HIV testing of MSM in Beirut as those observed in studies elsewhere of MSM; hence, prevention efforts in Lebanon can likely benefit from lessons learned and interventions developed in other regions, particularly for younger, gay-identified men. Further research is needed to determine how prevention efforts may need to be tailored to address the needs of men who are less integrated into or do not identify with the gay community.

A Qualitative Exploration of Sexual Risk and HIV Testing Behaviors among Men Who Have Sex with Men in Beirut, Lebanon

PubMed Central

Wagner, Glenn J.; Aunon, Frances M.; Kaplan, Rachel L.; Rana, Yashodhara; Khouri, Danielle; Tohme, Johnny; Mokhbat, Jacques

2012-01-01

Men who have sex with men (MSM) may account for most new HIV infections in Lebanon, yet little is known about the factors that influence sexual risk behavior and HIV testing in this population. Qualitative interviews were conducted with 31 MSM living in Beirut, and content analysis was used to identify emergent themes. Mean age of the participants was 28.4 years, and all identified as either gay (77%) or bisexual (23%). Half reported not using condoms consistently and one quarter had not been HIV-tested. Many described not using condoms with a regular partner in the context of a meaningful relationship, mutual HIV testing, and a desire to not use condoms, suggesting that trust, commitment and intimacy play a role in condom use decisions. Condoms were more likely to be used with casual partners, partners believed to be HIV-positive, and with partners met online where men found it easier to candidly discuss HIV risk. Fear of infection motivated many to get HIV tested and use condoms, but such affect also led some to avoid HIV testing in fear of disease and social stigma if found to be infected. Respondents who were very comfortable with their sexual orientation and who had disclosed their sexuality to family and parents tended to be more likely to use condoms consistently and be tested for HIV. These findings indicate that similar factors influence the condom use and HIV testing of MSM in Beirut as those observed in studies elsewhere of MSM; hence, prevention efforts in Lebanon can likely benefit from lessons learned and interventions developed in other regions, particularly for younger, gay-identified men. Further research is needed to determine how prevention efforts may need to be tailored to address the needs of men who are less integrated into or do not identify with the gay community. PMID:23029103

The Past, Present, and Future of HIV Prevention: Integrating Behavioral, Biomedical, and Structural Intervention Strategies for the Next Generation of HIV Prevention

PubMed Central

Rotheram-Borus, Mary Jane; Swendeman, Dallas; Chovnick, Gary

2010-01-01

In the past 25 years, the field of HIV prevention research has been transformed repeatedly. Today, effective HIV prevention requires a combination of behavioral, biomedical, and structural intervention strategies. Risk of transmitting or acquiring HIV is reduced by consistent male and female-condom use, reductions in concurrent and/or sequential sexual and needle-sharing partners, male circumcision, and treatment with antiretroviral medications. At least 144 behavioral prevention programs have been found effective in reducing HIV transmission acts; however, scale up of these programs has not occurred outside of the United States. A series of recent failures of HIV-prevention efficacy trials for biomedical innovations such as HIV vaccines, treating herpes simplex 2 and other sexually transmitted infections, and diaphragm and microbicide barriers highlights the need for behavioral strategies to accompany biomedical strategies. This challenges prevention researchers to reconceptualize how cost-effective, useful, realistic, and sustainable prevention programs will be designed, delivered, tested, and diffused. The next generation of HIV prevention science must draw from the successes of existing evidence-based interventions and the expertise of the market sector to integrate preventive innovations and behaviors into everyday routines. PMID:19327028

Condom use and prevalence of syphilis and HIV among female sex workers in Andhra Pradesh, India – following a large-scale HIV prevention intervention

PubMed Central

2011-01-01

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 were small. 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. PMID:22376071

The other STDs. Linked with HIV transmission, they are attracting new attention.

PubMed

Lande, R E

1992-12-01

Health officials began neglecting sexually transmitted diseases (STDs) (syphilis, gonorrhea, chlamydia, trichomoniasis, and chancroid) when the AIDS epidemic began. They now refocus efforts on STDs because data indicate that STDs facilitate HIV transmission. Even though the risk of HIV transmission is lower in people with nonulcerative STDs than those with genital ulcers (0-4 vs. 2-5 times), the link between nonulcerative STDs and HIV transmission is a greater problem since nonulcerative STD cases occur more often than genital ulcers. Many AIDS control programs execute STD control activities. Countries must improve existing STD control programs. They should strengthen STD surveillance. Viet Nam has established surveillance sites at STD clinics in 4 cities. Training different health providers in STD control would make STD services accessible to more people. These providers include nurses, midwives, pharmacists, and even traditional healers and should be based at pharmacies and primary health care, maternal and child health, and family planning clinics. Primary health care workers should use symptoms to diagnose and treat STDs rather than laboratory tests. 1 drawback of this syndromic approach is that about 50% of women do not exhibit STD symptoms. STD control programs must guarantee a steady reserve of drugs. In Zimbabwe, primary health clinics receive STD drugs from a decentralized drug distribution system (5-8 warehouses) rather than the older centralized system (1 warehouse). This has reduced the waiting time from 6 months to 4-6 weeks. Programs need to encourage individuals to seek early treatment of STDs via health education campaigns (e.g., mass media), outreach to high risk groups such as prostitutes and the patron, and contact tracing. STD counselors should promote condom use. An STD program in Nairobi, Kenya informs patients to use a condom during sex with any causal sex partner, shows patients how to put on and take off the condom, and tells them where they can obtain condoms.

[Alcohol and illicit drug use and its influence on the sexual behavior of teenagers from Minas Gerais State, Brazil].

PubMed

Bertoni, Neilane; Bastos, Francisco I; Mello, Maeve Brito de; Makuch, Maria Yolanda; Sousa, Maria Helena de; Osis, Maria José; Faúndes, Anibal

2009-06-01

This article summarizes the findings of a survey including 5,981 students from public schools in Minas Gerais State, Brazil. The analysis assessed the influence of drug use on sexual practices. Among the boys engaged in relationships with casual partners who stated having used illicit drugs, 55.7% reported consistent condom use, as compared to 65.4% among those not reporting such habits. Among boys engaged in relationships with stable partners who reported illicit drug use, consistent condom use was reported by 42.7%, versus 64.1% among those not reporting such habits. In the subgroup of boys engaged in stable relationships who did not report illicit drug use, consistent condom use was less frequent among those that used alcohol/cigarettes, compared to those who did not drink or smoke (60.7% vs. 71.1%). Girls were less likely than boys to use condoms consistently, regardless of the nature of their relationships, without a noticeable influence of drug use. Policies to prevent drug abuse, sexually transmitted diseases, and unplanned pregnancy should be fully integrated.

Men who have sex with men in Southeastern Europe: Underground and at increased risk for HIV/STIs.

PubMed

Longfield, Kim; Astatke, Hibist; Smith, Reid; McPeak, Georgia; Ayers, Jim

2007-01-01

This paper reports on research that aimed to identify risk factors and preventive behaviours for HIV/STIs among men who have sex with men in Bulgaria, Kosovo, Macedonia and Romania. Twelve peer researchers conducted interviews on sexual behaviour, condom use and HIV/STI awareness. Data analysis revealed common themes across countries. Sexual activity takes place both in public spaces and private homes. Many men believe that careful partner selection and closing sexual networks to outsiders mitigate risk. Risk behaviours include unprotected sex within multiple partnerships, inconsistent condom use and the use of oil-based lubricants that compromise the integrity of condoms. Perceived susceptibility for infection is low and misconceptions exist about modes of transmission. Stigma and discrimination force men into clandestine settings and relationships where safer sexual behaviour is difficult. HIV prevention programmes should convey messages through the internet and peer networks, improve access to condoms and water-based lubricant, raise awareness about STIs, link men who have sex with men to appropriate services and reduce stigma to enable safer behaviour.

Social marketing of condoms: selling protection and changing behavior.

PubMed

Townsend, S

1991-06-01

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.

Condom Use Negotiation in Heterosexual African-American Adults: Responses to Types of Social Power-Based Strategies

PubMed Central

Otto-Salaj, Laura L.; Reed, Barbara; Brondino, Michael J.; Gore-Felton, Cheryl; Kelly, Jeffrey A.; Stevenson, L. Yvonne

2009-01-01

Little research has been performed on how people respond to different strategies to negotiate condom use in sexual situations, and whether certain strategies tend to be perceived as more or less effective in condom use negotiation. This study examined gender differences and preferences in the use of and response to six different styles of condom use negotiation with a hypothetical sexual partner of the opposite gender. Participants were 51 heterosexually-active African-American men and women between the ages of 18 and 35, attending an inner-city community center. Study participants completed a semi-structured qualitative interview in which they were presented with six negotiation strategies —coercive, reward, legitimate, expert, referent, and informational--based on Raven’s 1992 Power/Interaction Model of Interpersonal Influence. Results showed that women participants responded best to referent, reward, and legitimate strategies, and worst to informational tactics. Men participants responded best to reward strategies, and worst to coercion to use condoms. Further, responses given by a subset of both women—and, to a greater extent, men--indicated that use of negotiation tactics involving coercion to use condoms may result in negative or angry reactions. Finally, response to strategies may vary with the value of the relationship as viewed by the target of negotiation. Implications for HIV prevention programs and media campaigns are discussed. PMID:18569536

Condom use among heterosexual immigrant Latino men in the southeastern United States.

PubMed

Knipper, Emily; Rhodes, Scott D; Lindstrom, Kristen; Bloom, Fred R; Leichliter, Jami S; Montaño, Jaime

2007-10-01

Latinos in the United States have been disproportionately affected by the intersecting epidemics of HIV and sexually transmitted diseases (STDs). We examined correlates of condom use among adult heterosexual Latino men who are members of a large multicounty soccer league in rural North Carolina. Of 222 participants, the mean (+/-SD) age was 29.8 (+/-8.3) years. Approximately 60% reported Mexico as their country of origin, 60% reported Grade 8 or below as their highest level of education, and 50% reported using condoms during their most recent vaginal intercourse episodes. Adjusting for relationship status, multivariable logistic regression identified four correlates of condom use: having sought health care information from family members (adjusted odds ratio [AOR]=3.68; 95% confidence interval [CI]=1.48-9.13); greater knowledge of HIV transmission and prevention (AOR = 2.61; CI = 1.23-5.54); greater condom use self-efficacy (AOR = 4.45; 95% CI = 2.12-9.36); and greater adherence to traditional masculine norms (AOR = 2.10; 95% CI = 1.02-4.33). Our findings underscore the need for innovative and targeted HIV and STD prevention programming among the emerging Latino community in the southeastern United States.

[AIDS campaigns have not influenced the use of condoms among young people].

PubMed

Bremberg, S

1991-06-26

Sexually transmitted diseases (STDs) are a significant health problem among teenagers. Chlamydia has been found in 10-20% of young people seeking advice, and HIV is a hugh potential threat. In the late 1980s campaigns started against STDs and AIDS have increased the use of condoms. In 1976, a youth counseling was set up in Linkoping, Sweden. During 1987-90 attenders were queried to find out if teenagers used the condom more extensively as a result of increased information in schools and in the mass media. 1184 visits of girls who admitted sexual intercourse were registered. 91% of them were aged 16-19. An average of 37.5% of the girls states that their partner had used the condom during the last intercourse. No change was observed in the rate of condom use. During the period 1987-90, pertinent information increased in schools and in the media. Nonetheless the results do not indicate that it affected the sexual behavior of young people, although it could have longterm effects. General information may have to he completed on the basis of a school program with social and psychological content.

Closing the condom KAP gap.

PubMed

Roberto, E L

1977-01-01

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 of over 30 available brands were known to users, and only 1 was known to nonusers; a brand differentiation and consciousness campaign is needed.

Ethiopia: hard work for successful AIDS prevention.

PubMed

1992-01-01

An innovative AIDS control program targeting sex workers and clients in Ethiopia has shown that hard work and government support are essential for the success of a program. Serosurveys conducted in 1988 and 1989 had shown that certain groups were particularly vulnerable to HIV infection: women who engage in formal or informal prostitution and their clients -- often migrant workers or truck drivers. So in mid-1990, Ethiopia's Department of AIDS Control (DAC) launched an intervention effort targeting these high-risk groups, a program entitled the Multiple Partner Sexual Contact (MPSC) Female and Male Mobilization and Condom Promotion Project. The program had a 3-layer strategy: 1) establishing a "trickle down" training process, which would create a network of MPSC peer educators and organizers; 2) identifying MPSC men to serve as educators for other men; and 3) ensuring the widespread availability of condoms for both men and women. As site for its pilot project, DAC selected Nazareth, a trading city of more than 30% among MPSC females. After 6 months of operation, the program's effectiveness convinced DAC to expand the project to 9 additional sites. An evaluation of the project has revealed several important findings: 1) retraining and motivation sessions must be constantly maintained; 2) men's resistance to condom use may be diminished by targeting them with education at the same time as the women; 3) interventions that take into account the socioeconomic issues faced by MPSC women make the program more effective; 4) it is important to develop new educational materials periodically; and 5) involving the owners and managers of sex-related businesses makes the program more effective.

Client demands for unsafe sex: the socioeconomic risk environment for HIV among street and off-street sex workers.

PubMed

Deering, Kathleen N; Lyons, Tara; Feng, Cindy X; Nosyk, Bohdan; Strathdee, Steffanie A; Montaner, Julio S G; Shannon, Kate

2013-08-01

Among sex workers (SWs) in Vancouver, Canada, this study identified social, drug use, sex work, environmental-structural, and client-related factors associated with being offered and accepting more money after clients' demand for sex without a condom. Cross-sectional study using baseline (February 2010 to October 2011) data from a longitudinal cohort of 510 SWs. A 2-part multivariable regression model was used to identify factors associated with 2 separate outcomes: (1) being offered more money for sex without a condom in the last 6 months; and (2) accepting more money, among those who had been offered more money. The sample included 490 SWs. In multivariable analysis, being offered more money for sex without a condom was more likely for SWs who used speedballs, had higher average numbers of clients per week, had difficulty accessing condoms, and had clients who visited other SWs. Accepting more money for sex without a condom was more likely for SWs self-reporting as a sexual minority and who had experienced client violence and used crystal methamphetamine less than daily (versus none) and less likely for SWs who solicited mainly indoors for clients (versus outdoor/public places). These results highlight the high demand for sex without a condom by clients of SWs. HIV prevention efforts should shift responsibility toward clients to reduce offers of more money for unsafe sex. Programs that mitigate the social and economic risk environments of SWs alongside the removal of criminal sanctions on sex work to enable condom use within safer indoor workspaces are urgently required.

Indigenous HIV Prevention Beliefs and Practices Among Low-Earning Chinese Sex Workers as Context for Introducing Female Condoms and Other Novel Prevention Options.

PubMed

Dunn, Jennifer; Zhang, Qingning; Weeks, Margaret R; Li, Jianghong; Liao, Susu; Li, Fei

2017-07-01

New interventions to reduce HIV and sexually transmitted infections (STI) among female sex workers are introduced into the context of women's existing prevention beliefs and practices. These indigenous practices affected implementation of our program to introduce female condoms to women in sex-work establishments in southern China. We used ethnographic field observations and in-depth interviews to document common prevention methods women reported using to protect themselves before and during intervention implementation. Individual, sex-work establishment, and other contextual factors, including sources of information and social and economic pressures to use or reject prevention options, shaped their perceptions and selection of these methods and affected adoption of female condoms as an additional tool. Efforts to improve uptake of effective prevention methods among low-income sex workers require attention to the context and spectrum of women's HIV/STI prevention practices when introducing innovations such as female condoms, microbicides, pre-exposure prophylaxis pills, and others, as they become available.

Factors Associated with HIV Discussion and Condom Use with Sexual Partners in an Underserved Community in South Africa

PubMed Central

Conserve, Donaldson F.; Middelkoop, Keren; King, Gary; Bekker, Linda-Gail

2016-01-01

We examined factors associated with discussing HIV and condom use with a sexual partner. Two cross-sectional surveys were conducted in 2004 prior to the implementation of an HIV awareness campaign in a South African community and in 2008 after a three-year education program. Overall, the proportion of individuals who had discussed HIV with a sexual partner increased from 76% in 2004 to 89% in 2008 (p < .001). Among respondents who had sex six months before completing the surveys, condom use significantly increased from 64% in 2004 to 79% in 2008 (p < .05). Respondents who discussed HIV with a sexual partner were more likely to use condoms than respondents who had not discussed HIV with a sexual partner (OR=2.08, 95% CI=1.16, 3.72). These findings indicate the importance of interventions aimed at promoting HIV awareness and discussion of HIV in communities with individuals at risk of acquiring HIV. PMID:27698549

Effectiveness of a model of risky sexual behavior prevention among adolescent boys in Thailand.

PubMed

Tipwareerom, Worawan; Powwattana, Arpaporn; Lapvongwatana, Punyarat; Crosby, Richard A

2011-05-01

The objectives of this study were to identify predictable factors affecting risky sexual behavior and to evaluate the effectiveness of a risky sexual behavior prevention program among boys one and two months after the program. The Information-Motivation-Behavioral skills (IMB) model program was carried out among 74 adolescent boys aged 10-13 years and 74 of their parents in Phitsanulok Province, Thailand. Repeated analysis was employed to analyze the program's effectiveness. After the program, mean scores for comfort in talking about sex, self-efficacy, and skills in condom use increased significantly (p<0.05), and mean scores regarding knowledge about sexually transmitted infections and skills in decision making decreased significantly (p<0.05) compared to baseline. Boys participating in this program improved their condom use skills and comfort talking about sex at two months follow-up (t=3.82, p<0.001; t=3.10, p=0.003, respectively). These results provided evidence for applicability of a prevailing theory-based intervention within the local cultural context.

Methods work better when couples talk.

PubMed

Keller, S

1996-01-01

Sexual partners who communicate about reproductive health issues reduce their risk of acquiring a sexually transmitted disease (STD) or of unintended pregnancy, but few couples feel comfortable talking openly about sex. AIDS prevention programs have focused on improving couple communication, but family planning programs have emphasized women-controlled contraception as more reliable than barrier methods. The effectiveness of barrier methods would likely improve, however, if clients are counseled in couple communication. Effective communication about sexual issues requires self-confidence, and strengthening a woman's self-confidence may also improve her ability to negotiate condom use. Small discussion groups held among female factory workers in Thailand in 1993-94 led to an increase from 60% to 90% in the number of women who felt confident in discussing STD risk with a partner and to an increase from 36% to 82% in those who said they would not be embarrassed to give a partner a condom. A Nigerian study also suggested that more education may also improve prospects for couple communication and contraceptive usage. A US study showed that adolescent women who communicated openly with their partners reduced their risks of unintended pregnancy and STDs, and a Kenyan study indicated that communication increases contraceptive usage among married couples. Various projects around the world are attempting to counsel women on communication and condom negotiation, and counselors are beginning the difficult task of teaching women how to convince men to use condoms.

Impact evaluation of a sexually transmitted disease preventive intervention among female sex workers in Hohhot, China.

PubMed

Shi, Yuhui; Guo, Shuyi; Bo, Fubao; Zhang, Xingguang; Cao, Wangnan; Wang, Peiyang

2013-01-01

The aim of this study was to evaluate the impact of HIV and sexually transmitted disease (STD) prevention interventions among female sex workers (FSWs) in the city of Hohhot in northern China. Three serial cross-sectional surveys were conducted in 2006, 2007, and 2008 among FSWs. A questionnaire was administered to the FSWs, and HIV and syphilis tests were performed for all participants. Intervention activities including condom promotion and provision, increased condom availability and accessibility, and voluntary HIV counseling and testing (VCT) were carried out among FSWs. There were 624 participants in the 2006 survey, 444 in the 2007 survey, and 451 in the 2008 survey. The United Nations General Assembly Special Session (UNGASS) indicators for FSWs increased from 13.9% in 2006 to 37.7% in 2008 (p<0.001). The average rate of consistent condom use with commercial clients in the month preceding the interview increased significantly from 39.8% in 2006 to 59.6% in 2008 (p<0.001). Not a single HIV-positive case was found among the FSWs over these 3 years, and the prevalence of syphilis decreased remarkably from 9.5% in 2006 to 1.3% in 2008. Logistic regression analysis showed that sauna or hair salon work venues, receiving services from intervention programs, and accepting HIV tests were factors associated with consistent condom use. The findings suggest that consistent condom use and awareness of HIV/AIDS prevention-related knowledge among FSWs have been improved by the intervention. Further prioritized and combined prevention programs aimed at FSWs are needed in order to prevent the HIV/AIDS epidemic spreading in the general population in China. Copyright © 2012 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Confronting the HIV epidemic in Asia and the Pacific: developing successful strategies to minimize the spread of HIV infection.

PubMed

Moodie, R; Aboagye-Kwarteng, T

1993-12-01

In Asia, the cumulative total of HIV-infected adults will reach 1.22 million by 1995, and, by 2000, the number is estimated to reach 11-45 million. The modes of transmission vary from country to country and include injecting drug users, commercial sex workers and their clients, commercial blood donors, hemophiliacs, and homosexuals. Social, cultural, and health factors also affect transmission, such as rites of passage to adulthood, lack of female autonomy, multiple sex partners, wars and civil unrest, and availability of drugs. The HIV epidemic has economic ramifications and causes, e.g., migrant worker camps, the sex industry, and rapid urbanization luring Burmese girls to Thailand. Governments must create an environment for behavior-change through financial, political, and legislative measures. Community organizations also play a role in prevention, as in programs initiated by a squatter settlement in Bangkok, where 36% of IV drug users were found to be HIV-positive. In Maharashtra State, India, peer-based prevention programs were developed for sex workers. Successful behavior change of individuals is based on redefinition of peer norms, understanding the danger and vulnerability to infection, and building confidence to change behavior. Successful programs require placing priority on HIV issues on the political agenda, negotiation and consensus-building skills, and competent program management. For instance, in Zimbabwe a project enlisted 380,000 people in 4500 education sessions within 2 years, and distributed 2.5 million condoms. Among sex workers, condom use increased from 5% to 50%. Implementation strategies include the provision of information and interpersonal education. In Zaire, mass media and social marketing efforts boosted condom sales from less than half a million in 1987 to over 20 million in 1991. The means to change behavior requires the availability of good quality condoms, disinfectants, and syringes. Furthermore, clinical management of gonorrhea, syphilis, human papillomavirus, and chancroid is vital to lowering the risk of HIV transmission. Continuous epidemiological research and the evaluation of prevention programs improve program effectiveness.

Disconnect between discourse and behavior regarding concurrent sexual partnerships and condom use: findings from a qualitative study among youth in Malawi.

PubMed

Romero, Stacy L; Ellis, Amy A; Gurman, Tilly A

2012-12-01

The practice of concurrent sexual partnerships (CP) is posited to be a contributor to the elevated risk of HIV transmission among youth in Malawi. The lens through which Malawian youth conceptualize the practices of CP and condom use has yet to be fully explored. The current study--a secondary data analysis of semi-structured in-depth interviews (n = 19) with Malawian youth aged 18 to 22 years--addresses this gap. Participants were interviewed about their sexual relationships and behavior, as well as their perceptions and knowledge regarding condom use and CP. In order to ensure that youth engaged in CP were oversampled, the recruitment process asked potential respondents to self-identify whether they currently participated in CP. Of the total sample (n = 19), 13 self-identified as currently engaging in CP. Data were analyzed using a grounded theory approach. This qualitative study highlights a disconnect between the high level of knowledge youth exhibit about HIV prevention methods and their actual reported condom use and CP behaviors. While some youth claimed to use condoms, their discourse demonstrated fluidity in that use changed over time, or interest in changing behavior was expressed, or was inconsistent between partnerships. The disconnect between knowledge of the consequences of risky sexual behavior and actual behavior was most evident among inconsistent condom users engaged in CP. This finding indicates knowledge alone has a limited role in the adoption of lower risk behaviors such as condom use and reduction of CP among youth. Moreover, findings from this study can inform HIV prevention programs operating in Malawi and the sub-Saharan Africa region by enabling them to provide tailored, more persuasive health promotion and prevention messaging.

Client demands for unsafe sex: the socio-economic risk environment for HIV among street and off-street sex workers

PubMed Central

DEERING, Kathleen N; LYONS, Tara; FENG, Cindy X; NOSYK, Bohdan; STRATHDEE, Steffanie A; MONTANER, Julio SG; SHANNON, Kate

2013-01-01

Objective Among sex workers (SWs) in Vancouver, Canada, this study identified social, drug use, sex work, environmental-structural and client-related factors associated with being offered and accepting more money after clients' demand for sex without a condom. Design Cross-sectional study using baseline (February/10-October/11) data from a longitudinal cohort of 510 SWs. Methods A two-part multivariable regression model was used to identify factors associated with two separate outcomes: (1) being offered and (2) accepting more money for sex without a condom in the last six months, among those who had been offered more money. Results The sample included 490 SWs. In multivariable analysis, being offered more money for sex without a condom was more likely for SWs who used speedballs, had higher average numbers of clients per week, had difficulty accessing condoms and had clients who visited other SWs. Accepting more money for sex without a condom was more likely for SWs self-reporting as a sexual minority and who had experienced client violence and used crystal methamphetamine use less than daily (vs. none), and less likely for SWs who solicited for clients mainly indoors (vs. outdoor/public places). Conclusions These results highlight the high demand for sex without a condom by clients of SWs. HIV prevention efforts should shift responsibility toward clients to reduce offers of more money for unsafe sex. Programs that mitigate the social and economic risk environments of SWs alongside the removal of criminal sanctions on sex work to enable condom use within safer indoor work spaces are urgently required. PMID:23614990

A day in my life as a peer-educator. Botswana.

PubMed

Ellis, S

1995-01-01

The experiences of a peer educator who joined the YWCA's Peer Approach Counselling by Teenagers (PACT) program in 1993 are related. She learned youth-to-youth counseling skills pertaining to contraceptives, relationships, decision-making, problem solving, leadership, and AIDS education. In 1994 she started working for Population Services International (PSI), a social marketing program for condoms whose main target groups are youth and young women. In Botswana almost 1/5 of 13-15 year-old youth have already had sex. Early sexual activity contributes to the high rate of teenage pregnancy (approximately 10-15% of 13-18 year olds are parents); and the alarming HIV infection rate (15-20% of the sexually active population). Choices and responsibilities are the themes that provide youth with the education to make informed decisions by which they can be better parents. Sometimes work involves other non-governmental associations (NGOs) such as the Botswana Welfare Association, the YWCA, or the Red Cross, but most of the work takes place at events such as fashion shows, radio programs, concerts, and festivals. A demonstration team travels across Botswana to stage serious condom demonstrations, which are followed by games and competitions, and a few questions about AIDS awareness. Youth are much more likely to participate in this informal setting. The existing institutions that teach youth about reproductive health, such as schools or clinics, are not being used efficiently. Research has shown that teenagers actually do think about using condoms but lack the negotiating skills, therefore responsible sexual behavior should be the basis of education in all schools. Unfortunately, many adults find correct condom usage and teenage sexuality sensitive topics. Although PSI and other NGOs have been successful in Botswana, much education is still needed. More support from parents and teachers could contribute to reaching more youth.

Nigeria using more condoms.

PubMed

1997-09-01

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

Thailand condom campaign reduced AIDS infections by fifty percent.

PubMed

1996-08-12

AIDS was first reported in Thailand in 1988 and quickly spread among the country's prostitutes, their clients, and their clients' wives until 750,000 Thais were infected by 1993. In 1990, the Thai government began to provide condoms to brothels and to educate men about the dangers of unprotected sex. As a result of this program, the number of military conscripts in the six northern provinces who were infected dropped from 13% in 1991 to 7% in 1995. Condom use with prostitutes has increased to 93%, and fewer men are visiting prostitutes. The key to this unprecedented success is the support of the Thai government and its acknowledgement that commercial sex could not be eradicated and, therefore, that the industry had to be involved in control efforts in a nonjudgmental way.

Vulnerability of women in southern Africa to infection with HIV: biological determinants and priority health sector interventions.

PubMed

Chersich, Matthew F; Rees, Helen V

2008-12-01

To review biomedical determinants of women's vulnerability to infection with HIV and interventions to counter this, within the southern African context. Apart from number of exposures, if any, several factors influence the efficiency of HIV transmission during sex. Acute HIV infection, with extraordinarily high semen viral load, in conjunction with concurrent partnerships maximizes this efficiency. Delaying sexual debut and avoiding HIV exposure among biologically and socially vulnerable youth is critical. Reducing unintended pregnancies keeps girls in school and prevents vertical (also possibly horizontal) transmission. Female condoms, especially newer versions, are an under-exploited prevention technology. Control of sexually transmitted infections (STI), which facilitate HIV acquisition and transmission, remains important, especially among the most at-risk populations. Pathogens, such as herpes simplex virus type 2, which contribute most to HIV transmission in southern Africa must be targeted, although the importance of bacterial vaginosis and Trichomonas vaginalis is under-recognized. Also, heavy episodic alcohol use affects sexual decision-making and condom skills. Moreover, prevailing social contexts, partly a consequence of poor leadership, constrain the behavioural 'choices' available for girls and women. Priority health sector interventions for preventing HIV are: male and female condom programming; prevention and control of STI; outreach to most vulnerable populations; HIV testing in all patient-provider encounters; male circumcision; and the integration of HIV prevention within sexual and reproductive health services. Future interventions during acute HIV infection and microbicides will reduce women's biological vulnerability. Far-reaching measures, such as sexual equity and alcohol control, create conditions necessary for achieving sustained prevention results. These are, however, contingent on stronger, more informed cultural and political leadership.

[Intervention effects of promoting the use of contraceptives in migrant population working in factory].

PubMed

Jiang, Xiaomei; Ren, Shanshan; Hou, Liyan; He, Dian; Pang, Cheng; Cheng, Yimin

2011-01-01

To evaluate the effectiveness of an intervention program on promoting the use of contraceptives in migrant population working in factories, and to compare the difference of results between the basic intervention mode and the comprehensive intervention mode. This was an epidemiologic intervention study carried out in each 2 factories in Shenzhen and Dongguan among migrant workers by comparing the effectiveness of a baseline survey and a end-line survey. The basic intervention mode was composed of spreading contraceptives and reproductive health information, conducting education and communication and providing references to access free services from family planning clinics (IEC). The comprehensive intervention mode provided more services on face to face counseling and distributing free contraceptives. The demographic characteristics of subjects before and after surveys were comparable. Whether in the basic group or comprehensive mode group, the awareness of contraceptive/reproductive health knowledge was increased significantly after intervention (P = 0.000), and the pass rate was higher in the comprehensive intervention group (P = 0.000). The self-reported most frequently used contraceptives was condoms. The proportion of using condoms and purchasing condoms was increased after intervention (P = 0.000) from 69.7% and 67.7% before intervention to 84.9% and 90.2% after basic intervention and 87.1% and 95.1% after comprehensive intervention. The proportion of using contraceptives every time was increased from 35.7% before intervention to 38.1% after basic intervention (P = 0.018) and to 42.9% after comprehensive intervention (P = 0.000). Intervention measures based on implementing in factories were effective in promoting contraception among migrant workers, and the integration of counseling and free contraceptive services with IEC was better. Carrying on and extending this kind of intervention measures to other migrant population in similar conditions is suggested.

Alcohol misuse, depressive symptoms, and HIV/STI risks of US Hispanic women.

PubMed

McCabe, Brian E; Schaefer Solle, Natasha; Peragallo Montano, Nilda; Mitrani, Victoria B

2017-10-01

Alcohol misuse and depressive symptoms have been linked to HIV/STI risk, but studies have rarely included Hispanic women, who have over four times greater HIV incidence than white, non-Hispanic women. Understanding the connections among alcohol misuse, depressive symptoms, and HIV/STI risks may suggest ways to meet specific needs of Hispanic women. This study's objective is to examine the relationships among alcohol misuse, depressive symptoms, and seven HIV/STI risk factors. Five hundred forty-eight US Hispanic women with intake data from a randomized trial were assessed for alcohol misuse (CAGE) and depressive symptoms (CES-D). GZLM and path analyses tested relationships between alcohol misuse or depressive symptoms and HIV/STI risk factors. Self-efficacy and condom use were not related to alcohol misuse or depressive symptoms, but only 15% of women reported consistent condom use. After controlling for demographics, women with alcohol misuse had significantly more perceived HIV/STI risk (OR = 2.15) and better HIV/STI knowledge (β = -.54); and women with depressive symptoms had significantly more perceived HIV/STI risk (OR = 1.76) and worse HIV/STI knowledge (β = .37). Interventions to increase condom use for Hispanic women are needed, regardless of mental disorders. Working with Hispanic women with alcohol misuse or depressive symptoms presents a need (and opportunity) to address issues directly related to HIV/STI risk. Women's health practitioners have an excellent opportunity to reach women by implementing regular screening programs in clinics that serve Hispanic women. For women with high depressive symptoms, poor HIV/STI knowledge should also be addressed. Future studies should test whether integrated and tailored risk reduction interventions affect these factors and lower HIV/STI risk for Hispanic women.

Pornography, Sexual Enhancement Products, and Sexual Risk of Female Sex Workers and their Clients in Southern India.

PubMed

Bradley, Janet; Rajaram, Subramanian Potty; Isac, Shajy; Gurav, Kaveri; Ramesh, B M; Gowda, Chandrashekhar; Moses, Stephen; Alary, Michel

2016-05-01

Despite their large numbers, and important role in the HIV epidemic in India, male clients of female sex workers (FSWs) are a difficult to reach population and little is known about their sexual behaviors. Using data from an integrated behavioral and biological assessment of 684 clients in Bangalore in 2012, we examined factors associated with their reports of having sex with three or more different female sex workers in the last month, and anal sex with sex workers. We included sociodemographic and sexual behavior factors and, for the first time in client studies in India, included data on the use of pornography and sexual enhancement products (SEPs) such as pills, oils, and sprays, in our multivariable analyses of client risk. Seventy-eight percent of clients had seen pornographic material and 8% reported ever having used SEPs. The profiles of men practicing the two risk behaviors examined were quite different. Travel in the past year, drunkenness in the past month, young age at first commercial sex, non-use of condoms at last sex, and finding sex workers in public places (but not use of pornography and SEPs) were independently associated with multiple partnering. Sex with a man or transsexual, being a white collar worker, seeking out FSWs at home, pornography and SEP use, and condom use at last FSW sex, were all independently associated with anal sex with an FSW. More research is needed to better understand the links between pornography and SEPs, and HIV risk behaviors, and HIV prevention programs need to be cognizant of the importance of ensuring that condom use is adequately promoted and supported in the context of anal sex in female sex worker-client interactions.

Comparative Effectiveness of Web-Based vs. Educator-Delivered HIV Prevention for Adolescent Substance Users: A Randomized, Controlled Trial.

PubMed

Marsch, Lisa A; Guarino, Honoria; Grabinski, Michael J; Syckes, Cassandra; Dillingham, Elaine T; Xie, Haiyi; Crosier, Benjamin S

2015-12-01

Young people who engage in substance use are at risk for becoming infected with HIV and diseases with similar transmission dynamics. Effective disease prevention programs delivered by prevention specialists exist but are rarely provided in systems of care due to staffing/resource constraints and operational barriers-and are thus of limited reach. Web-based prevention interventions could possibly offer an effective alternative to prevention specialist-delivered interventions and may enable widespread, cost-effective access to evidence-based prevention programming. Previous research has shown the HIV/disease prevention program within the Web-based therapeutic education system (TES) to be an effective adjunct to a prevention specialist-delivered intervention. The present study was the first randomized, clinical trial to evaluate the comparative effectiveness of this Web-based intervention as a standalone intervention relative to a traditional, prevention specialist-delivered intervention. Adolescents entering outpatient treatment for substance use participated in this multi-site trial. Participants were randomly assigned to either a traditional intervention delivered by a prevention specialist (n=72) or the Web-delivered TES intervention (n=69). Intervention effectiveness was assessed by evaluating changes in participants' knowledge about HIV, hepatitis, and sexually transmitted infections, intentions to engage in safer sex, sex-related risk behavior, self-efficacy to use condoms, and condom use skills. Participants in the TES intervention achieved significant and comparable increases in HIV/disease-related knowledge, condom use self-efficacy, and condom use skills and comparable decreases in HIV risk behavior relative to participants who received the intervention delivered by a prevention specialist. Participants rated TES as easier to understand. This study indicates that TES is as effective as HIV/disease prevention delivered by a prevention specialist. Because technology-based interventions such as TES have high fidelity, are inexpensive and scalable, and can be implemented in a wide variety of settings, they have the potential to greatly increase access to effective prevention programming. Copyright © 2015 Elsevier Inc. All rights reserved.

Empowering sex workers in India to reduce vulnerability to HIV and sexually transmitted diseases⋆

PubMed Central

Swendeman, Dallas; Basu, Ishika; Das, Sankari; Jana, Smarajit; Rotheram-Borus, Mary Jane

2010-01-01

The Sonagachi Project was initiated in Kolkata, India in 1992 as a STD/HIV intervention for sex workers. The project evolved to adopt strategies common to women’s empowerment programs globally (i.e., community mobilization, rights-based framing, advocacy, micro-finance) to address common factors that support effective, evidence-based HIV/STD prevention. The Sonagachi model is now a broadly diffused evidence-based empowerment program. We previously demonstrated significant condom use increases among female sex workers in a 16 month replication trial of the Sonagachi empowerment intervention (n = 110) compared to a control community (n = 106) receiving standard care of STD clinic, condom promotion, and peer education in two randomly assigned rural towns in West Bengal, India (Basu et al., 2004). This article examines the intervention’s impacts on 21 measured variables reflecting five common factors of effective HIV/STD prevention programs to estimate the impact of empowerment strategies on HIV/STD prevention program goals. The intervention which was conducted in 2000–2001 significantly: 1) improved knowledge of STDs and condom protection from STD and HIV, and maintained STD/HIV risk perceptions despite treatment; 2) provided a frame to motivate change based on reframing sex work as valid work, increasing disclosure of profession, and instilling a hopeful future orientation reflected in desire for more education or training; 3) improved skills in sexual and workplace negotiations reflected in increased refusal, condom decision-making, and ability to change work contract, but not ability to take leave; 4) built social support by increasing social interactions outside work, social function participation, and helping other sex workers; and 5) addressed environmental barriers of economic vulnerabilities by increasing savings and alternative income, but not working in other locations, nor reduced loan taking, and did not increase voting to build social capital. This study’s results demonstrate that, compared to narrowcast clinical and prevention services alone, empowerment strategies can significantly impact a broader range of factors to reduce vulnerability to HIV/STDs. PMID:19716639

Empowering sex workers in India to reduce vulnerability to HIV and sexually transmitted diseases.

PubMed

Swendeman, Dallas; Basu, Ishika; Das, Sankari; Jana, Smarajit; Rotheram-Borus, Mary Jane

2009-10-01

The Sonagachi Project was initiated in Kolkata, India in 1992 as a STD/HIV intervention for sex workers. The project evolved to adopt strategies common to women's empowerment programs globally (i.e., community mobilization, rights-based framing, advocacy, micro-finance) to address common factors that support effective, evidence-based HIV/STD prevention. The Sonagachi model is now a broadly diffused evidence-based empowerment program. We previously demonstrated significant condom use increases among female sex workers in a 16 month replication trial of the Sonagachi empowerment intervention (n=110) compared to a control community (n=106) receiving standard care of STD clinic, condom promotion, and peer education in two randomly assigned rural towns in West Bengal, India (Basu et al., 2004). This article examines the intervention's impacts on 21 measured variables reflecting five common factors of effective HIV/STD prevention programs to estimate the impact of empowerment strategies on HIV/STD prevention program goals. The intervention which was conducted in 2000-2001 significantly: 1) improved knowledge of STDs and condom protection from STD and HIV, and maintained STD/HIV risk perceptions despite treatment; 2) provided a frame to motivate change based on reframing sex work as valid work, increasing disclosure of profession, and instilling a hopeful future orientation reflected in desire for more education or training; 3) improved skills in sexual and workplace negotiations reflected in increased refusal, condom decision-making, and ability to change work contract, but not ability to take leave; 4) built social support by increasing social interactions outside work, social function participation, and helping other sex workers; and 5) addressed environmental barriers of economic vulnerabilities by increasing savings and alternative income, but not working in other locations, nor reduced loan taking, and did not increase voting to build social capital. This study's results demonstrate that, compared to narrowcast clinical and prevention services alone, empowerment strategies can significantly impact a broader range of factors to reduce vulnerability to HIV/STDs.

Post-abortion care and voluntary HIV counselling and testing--an example of integrating HIV prevention into reproductive health services.

PubMed

Rasch, Vibeke; Yambesi, Fortunata; Massawe, Siriel

2006-05-01

To assess the acceptance and outcome of voluntary HIV counselling and testing (VCT) among women who had an unsafe abortion. 706 women were provided with post-abortion contraceptive service and offered VCT. We collected data on socioeconomic characteristics and contraceptive use and determined the HIV status of those who accepted VCT. Using a nested case-control design, we compared women who accepted HIV testing with women who did not. To study the association between socioeconomic factors, HIV testing acceptance and condom use in more detail, we did stratified analyses based on age and marital status. 58% of the women who had an unsafe abortion accepted HIV testing. Women who earned an income were more likely to accept testing than housewives. Women who accepted testing were more likely to accept using a condom. The HIV prevalence rate was 19% among single women aged 20-24 years and 25% among single women aged 25-45 years. HIV testing and condoms were accepted by most women who had an unsafe abortion. The poor reproductive health of these women could be improved by good post-abortion care that includes contraceptive counselling, VCT and condom promotion.

Factors associated with the take-up of voluntary medical male circumcision amongst learners in rural KwaZulu-Natal.

PubMed

George, Gavin; Govender, Kaymarlin; Beckett, Sean; Montague, Carl; Frohlich, Janet

2017-09-01

Voluntary medical male circumcision (VMMC) is an integral part of South Africa's HIV prevention programme. School-going males, in particular, are considered a cost-effective target population. However, ambitious policy targets have not been achieved due to the plateau in demand for VMMC. This study documents the factors influencing demand for VMMC amongst school-going males. Data were collected from 750 learners (251 circumcised and 499 uncircumcised) from 42 secondary schools in KwaZulu-Natal, South Africa. There was a positive association between the perceived benefit of VMMC and the likelihood of undergoing circumcision (AOR: 1.41, p = 0.01). There was a negative association between self-efficacy to use condoms and likelihood of undergoing VMMC (AOR: 0.75, p < 0.01). Learners who perceived VMMC as having a number of health benefits, including reducting of the chances of contracting HIV and sexually transmitted infections (STIs), increasing penile hygiene and the belief that VMMC allows them to use condoms less frequently, were more likely to undergo VMMC. Of concern, learners who were confident in their ability to access condoms and t use a condom with their partner were less likely to undergo VMMC.

Prevention is still the best medicine. Condom social marketing campaign changes attitudes and actions in Guinea.

PubMed

Hess, L L

1993-09-01

In Guinea, jingles promoting Prudence condoms are heard on radio and television in 4 different national languages 5 times a day. This has produced an attitudinal change through an intense national media campaign orchestrated by the USAID-financed Social Marketing of Contraceptives Project carried out by Population Services International (PSI), which provides family planning information, products and services through public and private outlets for 500,000 sexually active couples. PSI's paid media campaign has sponsored call-in talk shows on women and AIDS and religion and AIDS at the rural radio station in Labe. Billboards placed in key locations remind people that using condoms helps prevent AIDS. PSI organized a team of 10 Prudence condom marketing agents in March 1992 to establish 400 nontraditional retail and 50 traditional retail and wholesale outlets for condoms. Outlets include pharmacies, restaurants, hotels, grocery stores, and nightclubs. The distributors sell the condoms at a profit. In the first 6 months, PSI distributed 2.3 million condoms. Young women want to space their children and limit the number of children, said the chief midwife for the Guinean Association for Family Well Being clinic in Conakry. Guinea's population growth rate is 2.8%, which will result in a doubling of the population in 25 years. In May 1992, Guinea's government ratified a national population policy supporting family planning. One of the primary goals is to increase contraceptive use to 25% of all couples. PSI works with the Ministry of Health and the Guinean Association for Family Well Being to integrate family planning and sexually transmitted disease prevention activities into 32 primary health care centers in Guinea's Forest Region. To combat the spread of HIV infection, PSI provides technical assistance to the National AIDS Committee to carry out AIDS information activities throughout the country, targeting the military, police, truck drivers, and students.

The impact of gender norms on condom use among HIV-positive adults in KwaZulu-Natal, South Africa.

PubMed

Fladseth, Kristin; Gafos, Mitzy; Newell, Marie Louise; McGrath, Nuala

2015-01-01

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.

The Impact of Gender Norms on Condom Use among HIV-Positive Adults in KwaZulu-Natal, South Africa

PubMed Central

Fladseth, Kristin; Gafos, Mitzy; Newell, Marie Louise; McGrath, Nuala

2015-01-01

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

Influence of alcohol on condom use pattern during non-spousal sexual encounter in male migrant workers in north India.

PubMed

Rizwan, S A; Kant, S; Goswami, K; Rai, S K; Misra, P

2014-01-01

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.

Remembering the message: the use of a reminder cue to increase condom use following a safer sex intervention.

PubMed

Dal Cin, Sonya; MacDonald, Tara K; Fong, Geoffrey T; Zanna, Mark P; Elton-Marshall, Tara E

2006-05-01

Condom use interventions may be more powerful if they provide cues to recall safe-sex messages when sexual activity occurs. The authors tested this notion by assigning sexually active introductory psychology students (N = 196) to a standard safe-sex intervention, a safe-sex with reminder intervention, or a control (drinking and driving) intervention. Participants assigned to the reminder intervention were given a "friendship bracelet" to wear and were instructed to have the bracelet remind them of the intervention. In a follow-up session (5-7 weeks later), they were asked questions pertaining to condom use. Of the 125 participants who had engaged in sexual intercourse, condom use at last intercourse was higher in the bracelet condition (55%) than in the standard (27%) or control (36%) conditions. The authors also found that the bracelet remained effective, even when participants were under the influence of alcohol. These findings therefore imply that health intervention programs may be more efficacious if they include strategies such as reminder cues to increase the salience of health information in the appropriate contexts. 2006 APA, all rights reserved

Análisis de costo-beneficio: prevención del VIH/sida en migrantes en Centroamérica

PubMed Central

Alarid-Escudero, Fernando; Sosa-Rubí, Sandra G.; Fernández, Bertha; Galárraga, Omar

2014-01-01

Objective To quantify the costs and benefits of three HIV prevention interventions in migrants in Central America: voluntary counseling and testing, treatment of sexually transmitted infections, and condom distribution. Materials and methods The methods were: a) identification and quantification of costs; b) quantification of benefits, defined as the potential savings in antiretroviral treatment of HIV cases prevented; and c) estimation of the cost-benefit ratio. Results The model estimated that 9, 21 and 8 cases of HIV were prevented by voluntary counseling and testing, treatment for sexually transmitted infections and condom distribution per 10 000 migrants, respectively. In Panama, condom distribution and treatment for sexually transmitted infections had a return of US$131/USD and US$69.8/USD. Returns in El Salvador were US$2.0/USD and US$42.3/USD in voluntary counseling and testing and condom distribution, respectively. Conclusion The potential savings on prevention have a large variation between countries. Nevertheless, the cost-benefit estimates suggest that the HIV prevention programs in Central America can potentially result in monetary savings in the long run. PMID:23918053

Childhood victimization and HIV risk behaviors among university students in Saint-Petersburg, Russia.

PubMed

Bogolyubova, Olga; Skochilov, Roman; Smykalo, Lyubov

2016-12-01

Exposure to childhood victimization and abuse has been shown to affect HIV risk in adult populations. In Russia, the existence of child abuse was largely unrecognized until 1990s and its behavioral consequences remain understudied. Our goal was to assess childhood victimization and HIV risk behavior among young adults in Saint-Petersburg, Russia: 743 students from 15 local universities were surveyed. Unprotected sexual intercourse was the most common type of HIV risk behavior: study participants reported no condom use at last intercourse (65.17%), inconsistent condom use (58.43%) and 30.81% never used condoms in the past 3 months. Childhood sexual victimization was significantly associated with unprotected sex at last intercourse and with inconsistent condom use in the past 3 months. Young adults in Russia are vulnerable to HIV epidemic due to the pervasiveness of unprotected sexual intercourse, and childhood sexual victimization is associated with risky sexual behavior in this population. Efforts to combat HIV epidemic in Russia must include programming for the prevention of childhood sexual abuse and the development of services for the survivors of childhood victimization.

Condom Negotiation Strategies and Actual Condom Use among Latino Youth

PubMed Central

Tschann, Jeanne M.; Flores, Elena; de Groat, Cynthia L.; Deardorff, Julianna; Wibbelsman, Charles J.

2010-01-01

Purpose To examine which condom negotiation strategies are effective in obtaining or avoiding condom use among Latino youth. Method Interviews were conducted with 694 Latino youth, 61% female, ages 16–22. Participants reported on their condom negotiation strategies, perceptions of whether their sexual partner wanted to use condoms, and actual condom use. Three strategies to obtain condom use (risk information, direct verbal/nonverbal communication, insist) and four strategies to avoid condom use (emotional coercion, ignore condom use, dislike condoms, seduction) were examined. Data were analyzed using multiple linear regression, and included youth (n = 574) who reported wanting to use or avoid condoms. Results Almost 60% of participants reported wanting to use condoms, and nearly all of these used some strategy to obtain condom use. Young men who wanted to use condoms were more likely to do so, compared to young women. Risk information and direct verbal/nonverbal communication were effective strategies to obtain condom use, even among youth who perceived their sexual partners as not wanting to use condoms. Ignoring condom use was an effective condom avoidance strategy, even when youth thought their partners wanted to use condoms. Unexpectedly, young men who expressed dislike of condoms had higher rates of condom use than young men not using this condom avoidance strategy. Conclusions This research identified condom negotiation strategies that are effective among Latino youth, even when they believe their partners do not want to use condoms. Health care providers could encourage Latino youth to use such condom negotiation strategies. PMID:20708564

Condom negotiation strategies and actual condom use among Latino youth.

PubMed

Tschann, Jeanne M; Flores, Elena; de Groat, Cynthia L; Deardorff, Julianna; Wibbelsman, Charles J

2010-09-01

To examine which condom negotiation strategies are effective in obtaining or avoiding condom use among Latino youth. Interviews were conducted with 694 Latino youth, 61% female, aged 16-22. Participants reported on their condom negotiation strategies, perceptions of whether their sexual partner wanted to use condoms, and actual condom use. Three strategies to obtain condom use (risk information, direct verbal/nonverbal communication, insist) and four strategies to avoid condom use (emotional coercion, ignore condom use, dislike condoms, seduction) were examined. Data were analyzed using multiple linear regression, and included youth (n = 574) who reported wanting to use or avoid condoms. Almost 60% of participants reported wanting to use condoms, and nearly all of these used some strategy to obtain condom use. Young men who wanted to use condoms were more likely to do so, compared with young women. Risk information and direct verbal/nonverbal communication were effective strategies to obtain condom use, even among youth who perceived their sexual partners as not wanting to use condoms. Ignoring condom use was an effective condom avoidance strategy, even when youth thought their partners wanted to use condoms. Unexpectedly, young men who expressed dislike of condoms had higher rates of condom use than young men not using this condom avoidance strategy. This research identified condom negotiation strategies that are effective among Latino youth, even when they believe their partners do not want to use condoms. Health care providers could encourage Latino youth to use such condom negotiation strategies.

Did an AIDS Peer Education Program Change First-Year College Students' Behaviors?

ERIC Educational Resources Information Center

Richie, Nicholas D.; Getty, Adelaide

1994-01-01

College students who did and did not attend an AIDS peer education program completed preprogram and postprogram surveys to determine their AIDS-related attitudes and behavior. Data analysis indicated students who attended the program were more likely to engage in preventive behaviors including condom use and HIV-antibody testing. (SM)

[Negotiating safer sex].

PubMed

Gordon, G; Charnock, D

1991-01-01

Women have generally assumed responsibility for contraception since the appearance of oral contraceptives and IUDs. But AIDS prevention programs are now asking women to assume responsibility for safer sex through use of condoms, a male method. Women are being asked to carry condoms, to negotiate their use each time they have sex, and to insist if the partner resists. The problem with this strategy is that frequently it is the male partner who makes sexual decisions, and women have less negotiating power. Women are considered feminine if they assume a passive role in sexual activity. This work suggests strategies to improve the negotiating power of women. Options and problems of speaking about safer sex vary in accordance with the nature of the relationship. A woman with a new partner can try to ascertain his sexual history, but may gain no information on his probable health even if he tells her the truth. It may be easier to convince him to use a condom at least in the beginning of the romance. Women working in the sex industry often have greater trouble convincing their friends and lovers to use a condom than their clients. Some family planning workers have begun to speak of safer sex with all their clients. Role playing and workshops or discussions with small groups of women having similar problems may help women overcome their reticence about discussing sexual topics. Some general suggestions to help women negotiate safer sex include choosing an opportune moment and planning in advance what to say; daring to speak directly without beating around the bush (the partner may also be gathering courage to speak); practicing placing condoms on objects and if necessary placing one on the partner without speaking; being honest with the partner about sex, love, and fidelity; and remembering that protection from condoms is mutual given that it is not possible to know who is infected. Until now, programs to help women practice safer sex have concentrated on sex industry workers or family planning clients. Adolescents are a particularly vulnerable group because of their usual lack of knowledge when the initiate their sex lives. Some sex education classes are beginning to include materials instructing young girls in how to negotiate with boys seeking sexual favors. Printed materials such as simple pamphlets made available by family planning programs to young people can help to raise the topics of HIV infection and safer sex. Greater societal awareness of the problem and improvements in the opportunities for women to exercise their basic rights will be needed to ensure all women the power to protect their own health.

The Relationship Between Pregnancy Prevention and STI/HIV Prevention and Sexual Risk Behavior Among American Indian Men.

PubMed

Rink, Elizabeth; FourStar, Kristofer; Anastario, Michael P

2017-01-01

We examined the relationship between American Indian men's attitudes toward pregnancy prevention, STI/HIV prevention, and sexual risk behavior. Attention was given to: (1) attitudes and intentions to use condoms and sexual risk behavior; (2) STI/HIV prevention characteristics and sexual risk behavior; (3) attitudes toward abstinence and monogamy and sexual risk behavior; and (4) decision-making in relationships and sexual risk behavior. Our sample included 120 heterosexual American Indian men aged 18 to 24 living on a reservation. Data were collected during in-depth interviews. A community-based participatory research framework was used to ensure the relevancy and acceptability of the study given the sensitivity of the topic. Results demonstrated that attitudinal factors were associated with sexual risk behavior, particularly inconsistent condom use. Attitudes associated with consistent condom use suggested greater levels of positive dispositions toward prevention and intention to use condoms. Consistent condom use was associated with more cautious attitudes toward sex with multiple sex partners. Study results suggested that American Indian men who reported sex with multiple partners exhibited a set of attitudes and beliefs toward pregnancy prevention and STI/HIV prevention that corresponded with a disposition resulting from their behaviors, in that engaging in sexual risk behavior elevated their levels of risk perception. Our findings suggest that heterosexual American Indian men living in rural environments need sexual and reproductive health programs and clinical services that address differing attitudes toward condom use within the context of multiple sex partners and sexual risk behavior. © 2015 National Rural Health Association.

HIV/AIDS knowledge and attitudes among West African immigrant women in Western Australia.

PubMed

Drummond, Peter D; Mizan, Ayse; Wright, Bernadette

2008-09-01

Most women who live in sub-Saharan countries have heard of HIV/AIDS, but there is still widespread misunderstanding about how HIV is spread, the consequences of infection, and how to protect against infection. The aim of the present study was to investigate knowledge about HIV and attitudes towards condom use in West African refugees who had settled in Perth, Western Australia, within the past 5 years. Knowledge about transmission of HIV, myths about how HIV is spread, incorrect beliefs about protective factors, the effectiveness of condoms in protecting against sexually transmissible infections, and attitudes towards condom use were investigated by survey in 51 West African women, and in 100 Australian women for comparison. Where possible, each West African woman was matched for age and level of education with an Australian woman. Knowledge of HIV was poorest in the least educated West African women, but many of the more highly educated women also had misconceptions about how HIV is spread, how to protect against HIV, and the effectiveness of condoms in protecting against HIV. Moreover, most West African women held negative attitudes towards condom use. Within the Australian sample, HIV knowledge was greatest in women with tertiary qualifications, and was greater in younger than older women; in addition, attitudes towards condom use differed across the age span. The findings in the present study suggest that educational programs that focus on knowledge about HIV should be tailored to meet the needs and cultural sensitivities of newly emerging immigrant communities, and should target particular demographic groups within the Australian population.

Attitude as a Mediator between Acculturation and Behavioral Intention.

PubMed

Ebrahim, Nasser B; Davis, Sharon; Tomaka, Joe

2016-11-01

Immigrants, specifically African-born black persons, are affected by the HIV epidemic in the U.S. The low level of condom use among immigrants is a risk factor for contracting HIV and STIs. Immigrants go through acculturation process in their new adopted countries-a process reported to influence many health risks and protective factors; however, the mechanism through which acculturation influences health behaviors is not well understood. Thus, study examined the mediating role of attitude in the relationship between acculturation and the intention to use male condoms in steady heterosexual relationships among Somali and Ethiopian immigrants in Minnesota. The study was a regression analysis and the method of data collection cross-sectional. Participants were (n = 205) Somali and Ethiopian immigrants in Minnesota who volunteered for the study. Study participants responded to questions on attitudes, behavioral intention, and acculturation levels. The indirect effect of acculturation through the mediator, attitude, was not significant, product coefficient (a × b) = 0.04, 95% CI: [0.00, 0.11]; hence attitude did not mediate the relationship between acculturation and the intention to use condoms in the study population. However, there were significant direct and total effects of acculturation (c' = .27, p < .05; c = .31, p < .05), respectively, on intention to use condoms. Results of the study may suggest that public health intervention strategies targeting condom use among immigrants should incorporate programs that improve English language training tailored to the cultural practices and values of the immigrants, and consider the effect of acculturation on condom use. © 2016 Wiley Periodicals, Inc.

Facts, attitudes, and health reasoning about HIV and AIDS: explaining the education effect on condom use among adults in sub-Saharan Africa.

PubMed

Baker, David P; Leon, Juan; Collins, John M

2011-10-01

In contrast to earlier in the HIV/AIDS pandemic, net of other demographic factors, formal education acts as a preventative factor in sub-Saharan Africa. Despite this trend, there has been almost no research on the causal mechanisms behind the widely reported education effect. Consistent with the education effect, structural equation modeling of the influence of education attainment on condom use with Demographic Health Survey data from nine sub-Saharan Africa nations collected between 2003 and 2005 finds that net of control variables, there is a robust, positive influence of education on condom use among sexually risky adults. Information-transfer and attitude change, the two most commonly assumed educational influences on the use of condoms, are tested, and although education attainment increases acquisition of basic facts and the inculcation of positive attitudes about HIV/AIDS, these factors have only weak influence on condom use. Given this, a new hypothesis about education's enhancement of health reasoning is developed from neuro-developmental and decision-making research. Modeling finds that education robustly influences health reasoning ability and this factor mediates a significant proportion of the education effect on condom use. The results raise concern about the enormous effort by NGOs in the region to use mainly fact- and attitude-based educational programs to reduce future HIV infections. Future research on the causal mechanisms behind the association between education and HIV/AIDS prevention should focus how on schooling enhances the cognitive skills needed for health reasoning.

Consistent condom use among Thai heterosexual adult males in Bangkok, Thailand.

PubMed

Janepanish, Poolsuk; Dancy, Barbara L; Park, Chang

2011-04-01

Thai heterosexual males between 20 and 39 years old are at increased risk for HIV infection. Consistent condom use is effective against HIV transmission, but little is known about determinants of consistent condom use for these males. The purpose of this study is to explore determinants of consistent condom use for this population. The determinants of interest are age, educational level, marital status, income, and concepts from the theory of planned behavior: attitude toward condom use, subjective norm about consistent condom use, perceived behavioral control (PBC) of consistent condom use, and intention to use condoms consistently. We used a cross-sectional descriptive research design with a convenience sample of 400 heterosexual Thai males between 20 and 39 years. Our sample had a mean age of 28.71 years (SD = 6.33). During the last three months, 39.5% reported using condoms consistently, 23% reported using condoms inconsistently, and 37.5% reported never using condoms. The results from the regression analyses revealed that marital status, income, subjective norm about consistent condom use, PBC of consistent condom use, and intention to use condoms consistently were determinants of consistent condom use. Also the effect of subjective norm about consistent condom use and PBC of consistent condom use on consistent condom use was mediated by intention to use condoms consistently. These results suggest that interventions to increase consistent condom use should focus on enhancing intention to use condoms consistently by promoting subjective norm about consistent condom use and PBC of consistent condom use.

Country on the verge of an AIDS epidemic. Russia, education (health).

PubMed

1997-06-30

This news brief indicates that HIV infections in Russia could rapidly increase from a few thousand currently to almost 800,000 by the year 2000. The Kremlin initiated an advertising campaign targeting 15-24 year olds with a message of safe sex. Health authorities are accepting the help of Medecins sans Frontieres (Doctors without Borders). The group will adapt strategies that were successful abroad to local Russian conditions. About 76% of HIV-infected persons are intravenous drug users. There is the potential for the spread of HIV heterosexually. Already, syphilis infections have increased by 60 times over the past 8 years. Syphilis cases increased from around zero in 1988 to almost 400,000 at present. HIV infections have spread rapidly in Kaliningrad, which is a port city and a crossroads for the drug trade. Medecins sans Frontieres is targeting education programs to young drug users and training programs to medical workers. Television spots, music, billboards, bus signs, and the press are being used to spread the message about using condoms to prevent HIV and other sexually transmitted diseases. The task of health education and behavior change will be difficult in a country where most people have unhealthy life styles of smoking, alcohol drinking, and non-use of seatbelts. People are well informed about the dangers of AIDS, but people do not adopt health-protective behavior. At present, foreign condom makers dominate the market and are the ones most likely to benefit from the campaign. Russian condom producers have not shifted production from the heavy-duty Soviet era condoms that are referred to as "galoshes" to thin Western-style condoms. The number of new cases in 1996 exceeded the total number of cases in the preceding 9 years. By May 1997 there were 4494 HIV-infected persons, of whom 259 had full-blown AIDS.

Condom use errors and problems in a national sample of young Croatian adults.

PubMed

Baćak, Valerio; Stulhofer, Aleksandar

2012-08-01

In this study, we examined the correlates of condom use errors and problems in a population-based study conducted in 2010 among young Croatian adults aged 18-25 years. Out of a total sample of 1,005 participants, 679 reported condom use in the preceding year. The analyses focused on four outcomes: condom breakage, condom slippage, condom-related erection loss, and delayed condom application. Eighteen percent of participants experienced breakage, 13% reported slippage, 17% reported erection loss, and 34% applied a condom after intercourse started. Multivariate logistic regression analyses were performed to examine the correlates of these condom use errors and problems. Condom breakage was less likely to be reported by women and older participants. The odds of breakage were increased for participants who reported being under the influence of drugs during sex and who reported other condom use errors and problems in the past year. Condom slippage was more likely to occur among younger participants and those who reported condom breakage and delayed condom application. Condom-related erection loss was positively associated with a higher number of sexual partners in the preceding year, condom breakage, and a higher score on the Anti-Erotic Obstacles to Condom Use Scale. Odds of delayed condom application were increased for participants who experienced condom breakage and for those who consumed alcohol before sex in the past year. Having used a condom at first sex significantly reduced the odds of applying a condom after intercourse started. In comparison to non-habitual condom users, habitual users were found less likely to report any of the assessed condom use errors and problems. Improving condom use skills remains an important task in Croatia, which is currently hampered by the absence of evidence-based sex education in schools.

Abstinence and abstinence-only education.

PubMed

Ott, Mary A; Santelli, John S

2007-10-01

To review recent literature on medical accuracy, program effectiveness, and ethical concerns related to abstinence-only policies for adolescent sexuality education. The federal government invests over 175 million dollars annually in 'abstinence-only-until-marriage' programs. These programs are required to withhold information on contraception and condom use, except for information on failure rates. Abstinence-only curricula have been found to contain scientifically inaccurate information, distorting data on topics such as condom efficacy, and promote gender stereotypes. An independent evaluation of the federal program, several systematic reviews, and cohort data from population-based surveys find little evidence of efficacy and evidence of possible harm. In contrast, comprehensive sexuality education programs have been found to help teens delay initiation of intercourse and reduce sexual risk behaviors. Abstinence-only policies violate the human rights of adolescents because they withhold potentially life-saving information on HIV and other sexually transmitted infections. Federal support of abstinence-only as an approach to adolescent sexuality education is of much concern due to medical inaccuracies, lack of effectiveness, and the withholding and distorting of health information.

HIV knowledge and sexual risk behavior among pregnant couples in South Africa: the PartnerPlus project.

PubMed

Villar-Loubet, Olga M; Cook, Ryan; Chakhtoura, Nahida; Peltzer, Karl; Weiss, Stephen M; Shikwane, Molatelo Elisa; Jones, Deborah L

2013-02-01

In sub-Saharan Africa, 60 % of people living with HIV are women and most are of childbearing age. Alarmingly, seroconversion rates during pregnancy are high and increase as pregnancy progresses, highlighting the importance of increasing HIV-knowledge among pregnant women and their partners. This study compared sexual risk behavior, HIV knowledge and condom use pre- to post-partum among South African couples (n = 239 couples) randomly assigned to an intervention or an enhanced standard of care with the PMTCT protocol at rural community health antenatal clinics. Consistent condom use and HIV-related knowledge increased baseline to post-intervention and was maintained at long term follow up post-partum among participants in the intervention condition. HIV knowledge mediated the relationship between the intervention and consistent condom use. Results from this pilot study provide support for the integration of HIV risk reduction interventions for both women and men into existing PMTCT services during and following pregnancy.

Mitigating circumstances: A model-based analysis of associations between risk environment and infrequent condom use among Chinese street-based sex workers.

PubMed

Chang, Ruth C; Hail-Jares, Katie; Zheng, Huang; He, Na; Bouey, Jennifer Z H

2018-01-01

Little is known about how freelance street-based sex workers navigate condom use while soliciting. Traditional behavioural model may fail to account for the complex risk environment that most street-based sex workers work within. We examine first the association of self-efficacy and the infrequent condom use, then we investigated the roles of clients and venues frequented on this association. Using a purposive chain-referral sampling method, we surveyed 248 street-based sex workers in Shanghai. The survey focused on sex workers HIV risk factors, sex work patterns, HIV knowledge, and related HIV self-efficacy. Clients types and behaviours, and characteristics of the venues frequented by these commercial sex workers were also collected. We conducted a series of multiple logistic regression models to explore how the association between a sex worker's self-efficacy with infrequent condom use change as client and venue characteristics were added to the models. We find that within the basic model, low self-efficacy was marginally associated with infrequent condom use (54.9% vs. 45.1%, AOR = 1.70, 95% CI = 0.95-3.03). As client- and venue- characteristics were added, the associations between self-efficacy and condom use were strengthened (AOR = 2.10 95% CI = 1.12-3.91 and 2.54 95% CI = 1.24-5.19 respectively). Those who reported middle-tiered income were more likely to report infrequent condom use compared to their peers of high income (AOR = 3.92 95% CI = 1.32-11.70) whereas such difference was not found between low income and high income sex workers. Visiting multiple venues and having migrant workers as clients were also associated with infrequent condom use. Our findings suggest sex worker's self-efficacy matters in their HIV risk behaviours only when environment characteristics were adjusted. Risk environment for street-based sex workers are complex. Programming addressing behavioural changes among female sex workers should adopt holistic, multilevel models with the consideration of risk environments.

Is food insecurity associated with HIV risk? Cross-sectional evidence from sexually active women in Brazil.

PubMed

Tsai, Alexander C; Hung, Kristin J; Weiser, Sheri D

2012-01-01

Understanding how food insecurity among women gives rise to differential patterning in HIV risks is critical for policy and programming in resource-limited settings. This is particularly the case in Brazil, which has undergone successive changes in the gender and socio-geographic composition of its complex epidemic over the past three decades. We used data from a national survey of Brazilian women to estimate the relationship between food insecurity and HIV risk. We used data on 12,684 sexually active women from a national survey conducted in Brazil in 2006-2007. Self-reported outcomes were (a) consistent condom use, defined as using a condom at each occasion of sexual intercourse in the previous 12 mo; (b) recent condom use, less stringently defined as using a condom with the most recent sexual partner; and (c) itchy vaginal discharge in the previous 30 d, possibly indicating presence of a sexually transmitted infection. The primary explanatory variable of interest was food insecurity, measured using the culturally adapted and validated Escala Brasiliera de Segurança Alimentar. In multivariable logistic regression models, severe food insecurity with hunger was associated with a reduced odds of consistent condom use in the past 12 mo (adjusted odds ratio [AOR] = 0.67; 95% CI, 0.48-0.92) and condom use at last sexual intercourse (AOR = 0.75; 95% CI, 0.57-0.98). Self-reported itchy vaginal discharge was associated with all categories of food insecurity (with AORs ranging from 1.46 to 1.94). In absolute terms, the effect sizes were large in magnitude across all outcomes. Underweight and/or lack of control in sexual relations did not appear to mediate the observed associations. Severe food insecurity with hunger was associated with reduced odds of condom use and increased odds of itchy vaginal discharge, which is potentially indicative of sexually transmitted infection, among sexually active women in Brazil. Interventions targeting food insecurity may have beneficial implications for HIV prevention in resource-limited settings.

Kids and condoms.

PubMed

Harrington-lueker, D

1991-05-01

The proposal of the school chancellor in New York City to dispense condoms to the city's 261,000 high school students met with protests from parents and religious groups that espouse abstinence and postponement of sexual activity. In Philadelphia there was a tumultuous meeting of the school board and AIDS prevention advocates. The promotion of condoms for AIDS prevention has become controversial, some claiming that it promotes promiscuity. In February 1991, there were 167,803 AIDS cases reported to the Centers for Disease Control of which 659 cases involved patients aged 13-19, an increase of 173 from the previous year. 1/5 of AIDS victims are in their 20s, and many more teenagers could be infected because of the long incubation period. In New York City 30% of cases are in the 20-29 age group with blacks, Hispanics, runaways, and teen prostitutes disproportionately affected. 37% of teen cases occur in areas outside of major cities. Gonorrhea, syphilis, chlamydia, and herpes have also increased to epidemic levels. There are 35 million people aged 10-19 whose number will increase by 10% in the 1990s, and they are facing a high risk of HIV infection. 53% of girls aged 15-19 were sexually active in 1988 increasing from 47% in 1982. 58% reported 2 or more sexual partners during that year, and few of them used condoms on a regular basis. Frank sex education programs have been adopted extensively, but behavior modification is the main issue. Some schools have provided condoms directly to students after parental consent. The school board of San Francisco faces a decision on providing condoms to students (85% from ethnic minorities) via a clinic or vending machines in restrooms. The recommendations of a Philadelphia task force also awaits school board action. In Los Angeles and Brookline, Massachusetts, a similar decision is pending. In Canada, condom vending machines have been installed in high schools in British Columbia, Ottawa, and Toronto.

Sexual behavior and condom use in female students in Dar-es-Salaam, Tanzania: differences by steady and casual partners.

PubMed

Maswanya, E S; Moji, K; Aoyagi, K; Takemoto, T

2011-06-01

In Tanzania female youth are increasingly becoming at greater risk of sexually transmitted HIV infection, whereby more than 80% cases occur through un-protected sex. The objective of this study was to examine related-factors which influence female students to have risky sexual contacts with casual partners including condom use and sex with sugar daddies. A cross section study involving face-to-face interview was conducted regarding sexual behavior among 219 sexually-debuted female students aged between 18 and 24 years who were attending high schools and colleges in Dar-es-salaam, Tanzania. Eighty-three percent had at least one boyfriend in the past 12 months, 57% had engaged in sex with a "sugar daddy", and 24% had engaged in sex with a casual partner other than a sugar daddy. Sixty-nine percent had ever used a condom, and 66% had used a condom during their most recent sexual encounter. Thirty-two percent reported always using a condom during sex with their boyfriends, whereas only 2% always used a condom with a sugar daddy. Decision-making about condom use during sex with boyfriends was made by couples together (48%) or by the girls alone (34%), whereas the decision during sex with a sugar daddy was predominantly made by the male partner (79%). Data were analyzed using Statistical Package for Social Sciences (SPSS) version 9.5 for frequencies, cross-tabulations and chi-squired test and statistical significance set at p<0.05. The study highlighted risk factors for female students towards HIV infection. Receiving money and/or presents were the major motivations for having sex irrelevant with types of sex partners. Although most female's students disagreed in principle to have sex in exchange for money or presents, sex with sugar daddies was common among female students and was a major risk factor for HIV infection. Based on the findings, recommendations for improvement in prevention programs among female youth within Tanzanian context are discussed.

The effect of sex education on adolescents' use of condoms: applying the Solomon four-group design.

PubMed

Kvalem, I L; Sundet, J M; Rivø, K I; Eilertsen, D A; Bakketeig, L S

1996-02-01

A school-based sex education program was developed in order to prevent sexually transmitted diseases and unwanted pregnancies. A Solomon four-group design, with random assignment to the different conditions, was used to evaluate an intervention based on cognitive social learning theory and social influence theory. The main goal of the intervention was to increase use of condoms. A stratified sample of 124 classes (2,411 students) was drawn at random from all the upper secondary schools (high schools/colleges) in one county in Norway. The results indicate a consistent interaction between pretest and intervention, which seems to have an effect on condom use. Pretest or intervention alone did not contribute to this effect. The interaction effect appeared among the students with few sexual partners. Several possible explanations to the observed interaction effect and the implication for future interventions are discussed.

Cross-cultural differences and sexual risk behavior of emerging adults.

PubMed

Thomas, Tami L; Yarandi, Hossein N; Dalmida, Safiya George; Frados, Andrew; Klienert, Kathleen

2015-01-01

The authors examined population-specific risk factors that increase emerging adults' risk of acquiring sexually transmitted infections (STIs), including the human papillomavirus (HPV). A cross-sectional sample of 335 diverse, emerging adults ages 18 to 24 years was recruited from a health center at a large university in the Southeastern United States. The mean age was 20.6 ± 1.9 years, majority were females (74.0%), and 61.0% were Hispanic. Findings revealed inconsistent condom use, reasons for not using condoms, and a need for more culturally specific intervention strategies. Healthcare providers should identify culturally specific reasons for inconsistent condom use, examine cultural and geographic differences in sexual risk behaviors among groups and communities, and modify communication, educational programs, and interventions accordingly. By adopting a multicultural approach to the control of STIs, nurses can address specific cultural attitudes and behaviors that may influence exposure to STIs, including HPV. © The Author(s) 2014.

Safer sex maintenance among gay men: are we making any progress?

PubMed

Ekstrand, M L

1992-08-01

Although early acquired immunodeficiency syndrome (AIDS) prevention programs produced dramatic reductions in unsafe sexual practices on the part of homosexual men, there is evidence that new behaviors have not been maintained consistently. Various cohort studies have related risky sex relapse to low self-efficacy, emotional depression, and relationship issues. Unprotected sex is widely perceived as more pleasurable than condom use and is likely to be practiced by gay men concerned with their partner's presumed preferences. This finding suggests a need to identify ways of increasing the pleasure associated with safe sex by eroticizing condom use. Approaches that include erotic descriptions of safe sex (e.g., pamphlets with explicit photographs, mass media campaigns that use sexually explicit language, and attractively packaged condoms) have been found to increase behavioral risk reduction practices. All interventions aimed at preventing risky sex relapse should be empirically based and delivered in a fashion acceptable to the homosexual community.

[Availability of condoms in Mexico City].

PubMed

Hernández-Girón, C; Cruz-Valdez, A; Quiterio-Trenado, M; Avila-Burgos, L; Peruga, A; Hernández-Avila, M

2001-12-01

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 effective strategy for the prevention of STI's/HIV, therefore the availability of this method of prevention is important to decrease the incidence of these diseases The results of this study indicate that the price for this method of prevention represents an important expense for the homes, which is a limiting factor for condom use, especially for those populations that include adolescents and young adults. It then becomes necessary for Government Institutions to implement programs that will subsidize this method of prevention. Availability is less in self-service shops and practically non-existent in bars and nightclubs. It is suggested that the availability of condom should be mandatory in public places, like bars and nightclubs, where the risk to start casual sexual contact is eminent.

Increasing condom use: evaluation of a theory-based intervention to prevent sexually transmitted diseases in young women.

PubMed

Bryan, A D; Aiken, L S; West, S G

1996-09-01

A multicomponent intervention to increase condom use in sexually active young women was designed, implemented, and evaluated in a randomized experiment. Participants were 198 unmarried female college students (mean age = 18.6 years) who received a 1-session condom promotion intervention or a control (stress management) intervention. The condom promotion intervention led to increased self-reported condom use up to 6 months following intervention as well as positive changes in perceived benefits of condom use, affective attitudes toward condom use and condom users, perceived acceptance of sexuality, control over the sexual encounter, perceived self-efficacy for condom use, and intentions to use condoms. Mediational analysis illustrated the mechanisms of the condom promotion intervention effects, linking psychological constructs affected by the intervention (perceived benefits, acceptance of sexuality, control over the sexual encounter, attitudes toward condoms, and self-efficacy for condom use) to condom use intentions.

Condoms - male

MedlinePlus

... Rubbers; Male condoms; Contraceptive - condom; Contraception - condom; Barrier method - condom ... infections.) Latex rubber Polyurethane Condoms are the only method of birth control for men that are not ...

Evaluation of the efficacy of a nonlatex condom: results from a randomized, controlled clinical trial.

PubMed

Walsh, Terri L; Frezieres, Ron G; Peacock, Karen; Nelson, Anita L; Clark, Virginia A; Bernstein, Leslie

2003-01-01

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.

Patterns of harm reduction service utilization and HIV incidence among people who inject drugs in Ukraine: A two-part latent profile analysis.

PubMed

Ompad, Danielle C; Wang, Jiayu; Dumchev, Konstantin; Barska, Julia; Samko, Maria; Zeziulin, Oleksandr; Saliuk, Tetiana; Varetska, Olga; DeHovitz, Jack

2017-05-01

Program utilization patterns are described within a large network of harm reduction service providers in Ukraine. The relationship between utilization patterns and HIV incidence is determined among people who inject drugs (PWID) controlling for oblast-level HIV incidence and treatment/syringe coverage. Data were extracted from the network's monitoring and evaluation database (January 2011-September 2014, n=327,758 clients). Latent profile analysis was used to determine harm reduction utilization patterns using the number of HIV tests received annually and the number of condoms, syringes, and services (i.e., information and counseling sessions) received monthly over a year. Cox proportional hazards regression determined the relations between HIV seroconversion and utilization class membership. In the final 4-class model, class 1 (34.0% of clients) received 0.1 HIV tests, 1.3 syringes, 0.6 condom and minimal counseling and information sessions per month; class 2 (33.6%) received 8.6 syringes, 3.2 condoms, and 0.5 HIV tests and counseling and information sessions; class 3 (19.1%) received 1 HIV test, 11.9 syringes, 4.3 condoms, and 0.7 information and counseling sessions; class 4 (13.3%) received 1 HIV test, 26.1 syringes, 10.3 condoms, and 1.8 information and 1.9 counseling sessions. Class 4 clients had significantly decreased risk for HIV seroconversion as compared to those in class 1 after controlling for oblast-level characteristics. Injection drug use continues to be a major mode of HIV transmission in Ukraine, making evaluation of harm reduction efforts in reducing HIV incidence among PWID critical. These analyses suggest that receiving more syringes and condoms decreased risk of HIV. Scaling up HIV testing and harm reduction services is warranted. Copyright © 2016. Published by Elsevier B.V.

Sexual behavior and condom use among male students in Dar-Es-Salaam, Tanzania with emphasis on contact with barmaids.

PubMed

Maswanya, Edward S; Moji, Kazuhiko; Yamamoto, Taro; Aoyagi, Kiyoshi; Yahata, Yuichiro; Takemoto, Tai-Ichiro

2012-03-01

The objective of this quantitative study was to identifying factors that influence young men to participate in risky sexual behavior that place them at risk of HIV infection, as young people are at higher risk for HIV infection than adults. A cross-sectional study design that employed face-to-face interview questionnaire to identify socio-demographic characteristics, sexual behavior, knowledge of HIV, STD, attitudes towards condoms was administered to 175 sexually active male students between 17 and 24 years old in college settings of Dar-es-Salaam city, Tanzania. In the previous 12 months, 80% of students had at least one steady sex partner (girlfriend), 71% had sex with a barmaid, 33% had sex with a casual partner and 83% had multiple sex partners. Condoms had been used at some time by 83% of students, and in the latest sexual encounter by 56%. However, only 37%, 22%, and 11% consistently used condoms during sex with girlfriends, casual partners and barmaids, respectively. Condom use was least popular during sex with barmaids, and 94% and 91% of students had experienced oral and anal sex with barmaids, respectively. STD infection was reported by 42% of students. Sex with barmaids was associated with alcohol and illicit drug intake, sex under their respective influences, and STD infection. Despite the high prevalence of these risky behaviors, 64% of students replied that they were at low or no risk of HIV infection. Our findings suggest that HIV prevention programs for male students should emphasize risks associated with multiple sexual partners, and sex with barmaids and casual partners, to increase the risk perception of HIV/AIDS. Condom use needs to be promoted.

Contraceptive social marketing in the Philippines. A new initiative.

PubMed

Migallos, G; Araneta, A

1994-01-01

By offering contraceptives at subsidized prices through pharmacies, drugstores, grocery shops, and other conveniently-located retail outlets, and promoting them with modern marketing techniques, social marketing programs can do much to reduce the unmet need for family planning. Users obviously benefit, while the family planning program benefits from advertising and marketing skills and some cost recovery. The Philippine Contraceptive Social Marketing Project (PCSMP) was formally launched in the Philippines in 1993 in response to the large unmet need in the country, and initial results are promising. The project was started with funding from the US Agency for International Development to provide affordable, quality contraceptives through the private sector to Filipino couples who choose to practice family planning. A 1988 survey found that only 22.4% of women aged 15-44 years were using modern methods of contraception and 13.8% were using traditional methods; approximately three million women therefore had unmet need for family planning. The PCSMP established an AIDS prevention component and a birth spacing component, enlisting the participation of oral contraceptive manufacturers Wyeth, Organon, and Schering, along with one condom distributor, Philusa. These companies lowered their product prices by 20% for the program. Despite objections from the Catholic church, sales of both oral pills and condoms increased in the first year. In its second year, the program will advertise Sensation condoms and the Couple's Choice Pills via television, through intensive distribution drives, consumer and trade promotions, and the continuous training of health professionals. The contraceptive injectable DMPA will be added to the Couple's Choice product line in April 1994. This method, too, will be heavily promoted.

[Factors associated with condom use and knowledge about STD/AIDS among teenagers in public and private schools in São Paulo, Brazil].

PubMed

Martins, Laura B Motta; da Costa-Paiva, Lúcia Helena S; Osis, Maria José D; de Sousa, Maria Helena; Pinto-Neto, Aarão M; Tadini, Valdir

2006-02-01

This study aimed to compare knowledge about STD/AIDS and identify the factors associated with adequate knowledge and consistent use of male condoms in teenagers from public and private schools in the city of São Paulo, Brazil. We selected 1,594 adolescents ranging 12 to 19 years of age in 13 public schools and 5 private schools to complete a questionnaire on knowledge of STD/AIDS and use of male condoms. Prevalence ratios were computed with a 95% confidence interval. The score on STD knowledge used a cutoff point corresponding to 50% of correct answers. Statistical tests were chi-square and Poisson multiple regression. Consistent use of male condoms was 60% in private and 57.1% in public schools (p > 0.05) and was associated with male gender and lower socioeconomic status. Female gender, higher schooling, enrollment in private school, Caucasian race, and being single were associated with higher knowledge of STDs. Teenagers from public and private schools have adequate knowledge of STD prevention, however this does not include the adoption of effective prevention. Educational programs and STD/AIDS awareness-raising should be expanded in order to minimize vulnerability.

When ''no'' means ''yes'': the gender implications of HIV programming in a Zimbabwean university.

PubMed

Masvawure, Tsitsi B; Terry, Paul E; Adlis, Sue; Mhloyi, Marvellous

2009-01-01

This study assessed the nature and extent of sexual risk-taking behavior by students in a Zimbabwean university and identified some of the sociocultural factors that facilitate sexual risk taking by female and male students. The main outcome measures of the study were condom use, number of sexual partners, and attitudes toward gender equity and equality. A cross-sectional design was used and a questionnaire was administered to 933 students. Information pertaining to students' sexual practices, condom use practices, attitudes toward HIV testing, and their beliefs pertaining to women's role in sexual decision making and a woman's right to refuse sexual intercourse were among some of the variables assessed. The vast majority of the university students (83%) are sexually experienced; only a third used condoms at their last sexual encounter; the use or nonuse of condoms was significantly associated with age, sex, marital status, and attitudes toward gender issues. There were also significant differences in the sexual behavior and attitudes of female and male students. Our study suggests that HIV prevention efforts targeted at university students need to incorporate a discussion of broader cultural beliefs, particularly those pertaining to gender role myths, if they are to be effective.

Twenty years of student sexual behavior: subcultural adaptations to a changing health environment.

PubMed

Netting, Nancy S; Burnett, Matthew L

2004-01-01

This twenty-year study analyzes changes in sexual behavior among students at Okanagan University College in British Columbia, Canada. Surveys conducted in 1980, 1990, and 2000 reveal a steady increase in safer sexual practices. Most students now question potential partners about their past, use condoms with a new sexual partner, and maintain fairly long-term monogamous relationships. Three sexual subcultures continue to coexist in fairly stable proportions: celibacy (about 30%), monogamy (about 60%), and free experimentation (about 10%). Each subculture has created its own response to the danger of HIV/AIDS: celibates exaggerate the danger they face, monogamists rely on love and fidelity for protection, and free experimenters have increased their use of condoms. While romantic feelings lead many monogamous couples to abandon condoms without objective HIV/AIDS knowledge, free experimenters still face the highest risk. Although they now use condoms more than half the time, their lifestyle, which involves multiple partners, risky sexual acts, and frequent drug and/or alcohol use, clearly remains dangerous. The persistence of distinct subcultures has implications for health education programs, which would be most effective if based on key values held by specific target groups.

Initiatives: Nigeria. Traditional healers and PPFN in wedlock.

PubMed

Adejo, A A

1996-04-01

The Planned Parenthood Federation of Nigeria (PPFN) runs a program to integrate modern contraception into the practice of traditional medicine. Under the project, traditional healers, largely male, are trained on the ideals of nonprescriptive contraceptives such as condoms, the oral contraceptive pill, and foaming tablets, and how to offer such services to their clients. They participate in a two-week, highly participatory training course which confers a comprehensive introduction to basic and integrated reproductive health care service delivery, simple human anatomy and physiology, and human reproduction. The benefits of modern contraception are reviewed along with community mobilization and counseling. Simple communication techniques such as songs, drama, and role play are discussed. Information on maternal and child health and child survival, basic hygiene, nutrition, and AIDS is also incorporated into the course. 136 traditional healers have thus far been trained in three local government areas (LGAs) of Lagos State and 150 in six other LGAs in Benue State. The project has resulted in strong referral linkages between traditional healers, modern practitioners, and PPFN.

Applying research to AIDS programs in villages. Burkina Faso project learns from community survey.

PubMed

Tankoano, F

1994-01-01

In 1991, 34 cases of acquired immunodeficiency syndrome (AIDS) were recorded for the province of Bam, which has a population of 4239. Since 1992, PLAN and the local Ministry of Health have been conducting an AIDS prevention program in the province. An initial baseline community survey to assess knowledge, attitude, and practices about the disease was conducted in order to tailor the program to the needs and characteristics of the target population. A questionnaire was administered to 300 randomly selected adults in 10 rural villages. The sexes were equally represented. 74% of the villagers were found to be illiterate and the major sources of health information were radio, health facilities, and friends and relatives; therefore, educational activities were carried out through non-written methods (traditional and modern) that employed these communication channels. Initially, 5 men and 5 women ("Village Communicators") were selected by their communities to be trained in information, education, and communication (IEC) techniques regarding AIDS prevention; under the supervision of their trainers, they organized and conducted 2 weekly sessions. An additional 62 women and 50 men were trained as Village Communicators to promote AIDS awareness among their own gender. A team of health personnel, artists, and a traditional music group conducted collective sessions to promote condom use and address problems relating to AIDS (polygamy, remarrying of spouses of AIDS victims, availability of testing during prenuptial visits). Although 90% of respondents had heard about AIDS, 30% did not understand the disease or its routes of transmission; so messages about the effects and the transmission of AIDS were emphasized. Because 56% of respondents admitted having had 2 or more sex partners, and a similar percentage admitted having had 2 or more sexual encounters per week, messages were disseminated on sexuality using community volunteers and the folkloric band. 42% of respondents were aware of the protective effect of condoms, but only 9% used them during their last sexual encounter; so village leaders, traditional healers, and PLAN and MOH staff promoted condom use at community sessions. Since 68% of respondents approved of the sale of condoms, a community-based system, which would be managed by village committees, for the sale and distribution of condoms was established.

Men and family planning: toward a policy of male involvement.

PubMed

Pillai, V K; Kelley, A C

1994-01-01

The stated aim of this discussion is to examine the extent of male use of family planning and the nature of men's role in family planning in developing countries. Case studies are presented which are successful examples of strategies for involving men in family planning. Policies that aim to increase male involvement must be sensitive to cultural values, apply to a decentralized government approach toward information and supplies, include adequate political will, and consider the costs and benefits of changing values. A male family planning policy would not always be compatible with all fertility values in developing countries or traditional values of the older population. A policy should stress the value of male individuals contributing as much as possible for their own and others' welfare. Community participation is considered important in order to create a feeling of mutual support. A sizeable investment will be required for mass distribution of contraceptive information. Schools are viewed as an ideal place for educating youth about the problems of high fertility and about use of family planning methods, such as the condom. Religious organizations should be used to educate people about responsible parenthood and to minimize barriers to use of modern contraception. Comic books on how to use condoms are suggested as a good source. Local authorities who are trusted are useful in influencing acceptance among local populations. Local personnel may be trained as information disseminators. Adequate contraceptive information needs to be supplied to a wide audience. Lack of supply and inadequate information are given as two key reasons for insufficient use of male contraception. Condoms should be priced to be affordable to the average person and free to those with no income. Program strategies that proved successful are cited for Thailand's Mechai Viravaidya program and Bali's grass-roots program. The vasectomy program in Bangladesh is also noted for its success. Low levels of condom use are attributed to factors such as price, education, availability, accessibility, culture, religion, and economic conditions. Male sterilization levels can be enhanced with wider availability of clinics and provision of correct information for challenging beliefs that vasectomy is a form of castration.

Condoms used but sex not well protected.

PubMed

Lau, J T F; Zhou, H; Su, X Y; Feng, T J; Hong, F C; Tsui, H Y; Ma, Y L; Wang, Z; Walden, D

2014-10-01

Condom use is often equated to safer sex. The prevalence of condom use during sex work among female sex workers (FSW) in China is high. Condom use, however, co-exists with condom failure and improper use and hence risk of HIV transmission. In a cross-sectional study, we interviewed 195 FSW in Shenzhen, China. The prevalence of condom use in the last episode of sex work was 97.4 %, However, respectively 53.8 and 86.2 % had experienced at least one condition of condom failure that may lead to genital contact (wearing condoms after penetration, condom breakage/slippage, condoms removed by clients) and at least one condition of improper condom use (not removing air from the tip of the condom, not pulling it down to the root of penis and not choosing good quality condoms). Factors of individual level (e.g. never choosing high quality condoms for sex work), inter-personal level (e.g. agreement to have unprotected sex if fond of clients or paid more) and environmental/structural level (e.g. non-availability of condoms) were associated with various types of condom failure and improper use. Although HIV prevention interventions have increased prevalence of condom use among FSW, the risk of HIV transmission may still be high as "unsafe" sex due to condom failure and improper use is prevalent. Interventions promoting safer sex need to address such issues and take socio-ecological factors into account. Condom use during sex work is not equivalent to well protected sex as the protective effects could be compromised by frequent condom failure and improper use.

Barriers to condom purchasing: Effects of product positioning on reactions to condoms.

PubMed

Scott-Sheldon, Lori A J; Glasford, Demis E; Marsh, Kerry L; Lust, Sarah A

2006-12-01

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.

Words can hurt: The effects of physical and psychological partner violence on condom negotiation and condom use among young women.

PubMed

Peasant, Courtney; Sullivan, Tami P; Ritchwood, Tiarney D; Parra, Gilbert R; Weiss, Nicole H; Meyer, Jaimie P; Murphy, James G

2017-04-12

Physical and psychological intimate partner violence (IPV) are prevalent on college campuses and may affect young women's condom use behavior. This study explored condom negotiation as a mediator of the relation of physical and psychological IPV to condom use among college women. A total of 235 heterosexual college women were recruited during September 2012-May 2013. Participants completed online questionnaires assessing lifetime history of IPV, frequency of condom negotiation, and use of condoms during the last 30 days. Specific forms of psychological IPV were related to less condom use. This association was mediated by condom negotiation, such that those who had experienced psychological IPV were less likely to negotiate condom use, and as a result, less likely to report using condoms in the past 30 days. Campus-based sexual health efforts should consider the relation of psychological IPV to condom negotiation and condom use and offer skills to promote condom negotiation among college women to increase condom use and reduce their risk of sexually transmitted infections.

Public opinion on sex education in US schools.

PubMed

Bleakley, Amy; Hennessy, Michael; Fishbein, Martin

2006-11-01

To examine US public opinion on sex education in schools to determine how the public's preferences align with those of policymakers and research scientists. Cross-sectional survey. July 2005 through January 2006. Randomly selected nationally representative sample of US adults aged 18 to 83 years (N = 1096). Support for 3 different types of sex education in schools: abstinence only, comprehensive sex education, and condom instruction. Approximately 82% of respondents indicated support for programs that teach students about both abstinence and other methods of preventing pregnancy and sexually transmitted diseases. Similarly, 68.5% supported teaching how to properly use condoms. Abstinence-only education programs, in contrast, received the lowest levels of support (36%) and the highest level of opposition (about 50%) across the 3 program options. Self-identified conservative, liberal, and moderate respondents all supported abstinence-plus programs, although the extent of support varied significantly. Our results indicate that US adults, regardless of political ideology, favor a more balanced approach to sex education compared with the abstinence-only programs funded by the federal government. In summary, abstinence-only programs, while a priority of the federal government, are supported by neither a majority of the public nor the scientific community.

Mobilizing collective identity to reduce HIV risk among sex workers in Sonagachi, India: The boundaries, consciousness, negotiation framework

PubMed Central

Ghose, Toorjo; Swendeman, Dallas; George, Sheba; Chowdhury, Debasish

2010-01-01

The significantly low rate of HIV infection and high rate of condom use among sex workers in Kolkata, India is partially attributable to a community-led structural intervention called the Sonagachi Project which mobilizes sex workers to engage in HIV education, formation of community-based organizations and advocacy around sex work issues. This research examines how Sonagachi Project participants mobilize collective identity and the manner in which collective identity influences condom use. Using purposive sampling methods, 46 Sonagachi Project participants were selected in 2005 for in-depth qualitative interviews. Taylor and Whittier’s (Taylor, V & Whittier, N (1992). Collective identities in social movement communities: lesbian feminist mobilization. In A. Morris & C. Mueller (Eds.) Frontiers in social movement theory. New Haven, CT: Yale University Press) model of identity-formation through boundaries, consciousness and negotiation was used to interpret results. Subjects mobilized collective identity by (1) building boundaries demarcating in-group sex workers from out-group members, (2) raising consciousness about sex work as legitimate labor and the transformative change that results from program participation, and (3) negotiating identity with out-group members. This research establishes a conceptual link between the boundaries, consciousness and negotiation framework of collective identity mobilization and condom use. Condom use among sex workers is motivated by each element of the boundaries, consciousness and negotiation model: condoms mark boundaries, enunciate the consciousness that sex with clients is legitimate labor, and help negotiate the identity of sex workers in interactions with clients. PMID:18455855

Mobilizing collective identity to reduce HIV risk among sex workers in Sonagachi, India: the boundaries, consciousness, negotiation framework.

PubMed

Ghose, Toorjo; Swendeman, Dallas; George, Sheba; Chowdhury, Debasish

2008-07-01

The significantly low rate of HIV infection and high rate of condom use among sex workers in Kolkata, India is partially attributable to a community-led structural intervention called the Sonagachi Project which mobilizes sex workers to engage in HIV education, formation of community-based organizations and advocacy around sex work issues. This research examines how Sonagachi Project participants mobilize collective identity and the manner in which collective identity influences condom use. Using purposive sampling methods, 46 Sonagachi Project participants were selected in 2005 for in-depth qualitative interviews. Taylor and Whittier's (Taylor, V & Whittier, N (1992). Collective identities in social movement communities: lesbian feminist mobilization. In A. Morris & C. Mueller (Eds.) Frontiers in social movement theory. New Haven, CT: Yale University Press) model of identity-formation through boundaries, consciousness and negotiation was used to interpret results. Subjects mobilized collective identity by (1) building boundaries demarcating in-group sex workers from out-group members, (2) raising consciousness about sex work as legitimate labor and the transformative change that results from program participation, and (3) negotiating identity with out-group members. This research establishes a conceptual link between the boundaries, consciousness and negotiation framework of collective identity mobilization and condom use. Condom use among sex workers is motivated by each element of the boundaries, consciousness and negotiation model: condoms mark boundaries, enunciate the consciousness that sex with clients is legitimate labor, and help negotiate the identity of sex workers in interactions with clients.

Diversity among clients of female sex workers in India: comparing risk profiles and intervention impact by site of solicitation. implications for the vulnerability of less visible female sex workers.

PubMed

Suryawanshi, Dipak; Bhatnagar, Tarun; Deshpande, Sucheta; Zhou, Weiwei; Singh, Pankaj; Collumbien, Martine

2013-01-01

It seems generally accepted that targeted interventions in India have been successful in raising condom use between female sex workers (FSWs) and their clients. Data from clients of FSWs have been under-utilised to analyse the risk environments and vulnerability of both partners. The 2009 Integrated Biological and Behavioural Assessment survey sampled clients of FSWs at hotspots in Andhra Pradesh, Maharashtra and Tamil Nadu (n=5040). The risk profile of clients in terms of sexual networking and condom use are compared across usual pick-up place. We used propensity score matching (PSM) to estimate the average treatment effect on treated (ATT) of intervention messages on clients' consistent condom use with FSW. Clients of the more hidden sex workers who solicit from home or via phone or agents had more extensive sexual networks, reporting casual female partners as well as anal intercourse with male partners and FSW. Clients of brothel-based sex workers, who were the least educated, reported the fewest number/categories of partners, least anal sex, and lowest condom use (41%). Consistent condom use varied widely by state: 65% in Andhra Pradesh, 36% in Maharashtra and 29% in Tamil Nadu. Exposure to intervention messages on sexually transmitted infections was lowest among men frequenting brothels (58%), and highest among men soliciting less visible sex workers (70%). Exposure had significant impact on consistent condom use, including among clients of home-based sex workers (ATT 21%; p=0.001) and among men soliciting other more hidden FSW (ATT 17%; p=0.001). In Tamil Nadu no impact could be demonstrated. Commercial sex happens between two partners and both need to be, and can be, reached by intervention messages. Commercial sex is still largely unprotected and as the sex industry gets more diffuse a greater focus on reaching clients of sex workers seems important given their extensive sexual networks.

Diversity among Clients of Female Sex Workers in India: Comparing Risk Profiles and Intervention Impact by Site of Solicitation. Implications for the Vulnerability of Less Visible Female Sex Workers

PubMed Central

Suryawanshi, Dipak; Bhatnagar, Tarun; Deshpande, Sucheta; Zhou, Weiwei; Singh, Pankaj; Collumbien, Martine

2013-01-01

Background It seems generally accepted that targeted interventions in India have been successful in raising condom use between female sex workers (FSWs) and their clients. Data from clients of FSWs have been under-utilised to analyse the risk environments and vulnerability of both partners. Methods The 2009 Integrated Biological and Behavioural Assessment survey sampled clients of FSWs at hotspots in Andhra Pradesh, Maharashtra and Tamil Nadu (n=5040). The risk profile of clients in terms of sexual networking and condom use are compared across usual pick-up place. We used propensity score matching (PSM) to estimate the average treatment effect on treated (ATT) of intervention messages on clients’ consistent condom use with FSW. Results Clients of the more hidden sex workers who solicit from home or via phone or agents had more extensive sexual networks, reporting casual female partners as well as anal intercourse with male partners and FSW. Clients of brothel-based sex workers, who were the least educated, reported the fewest number/categories of partners, least anal sex, and lowest condom use (41%). Consistent condom use varied widely by state: 65% in Andhra Pradesh, 36% in Maharashtra and 29% in Tamil Nadu. Exposure to intervention messages on sexually transmitted infections was lowest among men frequenting brothels (58%), and highest among men soliciting less visible sex workers (70%). Exposure had significant impact on consistent condom use, including among clients of home-based sex workers (ATT 21%; p=0.001) and among men soliciting other more hidden FSW (ATT 17%; p=0.001). In Tamil Nadu no impact could be demonstrated. Conclusion Commercial sex happens between two partners and both need to be, and can be, reached by intervention messages. Commercial sex is still largely unprotected and as the sex industry gets more diffuse a greater focus on reaching clients of sex workers seems important given their extensive sexual networks. PMID:24023877

The Role of Dyad-Level Factors in Shaping Sexual and Drug-Related HIV/STI Risks among Sex Workers with Intimate Partners

PubMed Central

Argento, Elena; Shannon, Kate; Nguyen, Paul; Dobrer, Sabina; Chettiar, Jill; Deering, Kathleen N.

2015-01-01

Background Despite high HIV burden among sex workers (SWs) globally, and relatively high prevalence of client condom use, research on potential HIV/STI risk pathways of intimate partnerships is limited. This study investigated partner/dyad-level factors associated with inconsistent condom use among SWs with intimate partners in Vancouver, Canada. Methods Baseline data (2010–2013) were drawn from a community-based prospective cohort of women SWs. Multivariable generalized estimating equations logistic regression examined dyad-level factors associated with inconsistent condom use (<100% in last six months) with up to three male intimate partners per SW. Adjusted odds ratios and 95% confidence intervals were reported (AOR[95%CI]). Results Overall, 369 SWs reported having at least one intimate partner, with 70.1% reporting inconsistent condom use. Median length of partnerships was 1.8 years, with longer duration linked to inconsistent condom use. In multivariable analysis, dyad factors significantly associated with increased odds of inconsistent condom use included: having a cohabiting (5.43[2.53–11.66]) or non-cohabiting intimate partner (2.15[1.11–4.19]) (versus casual partner), providing drugs (3.04[1.47–6.30]) or financial support to an intimate partner (2.46[1.05–5.74]), physical intimate partner violence (2.20[1.17–4.12]), and an intimate partner providing physical safety (2.08[1.11–3.91]); non-injection drug use was associated with a 68% reduced odds (0.32[0.17–0.60]). Conclusions Our study highlights the complex role of dyad-level factors in shaping sexual and drug-related HIV/STI risk pathways for SWs from intimate partners. Couple and gender-focused interventions efforts are needed to reduce HIV/STI risks to SWs through intimate partnerships. This research supports further calls for integrated violence and HIV prevention within broader sexual/reproductive health efforts for SWs. PMID:26585612

How often do condoms fail? : A cross-sectional study exploring incomplete use of condoms, condom failures, and other condom problems among Black and White MSM in the Southern U.S

PubMed Central

Hernández-Romieu, Alfonso C.; Siegler, Aaron; Sullivan, Patrick S.; Crosby, Richard; Rosenberg, Eli S.

2015-01-01

Objectives Compare the occurrence of risk-inducing condom events (condom failures and incomplete use) and the frequency of their antecedents (condom errors, fit/feel problems, and erection problems) between Black and White MSM, and determine the associations between risk-inducing condom events and their antecedents. Methods We studied cross-sectional data of 475 MSM who indicated using a condom as an insertive partner in the previous 6 months enrolled in a cohort study in Atlanta, GA. Results Nearly 40% of Black MSM reported breakage or incomplete use, and they were more likely to report breakage, early removal, and delayed application of a condom than White MSM. Only 31% and 54% of MSM reported correct condom use and suboptimal fit/feel of a condom respectively. The use of oil-based lubricants and suboptimal fit/feel were associated with higher odds of reporting breakage (P = 0.009). Suboptimal fit/feel was also associated with higher odds of incomplete use of condoms (P <0.0001). Conclusions Incomplete use of condoms and condom failures were especially common among Black MSM. Our findings indicate that condoms likely offered them less protection against HIV/STI when compared to White MSM. More interventions are needed, particularly addressing the use of oil-based lubricants and suboptimal fit/feel of condoms. PMID:25080511

Jamaica: a middle-aged program searches for new horizons.

PubMed

1984-01-01

The advertising and marketing consultant for Jamaica's Commercial Distribution of Contraceptives (JCDC) program, states that the program has reached a state of maturity that has resulted in some inertia. Although still the leader among contraceptive social marketing (CSM) programs in reaching the greatest percentage of its target market, product sales are no longer on an upswing, and retail outlets are not increasing in number. The project is hoping that the introduction of a new thin condom can help, but more than 1 new product may be needed to recapture momentum. The JCDC began in 1974 when Westinghouse Health Systems won a 3 year Agency for International Development (AID) award to create a Jamaican CSM program. Challenges facing the new social marketing project included: oral contraceptives (OCs) were sold only by prescription; most pharmacies were located in urban areas; many consumers associated condoms with prostitution and disease; and retailers were reluctant to carry contraceptives and ignorant of OC side effects. The 1st breakthrough came when Westinghouse obtained government permission to sell a project pill without prescription. After market research, project managers chose the name "Perle" for the JCDC's pill, manufactured in the US by Syntex as Noriday. "Panther" became the project's condom. Prices were set at US17 cents for a Panther 3-pack and 34 cents for a Perle cycle. Advertising messages appeared on television, radio, bus shelters, cinema screens, billboards, and point of purchase displays. By the end of the 1st year's sales, a soft goods manufacturer had asked permission to produce Panther T-shirts and a Reggae composer had popularized songs about the product. Such promotional tactics boosted sales of all contraceptives on the island. About 690,000 Panther condoms and 450,000 other brands were sold in 1976; 195,000 Perle cycles were purchased compared with 135,000 cycles for all other brands combined. By 1977, Westinghouse was reducing advertising and concentrating on expanding retail sales outlets. Panther was being sold through 1108 outlets; Perle was distributed via 267 predominantly pharmacy outlets. In 1977 AID's contract with Westinghouse ended and the Jamaican National Family Planning Board took over the project management. With its subsidy markedly reduced, the JCDC soon was experiencing difficulty in Jamaica's troubled economy; as well as difficulty in expanding sales outlet. Despite the project's financial pinch, the JCDC has -- with some success -- used imaginative tactics like contests to spur sales.

Condom Use Among Female Sex Workers in China: Role of Gatekeepers

PubMed Central

YANG, HONGMEI; LI, XIAOMING; STANTON, BONITA; FANG, XIAOYI; ZHAO, RAN; DONG, BAIQING; LIU, WEI; LIANG, SHAOLING; ZHOU, YUEJIAO; HONG, YAN

2007-01-01

Objective 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. Goals 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. Study The authors conducted a cross-sectional study among 454 establishment-based FSWs in one Chinese county. Results 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. Conclusions 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. PMID:16118607

RCT of an integrated CBT-HIV intervention on depressive symptoms and HIV risk.

PubMed

Tobin, Karin; Davey-Rothwell, Melissa A; Nonyane, Bareng A S; Knowlton, Amy; Wissow, Lawrence; Latkin, Carl A

2017-01-01

Depression and depressive symptoms mediate the association between drug use and HIV risk. Yet, there are few interventions that target depressive symptoms and HIV risk for people who use drugs (PWUD). This study was a randomized controlled trial of an integrated cognitive behavioral therapy and HIV prevention intervention to reduce depressive symptoms, injection risk behaviors and increase condom use in a sample of urban people who used heroin or cocaine in the prior 6 months. A total of 315 individuals aged 18-55, who self-reported at least one HIV drug and sex risk behavior and scored ≥16 and <40 on the Centers for Epidemiologic Studies-Depression (CES-D) scale were randomized using a two-block design, stratified by sex to ensure equivalent numbers, to a 10 session intervention arm (n = 162) or a single session control arm (n = 153). The outcomes of interest were decreases in CES-D score and injection risk behaviors and increases in condom use. The sample was majority African American (85%) and unemployed (94%). Nearly half (47%) reported injection in the prior 6 months and only 19% were taking medication for depression. Follow-up assessments were conducted at 6 and 12 months. Retention at 12 months was 94%. Intervention arm was associated with statistically significantly lower CES-D score at 12 month compared to control. No differences were observed between arms in injection risk. At 6 month, intervention was associated with greater odds of condom use with non-main partner. These findings suggest the potential role of the integrated intervention in reducing depressive symptoms, but weak impact on HIV risk. This trial is registered with ClinicalTrials.gov under the title "Neighborhoods, Networks, Depression, and HIV Risk" number NCT01380613.

Differences between men and women in condom use, attitudes, and skills in substance abuse treatment seekers

PubMed Central

Calsyn, Donald A.; Peavy, K. Michelle; Wells, Elizabeth A.; Campbell, Aimee N. C.; Hatch-Maillette, Mary A; Greenfield, Shelly F.; Tross, Susan

2012-01-01

Examining attitudes and skills regarding condom use by men and women in substance abuse treatment who engage in high risk sexual behavior may help to explain their inconsistent condom use. Men and women enrolled in two multi-site HIV risk reduction studies were administered the Condom Barriers Scale, Condom Use Skills and an audio computer-assisted structured interview assessing sexual risk behavior. Men endorsed more barriers to condom use than women, especially in the Effects on Sexual Experience factor. For both men and women, stronger endorsement of barriers to condom use was associated with less use of condoms. However, the difference between condom users and condom non-users in endorsement of condom barriers in general is greater for men than women, especially for those who report having casual partners. Findings support the need to focus on gender-specific barriers to condom use in HIV/STI prevention interventions, especially risk behavior intervention techniques that address sexual experience with condoms. PMID:23414501

Action-specific Cognitions of Planned and Preparatory Behaviors of Condom Use among Dutch Adolescents

PubMed Central

Kok, Gerjo

2008-01-01

Many adolescents fail to use condoms, even when they are motivated to do so. An important reason for their failure to use condoms is that they do not prepare themselves for potential sexual encounters. The present study examined the circumstances under which Dutch adolescents were likely to prepare themselves for condom use (buying and carrying). In a sample of 399 secondary school students, including students with and without sexual experience, it was found that intended condom use was not sufficient to ensure that adolescents plan and prepare for condom use. It was found that having the goal of condom use did not necessarily result in preparatory behavior, such as condom buying and condom carrying. The data showed that action-specific social-cognitive factors of preparatory behavior explained preparatory behavior, beyond the decision to use condoms. This suggests that interventions aimed at promoting condom use should focus not only on condom use itself, but should also motivate and encourage adolescents to buy and carry condoms. PMID:18193348

Action-specific cognitions of planned and preparatory behaviors of condom use among Dutch adolescents.

PubMed

van Empelen, Pepijn; Kok, Gerjo

2008-08-01

Many adolescents fail to use condoms, even when they are motivated to do so. An important reason for their failure to use condoms is that they do not prepare themselves for potential sexual encounters. The present study examined the circumstances under which Dutch adolescents were likely to prepare themselves for condom use (buying and carrying). In a sample of 399 secondary school students, including students with and without sexual experience, it was found that intended condom use was not sufficient to ensure that adolescents plan and prepare for condom use. It was found that having the goal of condom use did not necessarily result in preparatory behavior, such as condom buying and condom carrying. The data showed that action-specific social-cognitive factors of preparatory behavior explained preparatory behavior, beyond the decision to use condoms. This suggests that interventions aimed at promoting condom use should focus not only on condom use itself, but should also motivate and encourage adolescents to buy and carry condoms.

Predictors of Condom Use Among Mexican Adolescents

PubMed Central

Alvarez, Carmen; Villarruel, Antonia M.; Zhou, Yan; Gallegos, Esther

2012-01-01

Mexican adolescents continue to be at increased risk for HIV infection due to inconsistent condom use. The purpose of this study was to identify predictors of condom use intentions and condom use among Mexican adolescents who participated in a randomized control trial designed to test a sexual-risk reduction intervention. Data from sexually active adolescents 17 to 21 years (n = 157) of age who were assigned to the control group were analyzed 48 months post intervention. Regression analysis showed that positive attitudes toward condoms, subjective norms, and control beliefs significantly explained intention to use condoms (R2 = .75, p < .001). Attitudes toward condoms (β = .67, p < .001), technical skills (β = .13, p = .01), and condom use self-efficacy (β = .24, p < .001) were significant predictors of condom use intention. Compared to those who inconsistently used condoms, adolescents who used condoms consistently had greater intention to use condoms and greater impulse control. Findings suggest that attitudes and control beliefs should be further explored with Mexican adolescents in order to support consistent condom use. PMID:20949835

Dispelling some myths about condoms.

PubMed

1997-01-01

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.

An event-level analysis of adding exogenous lubricant to condoms in a sample of men who have vaginal sex with women.

PubMed

Reece, Michael; Mark, Kristen; Herbenick, Debby; Hensel, Devon J; Jawed-Wessel, Sofia; Dodge, Brian

2012-03-01

Little is known about the characteristics of sexual events during which individuals choose to use lubricant with condoms. The aims of this article were to evaluate the determinants of adding lubricant to condoms during baseline and at the event level, to assess the event-level variables' influence on adding lubricants to condoms, and to assess the event-level influence of using condoms with lubricant on event-level condom attitudes. A total of 1,874 men completed a 30-day Internet-based prospective daily diary study of sexual behavior and condom use. Baseline data included demographic variables and information about condom education. Daily diary data included reports of penile-vaginal sex regarding intercourse duration, intercourse intensity, intoxication level, condom application method, partner contraceptive method, and partner and relationship characteristics. Lubricant was added to 24.3% of the study-provided condoms and 26.2% of the condoms selected by study participants. Those with more education and those who were married were more likely to add lubrication to condoms. Adding lubricant to condoms, a female partner putting the condom on with her hands and using contraception, and the event occurring with a wife (vs. girlfriend) was significantly associated with longer intercourse. Event-level lubricant and condom use significantly predicted lower willingness to buy the condom it was used with, as well as to recommend the condom. Adding exogenous lubricant was not related to the participants' confidence in condoms as a method to prevent pregnancy and sexually transmitted infections. The event-level nature of this study provided for a more comprehensive assessment of the situational factors that are associated with applying lubricant to condoms. Findings from this study suggest that men are adding lubricant to condoms for reasons other than to increase condom efficacy. © 2012 International Society for Sexual Medicine.

Lights, camera, condoms! Assessing college men's attitudes toward condom use in pornography.

PubMed

Kraus, Shane W; Rosenberg, Harold

2016-01-01

Investigate male college students' attitudes toward actors' use of condoms in pornography. Two hundred thirteen undergraduate males attending a large, state-supported midwestern university in the fall semester, 2012. Using a Web-based procedure, participants completed questionnaires assessing their pornography use, sexual history characteristics, and their attitudes toward condom use by adult performers. Factor analysis of the 11-item condom use attitudes questionnaire supported 2 distinct subscales: Condom Supportive Attitudes and Condom Critical Attitudes. Although participants typically agreed with statements supportive of condom use and generally disagreed with statements critical of condom use in pornography, gay men had significantly higher condom supportive subscale scores than did heterosexual men. Neither subscale was correlated with weekly viewing of pornography. Although some producers of adult films argue that actors wearing condoms will displease many viewers, current findings suggest that young men express support for use of condoms by pornographic film actors.

The effects of safer-sex stories on college students' attitudes toward condoms.

PubMed

Wright, S S; Kyes, K B

1996-01-01

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.

Two-Year Follow-Up of a Sexual Health Promotion Program for Spanish Adolescents.

PubMed

Espada, Jose P; Escribano, Silvia; Morales, Alexandra; Orgilés, Mireia

2017-12-01

The aim is to evaluate the effects of the Competencias para adolescentes con una sexualidad saludable (COMPAS) program and compare them with an evidence-based program ( ¡Cuídate!) and a control group (CG). Eighteen public high schools were randomly assigned to one of the three experimental conditions. Initially, 1,563 Spanish adolescents between 14 and 16 years of age participated, and 24 months after their implementation, 635 of them completed a survey. Self-report measures collected data on sexual behavior, knowledge, attitudes, intention, sexual risk perception, and perceived norm. Compared to the CG, COMPAS increased the level of knowledge about sexually transmitted infections and improved the attitudes toward people living with human immunodeficiency virus at the 2-year follow-up. Neither intervention had a long-term impact on behavioral variables. Results suggest that COMPAS has a comparable impact to the other intervention on the variables predicting consistent condom use. Reinforcing the messages and skills that have the greatest impact on condom use and adding booster sessions following program completion as strategies to maintain long-term effects are necessary.

Intention to use the female condom following a mass-marketing campaign in Lusaka, Zambia.

PubMed Central

Agha, S

2001-01-01

OBJECTIVES: This report examines intention to use the female condom among men and women in Lusaka, Zambia, who were exposed to mass-marketing of the female condom. METHODS: The study used data from a representative sample of consumers at outlets that sell or distribute the female condom and the male condom. RESULTS: In spite of a high level of awareness of the female condom, use of this method in the last year was considerably lower than use of the male condom. Intention to use the female condom in the future was highest among respondents who had used only the female condom in the last year. CONCLUSIONS: The female condom is likely to be most important for persons who are unable or unwilling to use the male condom. PMID:11211646

Changes in sexual behavior and risk of HIV transmission after antiretroviral therapy and prevention interventions in rural Uganda.

PubMed

Bunnell, Rebecca; Ekwaru, John Paul; Solberg, Peter; Wamai, Nafuna; Bikaako-Kajura, Winnie; Were, Willy; Coutinho, Alex; Liechty, Cheryl; Madraa, Elizabeth; Rutherford, George; Mermin, Jonathan

2006-01-02

The impact of antiretroviral therapy (ART) on sexual risk behavior and HIV transmission among HIV-infected persons in Africa is unknown. To assess changes in risky sexual behavior and estimated HIV transmission from HIV-infected adults after 6 months of ART. A prospective cohort study was performed in rural Uganda. Between May 2003 and December 2004 a total of 926 HIV-infected adults were enrolled and followed in a home-based ART program that included prevention counselling, voluntary counseling and testing (VCT) for cohabitating partners and condom provision. At baseline and follow-up, participants' HIV plasma viral load and partner-specific sexual behaviors were assessed. Risky sex was defined as inconsistent or no condom use with partners of HIV-negative or unknown serostatus in the previous 3 months. The rates of risky sex were compared using a Poisson regression model and transmission risk per partner was estimated, based on established viral load-specific transmission rates. Six months after initiating ART, risky sexual behavior reduced by 70% [adjusted risk ratio, 0.3; 95% confidence interval (CI), 0.2-0.7; P = 0.0017]. Over 85% of risky sexual acts occurred within married couples. At baseline, median viral load among those reporting risky sex was 122 500 copies/ml, and at follow-up, < 50 copies/ml. Estimated risk of HIV transmission from cohort members declined by 98%, from 45.7 to 0.9 per 1000 person years. Providing ART, prevention counseling, and partner VCT was associated with reduced sexual risk behavior and estimated risk of HIV transmission among HIV-infected Ugandan adults during the first 6 months of therapy. Integrated ART and prevention programs may reduce HIV transmission in Africa.

An Intervention Study Examining the Effects of Condom Wrapper Graphics and Scent on Condom Use in the Botswana Defence Force

PubMed Central

Tran, Bonnie Robin; Thomas, Anne Goldzier; Vaida, Florin; Ditsela, Mooketsi; Phetogo, Robert; Kelapile, David; Haubrich, Richard; Chambers, Christina; Shaffer, Richard

2014-01-01

Free condoms provided by the government are often not used by Botswana Defence Force (BDF) personnel due to a perceived unpleasant scent and unattractive wrapper. Formative work with the BDF found that scented condoms and military inspired (camouflage) wrapper graphics were appealing to personnel. A non-randomized intervention study was implemented to determine if condom wrapper graphics and scent improved condom use in the BDF. Four military sites were selected for participation. Two sites in the south received the intervention condom wrapped in a generic wrapper and two sites in the north received the intervention condom wrapped in a military inspired wrapper; intervention condoms were either scented or unscented. 211 male soldiers who ever had sex, aged 18–30 years, and stationed at one of the selected sites consented to participate. Sexual activity and condom use were measured pre- and post-intervention using sexual behavior diaries. A condom use rate (CUR; frequency of protected sex divided by total frequency of sex) was computed for each participant. Mean CURs significantly increased over time (85.7% baseline vs. 94.5% post-intervention). Adjusted odds of condom use over time were higher among participants who received the intervention condom packaged in the military wrapper compared with the generic wrapper. Adjusted odds of condom use were also higher for participants who reported using scented versus unscented condoms. Providing scented condoms and condoms packaged in a miltiary inspired wrapper may help increase condom use and reduce HIV infection among military personnel. PMID:24266459

Testing a Risky Sex Behavior Intervention Pilot Website for Adolescents

PubMed Central

Starling, Randall; Helme, Don; Nodulman, Jessica A.; Bryan, Angela D.; Buller, David B.; Donohew, Robert Lewis; Woodall, W. Gill

2015-01-01

Background and Purpose Each year, teenagers account for about one-fifth of all unintended pregnancies in the United States. As such, delivering sexual risk reduction educational materials to teens in a timely fashion is of critical importance. Web-based delivery of these materials shows promise for reaching and persuading teens away from risky sexual and substance abuse behaviors. The purpose of this study was to pilot test a web-based program aimed at reducing risky sexual behavior and related outcomes among adolescents in a high school setting. Methods A beta-test of the website was conducted in three public schools in New Mexico, USA with 173 students in 9th and 10th grades recruited from existing health education classes. Participants spent approximately three hours over a period of two days completing the online program in school computer labs. Results Pretest to posttest results indicated that self-efficacy for condom use and condom use intentions, two theoretical mediators of changes in condom use behavior, were significantly changed. Adolescents also reported high satisfaction with the website content. Conclusion BReady4it provided an innovative sex and substance abuse education to teenagers that revealed promising positive changes in cognitive constructs that are inversely related to risky sexual behavior among users. PMID:26167134

Building skills of recovering women drug users to reduce heterosexual AIDS transmission.

PubMed Central

Schilling, R F; el-Bassel, N; Schinke, S P; Gordon, K; Nichols, S

1991-01-01

Although most women infected with HIV are intravenous drug users, some contact the virus through sexual contact with IV drug users. To reach at-risk women, public health officials must develop a range of prevention strategies. One approach, skills training, holds promise as a means of altering risk-related sexual behavior. In this study, 91 women methadone patients were pretested and randomly assigned to an information-only control control group or a skills-building intervention group. Skills-building intervention consisted of five sessions of small groups in which participants identified their own high risk sexual behaviors, discussed their negative associations with condoms, and practiced skills which involved asking partners to use condoms. Compared with members of the control group, respondents in the intervention group reported that they initiated discussion of sexual issues with their partners more frequently, felt more comfortable talking with them about safer sex, and reported using and carrying condoms more frequently. The high rates of attendance and program retention by skills-building participants suggest that such groups may be supportive and useful in the design of risk reduction and drug abuse treatment programs. The modest outcomes of this study underscore the difficulty of altering risk behavior but also serve as a basis for future AIDS prevention studies. PMID:1905051

Safety and acceptability of a baggy latex condom.

PubMed

Macaluso, M; Blackwell, R; Carr, B; Meinzen-Derr, J; Montgomery, M; Roark, M; Lynch, M; Stringer, E M

2000-03-01

A total of 104 couples participated in a randomized crossover trial to compare a new baggy condom with a straight-shaft condom produced by the same manufacturer. Participants completed a coital log after using each condom. All couples used five condoms of each type. Among 102 couples who did not report major deviations from the protocol, the breakage rate was eight of 510 (1.6%) for the baggy condom, and six of 510 (1.2%) for the standard condom (rate difference, RD = 0. 4%, 95% confidence interval of the RD, CI = -1.0%; +1.8%). Slippage was reported in 50 baggy condom logs and in 58 standard condom logs; the slippage rate was 50 of 510 (9.8%) for the baggy condom, and 58 of 510 (11.4%) for the standard condom (RD = -1.6%, 95% CI = -5.4%; +2.2%). Slippage was most often partial (<1 inch) and may not indicate condom failure. Severe slippage rates were 11 of 510 (2.2%) for the baggy condom, and 18 of 510 (3.5%) for the standard condom (RD = -1.4%, 95% CI = -3.4%; +0.7%). The findings support the conclusion that the two condoms are equivalent with respect to breakage and slippage. The participants appeared to prefer the baggy condom, suggesting that the new product may be more acceptable to the public than the traditional straight-shaft condoms, and may be easier to use consistently over long time periods.

Global update: Malaysia.

PubMed

1993-01-01

Malaysia produces more condoms than any other country in the world, yet it has one of the lowest per capita condom usage rates. The official number of HIV-infected persons and of persons with AIDS in Malaysia is 5140 and 72, respectively. People working in AIDS prevention efforts believe the actual number of HIV-infected people is closer to 50,000 and climbing. People working in AIDS prevention efforts believe the actual number of HIV-infected people is closer to 50,000 and climbing. Public health officials report that AIDS is spreading rapidly through Malaysia's relatively large population of IV drug users. The Ministry of Health wants to introduce comprehensive and pragmatic efforts to stem the AIDS epidemic. They include sex education in schools, ways to prevent IV drug users from sharing needles, promotion of condoms among high risk groups, and screening to monitor HIV transmission. Islamic and Catholic groups oppose these program and policy measures, however. The new director of the Ministry's AIDS prevention unit announced during a meeting of health officials that a return to the teaching of Islam and adoption of Islamic values are the means to deal with AIDS. He suggested that boys and girls be separated, television be rigorously censored, and that Muslim scholars not be limited to mosques to do their teaching. The government has greatly increased the 1993 AIDS budget with all of the funds dedicated to blood screening, nongovernmental organizations (NGOs), and health education. The deputy health minister noted that the NGOs are supposed to address the more sensitive issues. The government does not allow any of the funds to directly go to condom promotion or programs for IV drug users, however.

Seropositive sex workers and HIV / AIDS prevention: a need for realistic policy development.

PubMed

Overs, C

1992-01-01

In a major change of official responses to prostitution many programs strive to reduce the incidence of infection by the human immunodeficiency virus (HIV) and by sexually transmitted diseases (STDs) among sex workers and clients by encouraging safer sex, albeit still trying to ensure that only HIV-negative people engage in sex work. Legal sanctions have been used to limit the activities of seropositive sex workers under the assumption that sex workers with HIV will transmit the virus because of a high prevalence of unprotected sex practices in some places. Where safer sex is the norm for commercial sex transactions, the concern is that sex workers may neglect safe practices and customers may become infected. The fact is that often the clients demand unprotected sex, even when sex workers prefer to use condoms. The risk of accidental infection when protected sex is practiced may even be lower in commercial transactions in which at least one partner is very experienced in condom use and other safe practices. It is usually assumed that HIV-positive sex workers will not inform clients of their status, however, and clients will not inform sex workers of their serostatus either. Where sex workers practice safe sex, intervention programs should provide education on condom use and ensure the availability of inexpensive condoms. In addition to gynecological, antenatal and STD services, health and social services, including child care and legal support, have to be easily accessible. Religious and cultural impediments to realistic HIV/STD prevention should be studied in order to modify or eliminate them. Sex workers who are seropositive probably behave similarly to other people in a community with regard to exposing others to risk, and they are careful about not infecting others, especially if it is guaranteed that their environment supports them.

"I do what I have to do to survive": An investigation into the perceptions, experiences and economic considerations of women engaged in sex work in Northern Namibia

PubMed Central

2011-01-01

Background There is little published research investigating sex work in Namibia, particularly in rural areas. Therefore, the aim of this paper was to determine the views of women engaged in sex work in the Oshakati area of Namibia concerning the main factors influencing their use, or non-use, of male condoms during transactional sexual exchanges. Methods Qualitative interviews were used to better understand the perceptions, experiences and economic considerations of female sex workers in Namibia who were involved in a Behavior Change Communication Program encouraging safer sex practices among high-risk populations in 2006 and 2007. Results While the Behavior Change Communication Program has made significant strides in educating and empowering young women to negotiate more consistent condom use with sexual partners, the gendered economic inequalities and power imbalances within rural and semi-urban Namibian society that favor men hinder further advancement towards positive behavioral change for HIV prevention and also hinder the development of the loving relationships sought by some sex workers. Conclusion This study found that sex workers and transactional sex encounters are heterogeneous entities dependent upon the characteristics of the man (known, stranger, wealthy, attractive to the woman) and the woman (in financial need, desiring love). These features all influence condom use. The 3 E's 'education, empowerment and economic independence' are critical factors needed to encourage and facilitate consistent condom use to prevent HIV transmission. Without financial independence and occupational alternatives building on their health education and empowerment, women who engage in sex work-and transactional sex more generally-will remain largely marginalized from Namibian society, and will continue engaging in risky sexual practices that facilitate HIV acquisition and transmission throughout the community. PMID:21813006

Using brothel leadership to promote condom use among brothel-based female sex workers in Abuja, Nigeria: study protocol for a cluster randomized pilot trial.

PubMed

Okafor, Uchenna; Crutzen, Rik; Okekearu, Ifeanyi; Adebajo, Sylvia; Uzoh, Adaora; Awo, Egbe Aneotah; Chima, Chukwuemeka; Agwagwa, Ogechukwu; van den Borne, Bart

2017-01-01

The HIV prevalence among female populations involved in sex work in Nigeria has heightened interest in HIV prevention programming for this sub-population with brothel-based female sex workers (BB FSWs) having a prevalence of 27.4%, six times higher than the prevalence in the general population. The clusters in the randomized pilot trial will be brothels and female sex workers (FSWs) residing in the brothels will be the participants of the study. The participants will receive free condom distribution as well as HIV prevention messages on condom use and negotiation skills to increase self-efficacy in handling social and gender power plays within their environment. Twelve brothels will be randomized into experimental and control conditions with a minimum total sample size of 200 participants. Recruitment of participants will be carried out from within the brothels. The control condition will receive a standard intervention consisting of a minimum of six interactive sessions with peer educators (PE) engaging their peers through group discussions and one on one interaction using pre-designed HIV prevention messages. The experimental condition will receive the standard intervention as well as interactive sessions with the brothel leadership (chairladies and brothel managers) to facilitate consistent condom use and appropriate condom use policies, conditions, and messaging. Both interventions will be delivered over a maximum period of 16 weeks, and male and female condoms will be distributed during the intervention. Quantitative assessments will be carried out at baseline and at 16 weeks follow-up, and the pilot findings will inform feasibility of and sample size estimation for a phase III trial. The primary outcomes measured are recruitment rate attrition rate and adherence to the intervention. Consistent condom use outcomes by FSWs within the brothel with all partner types and enhanced self-efficacy for condom negotiation with all partner types will be the primary outcomes for the main study, and the feasibility of their measurement will be determined in this pilot trial. The manuscript describes the protocol for a pilot study to determine the feasibility of a behavioral intervention to improve consistent condom use among BB FSWs. The results of this pilot will inform a larger intervention for HIV prevention for this target group in Nigeria. The Institutional Review Board (IRB) of the Institute of Human Virology, Nigeria; Protocol Number NHREC/10/15/2014a-026.

Evaluation of Three Adolescent Sexual Health Programs in Ha Noi and Khanh Hoa Province, Vietnam

PubMed Central

Pham, Van; Nguyen, Hoang; Tho, Le Huu; Minh, Truong Tan; Lerdboon, Porntip; Riel, Rosemary; Green, Mackenzie S.; Kaljee, Linda M.

2012-01-01

With an increase in sexual activity among young adults in Vietnam and associated risks, there is a need for evidence-based sexual health interventions. This evaluation of three sexual health programs based on the Protection Motivation Theory (PMT) was conducted in 12 communes in Ha Noi, Nha Trang City, and Ninh Hoa District. Inclusion criteria included unmarried youth 15–20 years residing in selected communes. Communes were randomly allocated to an intervention, and participants were randomly selected within each commune. The intervention programs included Vietnamese Focus on Kids (VFOK), the gender-based program Exploring the World of Adolescents (EWA), and EWA plus parental and health provider education (EWA+). Programs were delivered over a ten-week period in the communities by locally trained facilitators. The gender-based EWA program with parental involvement (EWA+) compared to VFOK showed significantly greater increase in knowledge. EWA+ in comparison to VFOK also showed significant decrease at immediate postintervention for intention to have sex. Sustained changes are observed in all three interventions for self-efficacy condom use, self-efficacy abstinence, response efficacy for condoms, extrinsic rewards, and perceived vulnerability for HIV. These findings suggest that theory-based community programs contribute to sustained changes in knowledge and attitudes regarding sexual risk among Vietnamese adolescents. PMID:22666565

Evaluation of three adolescent sexual health programs in ha noi and khanh hoa province, Vietnam.

PubMed

Pham, Van; Nguyen, Hoang; Tho, Le Huu; Minh, Truong Tan; Lerdboon, Porntip; Riel, Rosemary; Green, Mackenzie S; Kaljee, Linda M

2012-01-01

With an increase in sexual activity among young adults in Vietnam and associated risks, there is a need for evidence-based sexual health interventions. This evaluation of three sexual health programs based on the Protection Motivation Theory (PMT) was conducted in 12 communes in Ha Noi, Nha Trang City, and Ninh Hoa District. Inclusion criteria included unmarried youth 15-20 years residing in selected communes. Communes were randomly allocated to an intervention, and participants were randomly selected within each commune. The intervention programs included Vietnamese Focus on Kids (VFOK), the gender-based program Exploring the World of Adolescents (EWA), and EWA plus parental and health provider education (EWA+). Programs were delivered over a ten-week period in the communities by locally trained facilitators. The gender-based EWA program with parental involvement (EWA+) compared to VFOK showed significantly greater increase in knowledge. EWA+ in comparison to VFOK also showed significant decrease at immediate postintervention for intention to have sex. Sustained changes are observed in all three interventions for self-efficacy condom use, self-efficacy abstinence, response efficacy for condoms, extrinsic rewards, and perceived vulnerability for HIV. These findings suggest that theory-based community programs contribute to sustained changes in knowledge and attitudes regarding sexual risk among Vietnamese adolescents.

What teenagers and young adults have to say about condoms and using condoms.

PubMed

Patient, D R; Orr, N M

2000-01-01

This study examined the perceptions of teenagers and young adults on condoms and condom use. By using two focus group sessions, 88 teenagers and young adults from South Africa were interviewed about their attitudes towards using condoms. The findings indicated that issues of image outweigh issues of risks in these groups. In obtaining condoms, these young adults did not trust free condoms and usually preferred anonymous points of purchase such as vending machines, which were also accessible at sites where they gathered for entertainment and socializing. In addition, the types of condoms available in the market were found to be unsuitable for these groups. Complaints on the color and size were noted, as well as the label of using condoms as boring and clinical. Lastly, to overcome the antipathy of using condoms, the paper suggests the following: development of black condoms, change of clinic and pharmacy staff attitude towards condom purchase, accessible distribution of condoms, and presentation of the product in such a way that it focuses on the fun aspect and less upon the clinical aspects.

Condoms and US college-aged men and women: briefly assessing attitudes toward condoms and general condom use behaviours.

PubMed

Hill, Brandon J; Amick, Erick E; Sanders, Stephanie A

2011-09-01

The purpose of this study was to develop an abbreviated reliable tool for assessing the attitudes US college-aged men and women have about condoms and condom use. An online questionnaire was constructed and completed by 674 participants incorporating modified items from the Attitudes Towards Condom Scale (1984) and the Multidimensional Condom Attitude Scale (1994), with the addition of gender-neutral worded and condom positive or erotic items. The original 40 items were reduced to 18 Likert-type items comprising the Brief Condom Attitude Scale (BCAS). Gender comparisons on a subset of 584 self-identified heterosexual participants indicated that women were significantly more likely to consider condoms as less protective, while men were significantly more likely to consider condoms as more interruptive. Additional analyses examining partnership indicated that monogamous participants were significantly more likely to view condoms as less interruptive, more erotic and less negative than non-monogamous participants. The BCAS appears to be a reliable measure for assessing US college-aged individuals' attitudes about condoms.

The relationship between attitude, assertiveness and condom use.

PubMed

Treffke, H; Tiggemann, M; Ross, M W

1992-01-01

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.

The impact of AIDS on an urban population of high-risk female minority adolescents: implications for intervention.

PubMed

Overby, K J; Kegeles, S M

1994-05-01

This study's purpose was to describe acquired immunodeficiency syndrome (AIDS)-related concerns, risk behaviors, and psychosocial/situational determinants of condom use among an urban minority population of sexually active, adolescent girls. In addition we sought to define the accuracy of personal AIDS risk-assessment, the relative importance of AIDS in relation to other concerns, and the broader context of sexual experience and attitudes in this population. A cross-sectional interview study was conducted involving sexually active female adolescents attending a pediatric clinic in an inner-city university-affiliated community hospital. Sixty-nine subjects (ages 13-19 yr, 90% African-American) were enrolled. While the goals of this study were primarily descriptive, subject characteristics felt to impact on condom use were identified prior to data collection and were examined against several measures of usage including: use at the time of last sexual intercourse, overall frequency of condom use, and reported behavior change to include initiation of or increased condom usage. Forty-one percent of participants reported knowing someone with AIDS. Global concern regarding this disease was high, although worry about poverty-related issues was often greater. Despite concern and high measures of AIDS risk (median number of sex partners, 3; past sexually transmitted disease, 55%; past pregnancy 77%), most participants perceived themselves to be at low personal risk owing to current monogamy, lack of intravenous drug use, and implicit trust in their partner's safety. Discussion with their partner about actual risk and awareness of the importance of past behaviors was generally lacking. Although 98% were aware that condoms may prevent AIDS, 64% used condoms half of the time or less when they had sex and use appeared to be primarily for contraception. Several intrinsic cognitive/psychological and extrinsic social/situational factors were found to correlate with measures of condom use. Participants' sexual histories and behavior emphasize the need for concern regarding AIDS risk in this population. Patterns of sexual behavior and beliefs regarding committed relationships raise challenging questions regarding how to motivate sexually active members of this population to use condoms more frequently. Programs aimed at AIDS prevention among urban minority adolescents need to be cognizant of the larger personal and sociocultural context in which these teenagers are making health-behavior choices.

The taste of condoms.

PubMed

Jeminez-david, R

1995-01-01

DKT International manufactures flavored condoms for sale in the Philippines. One year after introduction to the market, flavored condoms now already 10% of total condom sales in the country. The production and sale of flavored condoms by DKT comes on the heels of recent market research. The organization examined the sex behavior and practices of 300 prostitutes in Pasay, and found that about half of the sex workers performed fellatio for their customers. Of those prostitutes who engaged in oral sex, 50% chose not to use condoms because they tasted bad. Were pleasant-tasting condoms put on the market, however, people may choose to use them more often during oral sex. BFAD had held up the renewal of DKT's license to market the flavored condoms pending data on why a flavored condom was being marketed. The author notes the anti-condom lobby's attempt to keep flavored condoms off of the market. Detractors claim that such condoms may be eaten by children who think that they are candy.

Condom acceptance and HIV prevention in reproductive health: the challenges.

PubMed

Mbizvo, M T

1991-12-01

The AIDS epidemic weighs heavily on the already burdened health care delivery systems of developing countries especially in central Africa. AIDS not only incurs high morbidity and mortality but has a severe impact on productivity, economic infrastructures, and development in those countries which need them the most. HIV is mainly spread through heterosexual intercourse in central Africa. Vertical transmission of HIV and breast feeding are other means. The key vehicle of HIV transmission in the US is still homosexual intercourse. Sexually transmitted diseases (STDs) facilitate HIV transmission via intercourse. Research shows that subsequent infection by other STDs hastens the development of AIDS in HIV-infected people. Some evidence indicates that pregnancy increases the risk of developing AIDS in a woman who is positive for HIV. The main means to prevent HIV transmission is the condom. Yet, in Rwanda, only 7% of women had ever used condoms despite the high rate (32%) of HIV-positive serology. The University of Zimbabwe Medical School believes adolescents are the most appropriate starting point for AIDS prevention since they tend to experiment with sexual behaviors. Its youth counseling program involves education and prevention messages within and outside educational settings through youth meeting places, youth workers, and other mass media. It hosts workshops at meeting places which use the problem solving approach to risk reduction behavior. The program invites schools, churches, and other educational settings to form Anti-AIDS Clubs. It advocates use of drama and music to promote AIDS awareness. The program has also branched out into community counseling where it works to eliminate the stigma and guilt associated with talking about sexual transmission of AIDS. Governments must learn who the STD and HIV transmission high risk groups are and then target them with information, education, and communication AIDS prevention programs.

Condom use in China: prevalence, policies, issues and barriers.

PubMed

Zou, Huachun; Xue, Hui; Wang, Xiaofang; Lu, Damien

2012-03-01

In this review, we describe condom use and its influencing factors in China, with a particular focus on the five populations that are at high risk for HIV/sexually transmissible infections (STI) infection: female sex workers, men who have sex with men, migrant workers, young people and sero-discordant couples. The risk for HIV/STI infection is high while condom use rates are low among these five populations. The 100% Condom Use Programme was successful in trial regions in increasing condom use and decreasing HIV/STI prevalence; however, long-term and routine condom promotion strategies should be in place to ensure better awareness of condom use, high availability of condoms and high rate of condom use among populations at high risk of HIV/STI infection in China. Realistic and vigorous condom-related policies and action plans should be developed and implemented to address the issues and barriers facing condom promotion in China.

Proficiency in condom use among migrant workers

PubMed Central

Rubens, Muni; McCoy, H. Virginia; Shehadeh, Nancy

2013-01-01

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). PMID:23876817

What the better half is thinking: A comparison of men’s and women’s responses and agreement between spouses regarding reported sexual and reproductive behaviors in Rwanda

PubMed Central

Hageman, Kathy M; Karita, Etienne; Kayitenkore, Kayitesi; Bayingana, Roger; van der Straten, Ariane; Stephenson, Rob; Conkling, Martha; Tichacek, Amanda; Mwananyanda, Lawrence; Kilembe, William; Haworth, Alan; Chomba, Elwyn; Allen, Susan A

2009-01-01

Objective To compare responses to a sexual behavioral survey of spouses in cohabiting heterosexual relationships in Kigali, Rwanda. Design Cross-sectional survey. Methods Husbands and wives in 779 cohabiting couples were interviewed separately with parallel questionnaires. Participants were recruited from a three-year old cohort of 1458 antenatal clinic attendees enrolled in a prospective study in 1988. Analyses compared responses at the gender- and couple-level for agreement and disagreement. Results Couples were in disagreement more than agreement. Women reported occasionally refusing sex, suggesting condom use, and believing married men were unfaithful. Men reported being in a faithful relationship, greater condom use, and being understanding when wives refused sex. Agreement included relationship characteristics, safety of condoms, and whether condoms had ever been used in the relationship. Disagreement included the preferred timing of next pregnancy, desire for more children, and whether a birth control method was currently used and type of method. Conclusions Rwandan husbands and wives differed in sexual behavior and reproductive-related topics. Couple-level reporting provides the most reliable measure for relationship aspects as couples’ agreement cannot be assumed among cohabiting partnerships. Furthermore, HIV prevention programs for couples should incorporate communication skills to encourage couple agreement of HIV-related issues. PMID:22110321

Effects of fear of abuse and possible STI acquisition on the sexual behavior of young African American women.

PubMed

Raiford, Jerris L; Diclemente, Ralph J; Wingood, Gina M

2009-06-01

We examined the interactive effects of fear of abuse and knowledge of sexually transmitted infections (STIs) on sexual risk behaviors in a sample of young African American women. We recruited 715 young African American women aged 15 to 21 years from a variety of health clinics and assessed them for fear of abuse because of negotiating condom use, knowledge of STIs, and several sexual risk behaviors. Overall, 75% of young African American women reported inconsistent condom use in the past 60 days. Surprisingly, under relatively higher levels of fear, young women with high STI knowledge were more likely than were those with low STI knowledge to exhibit inconsistent condom use in the past 60 days (89% vs 80%; chi(2) = 4.32; P < or = .04) and during the last sexual intercourse with a main sexual partner (76% vs 70%; chi(2) = 8.06; P < or = .01). Most HIV prevention interventions focus on increasing knowledge about the transmission of STIs. However, other contextual factors such as fear of abuse because of negotiating condom use may heighten the risk of HIV infection. Our findings highlight the need for combining dating violence prevention activities with STI and HIV prevention programs targeting young African American women.

Effects of government registration on unprotected sex among female sex workers in Tijuana, Mexico

PubMed Central

Sirotin, Nicole; Strathdee, Steffanie A.; Lozada, Remedios; Abramovitz, Daniela; Semple, Shirley J.; Bucardo, Jesús; Patterson, Thomas L.

2010-01-01

Background Sex work is partially regulated in Tijuana, but little is known of its health effects. A recent behavioral intervention among female sex workers (FSWs) decreased incidence of HIV/STIs by 40%. We evaluated effects of sex worker regulation on condom use among FSWs randomized to this intervention. Methods FSWs aged ≥18 years who reported unprotected sex with ≥1 client in the last 2 months and whether they were registered with Tijuana’s Municipal Health Department underwent a brief, theory-based behavioral intervention to increase condom use. At baseline and 6 months, women underwent interviews and testing for HIV, syphilis, C. trachomatis and N. gonorrhoeae. Negative binomial regression was used to determine the effect of registration on numbers of unprotected sex acts and cumulative HIV/STI incidence. Results Of 187 women, 83 (44%) were registered. Lack of registration was associated with higher rates of unprotected sex (rate ratio: 1.7, 95% CI: 1.2–2.3), compared to FSWs who were registered, after controlling for potential confounders. Conclusions Registration predicted increased condom use among FSWs enrolled in a behavioral intervention. Public health programs designed to improve condom use among FSWs may benefit from understanding the impact of existing regulation systems on HIV risk behaviors. PMID:20956076

The Effectiveness of a Female Condom Intervention on Women's Use of Condoms.

ERIC Educational Resources Information Center

Hardwick, Deborah

2002-01-01

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…

Brief report on the effect of providing single versus assorted brand name condoms to hospital patients: a descriptive study

PubMed Central

Williams, James L; Christensen, Carol J; Cagle, Henry H; Homan, Chriss E

2001-01-01

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. PMID:11446904

Condom Access: Associations with Consistent Condom Use among Female Sex Workers in Two Northern Border Cities of Mexico

PubMed Central

Muñoz, Fátima A.; Pollini, Robin A.; Zúñiga, María Luisa; Strathdee, Steffanie A.; Lozada, Remedios; Martínez, Gustavo A.; Valles-Medina, Ana M.; Sirotin, Nicole; Patterson, Thomas L.

2011-01-01

To determine whether condom access is associated with consistent condom use among FSWs in Tijuana and Ciudad Juarez, between 2004 and 2006 we administered a questionnaire to 924 FSWs who reported unprotected sex with a client in the past two months. Of these women, 43% reported consistent (“often” or “always”) condom use; 74% said condoms were available; and 38% reported having access to free condoms. In a logistic regression, factors positively associated with consistent condom use were condom availability (AdjOR = 2.00; 95% CI: 1.32–3.03), condom affordability (AdjOR = 1.72; 95% CI: 1.25–2.38) and self–efficacy (AdjOR = 2.16; 95% CI: 1.54–3.04). Factors inversely associated with consistent condom use included poor financial status (AdjOR = 0.65; 95% CI: 0.47–0.90), methamphetamine use (AdjOR = 0.58; 95% CI: 0.40–0.83), alcohol use (AdjOR = 0.68; 95% CI: 0.49–0.96), and recent injection drug use (AdjOR = 0.62; 95% CI: 0.39–0.97). While increased condom availability may improve condom use among FSWs in general, interventions to broaden condom use among lower-income and drug-using FSWs are critically needed. PMID:20973665

Behavioral and psychosocial interventions for HIV prevention in floating populations in China over the past decade: a systematic literature review and meta-analysis.

PubMed

Liu, Xiaona; Erasmus, Vicki; Wu, Qing; Richardus, Jan Hendrik

2014-01-01

Floating populations have been repeatedly characterized as "the tipping point" for the HIV epidemic in China. This study aims to systematically summarize and assess the effectiveness of HIV prevention interventions in floating populations in China over the past decade. We conducted a systematic search in three international databases for literature published between 2005 and 2012 with condom use as the primary outcome, and knowledge about HIV transmission and prevention and stigma towards HIV-infected individuals as secondary outcomes. The impact of interventions on changing the primary and secondary outcomes was calculated by risk difference (RD). We also performed subgroup analyses and meta-regression based on different study characteristics, using Stata 12.0, for the primary outcome. Sixteen studies (out of 149) involved 19 different programs and a total of 10,864 participants at entry from 11 provinces in China. The pooled effect estimate of all studies indicated that people participating in HIV-related interventions were 13% more likely to use condoms (95%CI: 0.07, 0.18), however, the effects on increasing condom use exhibited significant heterogeneity across programs (P<0.01, I2 = 0.93). The meta-regression results suggest that interventions have been significantly less successful in changing condom use in more recent studies (β, 0.14; 95%CI: 0.01, 0.27), adjusted for sexual relationship, study design and follow-up period. Regarding the secondary outcomes, HIV-related interventions were successful at improving knowledge about HIV transmission and prevention (RD, -0.26; 95%CI: -0.36, -0.16 and RD, -0.25; 95%CI: -0.33, -0.16, respectively), and decreasing stigma (RD, 0.18; 95%CI: 0.09, 0.27). The included studies between 2005 and 2012 indicate that HIV prevention interventions among Chinese floating populations in the past decade were only marginally effective at increasing condom use, but relatively successful at increasing HIV knowledge and decreasing stigma. To avert new infections, novel sexual risk-reduction interventions taking into account the changing socio-economic and cultural situation of Chinese floating populations are urgently needed.

Is Food Insecurity Associated with HIV Risk? Cross-Sectional Evidence from Sexually Active Women in Brazil

PubMed Central

Tsai, Alexander C.; Hung, Kristin J.; Weiser, Sheri D.

2012-01-01

Background Understanding how food insecurity among women gives rise to differential patterning in HIV risks is critical for policy and programming in resource-limited settings. This is particularly the case in Brazil, which has undergone successive changes in the gender and socio-geographic composition of its complex epidemic over the past three decades. We used data from a national survey of Brazilian women to estimate the relationship between food insecurity and HIV risk. Methods and Findings We used data on 12,684 sexually active women from a national survey conducted in Brazil in 2006–2007. Self-reported outcomes were (a) consistent condom use, defined as using a condom at each occasion of sexual intercourse in the previous 12 mo; (b) recent condom use, less stringently defined as using a condom with the most recent sexual partner; and (c) itchy vaginal discharge in the previous 30 d, possibly indicating presence of a sexually transmitted infection. The primary explanatory variable of interest was food insecurity, measured using the culturally adapted and validated Escala Brasiliera de Segurança Alimentar. In multivariable logistic regression models, severe food insecurity with hunger was associated with a reduced odds of consistent condom use in the past 12 mo (adjusted odds ratio [AOR] = 0.67; 95% CI, 0.48–0.92) and condom use at last sexual intercourse (AOR = 0.75; 95% CI, 0.57–0.98). Self-reported itchy vaginal discharge was associated with all categories of food insecurity (with AORs ranging from 1.46 to 1.94). In absolute terms, the effect sizes were large in magnitude across all outcomes. Underweight and/or lack of control in sexual relations did not appear to mediate the observed associations. Conclusions Severe food insecurity with hunger was associated with reduced odds of condom use and increased odds of itchy vaginal discharge, which is potentially indicative of sexually transmitted infection, among sexually active women in Brazil. Interventions targeting food insecurity may have beneficial implications for HIV prevention in resource-limited settings. Please see later in the article for the Editors' Summary PMID:22505852

Knowledge and perception of young adults in Nigeria on effectiveness of condom use in prevention of sexually transmitted infections.

PubMed

Anyanwu, Philip Emeka; Fulton, John

2017-04-01

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.

Incorporating Communication into the Theory of Planned Behavior to Predict Condom Use Among African American Women

PubMed Central

Guan, Mengfei; Coles, Valerie B.; Samp, Jennifer A.; Sales, Jessica McDermott; DiClemente, Ralph J.; Monahan, Jennifer L.

2016-01-01

The present research extends the Theory of Planned Behavior (TPB) to investigate how communication-related variables influence condom use intention and behavior among African American women. According to the TPB, attitudes, subjective norms, and self-efficacy are associated with behavioral intent, which predicts behavior. For women, it was argued that condom negotiation self-efficacy was more important than condom use self-efficacy in predicting consistent condom use. Moreover, an important environmental factor that affects condom use for African American women is fear or worry when negotiating condom use because the sex partners might leave, threaten, or abuse them. Fears associated with negotiating condom use were predicted to be negatively associated with attitudes, subjective norms, and self-efficacy. African American women (N = 560; M age = 20.58) completed assessments of TPB variables at baseline and condom use three months later. Condom negotiation self-efficacy was a significant indicator of behavioral intent while condom use self-efficacy was not. Fear of condom negotiation was negatively associated with all TPB components, which was in turn significantly associated with behavioral intent and condom use. Implications for the TPB, safer sex literature, and STI prevention intervention design are discussed. PMID:27565192

Acceptability of male condom: An Indian scenario

PubMed Central

Donta, Balaiah; Begum, Shahina; Naik, D.D.

2014-01-01

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. PMID:25673537

Infrequent condom use with casual partners among New Zealand gay and bisexual men.

PubMed

Saxton, Peter J; Dickson, Nigel P; Hughes, Anthony J; Ludlam, Adrian H

2015-12-04

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.

Distal & Proximal Influences on Men's Intentions to Resist Condoms: Alcohol, Sexual Aggression History, Impulsivity, and Social-Cognitive Factors

PubMed Central

Davis, Kelly Cue; Danube, Cinnamon L.; Neilson, Elizabeth C.; Stappenbeck, Cynthia A.; Norris, Jeanette; George, William H.; Kajumulo, Kelly F.

2015-01-01

Recent scientific evidence demonstrates that many young men commonly resist condom use with their female sex partners and that both alcohol intoxication and a history of sexual aggression may increase the risk of condom use resistance (CUR). Using a community sample of heterosexual male non-problem drinkers with elevated sexual risk (N=311), this alcohol administration study examined the direct and indirect effects of intoxication and sexual aggression history on men's CUR intentions through a sexual risk analogue. State impulsivity, CUR-related attitudes, and CUR-related self-efficacy were assessed as mediators. Results demonstrated that alcohol intoxication directly increased CUR intentions, and sexual aggression history both directly and indirectly increased CUR intentions. These findings highlight the importance of addressing both alcohol use and sexual aggression in risky sex prevention programs, as well as indicate the continued worth of research regarding the intersection of men's alcohol use, sexual aggression, and sexual risk behaviors, especially CUR. PMID:26156881

The Implementation of a Culturally Based HIV Sexual Risk Reduction Program for Latino Youth in a Denver Area High School

ERIC Educational Resources Information Center

Mueller, Trisha E.; Castaneda, Charlene Angel; Sainer, Shannon; Martinez, Donna; Herbst, Jeffrey H.; Wilkes, Aisha L.; Villarruel, Antonia M.

2009-01-01

In the United States, Latino youth experience disproportionately higher rates of teen pregnancy and sexually transmitted infections (STIs) than non-Latino Whites. As a result, organizations serving Latino youth seek culturally appropriate evidence-based prevention programs that promote sexual abstinence and condom use. "Cuidate" is an…

A five-city trial of a behavioural intervention to reduce sexually transmitted disease/HIV risk among sex workers in China.

PubMed

Rou, Keming; Wu, Zunyou; Sullivan, Sheena G; Li, Fan; Guan, Jihui; Xu, Chen; Liu, Wei; Liu, Dahua; Yin, Yueping

2007-12-01

To explore and evaluate a sexually transmitted disease (STD)/HIV intervention program targeting female sex workers working in entertainment establishments in five different settings in China. A prospective, community-based, pre/post, intervention trial set in entertainment establishments (karaoke bars, massage parlours, dance halls, beauty parlours) where sex workers operate at sites in five provinces of China: Anhui, Beijing, Fujian, Guangxi and Xinjiang. The participants were all sex workers working in targeted entertainment establishments. A Women's Health Clinic was set up near participants' places of work at each site. Clinic-based outreach activities, including awareness-raising, condom promotion, and sexual health care, were developed and delivered to sex workers. Cross-sectional surveys at baseline and post-intervention were used to evaluate changes in condom use with the last three clients, and the prevalence of chlamydia and gonorrhoea. In total, 907 sex workers were surveyed at baseline and 782 at 12 months post-intervention. Outreach teams made 2552 visits to the target entertainment establishments, approached 13,785 female sex workers, and distributed 33,575 copies of education material and 5102 packets of condoms. The rate of condom use with the most recent three clients increased from 55.2% at baseline to 67.5% at 12 months evaluation. The prevalence of gonorrhoea fell from 26% at baseline to 4% after intervention, and that of chlamydia fell from about 41 to 26%. The intervention was effective for increasing condom use and reducing STD among sex workers. The results were used to develop national guidelines on sex worker interventions for nationwide scale up.

Study: condoms in school do not promote sex. Very few high schools offer condoms, however.

PubMed

2003-10-01

A recent study of high school student behavior in schools where condoms are available suggests that the mere fact of having condoms there does not increase sexual behavior among students. Researchers found that in schools where condoms are available, condom use was significantly higher among sexually active students.

Reasons for not Using Condoms among Heterosexual Men in Belgrade, Serbia.

PubMed

Bjekić, Milan; Sipetić-Grujičić, Sandra; Vlajinac, Hristina; Nikolić, Aleksandra

2018-04-01

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 frequent reason for not using a condom in our participants was the statement that condom decreased sexual pleasure. Several studies (7,8) have reported that this is one of the main reasons for not using a condom. In Randolph et al. (9), both women and men rated unprotected vaginal intercourse as more pleasurable than protected vaginal sex. In particular, men believe that condoms reduce sexual pleasure and they are less likely to use them in practice. Condom-associated erection problems or problems with condom fit were reported by 42% of our participants (items 1, 14, 15 in Table 1). Several studies have shown that men experiencing condom-associated erection problems practiced unprotected vaginal intercourse significantly more frequently than men who did not experience this problem (10,11). Although alcohol use has been found to be an independent and important risk factor for unprotected sex (5,12), only 5.5% of our participants reported that alcohol intake was the main reason for not using a condom. In the present study, participants who had never or sometimes used condoms reported significantly more frequently that they forgot to bring or even use a condom when it was available, which illustrates their risky behavior and unwillingness to use a condom. Patients who had often used a condom reported condom failure significantly more frequently because of their partners refusing to use it. Since men believe more frequently than women that condoms reduce sexual pleasure, the question is whether they could not persuade their partners or find a good excuse not to use it. In summary, the results of the present study indicate the main factors that should be considered when promoting condom use. Such promotion should include advice about using condoms, a demonstration of correct use, and provision of condoms to the patient.

Sub-Saharan African university students' beliefs about condoms, condom-use intention, and subsequent condom use: a prospective study.

PubMed

Heeren, G Anita; Jemmott, John B; Mandeya, Andrew; Tyler, Joanne C

2009-04-01

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.

Geographic Variation in Condom Availability and Accessibility.

PubMed

Shacham, Enbal; J Nelson, Erik; Schulte, Lauren; Bloomfield, Mark; Murphy, Ryan

2016-12-01

Identifying predictors that contribute to geographic disparities in sexually transmitted infections (STIs) is necessary in order to reduce disparities. This study assesses the spatial relationship condom availability and accessibility in order to better identify determinants of geographic disparities in STIs. We conducted a telephone-based audit among potential-condom selling establishments. Descriptive analyses were conducted to detect differences in condom-selling characteristics by stores and by store type. Geocoding, mapping, and spatial analysis were conducted to measure the availability of condoms. A total of 850 potential condom-selling establishments participated in the condom availability and accessibility audit in St. Louis city; 29 % sold condoms. There were several significant geographic clusters of stores identified across the study area. The first consisted of fewer convenience stores and gas stations that sold condoms in the northern section of the city, whereas condoms were less likely to be sold in non-convenience store settings in the southwestern and central parts of the city. Additionally, locations that distributed free condoms clustered significantly in city center. However, there was a dearth of businesses that were neither convenience stores nor gas stations in the northern region of the city, which also had the highest concentration of condoms sold. This initial study was conducted to provide evidence that condom availability and accessibility differ by geographic region, and likely are a determinant of social norms surrounding condom use and ultimately impact STI rates.

A total market approach for condoms in Myanmar: the need for the private, public and socially marketed sectors to work together for a sustainable condom market for HIV prevention.

PubMed

Htat, Han Win; Longfield, Kim; Mundy, Gary; Win, Zaw; Montagu, Dominic

2015-03-01

Concerns about appropriate pricing strategies and the high market share of subsidized condoms prompted Population Services International (PSI)/Myanmar to adopt a total market approach (TMA). This article presents data on the size and composition of the Myanmar condom market, identifies inefficiencies and recommends methods for better targeting public subsidy. Data on condom need and condom use came from PSI/Myanmar's (PSI/M's) behavioural surveys; data for key populations' socioeconomic status profiles came from the same surveys and the National Tuberculosis Prevalence Survey. Data on market share, volumes, value and number of condoms were from PSI/M's quarterly retail audits and Joint United Nations Programme on HIV/AIDS (UNAIDS). Between 2008 and 2010, the universal need for condoms decreased from 112.9 to 98.2 million while condom use increased from 32 to 46%. Free and socially marketed condoms dominated the market (94%) in 2009-11 with an increase in the proportion of free condoms over time. The retail price of socially marketed condoms was artificially low at 44 kyats ($0.05 USD) in 2011 while the price for commercial condoms was 119-399 kyats ($0.15-$0.49 USD). Equity analyses demonstrated an equal distribution of female sex workers across national wealth quintiles, but 54% of men who have sex with men and 55% of male clients were in the highest two quintiles. Donor subsidies for condoms increased over time; from $434,000 USD in 2009 to $577,000 USD in 2011. The market for male condoms was stagnant in Myanmar due to: limited demand for condoms among key populations, the dominance of free and socially marketed condoms on the market and a neglected commercial sector. Subsidies for socially marketed and free condoms have prevented the growth of the private sector, an unintended consequence. A TMA is needed to grow and sustain the condom market in Myanmar, which requires close co-ordination between the public, socially marketed and commercial sectors. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2015; all rights reserved.

A total market approach for condoms in Myanmar: the need for the private, public and socially marketed sectors to work together for a sustainable condom market for HIV prevention

PubMed Central

Longfield, Kim; Mundy, Gary; Win, Zaw; Montagu, Dominic

2015-01-01

Background Concerns about appropriate pricing strategies and the high market share of subsidized condoms prompted Population Services International (PSI)/Myanmar to adopt a total market approach (TMA). This article presents data on the size and composition of the Myanmar condom market, identifies inefficiencies and recommends methods for better targeting public subsidy. Methodology Data on condom need and condom use came from PSI/Myanmar’s (PSI/M’s) behavioural surveys; data for key populations’ socioeconomic status profiles came from the same surveys and the National Tuberculosis Prevalence Survey. Data on market share, volumes, value and number of condoms were from PSI/M’s quarterly retail audits and Joint United Nations Programme on HIV/AIDS (UNAIDS). Results Between 2008 and 2010, the universal need for condoms decreased from 112.9 to 98.2 million while condom use increased from 32 to 46%. Free and socially marketed condoms dominated the market (94%) in 2009–11 with an increase in the proportion of free condoms over time. The retail price of socially marketed condoms was artificially low at 44 kyats ($0.05 USD) in 2011 while the price for commercial condoms was 119–399 kyats ($0.15–$0.49 USD). Equity analyses demonstrated an equal distribution of female sex workers across national wealth quintiles, but 54% of men who have sex with men and 55% of male clients were in the highest two quintiles. Donor subsidies for condoms increased over time; from $434 000 USD in 2009 to $577 000 USD in 2011. Conclusion The market for male condoms was stagnant in Myanmar due to: limited demand for condoms among key populations, the dominance of free and socially marketed condoms on the market and a neglected commercial sector. Subsidies for socially marketed and free condoms have prevented the growth of the private sector, an unintended consequence. A TMA is needed to grow and sustain the condom market in Myanmar, which requires close co-ordination between the public, socially marketed and commercial sectors. PMID:25759450

Prophylactic Procurement of University Students in Southern Ethiopia: Stigma and the Value of Condom Machines on Campus

PubMed Central

Wells, Christopher J.; Alano, Abraham

2013-01-01

Introduction 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. Methods 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. Results 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. Conclusions 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. PMID:23565272

Sexual Activity and Condom Use among Israeli Adolescents.

PubMed

Shilo, Guy; Mor, Zohar

2015-08-01

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.

Errors and Predictors of Confidence in Condom Use amongst Young Australians Attending a Music Festival.

PubMed

Hall, Karina M; Brieger, Daniel G; De Silva, Sukhita H; Pfister, Benjamin F; Youlden, Daniel J; John-Leader, Franklin; Pit, Sabrina W

2016-01-01

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.

Effects through 24 months of an HIV/AIDS prevention intervention program based on protection motivation theory among preadolescents in the Bahamas.

PubMed

Gong, Jie; Stanton, Bonita; Lunn, Sonja; Deveaux, Lynette; Li, Xiaoming; Marshall, Sharon; Brathwaite, Nanika V; Cottrell, Leslie; Harris, Carole; Chen, Xinguang

2009-05-01

The purpose of this work was to report the intervention effects of Focus on Youth in the Caribbean (youth HIV intervention), an HIV prevention intervention based on protection motivation theory, through 24 months of follow-up on sexual risk and protection knowledge, perceptions, intentions, and behavior among Bahamian sixth-grade youth. We randomly assigned 1360 sixth-grade youth (and their parents) attending 15 government elementary schools in the Bahamas to 1 of 3 conditions: (1) youth HIV intervention plus a parental monitoring/communication/HIV education intervention; (2) youth HIV intervention plus a parental goal-setting intervention; or (3) an environmental protection intervention plus the parental goal-setting intervention. Baseline and 4 follow-up surveys at 6-month intervals were conducted. Intervention effects were assessed using the mixed model for continuous outcome variables and the generalized linear mixed model for dichotomous outcome variables. Through 24 months of follow-up, youth HIV intervention, in combination with the parent interventions, significantly increased youths' HIV/AIDS knowledge, perceptions of their ability to use condoms, perception of the effectiveness of condoms and abstinence, and condom use intention and significantly lowered perceived costs to remaining abstinent. There was a trend for higher condom use among youth in the Focus on Youth in the Caribbean groups at each follow-up interval. Focus on Youth in the Caribbean, in combination with 1 of 2 parent interventions administered to preadolescents and their parents in the Bahamas, resulted in and sustained protective changes on HIV/AIDS knowledge, sexual perceptions, and condom use intention. Although rates of sexual experience remained low, the consistent trend at all of the follow-up periods for higher condom use among youth who received youth intervention reached marginal significance at 24 months. Additional follow-up is necessary to determine whether the apparent protective effect is statistically significant as more youth initiate sex and whether it endures over time.

Women of courage: commercial sex workers mobilize for HIV / AIDS prevention in Nigeria.

PubMed

Williams, E E

1994-05-01

The Calabar Project in Nigeria, which seeks to reduce the vulnerability of prostitutes to HIV infection, began informally in 1987. By 1988, a formal, community-based intervention was created to promote condom use, provide health education as well as literacy and vocational training, and seek better working and living conditions for the prostitutes. The first task of the Calabar Project was to overcome the resistance of the hotel owners and managers where the prostitutes work and to win the confidence of the women. The owners and managers had to be convinced that it was in their best interest for the women to insist on condom use by their clients. The women had to be informed about the nature of HIV/AIDS and to be convinced that the project sought improvements in their general welfare. This was accomplished by helping the prostitutes improve both their relationship with the local police and their access to health services. Negotiations with hotel owners stabilized the prostitutes' rent for a year to enable the women to increase their charges for services and reduce the number of clients they needed so they could insist on condom use. Peer educators were trained to provide health education and to teach prostitutes techniques to get clients to use condoms. Clients were reached through the prostitutes and by providing information to small groups in hotel bars. Condoms were initially distributed for free and eventually were sold through a social marketing program. Peer educators also encouraged prostitutes and their clients to use a clinic the project established to diagnose and treat sexually transmitted diseases. In 1993, the Calabar Project helped create a vocational and literacy training center to improve the women's ability to understand the complex issues related to HIV/AIDS and to give the women a way to supplement their income and improve their self-esteem. By this time, more than 60% of the women reported using condoms for all sex acts.

Effects Through 24 Months of an HIV/AIDS Prevention Intervention Program Based on Protection Motivation Theory Among Preadolescents in the Bahamas

PubMed Central

Gong, Jie; Stanton, Bonita; Lunn, Sonja; Deveaux, Lynette; Li, Xiaoming; Marshall, Sharon; Brathwaite, Nanika V.; Cottrell, Leslie; Harris, Carole; Chen, Xinguang

2010-01-01

OBJECTIVES The purpose of this work was to report the intervention effects of Focus on Youth in the Caribbean (youth HIV intervention), an HIV prevention intervention based on protection motivation theory, through 24 months of follow-up on sexual risk and protection knowledge, perceptions, intentions, and behavior among Bahamian sixth-grade youth. METHODS We randomly assigned 1360 sixth-grade youth (and their parents) attending 15 government elementary schools in the Bahamas to 1 of 3 conditions: (1) youth HIV intervention plus a parental monitoring/communication/HIV education intervention; (2) youth HIV intervention plus a parental goal-setting intervention; or (3) an environmental protection intervention plus the parental goal-setting intervention. Baseline and 4 follow-up surveys at 6-month intervals were conducted. Intervention effects were assessed using the mixed model for continuous outcome variables and the generalized linear mixed model for dichotomous outcome variables. RESULTS Through 24 months of follow-up, youth HIV intervention, in combination with the parent interventions, significantly increased youths’ HIV/AIDS knowledge, perceptions of their ability to use condoms, perception of the effectiveness of condoms and abstinence, and condom use intention and significantly lowered perceived costs to remaining abstinent. There was a trend for higher condom use among youth in the Focus on Youth in the Caribbean groups at each follow-up interval. CONCLUSIONS Focus on Youth in the Caribbean, in combination with 1 of 2 parent interventions administered to preadolescents and their parents in the Bahamas, resulted in and sustained protective changes on HIV/AIDS knowledge, sexual perceptions, and condom use intention. Although rates of sexual experience remained low, the consistent trend at all of the follow-up periods for higher condom use among youth who received youth intervention reached marginal significance at 24 months. Additional follow-up is necessary to determine whether the apparent protective effect is statistically significant as more youth initiate sex and whether it endures over time. PMID:19380429

Risky Business: condom failures as experienced by female sex workers in Mombasa, Kenya.

PubMed

Bradburn, Caitlyn K; Wanje, George; Pfeiffer, James; Jaoko, Walter; Kurth, Ann E; McClelland, R Scott

2017-03-01

Limited research exists about condom failure as experienced by female sex workers. We conducted a qualitative study to examine how female sex workers in Mombasa, Kenya contextualise and explain the occurrence of condom failure. In-depth, semi-structured interviews were conducted with thirty female sex workers to ascertain their condom failure experiences. We qualitatively analysed interview transcripts to determine how the women mitigate risk and cope with condom failure. Condom failure was not uncommon, but women mitigated the risk by learning about correct use, and by supplying and applying condoms themselves. Many female sex workers felt that men intentionally rupture condoms. Few women were aware of or felt empowered to prevent HIV, STIs, and pregnancy after condom failure. Interventions to equip female sex workers with strategies for minimising the risk of HIV, STIs, and pregnancy in the aftermath of a condom failure should be investigated.

Violence against female sex workers in Karnataka state, south India: impact on health, and reductions in violence following an intervention program.

PubMed

Beattie, Tara S H; Bhattacharjee, Parinita; Ramesh, B M; Gurnani, Vandana; Anthony, John; Isac, Shajy; Mohan, H L; Ramakrishnan, Aparajita; Wheeler, Tisha; Bradley, Janet; Blanchard, James F; Moses, Stephen

2010-08-11

Violence against female sex workers (FSWs) can impede HIV prevention efforts and contravenes their human rights. We developed a multi-layered violence intervention targeting policy makers, secondary stakeholders (police, lawyers, media), and primary stakeholders (FSWs), as part of wider HIV prevention programming involving >60,000 FSWs in Karnataka state. This study examined if violence against FSWs is associated with reduced condom use and increased STI/HIV risk, and if addressing violence against FSWs within a large-scale HIV prevention program can reduce levels of violence against them. FSWs were randomly selected to participate in polling booth surveys (PBS 2006-2008; short behavioural questionnaires administered anonymously) and integrated behavioural-biological assessments (IBBAs 2005-2009; administered face-to-face). 3,852 FSWs participated in the IBBAs and 7,638 FSWs participated in the PBS. Overall, 11.0% of FSWs in the IBBAs and 26.4% of FSWs in the PBS reported being beaten or raped in the past year. FSWs who reported violence in the past year were significantly less likely to report condom use with clients (zero unprotected sex acts in previous month, 55.4% vs. 75.5%, adjusted odds ratio (AOR) 0.4, 95% confidence interval (CI) 0.3 to 0.5, p < 0.001); to have accessed the HIV intervention program (ever contacted by peer educator, 84.9% vs. 89.6%, AOR 0.7, 95% CI 0.4 to 1.0, p = 0.04); or to have ever visited the project sexual health clinic (59.0% vs. 68.1%, AOR 0.7, 95% CI 0.6 to 1.0, p = 0.02); and were significantly more likely to be infected with gonorrhea (5.0% vs. 2.6%, AOR 1.9, 95% CI 1.1 to 3.3, p = 0.02). By the follow-up surveys, significant reductions were seen in the proportions of FSWs reporting violence compared with baseline (IBBA 13.0% vs. 9.0%, AOR 0.7, 95% CI 0.5 to 0.9 p = 0.01; PBS 27.3% vs. 18.9%, crude OR 0.5, 95% CI 0.4 to 0.5, p < 0.001). This program demonstrates that a structural approach to addressing violence can be effectively delivered at scale. Addressing violence against FSWs is important for the success of HIV prevention programs, and for protecting their basic human rights.

Self-Reported Penis Size and Experiences with Condoms Among Gay and Bisexual Men

PubMed Central

Grov, Christian; Wells, Brooke E.

2018-01-01

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

Malaysian made condoms sold locally as well as exported.

PubMed

1979-01-01

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.

An event-level examination of successful condom negotiation strategies among young women.

PubMed

Peasant, Courtney; Montanaro, Erika A; Kershaw, Trace S; Parra, Gilbert R; Weiss, Nicole H; Meyer, Jaimie P; Murphy, James G; Ritchwood, Tiarney D; Sullivan, Tami P

2017-01-01

This study examines the effect of condom negotiation strategies on condom use and partner type and substance use before sex as moderators of strategy effectiveness. Women reported their daily sexual behavior during the last month. Withholding sex was more strongly associated with condom use when utilized with a non-casual sex partner. Directly requesting condom use was more strongly and using deceptive reasons to influence condom use was less strongly related to condom use during substance use. Results underscore the importance of understanding the contexts in which condom negotiation strategies are successful in order to improve HIV/sexually transmitted infection prevention efforts among women.

Predicting Condom Use among STD Clinic Patients Using the Information-Motivation-Behavioral Skills (IMB) Model

PubMed Central

Scott-Sheldon, Lori A. J.; Carey, Michael P.; Vanable, Peter A.; Senn, Theresa E.; Coury-Doniger, Patricia; Urban, Marguerite A.

2010-01-01

We assessed determinants of condom use postulated by the IMB model among STD patients (N = 1,474). The model provided acceptable fit to the data (CFI = .99, RMSEA = .04). Information was unrelated to condom use but had a negative effect on behavioral skills. Motivation had a positive effect on behavioral skills and condom use. Behavioral skills had a positive effect on condom use. In multiple-groups analyses, stronger associations between motivation and condom use were found among participants reporting no prior STD treatment. Interventions among STD patients should include activities addressing condom use motivation and directly enhancing condom skills. PMID:20453055

Facilitating condom use with clients during commercial sex in Nevada's legal brothels.

PubMed

Albert, A E; Warner, D L; Hatcher, R A

1998-04-01

This study examined condom use in legal Nevada brothels. Forty female prostitutes in two brothels were interviewed about client resistance to condoms and techniques for facilitating condom use. Of 3290 clients in the previous month, 2.7% (95% confidence interval [CI] = 2.2%,3.4%) were reluctant to use condoms. Of these individuals, 72% ultimately used condoms, while 12% chose nonpenetrative sex without condoms. The remaining 16% left the brothels without services. Condom use rates were markedly lower with nonpaying sex partners (lowers) than with clients. Brothel prostitutes may be at greater risk for acquiring HIV and other sexually transmitted diseases from lovers than from clients.

[The homosexual transmission of HIV/AIDS in Mexico].

PubMed

Izazola-Licea, J A; Avila-Figueroa, R C; Gortmaker, S L; del Río-Chiriboga, C

1995-01-01

To analyze HIV homosexual transmission in Mexico, epidemic trends and biological and social risk factors. This analysis is based on 19,090 notifications of AIDS cases and on a review of two previous studies that include 3,029 behavioral interviews (together with HIV serological screening tests) carried out at the Information Center of the Mexican Council for Control and Prevention of AIDS (CONASIDA) (1988-89) and during a 1988 study in six Mexican cities. Cities were included because they were the larger in the country and/or because they were the larger in the country and/or because they were touristic places (Mexico City, Guadalajara, Monterrey, Acapulco, Tijuana and Merida). Logistic regressions were used to estimate the odds ratios for HIV seropositivity and for condom use. Seventy-two percent of the total reported AIDS cases (19,090) up to June 30, 1994, were associated with male homosexual behaviors. In absolute numbers, cases under this category exhibited a rising trend until the end of 1993. HIV seroprevalence was 31% in 2,314 men with homosexual practices who attended "FLORA", the AIDS Information Center in Mexico, from January 1988 to June 30, 1989. The main predictive variables for seropositivity were exclusive homosexual behavior, more than 40 lifetime sexual partners, mixed sexual behavior (both insertive and receptive and intercourse), sex with a person with AIDS, history of syphilis, and anal or genital warts. In general, these risk factors (data from the Information Center) are similar to those found in the six Mexican cities study. There were significant differences in HIV prevalence among the high-risk city samples (the highest in Mexico City with 25% and the lowest in Monterrey with 2.4%). Reported condom use was very low in both studies: only 5% used a condom in all of their sexual relationships. A statistically significant protective effect for HIV infection was found only for those who reported using a condom in all sexual encounters. In the six cities study, city of residence was a strong predictor of condom use. HIV homosexual transmission is steadily increasing; the recent decline in the percentage of homosexual cases is artificial because of the increment of cases under other categories. Men who report exclusive homosexual behavior have higher prevalence rates of infection than bisexual men. Individuals with insertive/receptive behavior (mixed) have the highest risk for HIV seropositivity, mainly because of sociological, rather than biological reasons. This difference in risks for HIV and condom use may be related to the selection of sexual partners from specific social networks. Condom use was demonstrated to be an effective method for preventing HIV seropositivity among those who always use condoms. However, it is alarming that only 5% of respondents reported condom use in all sexual encounters. Social and geographic differences in the cumulative numbers of cases, HIV prevalence, sexual practices and condom use must be taken into account in the planning of preventive programs.

Assessing reported condom use among female sex workers in southern India through examination of condom availability.

PubMed

Bradley, Janet; Moses, Stephen; Blanchard, James F; Rajaram, S; Ramesh, B M; Verma, Supriya; Alary, Michel

2010-02-01

A key indicator of success of HIV prevention programmes is the number of female sex worker (FSW) sex acts protected by condoms. This measure usually relies on FSW reports, which may be biased. We examined condom availability data in five Karnataka districts to estimate the proportion of FSW sex acts potentially protected by condoms. Financial, programme, population, condom and contraceptive data were obtained from governmental and non-governmental sources, surveys and HIV prevention programmes. Sexual behaviour data were obtained from general population and FSW surveys. We examined four scenarios in a sensitivity analysis, each one assuming different proportions of available condoms that might have been used by sex workers. Possible condom use rates for all FSW sex acts ranged from 3%-36% in 2004 to 56%-96% in 2008. The two most realistic scenarios that discounted the number of private sector condoms that might have been bought for sex acts other than with FSWs showed that 16-24% of FSW sex acts could have been protected by condoms in 2004 rising to 77-85% in 2008. These data suggest that condom availability in these Karnataka districts in 2004 was low in relation to the number of FSW sex acts, but rose substantially over the ensuing 4 years. Condom availability data can be useful for triangulation with other available data, such as self-reported condom use, to provide a range of possibilities regarding the number of FSW sex acts protected by condoms.

Selling condoms to women: liberation plus legislation gives new life to the old rubber.

PubMed

Wilkinson, S

1985-10-01

Liberation in combination with legislation gives new life to condoms, which now find their way into the purses, brief cases, and shopping carts of increasing numbers of women. The number of female buyers of condoms has risen from 15% in the mid-1970s to perhaps as high as 40% today, thanks to the increasing number of women who are dissatisfied with contraceptive alternatives and a condom industry that is playing to its growing female audience with new packaging and marketing methods. The condom has a distinct advantage in an age when women are more concerned and knowledgeable about their bodies than ever before. The condom has no side effects. The $200 million-a-year condom industry enjoys a current growth rate in sales of about 12%. This is not too bad for a product that has been termed "16th century technology." Currently, Youngs, Schmid, and approximately 4 dozen other US condom companies mold, dry, test, roll and pack nearly 1000 condoms a minute, 400-500 million condoms a year. The Japanese buy 612 million condoms a year. Fewer than 15% of all US couples use condoms, which account for a quarter of the $800 million-a-year contraceptive industry. The growth in condoms was steady until about 3 years ago when it really started to move. There are 3 reasons for the growth spurt. In 1977, the Supreme Court struck down some lingering blue-nosed state laws that regulated who could buy condoms (not minors), where and why they could be sold (only in pharmacies for "disease control" rather than for contraception), how they could be advertised to the public (not at all), and where they could be displayed (out of sight). At the same time, a number of female contraceptive methods considerably trendier and more sophisticated than condoms fell into public, if not medical, disrepute. Finally, venereal diseases have grown in number to fill a category called sexually transmitted diseases (STDs) that includes more than 30 ailments. Condoms are the only contraceptives that also are effective venereal disease barriers. Consequently, condoms moved from under the counter to in front of it. Most notable of the condom industry's recent innovations have been unisex merchandising. It was decided that a lot more women would buy condoms if the packaging had femine appeal. With or without a yuppie clientele, the condom business is so healthy that existing advertising strictures have not hampered sales. Women are the primary purchasers of condoms in pharmacies and grocery stores.

Assertive communication in condom negotiation: Insights from late adolescent couples’ subjective ratings of self and partner

PubMed Central

Schmid, Amy; Leonard, Noelle R.; Ritchie, Amanda S.; Gwadz, Marya V.

2015-01-01

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

Relation between HIV status, risky sexual behavior, and mental health in an MSM sample from three Chilean cities.

PubMed

Gómez, Fabiola; Barrientos, Jaime; Cárdenas, Manuel

2017-04-20

To explore the association among HIV status; negative psychological symptoms (anxiety, depression, and hostility); and risky sexual behaviors (multiple sexual partners and unprotected sexual intercourse) in a Chilean sample of men who have sex with men (MSM). This study had a cross-sectional design and a sample of 325 MSM whose ages ranged from 18 to 64 years (mean: 30.8; standard deviation: 9.8). Association tests (chi-squared) and group mean comparisons (Student's t-tests and F-tests) were performed. No statistically significant differences were found for condom use or for the number of sexual partners between HIV-positive men and those who are not infected. In both groups, about 50% reported sexual encounters without condom use in the past six months. There were statistically significant differences in symptoms associated with depression between the two groups. These results reveal the need to strengthen messages about the importance of condom use, as the only way to prevent HIV, and as a means of preventing HIV infection and reinfection, in national prevention and self-care programs for sexually active subjects. More studies are needed in Latin America to advance HIV prevention efforts for the MSM population. The data generated by this study can be used to inform the development of HIV prevention programming strategies and interventions targeting the MSM population in Latin America.

Innovations in traditional Vietnam.

PubMed

Waldner, R

1997-01-01

In Viet Nam, the 1990 designation of population as a top government concern resulted in a tenfold increase in spending on family planning (FP) and health. The Viet Nam FP Association has developed a number of innovative ways of promoting FP, including a telephone counseling service. The population of Viet Nam has doubled since 1960, and the average per capita income remains very low; thus, condoms and oral contraceptives (OCs) are prohibitively expensive for many families. The FP program provides free condoms, OCs, and IUDs but often runs out of supplies. Need for condoms is estimated at 200 million/year, but the two factories only produce 30 million. OCs are imported from Hungary and have a bad reputation among Vietnamese women. The most commonly used contraceptive is the IUD, but poor quality of care at insertion leads many women to suffer infections. Viet Nam has a high rate of legal abortion, with most procedures occurring in the first month of pregnancy. The FP Association has cautiously introduced sex education in the schools in a pilot program that will be continued nationwide. The Association also opened a special club for young people and one for miliary personnel. These clubs provide contraceptive information along with soft drinks and music. The government's two-child policy is widely accepted but must overcome the obstacles of large family preference in rural areas and of son preference.

[Community-based intervention to control STD/AIDS in the Amazon region, Brazil].

PubMed

Benzaken, Adele Schwartz; Galbán Garcia, Enrique; Sardinha, José Carlos Gomes; Pedrosa, Valderiza Lourenço; Paiva, Vera

2007-12-01

To describe a case study of community-based intervention, developed in a constructionist-emancipatory framework to control STD/AIDS. Descriptive study developed in the town of Manacapuru, in the state of Amazonas, from 1997 to 2004, focusing on procedures designed in collaboration with government agents, health professionals and the community. Data on the dynamics of prostitution and condom sales in this town, preventive practices and STD/AIDS care and process assessment were collected. Actions targeting STD prevention and care in the public healthcare system, a testing center, an epidemiological surveillance system and sex workers' qualification were established concomitantly. It was observed the strengthening of sex workers as peer educators and their legitimization as citizens and health agents in projects involving transvestites, homosexuals and students. There was an increase in condom sales in town, as well as in condom use among sex workers; reduction in bacterial STD; and stabilization of the incidence of HIV/AIDS infections and congenital syphilis. The sustainability of the intervention program studied, organized within the sphere of action of the Sistema Unico de Saúde (National Health System), was promoted by a political pact, which guaranteed headquarters and municipal law-regulated budget, as well as by the constant debate over the process and program results. The study strengthened the notion that effective control of STD/AIDS depends on a synergic approach that combines interventions on individual (biological-behavioral), sociocultural and programmatic levels.

Condom negotiation: experiences of sexually active young women.

PubMed

East, Leah; Jackson, Debra; O'Brien, Louise; Peters, Kathleen

2011-01-01

This paper is a report of a study of sexually active young women's experiences of negotiating condom use both before and after diagnosis of a sexually transmitted infection. The male condom is the most efficient method in preventing and reducing the transmission of sexually transmitted infections. However, condom use can be hindered by factors including societal norms and gender roles, which can create difficulties for women in initiating and negotiating condom use in heterosexual partnerships. A feminist narrative approach was used, and ten women's stories were collected via online interviews in 2007. None of the women initiated or negotiated use of the male condom for various reasons. Some relied on their male partners to initiate condom use, some were unable to practise safer sex due to the abuse and unequal gender dynamics that existed in their sexual relationships, and some thought that condom use was not necessary because of a belief that they were in safe and monogamous relationships. Even following diagnosis of a sexually transmitted infection, some women said that they were not empowered enough to initiate condom use with subsequent sexual partners, resulting in continued high-risk sexual behaviour. Successful condom promotion relies on the recognition of the gender factors that impede young women's condom negotiation and use. Strategies that overcome gender dynamics and empower women to negotiate condom use have the ability to promote condom use among this group. © 2010 Blackwell Publishing Ltd.

Online purchases of an expanded range of condom sizes in comparison to current dimensional requirements allowable by US national standards.

PubMed

Cecil, Michael; Warner, Lee; Siegler, Aaron J

2013-11-01

Across studies, 35-50% of men describe condoms as fitting poorly. Rates of condom use may be inhibited in part due to the inaccessibility of appropriately sized condoms. As regulated medical devices, condom sizes conform to national standards such as those developed by the American Society for Testing and Materials (ASTM) or international standards such as those developed by the International Organisation for Standardisation (ISO). We describe the initial online sales experience of an expanded range of condom sizes and assess uptake in relation to the current required standard dimensions of condoms. Data regarding the initial 1000 sales of an expanded range of condom sizes in the United Kingdom were collected from late 2011 through to early 2012. Ninety-five condom sizes, comprising 14 lengths (83-238mm) and 12 widths (41-69mm), were available. For the first 1000 condom six-pack units that were sold, a total of 83 of the 95 unique sizes were purchased, including all 14 lengths and 12 widths, and both the smallest and largest condoms. Initial condom purchases were made by 572 individuals from 26 countries. Only 13.4% of consumer sales were in the ASTM's allowable range of sizes. These initial sales data suggest consumer interest in an expanded choice of condom sizes that fall outside the range currently allowable by national and international standards organisations.

Condom use among Hispanic men with secondary female sexual partners.

PubMed Central

Marin, B V; Gomez, C A; Tschann, J M

1993-01-01

Greater understanding of psychosocial predictors of the use of condoms among Hispanics is needed in prevention efforts related to the human immunodeficiency virus and sexually transmitted disease epidemics among Hispanics in the United States. A telephone survey was carried out in nine States that have large populations of Hispanics, using a stratified clustered random digit dialing sampling strategy. The survey yielded interviews with 968 Hispanic men ages 18-49 years. Of them, 361 (37.8 percent) reported at least one secondary female sexual partner in the 12 months prior to the interview. Predictors were identified of condom use by those men with their secondary sex partners. Key predictors of the subjects' condom use with secondary partners included carrying condoms; self-efficacy, or a measure of the subject's perceived ability to use condoms under difficult circumstances; positive attitude toward condom use; having friends who used condoms; and lack of symptoms of depression in the week before the interview (R2 = 0.35). Significant predictors of condom carrying were being comfortable in sexual situations, positive attitude toward condom use, and self-efficacy to use condoms. Less acculturated men had more positive attitudes toward condom use and carried them more than did more acculturated men. The researchers found encouraging levels of condom use with secondary sexual partners among Hispanic men with multiple partners.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8265759

Plastic condoms.

PubMed

1968-01-01

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 mandrel. The condom is then ready for packaging, either on automatic equipment or manually into small envelopes of highly polished paper. Although their present design is based on a heat-sealed blank, it may be possible shortly to manufacture plastic condoms on the same principle as rubber ones. A dipping process would be used, but with less sophisticated technology and with higher outputs per increment of capital investment. The present equipment used to make plastic condoms cost about 3,000 for one stamping machine and 22 assembly and testing machines. On a three shift per day, 300-day working year, it is possible, with experienced workers, to make 100,000 gross of plastic condoms for each manufacturing unit annually. As the technology is refined, the output should improve significantly.

Talking the talk, walking the walk: social network norms, communication patterns, and condom use among the male partners of female sex workers in La Romana, Dominican Republic.

PubMed

Barrington, Clare; Latkin, Carl; Sweat, Michael D; Moreno, Luis; Ellen, Jonathan; Kerrigan, Deanna

2009-06-01

Male partners of female sex workers are rarely targeted by HIV prevention interventions in the commercial sex industry, despite recognition of their central role and power in condom use negotiation. Social networks offer a naturally existing social structure to increase male participation in preventing HIV. The purpose of this study was to explore the relationship between social network norms and condom use among male partners of female sex workers in La Romana, Dominican Republic. Male partners (N =318) were recruited from 36 sex establishments to participate in a personal network survey. Measures of social network norms included 1) perceived condom use by male social network members and 2) encouragement to use condoms from social network members. Other social network characteristics included composition, density, social support, and communication. The primary behavioral outcome was consistent condom use by male partners with their most recent female sex worker partner during the last 3 months. In general, men reported small, dense networks with high levels of communication about condoms and consistent condom use. Multivariate logistic regression revealed consistent condom use was significantly more likely among male partners who perceived that some or all of their male social network members used condoms consistently. Perceived condom use was, in turn, significantly associated with dense networks, expressing dislike for condoms, and encouragement to use condoms from social network members. Findings suggest that the tight social networks of male partners may help to explain the high level of condom use and could provide an entry point for HIV prevention efforts with men. Such efforts should tap into existing social dynamics and patterns of communication to promote pro-condom norms and reduce HIV-related vulnerability among men and their sexual partners.

Integrated bio-behavioural HIV surveillance surveys among female sex workers in Sudan, 2011-2012.

PubMed

Elhadi, Magda; Elbadawi, Abdulateef; Abdelrahman, Samira; Mohammed, Ibtisam; Bozicevic, Ivana; Hassan, Ehab A; Elmukhtar, Mohammed; Ahmed, Sally; Abdelraheem, Mohammed Sidahmed; Mubarak, Nazik; Elsanousi, Salwa; Setayesh, Hamidreza

2013-11-01

To assess HIV and syphilis prevalence, HIV-related behaviours and testing for HIV in female sex workers (FSW) in Sudan. Bio-behavioural surveys using respondent-driven sampling were carried out among FSW in the capital cities of 14 states in Sudan in 2011-2012. HIV and syphilis testing was done by rapid tests. 4220 FSW aged 15-49 years were recruited. The median age of recruited women varied from 21 to 28 years per site. The highest HIV prevalence was measured at two sites in the eastern zone (5.0% and 7.7%), while in the other zones it ranged from 0% to 1.5%. Syphilis prevalence ranged from 1.5% in the northern zone to 8.9% in the eastern zone. Ever having been tested for HIV was reported by 4.4%-23.9% of FSW across all sites. Condom use at last sex with a client varied from 4.7% to 55.1%, while consistent condom use with clients in the month preceding the surveys was reported by 0.7%-24.5% of FSW. The highest reporting of ever injecting drugs was measured at a site in the western zone (5.0%). The surveys' findings indicate that the highest burden of HIV in FSW is in the eastern states of the country. Condom use and HIV testing data demonstrate the need for HIV interventions that should focus on HIV testing and risk reduction strategies that include stronger condom promotion programmes in FSW and their clients.

Condom makers jockey for position in barrier warfare.

PubMed

1995-01-01

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.

Bangladesh's SMP earns top marks.

PubMed

1984-01-01

A recent evaluation funded by the US Agency for International Development (AID) confirms that Bangladesh's contraceptive social marketing program has exceeded its planner's goals and demonstrated the ability of such a system to widely distribute contraceptive products at a low cost. The project, which began contraceptive sales in 1975, distributes condoms, oral contraceptives, and foaming vaginal tablets. Almost 25% of contraceptive users in Bangladesh are serviced by the social marketing program. By the end of 1983, the program was providing 1,022,000 couple years of protection; this included 84 million condoms, 1.7 million pill cycles, and 5.1 million spermicidal tablets each year. The program's cost for 1 couple year of protection is US$1.66. Social marketing sales have accounted for all increases in couple years of protection experienced by the country's national population program since 1975. Sales have been boosted by recent efforts to draw rural medical practitioners into family planning activities. Mobile film units have further increased sales. The USAID report identifies 3 elements that have spearheaded the social marketing program's achievements: 1) the existence of a committed core management team, 2) the granting of autonomy to make daily decisions to this management team, and 3) central control fo the product distribution system by management rather than by subcontractors. Overall, the social marketing program is credited with legitimizing discussion of contraception in a country formerly considered too conservative to tolerate open product promotion.

The impact of the African Youth Alliance program on the sexual behavior of young people in Uganda.

PubMed

Karim, Ali Mehryar; Williams, Timothy; Patykewich, Leslie; Ali, Disha; Colvin, Charlotte E; Posner, Jessica; Rutaremwa, Gideon

2009-12-01

This study evaluates the impact of the African Youth Alliance (AYA) program on the sexual behavior of young people aged 17-22 in Uganda. Between 2000 and 2005, the comprehensive multicomponent AYA program implemented behavior-change communication and youth-friendly clinical services, and it coordinated policy and advocacy. The program provided institutional capacity building and established coordination mechanisms between agencies that implemented programs for young people. The analysis of findings from both a self-reported exposure design and a static group comparison design indicated that AYA had a positive impact on sexual behavior among young females but not among young males. AYA-exposed girls were at least 13 percentage points more likely to report having used a condom at last sex, at least 10 percentage points more likely to report that they had consistently used condoms with their current partner, at least 10 percentage points more likely to have used contraceptives at last sex, and 13 percentage points more likely to have had fewer sex partners during the past 12 months, compared with girls who were not exposed to the AYA program. Scaling up the AYA program in Uganda could, therefore, be expected to improve significantly the sexual and reproductive health of young women. Effective strategies for promoting safer sexual behaviors among boys and young men must be identified, however.

Condom availability in high risk places and condom use: a study at district level in Kenya, Tanzania and Zambia

PubMed Central

2012-01-01

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 initiated. Although condom distribution in drinking places has been pinpointed in the HIV/AIDS prevention strategies of all the three countries, its priority relative to other HIV/AIDS measures must be reassessed locally, nationally and regionally. In practical terms very clear supply chains of condoms to both formal and informal drinking places could make condom provision better and more reliable. PMID:23181969

Condom availability in high risk places and condom use: a study at district level in Kenya, Tanzania and Zambia.

PubMed

Sandøy, Ingvild Fossgard; Blystad, Astrid; Shayo, Elizabeth H; Makundi, Emmanuel; Michelo, Charles; Zulu, Joseph; Byskov, Jens

2012-11-26

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 pinpointed in the HIV/AIDS prevention strategies of all the three countries, its priority relative to other HIV/AIDS measures must be reassessed locally, nationally and regionally. In practical terms very clear supply chains of condoms to both formal and informal drinking places could make condom provision better and more reliable.

Are condom instructions readable? Results of a readability study.

PubMed Central

Richwald, G A; Wamsley, M A; Coulson, A H; Morisky, D E

1988-01-01

The use of condoms has assumed a central position in the current strategy to prevent sexual transmission of the human immunodeficiency virus. The effectiveness of condoms in disease prophylaxis is dependent, to a degree, on their correct use. Condom manufacturers routinely include information on condom use either printed on the actual package or in an enclosed package insert. With the use of three readability formulas, the reading grade level was determined for 14 different sets of instructions included with 25 brands of condoms manufactured by 7 domestic and 1 overseas manufacturer. The readability formulas, when applied to instructions for condom use, estimated that, conservatively, 8 of the 14 instructions required at least reading at the level of a high school graduate and none required less than a 10th grade level. Clearly written instructions and simple concepts could assist current and future condom users in the correct use of condoms and improve the effectiveness of condoms in the prevention of AIDS and other sexually transmitted diseases. PMID:3136494

Condom Misuse Among Adjudicated Girls: Associations with Laboratory - Confirmed Chlamydia and Gonorrhea

PubMed Central

Crosby, Richard; Salazar, Laura F.; DiClemente, Ralph J.; Yarber, William L.; Caliendo, Angela M.; Staples-Horne, Michelle

2009-01-01

Objectives To identify the prevalence of condom use errors among detained female teens and to test two inter-related hypotheses concerning condom failure. Methods A cross-sectional survey of 134 female teens recruited within eight detention facilities. Measures were collected using audio-computer assisted self-interviewing. Assessment for the presence of C. trachomatis and N. gonorrhoeae was also conducted. Results Five forms of condom use errors/problems were common: not discussing condom use with the partner (34.3%), not having a condom when one was desired (48.5%), starting sex before application (21.6%), removing condoms before sex concludes (26.9%), and breakage (32.8%). Significant, associations were found between condom errors/problems and drug/alcohol use. Errors/problems with condom use were significantly higher among teens diagnosed with an STD (P=.039 for an index measure; P=.022 for a single-item measure). Conclusions Findings suggest that detained female teens may have experienced multiple condom use error and problems thereby increasing their vulnerability to STD acquisition. PMID:18082855

Women's willingness to experiment with condoms and lubricants: A study of women residing in a high HIV seroprevalence area.

PubMed

Sanders, Stephanie A; Crosby, Richard A; Milhausen, Robin R; Graham, Cynthia A; Tirmizi, Amir; Yarber, William L; Beauchamps, Laura; Mena, Leandro

2018-03-01

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.

A randomized community trial of enhanced family planning outreach in Rakai, Uganda.

PubMed

Lutalo, Tom; Kigozi, Godfrey; Kimera, Edward; Serwadda, David; Wawer, Maria J; Zabin, Laurie Schwab; Gray, Ronald H

2010-03-01

A randomized community trial of a family planning outreach program was conducted in Rakai District, Uganda. Five communities received standard services; six intervention communities received additional family planning information, counseling, and contraceptive methods from government service providers and community-based volunteer agents using social marketing and other strategies. Condom use was promoted in all of the communities. The community-based family planning outreach program was implemented in two phases--1999-2000 (early) and 2001(late)--and its impact was evaluated by means of population surveys in 2002-03. At follow-up, hormonal contraceptive prevalence was 23 percent in the intervention communities, compared with 20 percent in the control communities. The differential was greater in the early-intervention communities than the late-intervention communities. Pregnancy rates at follow-up were 15 percent in the control and 13 percent in the intervention communities. No differentials in condom use were found between study arms. Family planning outreach via social marketing can significantly increase hormonal contraceptive use and decrease pregnancy rates, but the impact of this outreach program was modest.

Condom negotiation across different relationship types by young women engaged in sex work in Phnom Penh, Cambodia

PubMed Central

Maher, Lisa; Mooney-Somers, Julie; Phlong, Pisith; Couture, Marie-Claude; Kien, Serey Phal; Stein, Ellen; Bates, Anna Juong; Sansothy, Neth; Page, Kimberly

2013-01-01

Cambodia's 100% Condom Use Programme is credited with an increase in consistent condom use in commercial sexual interactions and a decrease in HIV prevalence among female sex workers (FSWs). There has been little improvement in condom use between FSWs and non-commercial partners, prompting calls for more innovative approaches to increasing condom use in these relationships. To understand why condoms are used or not used in sexual interactions involving FSWs, we examined condom negotiation across different types of relationships. We conducted 33 in-depth interviews with young (15 to 29 years) women engaged in sex work in Phnom Penh. There was an important interplay between the meanings of condom use and the meanings of women's relationships. Commercial relationships were characterised as inherently risky and necessitated condom use. Despite a similar lack of sexual fidelity, sweetheart relationships were rarely construed as risky and typically did not involve condom use. Husbands and wives constructed their sexual interactions with each other differently, making agreement on condom use difficult. The lack of improvement in condom use in FSWs' non-commercial sexual relationships needs to be understood in relation to both sex work and the broader Cambodian sexual culture within which these relationships are embedded. PMID:23432108

Promoting condom-only brothels through solidarity and support for brothel managers.

PubMed

Sakondhavat, C; Werawatanakul, Y; Bennett, A; Kuchaisit, C; Suntharapa, S

1997-01-01

Brothel workers in Thailand are at high risk of HIV infection but they alone do not have adequate bargaining power to insist on condom use with all clients. Brothel managers, on the other hand, are a source of influence over both clients and their workers and can promote universal condom use in their establishments. To test whether brothel managers in Khon Kaen City would adopt and successfully implement a condom-only policy in their establishments, all 24 brothel managers in Khon Kaen City attended a meeting on the dangers of HIV and benefits of an all-condom policy. Ideas on how to implement the policy were discussed. Follow-up visits were made once a month to brothels to resupply condoms, provide reinforcement and to collect data. All brothel managers approved of the condom-only in principle and are now implementing the policy. Results of the evaluation of condom use and degree of solidarity in these 24 brothels are available for the AIDS prevention programme. However, a condom-only policy in brothels can only succeed if managers and brothel workers show solidarity in rejecting all non-condom using clients. Laws to promote condom use may not be needed if brothels are given the opportunity to implement a condom-only policy using their own resourcefulness and determination.

Conceptualizing women's attitudes toward condom use with the tripartite model.

PubMed

Hood, Kristina B; Shook, Natalie J

2013-01-01

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.

Predicting the Intention to Use Condoms and Actual Condom Use Behaviour: A Three-Wave Longitudinal Study in Ghana

PubMed Central

Teye-Kwadjo, Enoch; Kagee, Ashraf; Swart, Hermann

2017-01-01

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

Condom use: exploring verbal and non-verbal communication strategies among Latino and African American men and women.

PubMed

Zukoski, Ann P; Harvey, S Marie; Branch, Meredith

2009-08-01

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.

Role of condom negotiation on condom use among women of reproductive age in three districts in Tanzania.

PubMed

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

2012-12-20

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.

Role of condom negotiation on condom use among women of reproductive age in three districts in Tanzania

PubMed Central

2012-01-01

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. PMID:23256530

Impact of an Intervention Designed to Reduce Sexual Health Risk Behaviors of African American Adolescents: Results of a Randomized Controlled Trial

PubMed Central

Jenner, Lynne W.; Walsh, Sarah; Demby, Hilary; Gregory, Alethia; Davis, Erin

2016-01-01

Objectives. To replicate an evidence-based HIV risk reduction program and assess its impact on 2 behavioral outcomes—inconsistency of condom use and frequency of sex—6 months after the program. Methods. The study was an individual-level randomized controlled trial in which we randomly assigned 850 youths (aged 14–18 years) to 1 of 2 conditions. The treatment (Becoming a Responsible Teen) is a group-level sociocognitive and skills training sexual education course; the control is a general health intervention that includes the same initial informational component as the treatment. Participants were recruited over 3 summers (2012–2014) from a summer employment program in New Orleans, Louisiana, that serves primarily African American adolescents. Results. Six months after program exposure, we found no statistically significant difference between treatment and control group members’ self-reported inconsistency of condom use or frequency of sex (P > .05). Conclusions. Although previous evidence has indicated that this particular program can be effective, this study’s findings indicate that it was not effective in this setting with this specific population. Results should provide an incentive to learn why the intervention works in some cases and what conditions are necessary for causal impacts. PMID:27689499

The effect of comprehensive sexual education program on sexual health knowledge and sexual attitude among college students in Southwest China.

PubMed

Chi, Xinli; Hawk, Skyler T; Winter, Sam; Meeus, Wim

2015-03-01

The purpose of this study was to evaluate whether a comprehensive sexual education program for college students in Southwest China (a) improved sexual health knowledge in reproduction, contraception, condom use, sexually transmitted diseases, and HIV; (b) increased accepting attitudes toward lesbian, gay, bisexual, and transsexual individuals; and (c) altered participants' attitudes toward premarital sex and monogamy. The program used diverse teaching methods, providing 6 sessions over a period of 9 weeks about sexual health knowledge and sexual attitudes to college students (age 18-26 years) in Southwest China. Sexual health knowledge and sexual attitudes of 80 comprehensive sexual education class students (education group) and 92 general mental health education class students (control group) were measured at baseline, the end of course (posttest), and 3 weeks after the end of course (follow-up). There were significant effects of the program on (a) sexual health knowledge, including reproductive health, contraception, condom use, and HIV/AIDS and (b) positive attitudes toward sexual minorities, although these changes may require further reinforcement. In contrast, the program did not alter students' attitudes about premarital sex or monogamy. The results are discussed in terms of recommendations of sex education in China and future directions for research. © 2013 APJPH.

A dose-response relationship between exposure to a large-scale HIV preventive intervention and consistent condom use with different sexual partners of female sex workers in southern India.

PubMed

Deering, Kathleen N; Boily, Marie-Claude; Lowndes, Catherine M; Shoveller, Jean; Tyndall, Mark W; Vickerman, Peter; Bradley, Jan; Gurav, Kaveri; Pickles, Michael; Moses, Stephen; Ramesh, Banadakoppa M; Washington, Reynold; Rajaram, S; Alary, Michel

2011-12-29

The Avahan Initiative, a large-scale HIV preventive intervention targeted to high-risk populations including female sex workers (FSWs), was initiated in 2003 in six high-prevalence states in India, including Karnataka. This study assessed if intervention exposure was associated with condom use with FSWs' sexual partners, including a dose-response relationship. Data were from a cross-sectional study (2006-07) of 775 FSWs in three districts in Karnataka. Survey methods accounted for the complex cluster sampling design. Bivariate and multivariable logistic regression was used to separately model the relationships between each of five intervention exposure variables and five outcomes for consistent condom use (CCU= always versus frequently/sometimes/never) with different sex partners, including with: all clients; occasional clients; most recent repeat client; most recent non-paying partner; and the husband or cohabiting partner. Linear tests for trends were conducted for three continuous intervention exposure variables. FSWs reported highest CCU with all clients (81.7%); CCU was lowest with FSWs' husband or cohabiting partner (9.6%). In multivariable analysis, the odds of CCU with all clients and with occasional clients were 6.3-fold [95% confidence intervals, CIs: 2.8-14.5] and 2.3-fold [95% CIs: 1.4-4.1] higher among FSWs contacted by intervention staff and 4.9-fold [95% CIs: 2.6-9.3] and 2.3-fold [95% CIs: 1.3-4.1] higher among those who ever observed a condom demonstration by staff, respectively, compared to those who had not. A significant dose-response relationship existed between each of these CCU outcomes and increased duration since first contacted by staff (P=0.001; P=0.006) and numbers of condom demonstrations witnessed (P=0.004; P=0.026); a dose-response relationship was also observed between condom use with all clients and number of times contacted by staff (P=0.047). Intervention exposure was not associated with higher odds of CCU with the most recent repeat client, most recent non-paying partner or with the husband or cohabiting partner. Study findings suggest that exposure to a large-scale HIV intervention for FSWs was associated with increased CCU with commercial clients. Moreover, there were dose-response relationships between CCU with clients and increased duration since first contacted by staff, times contacted by staff and number of condom demonstrations. Additional program effort is required to increase condom use with non-commercial partners.

A dose-response relationship between exposure to a large-scale HIV preventive intervention and consistent condom use with different sexual partners of female sex workers in southern India

PubMed Central

2011-01-01

Background The Avahan Initiative, a large-scale HIV preventive intervention targeted to high-risk populations including female sex workers (FSWs), was initiated in 2003 in six high-prevalence states in India, including Karnataka. This study assessed if intervention exposure was associated with condom use with FSWs’ sexual partners, including a dose-response relationship. Methods Data were from a cross-sectional study (2006-07) of 775 FSWs in three districts in Karnataka. Survey methods accounted for the complex cluster sampling design. Bivariate and multivariable logistic regression was used to separately model the relationships between each of five intervention exposure variables and five outcomes for consistent condom use (CCU= always versus frequently/sometimes/never) with different sex partners, including with: all clients; occasional clients; most recent repeat client; most recent non-paying partner; and the husband or cohabiting partner. Linear tests for trends were conducted for three continuous intervention exposure variables. Results FSWs reported highest CCU with all clients (81.7%); CCU was lowest with FSWs’ husband or cohabiting partner (9.6%). In multivariable analysis, the odds of CCU with all clients and with occasional clients were 6.3-fold [95% confidence intervals, CIs: 2.8-14.5] and 2.3-fold [95% CIs: 1.4-4.1] higher among FSWs contacted by intervention staff and 4.9-fold [95% CIs: 2.6-9.3] and 2.3-fold [95% CIs: 1.3-4.1] higher among those who ever observed a condom demonstration by staff, respectively, compared to those who had not. A significant dose-response relationship existed between each of these CCU outcomes and increased duration since first contacted by staff (P=0.001; P=0.006) and numbers of condom demonstrations witnessed (P=0.004; P=0.026); a dose-response relationship was also observed between condom use with all clients and number of times contacted by staff (P=0.047). Intervention exposure was not associated with higher odds of CCU with the most recent repeat client, most recent non-paying partner or with the husband or cohabiting partner. Conclusion Study findings suggest that exposure to a large-scale HIV intervention for FSWs was associated with increased CCU with commercial clients. Moreover, there were dose-response relationships between CCU with clients and increased duration since first contacted by staff, times contacted by staff and number of condom demonstrations. Additional program effort is required to increase condom use with non-commercial partners. PMID:22375863

The impact of peer outreach on HIV knowledge and prevention behaviours of male sex workers in Mombasa, Kenya.

PubMed

Geibel, Scott; King'ola, Nzioki; Temmerman, Marleen; Luchters, Stanley

2012-08-01

Targeting most at-risk populations is an essential component of HIV prevention strategies. Peer education programmes have been found to increase HIV knowledge, condom use and safer sex behaviours among female sex workers in Africa and men who have sex with men elsewhere. The authors aimed to evaluate the impact of a peer-driven intervention on male sex workers who sell sex to men in Mombasa, Kenya. Using time-venue sampling, a baseline survey of 425 male sex workers was conducted in late 2006, after which, 40 peer educators were trained in HIV prevention, basic counselling skills and distribution of condoms and lubricants. A follow-up time-venue survey of 442 male sex workers was conducted in early 2008, and pre- and post-intervention changes were examined. The impact of peer educator exposure on HIV knowledge and condom use was analysed. Positive changes in HIV prevention behaviours were observed, including increases in consistent use of condoms with both male clients (35.9%-50.2%, p<0.001) and non-paying male partners (27.4%-39.5%, p=0.008). Exposure to peer educators (AOR=1.97, 95% CI 1.29 to 3.02) and ever having been counselled or tested for HIV (AOR=1.71, 95% CI 1.10 to 2.66) were associated with consistent condom use in multivariate analysis. Peer educator contact was also associated with improved HIV knowledge and use of water-based lubricants. Peer outreach programming reached highly stigmatised male sex workers in Mombasa, resulting in significant, but limited, improvements in HIV knowledge and prevention behaviours. Improved peer coverage and additional prevention initiatives are needed to sufficiently mitigate HIV transmission.

Condom use and associated factors among men who have sex with men in Togo, West Africa

PubMed Central

Bakai, Tchaa Abalo; Ekouevi, Didier Koumavi; Tchounga, Boris Kévin; Balestre, Eric; Afanvi, Kossivi Agbélénko; Goilibe, Kariyiare Benjamin; Kassankogno, Yao; Pitche, Vincent Palokinam

2016-01-01

Introduction In 2011, the prevalence of HIV among men who have sex with men (MSM) in Togo was estimated at 19.6% compared to 3.4% in the general population. This study aimed to describe condom use and associated factors among MSM in Togo. Methods In 2011, a cross-sectional survey was conducted using the snowball sampling method among MSM in Togo. This study enrolled MSM aged 18 years and above who reported having sexual contact with other men within the last 30 days. A standardized survey form was used for data collection, and multivariate analyses were performed. Results A total of 724 MSM were included in this study. The median age was 25 years [22-28], 90.3% had at least a secondary school level. The sexual practices during the last sexual encounter with another man included: insertive anal sex (62.2%), receptive anal sex (56.6%), oral sex (33.8%) and oral-anal sex (8.6%). A condom was used during the last insertive and receptive anal encounters in 78.4% and 81.2% of the time, respectively. In multivariate analysis, condom use was positively associated with previous participation in HIV/STD prevention activities (aOR=1.72; 95% CI=[1.09-2.71]), with the consideration of the last sexual partner as a casual one (aOR=1.87; 95% CI=[1.24-2.82]) and with having at least a secondary school level (aOR=2.40; 95% CI=[1.22-4.69]). Conclusion One out of five MSM did not use a condom during the last anal encounter with another man. HIV prevention programs in Africa should develop specific interventions targeting MSM to reduce the incidence of HIV in this hidden population. PMID:27279945

Unprotected anal intercourse behavior and intention among male sex workers in Shenzhen serving cross-boundary male clients coming from Hong Kong, China - prevalence and associated factors.

PubMed

Lau, Joseph T F; Cai, Wende; Tsui, Hi Yi; Chen, Lin; Cheng, Jinquan; Lin, Chunqing; Gu, Jing; Hao, Chun

2012-01-01

The HIV epidemic among men who have sex with men (MSM) in China is becoming very serious. Unprotected anal intercourse (UAI) among MSM during cross-boundary commercial sex spread HIV across geographic areas. This study interviewed 186 Chinese male sex workers (MSW) in Shenzhen, China, serving cross-boundary Hong Kong male clients; 49.5% had had UAI with their Hong Kong male clients (last six months) and 24.2% intended to do so (future six months). Multivariate analyses showed that perceived efficacy of condom use for HIV prevention, perceived prevalence of HIV among Hong Kong MSM (>4%), and perceived ability to convince Hong Kong male clients to use condoms during anal sex were associated with lower likelihoods of UAI with such clients (OR = 0.04-0.09); the reverse was true for those who left the decision of condom use to their Hong Kong male clients (OR = 6.44). Perceived condom efficacy, self-efficacy in protection against HIV infection, and perceived control over condom use were associated with an intention for UAI (OR = 0.06-80.44). Adjusting for background variables, the scales representing contextual (Clients Characteristics, Substance Use, or Environmental Influences) and affective factors (Fear of Diseases) were associated with UAI (adjusted OR = 0.44-32.61). Except the Fear of Diseases scale, other scales were associated with an intention for UAI (adjusted OR = 4.59-43.32). MSW are at high risk of HIV transmission. Various factors are associated with UAI with male cross-boundary clients; these factors and the context of sex work need to be considered when designing HIV prevention programs.

Findings from Encontros: a multi-level STI/HIV intervention to increase condom use, reduce STI, and change the social environment among sex workers in Brazil

PubMed Central

Lippman, Sheri A.; Chinaglia, Magda; Donini, Angela A.; Diaz, Juan; Reingold, Arthur; Kerrigan, Deanna L.

2012-01-01

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

Findings from Encontros: a multilevel STI/HIV intervention to increase condom use, reduce STI, and change the social environment among sex workers in Brazil.

PubMed

Lippman, Sheri A; Chinaglia, Magda; Donini, Angela A; Diaz, Juan; Reingold, Arthur; Kerrigan, Deanna L

2012-03-01

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.

Interaction between 5-HTTLPR Polymorphism and Abuse History on Adolescent African-American Females’ Condom Use Behavior Following Participation in an HIV Prevention Intervention

PubMed Central

Sales, Jessica M.; DiClemente, Ralph J.; Brody, Gene H.; Philibert, Robert A.; Rose, Eve

2013-01-01

Not everyone exposed to an efficacious HIV intervention will reduce sexual risk behaviors, yet little is known about factors associated with “failure to change” high risk sexual behaviors post-intervention. History of abuse and polymorphisms in the serotonin transporter gene (5-HTT) may be associated with non-change. The current study sought to identify genetic, life history, and psychosocial factors associated with adolescents’ failure to change condom use behaviors post-participation in an HIV prevention intervention. A sub-set of participants from a clinic-based sample of adolescent African-American females (N = 254) enrolled in a randomized trial of an HIV-prevention was utilized for the current study. 44.1% did not increase their condom use from baseline levels 6 months after participating in the STI/HIV prevention intervention. In multivariable logistic regression analysis, an interaction between abuse and 5-HTTLPR group was significantly associated with non-change status, along with partner communication frequency scores at follow-up. Follow-up tests found that having a history of abuse was significantly associated with greater odds of non-change in condom use post-intervention for only those with the s allele. For those with ll allele, participants with higher partner communication frequency scores were at decreased odds of non-change in condom use post-intervention. Thus, STI/HIV interventions for adolescent females may consider providing a more in-depth discussion and instruction on how to manage and overcome fear or anxiety related to being assertive in sexual decisions or sexual situations. Doing so may improve the efficacy of STI/HIV prevention programs for adolescent women who have experienced abuse in their lifetime. PMID:23479192

Behavioral training and AIDS risk reduction: overcoming barriers to condom use.

PubMed

Weisse, C S; Turbiasz, A A; Whitney, D J

1995-02-01

To assess the short- and long-term effects of an AIDS-prevention workshop on undergraduates' attitudes about condom use and AIDS, 31 participants and 31 controls were studied immediately after training sessions as well as three months later. The workshop was aimed at reducing embarrassment to purchase condoms, encouraging positive attitudes about condoms, and promoting knowledge about AIDS. To help students overcome their embarrassment over condom purchases, a behavioral intervention was included allowing students to make condom purchases at nearby drug stores. Results revealed that participants reported less embarrassment over condom purchases after training sessions and that this effect became even stronger over time. Knowledge about AIDS and positive attitudes about condoms also increased immediately after the workshop, but these changes did not persist. Results suggest that AIDS prevention workshops may lead to transient changes unless a specific skill (i.e., condom purchasing) is targeted via behavioral training.

Drugs, Sex, and Condoms: Identification and Interpretation of Race-Specific Cultural Messages Influencing Black Gay and Bisexual Young Men Living with HIV

PubMed Central

Harper, Gary W.; Tyler, April Timmons; Bruce, Douglas; Graham, Louis; Wade, Ryan M.

2016-01-01

Black gay and bisexual young men carry a disproportionate burden of HIV in the United States. This study explored Black gay and bisexual young men living with HIV’s identification and interpretation of race-specific cultural messages regarding substance use, sexual activity, and condom use. A total of 36 Black gay and bisexual young men living with HIV (ages 16-24, mean=20.6 years) from four geographically diverse regions of the US participated in qualitative in-depth interviews. Results from this study elucidate the ways in which these young men interpret various forms of race-specific cultural messages and experiences regarding substance use, sexual activity, and condom use. Participants discussed cultural messages and experiences promoting and discouraging condoms and substance use. Regarding sexual activity, only messages and experiences promoting sex were reported. Across all three categories, messages and experiences promoting risk were predominant. Data further revealed that socially transmitted cultural messages received by young men emanated from multiple sources, such as family, peers, sexual partners, community/neighborhood, and the broader society. Race-specific cultural messages and experiences should be addressed in interventions for this population, and programs should assist young men in developing a critical consciousness regarding these messages and experiences in order to promote health and well-being. PMID:27883219

Men's perspectives on cancer prevention behaviors associated with HPV.

PubMed

FitzGerald, Serena; Cornally, Nicola; Hegarty, Josephine

2018-02-01

The human papillomavirus (HPV) is associated with the diagnosis of anal, penile, and oropharyngeal cancers in men. Evidence indicates that correct condom use in addition to obtaining the HPV vaccine provides the greatest protection from HPV infections. To explore young men's beliefs and behavioral intention in relation to receiving the HPV vaccine and using a condom correctly and consistently for sexual contact. A cross-sectional study underpinned by the theory of planned behavior (TPB) was conducted with male participants (n = 359, 18-28 years) who completed an online survey. Descriptive, correlational, and hierarchical regression analyses were performed on both status variables and variables of the TPB. Subjective norms (β = 0.519, P < .001) was identified as the most influential predictor in relation to men's intention to receive the HPV vaccine, while relationship status (β = -0.215, P < .001) and attitudes (β = 0.394, P < .001) presented as the most significant predictors of intention to use a condom. Summarily, 51% of the variance in intention to receive the HPV vaccine and 44% in intention to use a condom were explained by the TPB model. Results from this study will impact on future sexual health research, education programs, and interventions for both HPV preventative behaviors towards the elimination of HPV-related cancers in men. Copyright © 2017 John Wiley & Sons, Ltd.

Drugs, Sex, and Condoms: Identification and Interpretation of Race-Specific Cultural Messages Influencing Black Gay and Bisexual Young Men Living with HIV.

PubMed

Harper, Gary W; Tyler, April Timmons; Bruce, Douglas; Graham, Louis; Wade, Ryan M

2016-12-01

Black gay and bisexual young men carry a disproportionate burden of HIV in the United States. This study explored Black gay and bisexual young men living with HIV's identification and interpretation of race-specific cultural messages regarding substance use, sexual activity, and condom use. A total of 36 Black gay and bisexual young men living with HIV (ages 16-24, mean = 20.6 years) from four geographically diverse regions of the United States participated in qualitative in-depth interviews. Results from this study elucidate the ways in which these young men interpret various forms of race-specific cultural messages and experiences regarding substance use, sexual activity, and condom use. Participants discussed cultural messages and experiences promoting and discouraging condoms and substance use. Regarding sexual activity, only messages and experiences promoting sex were reported. Across all three categories, messages and experiences promoting risk were predominant. Data further revealed that socially transmitted cultural messages received by young men emanated from multiple sources, such as family, peers, sexual partners, community/neighborhood, and the broader society. Race-specific cultural messages and experiences should be addressed in interventions for this population, and programs should assist young men in developing a critical consciousness regarding these messages and experiences in order to promote health and well-being. © Society for Community Research and Action 2016.

HIV risk and sexual health among female migrants in China.

PubMed

Huang, Wen; Dong, Yanyan; Chen, Lin; Song, Dandan; Wang, Jun; Tao, Haidong; Zaller, Nickolas; Zhang, Hongbo; Operario, Don

2016-09-01

Sexual behavior is the dominant mode of HIV transmission in China, and young female migrants are among the populations at highest risk. This article examines how HIV-related risk behaviors among female migrants might vary according to workplace settings. Participants were young female migrants recruited from three workplace settings-factories, restaurants and entertainment venues. In a cross-sectional survey, we assessed 457 participants' sociodemographic characteristics, HIV/AIDS-related knowledge, condom use knowledge, sexual behaviors, condom use behavior and reproductive health factors. Participants working in entertainment venues were significantly more likely than those working in factories and restaurants to report sexual behavior, unprotected sex, multiple pregnancy terminations and sexually transmitted infections (STI). However, participants working in factories and restaurants reported significantly lower levels of HIV/AIDS knowledge, condom use knowledge, condom use self-efficacy and history of HIV/AIDS counseling and testing. Independent correlates of unprotected sex included employment in an entertainment venue, abortion history and sexual self-efficacy. Independent correlates of STI or genitourinary tract infection included employment in an entertainment venue, abortion history, recent migration and recent unprotected sex. These findings indicate a need for sexual and reproductive health interventions prioritizing young female migrants, and call for programs that can be incorporated into different workplace settings. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Assertive Communication in Condom Negotiation: Insights From Late Adolescent Couples' Subjective Ratings of Self and Partner.

PubMed

Schmid, Amy; Leonard, Noelle R; Ritchie, Amanda S; Gwadz, Marya V

2015-07-01

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.

Condom use among female commercial sex workers in Nevada's legal brothels.

PubMed Central

Albert, A E; Warner, D L; Hatcher, R A; Trussell, J; Bennett, C

1995-01-01

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

Patterns of condom use among students at historically Black colleges and universities: implications for HIV prevention efforts among college-age young adults.

PubMed

El Bcheraoui, Charbel; Sutton, Madeline Y; Hardnett, Felicia P; Jones, Sandra B

2013-01-01

Over 1.1 million Americans are living with human immunodeficiency virus (HIV), and African-American youth and young adults are disproportionately affected. Condoms are the most effective prevention tool, yet data regarding condom use patterns for African-American college youth are lacking. To inform and strengthen HIV prevention strategies with African-American college-age youth, we surveyed students attending 24 historically Black colleges and universities regarding condom use patterns. Students were administered anonymous questionnaires online to explore knowledge, attitudes, and practices related to condom use during last sexual intercourse (LSI). Among 824 sexually active respondents (51.8% female, median age 20 years, 90.6% heterosexuals), 526 (63.8%) reported condom use during LSI. Students who used condoms for disease prevention, whose mothers completed high school or had some college education or completed college were more likely to have used a condom during LSI. Spontaneity of sexual encounters, not feeling at risk of HIV, and partner-related perceptions were associated with condom non-use during LSI (p<0.05). Over a third of our college youth sample did not use a condom during LSI and may benefit from increased condom education efforts. These efforts should highlight condoms' effectiveness in protection from HIV. Future HIV education and prevention strategies with similar groups of young adults should explore the implications of maternal education, clarify perceptions of HIV risk, and consider strategies that increase consistent condom use to interrupt sexual transmission of HIV.

Predictors of condom use and refusal among the population of Free State province in South Africa

PubMed Central

2012-01-01

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 for condom-use and improving skills for correct use. They should also incorporate interventions to reduce the shame associated with condoms and individual counselling of those likely to refuse condoms. PMID:22639964

Programs to improve adolescent sexual and reproductive health in the US: a review of the evidence.

PubMed

Manlove, Jennifer; Fish, Heather; Moore, Kristin Anderson

2015-01-01

US adolescents have high rates of teen pregnancy, childbearing, and sexually transmitted infections (STIs), highlighting the need to identify and implement effective programs that will help improve teen sexual and reproductive health. This review identified 103 random-assignment evaluations of 85 programs that incorporated intent-to-treat analyses and assessed impacts on pregnancy, childbearing, STIs, and their key determinants - sexual activity, number of sexual partners, condom use, and other contraceptive use - among teens. This review describes the evidence base for five broad program approaches, including abstinence education, comprehensive sex education, clinic-based programs, youth development programs, and parent-youth relationship programs. We also describe programs with impacts on key outcomes, including pregnancy/childbearing, STIs, and those that found impacts on both sexual activity and contraceptive use. Our review identified 52 effective programs: 38 with consistent impacts on reproductive health outcomes, and 14 with mixed findings (across subpopulations, follow-ups, or multiple measures of a single outcome). We found that a variety of program approaches produced impacts on sexual and reproductive health outcomes. Parent-youth relationship programs and clinic-based program evaluations more frequently showed impacts than other program approaches, although we also identified a number of abstinence-education, comprehensive sex education, and youth-development programs with impacts on sexual and reproductive health outcomes. Overall, we identified nine program evaluations with impacts on teen pregnancies or births, five with impacts on reducing STIs, and 15 with impacts on both delaying/reducing sexual activity and increasing contraceptive use (including condom use). Future efforts should conduct replications of existing program evaluations, identify implementation components linked to impacts, rigorously evaluate programs that appear promising, and expand the evidence base on programs that impact hormonal and long-acting contraceptive method use.

Efficacy of a combined contraceptive regimen consisting of condoms and emergency contraception pills.

PubMed

Zhao, Rui; Wu, Jun-Qing; Li, Yu-Yan; Zhou, Ying; Ji, Hong-Lei; Li, Yi-Ran

2014-04-14

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.

Predicting having condoms available among adolescents: the role of personal norm and enjoyment.

PubMed

Jellema, Ilke J; Abraham, Charles; Schaalma, Herman P; Gebhardt, Winifred A; van Empelen, Pepijn

2013-05-01

Having condoms available has been shown to be an important predictor of condom use. We examined whether or not personal norm and goal enjoyment contribute to predicting having condoms available in the context of cognition specified by the theory of planned behaviour (TPB). Prospective survey study, with a baseline and follow-up measurement (at 3 months). Data were gathered using an online survey. In total 282 adolescents (mean age = 15.6, 74% female adolescents) completed both questionnaires. At baseline, demographics, sexual experience, condom use, TPB variables, descriptive norm, personal norm, and enjoyment towards having condoms available were measured. At T2 (3 months later) having condoms available was measured. Direct and moderating effects of personal norm and goal enjoyment were examined by means of hierarchical linear regression analyses. Regression analyses yielded a direct effect of self-efficacy and personal norm on condom availability. In addition, moderation of the intention-behaviour relation by goal enjoyment added to the variance explained. The final model explained approximately 35% of the variance in condom availability. Personal norm and goal enjoyment add to the predictive utility of a TPB model of having condoms available and may be useful intervention targets. What is already known about this subject? Having condoms available is an important prerequisite for actual condom use. The theory of planned behaviour has successfully been applied to explain condom availability behaviour. The theory of planned behaviour has been criticized for not adequately taking into account affective motivation. What does this study add? Personal norm and goal enjoyment add to the predictive utility of the model. Personal norm explains condom availability directly, enjoyment increases intention enactment. Personal norm and goal enjoyment therefore are useful intervention targets. © 2012 The British Psychological Society.

Brand equity and willingness to pay for condoms in Zimbabwe.

PubMed

Evans, W Douglas; Taruberekera, Noah; Longfield, Kim; Snider, Jeremy

2011-10-26

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.

A qualitative examination of men's condom use attitudes and resistance: "it's just part of the game".

PubMed

Davis, Kelly Cue; Schraufnagel, Trevor J; Kajumulo, Kelly F; Gilmore, Amanda K; Norris, Jeanette; George, William H

2014-04-01

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.

Community norms about youth condom use in Western Kenya: is transition occurring?

PubMed

Tavrow, Paula; Karei, Eunice Muthengi; Obbuyi, Albert; Omollo, Vidalyne

2012-06-01

Most HIV prevention strategies for African youth have been ineffective in changing key behaviors like condom use, partly because community antagonism and structural barriers have rarely been addressed. Through qualitative research in rural Western Kenya, we sought to describe the attitudes of different segments of society towards youth condom use and to identify where transitions may be occurring. We found that about half of community members strongly opposed youth condom use, with many advocating punishment such as beatings and expulsion. Our research revealed significant differences in attitudes by gender, with females generally more opposed to youth condom use. Health providers, teachers and male students seemed to be transitioning to more permissive attitudes. They also had more accurate knowledge about the condom. Building on these transitional views, we would recommend that schools eliminate sanctions for students found with condoms and that clinics discourage providers from interrogating youths about their reasons for wanting condoms. Furthermore, we believe that health campaigns should portray condoms as "disaster preparedness" devices for responsible youths, and more efforts should be made to dispel myths about condoms' efficacy.

Body mass index, depression, and condom use among HIV-infected men who have sex with men: a longitudinal moderation analysis.

PubMed

Blashill, Aaron J; Mayer, Kenneth H; Crane, Heidi M; Baker, Joshua S; Willig, James H; Willig, Amanda L; Grasso, Chris; O'Cleirigh, Conall; Safren, Steven A

2014-05-01

Findings have been inconsistent regarding the association of obesity and sexual risk behaviors. The purpose of the current study was to assess the prospective nature of body mass index (BMI), depression, and their interaction in predicting condom use during anal intercourse among HIV-infected men who have sex with men (MSM). The sample (N = 490) was obtained from a large, HIV clinical cohort from four sites across the U.S. The following inclusion criteria were employed: identification as MSM and had completed at least one wave of patient-reported measures (e.g., depression, as measured by the PHQ-9) in the clinical cohort study. Longitudinal linear mixed-effects modeling revealed a significant BMI by depression interaction. Depressive symptoms were predictive of less frequent condom use for obese but not overweight men. Analogous results were found in regard to comparisons between normal weight and overweight men. Obesity, in the context of depression, is a risk factor for unprotected anal intercourse among HIV-infected MSM. Cognitive behavioral interventions to reduce HIV transmission risk behaviors among HIV-infected MSM should adopt an integrated perspective, combining sexual risk reduction with treatment for depression and body-related concerns.

FDA: polyurethane condom carries "extremely misleading" label. Federal agency allows distribution for public health's sake.

PubMed

1995-02-01

The labeling of the Avanti polyurethane condom selling in 10 Western states makes misleading claims about protection from pregnancy and sexually transmitted diseases (STDs) according to officials at the US Food and Drug Administration (FDA). Avanti is sold in a foil package printed with the claim that it is effective against pregnancy, HIV, and STDs. However, polyurethane condoms have not undergone clinical efficacy testing for contraception or STDs, according to officials. The manufacturer of the condom refuted this allegation, stating that latex condoms have the same claims on them. In early 1995 the FDA met with the manufacturer and other companies developing plastic condoms, and concluded that these condoms could not make such claims, nor any claims about slippage and breakage rates. Despite warnings in 1993 to the manufacturer of Avanti about labeling restrictions, the company printed pregnancy and STD efficacy claims on the boxes and individual packages. The FDA later worked out a compromise with the firm in which only the boxes had to be reprinted with the generic label. The FDA had to weigh the risk of the public health cost of delaying sale of the condom, which is the first impermeable condom proven safe for people with latex allergies. In 1991 the FDA was defining standards for clinical testing and labeling of polyurethane condoms under congressional mandate, but the manufacturer of Avanti began mass production based on a preliminary approval determining that the condom was equivalent to latex condoms already on the market. 7000 Avanti condoms were subsequently tested in five countries, but these user tests did not compare Avanti to latex condoms and did not test for pregnancy and STD protection. Test results submitted to the FDA by the company indicated that, although Avanti is more than 1/3 less elastic than latex condoms, it did not break more frequently in an in-use study involving 187 couples.

Predictors of Consistent Condom Use Among Young African American Women

PubMed Central

DiClemente, Ralph J.; Salazar, Laura F.; Wingood, Gina M.; McDermott-Sales, Jessica; Young, April M.; Rose, Eve

2012-01-01

The purpose of this study was to determine the predictive value of selected factors to the consistent use of condoms among high-risk young African American women. A clinic-based, prospective, study of 242 young, African-American women (ages 15–21) was conducted. In multivariate analysis, consistent condom use was predicted by having greater perceptions of condom negotiation self-efficacy, lower fear of negotiating condom use, and having communicated with sex partners (during the recall period) about condom use. Relational variables were predictive of consistent condom use among young African American women. STD/HIV preventive interventions should target these factors, perhaps in dyad-level interventions. PMID:21796442

Predictors of consistent condom use among young African American women.

PubMed

Crosby, Richard A; DiClemente, Ralph J; Salazar, Laura F; Wingood, Gina M; McDermott-Sales, Jessica; Young, April M; Rose, Eve

2013-03-01

The purpose of this study was to determine the predictive value of selected factors to the consistent use of condoms among high-risk young African American women. A clinic-based, prospective, study of 242 young, African-American women (ages 15-21) was conducted. In multivariate analysis, consistent condom use was predicted by having greater perceptions of condom negotiation self-efficacy, lower fear of negotiating condom use, and having communicated with sex partners (during the recall period) about condom use. Relational variables were predictive of consistent condom use among young African American women. STD/HIV preventive interventions should target these factors, perhaps in dyad-level interventions.

Condoms, Culture, and Conviction: The Effect of Acculturation and Religiosity on Latina Condom Use during First Sex with New Partners.

PubMed

Smith, Scott James

2017-04-03

Latinas in the United States are less likely than their non-Hispanic peers to use condoms. Previous research has identified acculturation and religiosity as two key determinants of Latina condom use, but results are inconsistent, impairing the translation of findings to practice. The current study examines these constructs together and addresses methodological concerns noted in the literature. Structural equation modeling performed on a nationally representative sample of Latinas indicated that intrinsic religiosity increased condom use whereas acculturation decreased condom use. Extrinsic religiosity indirectly increased condom use via intrinsic religiosity. Implications for practice and policy are discussed.

Special report: the truth about condoms. Restrictive label could impede plastic condom sales.

PubMed

1995-01-01

You walk into a drugstore to buy a package of plastic condoms. You happen to notice the label says that no one's sure how well they protect you from pregnancy or sexually transmitted diseases (STDs) like AIDS. Then, the label indirectly points you in the direction of latex condoms. What would you do? Some observers familiar with the condom industry speculate that the restrictive labeling carried on each package of the new plastic condoms for men will not interfere with consumers' purchasing decisions. Other predict an instant replay of the situation faced by makers of the polyurethane Reality female condom: A lack of data on pregnancy rates and STD rates resulted in a label touting latex as a superior product, which in turn caused an onslaught of negative press about the first plastic condom. The US Food and Drug Administration, finding itself in a similar position with approving plastic condoms for men, recently released interim labeling to be followed by all manufacturers who want to sell the new male condoms. Essentially, the manufacturers must point out on the front of the condom box that the product is "for latex-sensitive condom users," and on the back of the box must tell a potential buyer that risks for pregnancy and STDs are not known for the product. Upon reading this disclaimer, the consumer then reads that "latex condoms for men, if used correctly with every act of vaginal intercourse, are highly effective at preventing pregnancy, as well as STDs, including AIDS (HIV infection)." full text

The Effect of Marriage and HIV Risks on Condom Use Acceptability in Rural Malawi

PubMed Central

Anglewicz, Philip; Clark, Shelley

2013-01-01

A large and increasing proportion of HIV transmissions in sub-Saharan Africa occur within marriage. Condom use within marriage could, therefore, be an important prevention strategy, but there is considerable debate about whether married couples would be willing to use condoms. This paper contributes to this debate by identifying key factors that affect the acceptability of condom use within marriage and actual condom use among men and women in rural Malawi, using three waves of longitudinal data from 2004, 2006 and 2008. Specifically, we focused on the effect of (1) entry into first marriage, (2) respondent’s HIV status, HIV perceptions, and risk behaviors, and (3) spouse’s HIV characteristics on condom use acceptability within marriage and actual condom use with a spouse or steady partner. Using fixed-effects regression, we found that getting married coincides with a pronounced attitudinal shift regarding the acceptability of condom use within marriage that cannot be explained by differences in fertility status or selection into marriage. In addition, we found that, for women, perceived HIV status of the respondent and spouse generally had greater influence than actual HIV status on the acceptability of condom use within marriage and actual condom use with a spouse or steady partner, even after HIV status is known; while actual HIV status and HIV risk behaviors are generally more important among men. Although condom use within marriage remained low, these findings suggest that attitudes about and use of condoms are susceptible to change and that both marital status and perceptions of risk are important influences on condom use. PMID:24161086

Time to talk condoms.

PubMed

Piotrow, P T; Rinehart, W

1991-09-01

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.

Condom use self-efficacy: effect on intended and actual condom use in adolescents.

PubMed

Baele, J; Dusseldorp, E; Maes, S

2001-05-01

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.

Reasons for Inconsistent Condom Use Found as Answers to a Multiple Response Question: A National Survey of Iranian Adults, 2013.

PubMed

Mirzaee, Moghaddameh; Jahani, Yunes; Sharifi, Hamid

2017-08-10

The use of condoms is important for preventing Sexually Transmitted Infections (STIs). However, the prevalence of condom use is not satisfactory. The aim of this study was to assess the reasons for inconsistent condom use in Iranian adults. Cross-sectional study. Data were gathered through multi-stage sampling. Participants were enrolled from 13 provinces in Iran aged between 19 and 29 years. They had ever-extramarital sex and did not use condoms regularly in their sexual contacts, asked the reasons for inconsistent condom use. We had 3,246 adults, from which 635 (19.5%) had ever-extramarital sex. Among them, 495 (77.96%) did not use condoms with regularity. The reason frequently chosen for inconsistent condom use was 'that it is not accessible' (49.3%). The differences between the categories of some variables, according to the choice of reasons for inconsistent condom use, were significant (P<0.05): age, gender, knowledge of HIV, attitude towards HIV, knowing infected HIV person and alcohol or stimulant(s) used before sexual contact. According to multivariate multilevel logistic, the effect of gender was significant on most of reasons for inconsistent condom use (P <0.05). Most of the reasons that were selected for inconsistent condom use were inaccessibility and not knowing that its use is essential. Hence, it is important to improve the knowledge of adults regarding STI/HIV and extend the locations of condom distribution. We should try to promote the culture of condom use as a routine.

The effect of marriage and HIV risks on condom use acceptability in rural Malawi.

PubMed

Anglewicz, Philip; Clark, Shelley

2013-11-01

A large and increasing proportion of HIV transmissions in sub-Saharan Africa occur within marriage. Condom use within marriage could, therefore, be an important prevention strategy, but there is considerable debate about whether married couples would be willing to use condoms. This paper contributes to this debate by identifying key factors that affect the acceptability of condom use within marriage and actual condom use among men and women in rural Malawi, using three waves of longitudinal data from 2004, 2006 and 2008. Specifically, we focused on the effect of (1) entry into first marriage, (2) respondent's HIV status, HIV perceptions, and risk behaviors, and (3) spouse's HIV characteristics on condom use acceptability within marriage and actual condom use with a spouse or steady partner. Using fixed-effects regression, we found that getting married coincides with a pronounced attitudinal shift regarding the acceptability of condom use within marriage that cannot be explained by differences in fertility status or selection into marriage. In addition, we found that, for women, perceived HIV status of the respondent and spouse generally had greater influence than actual HIV status on the acceptability of condom use within marriage and actual condom use with a spouse or steady partner, even after HIV status is known; while actual HIV status and HIV risk behaviors are generally more important among men. Although condom use within marriage remained low, these findings suggest that attitudes about and use of condoms are susceptible to change and that both marital status and perceptions of risk are important influences on condom use. Copyright © 2013 Elsevier Ltd. All rights reserved.

State of condom use in HIV prevention science and practice.

PubMed

Crosby, Richard A

2013-03-01

Condom use remains as the frontline defense against the HIV/AIDS pandemic. Fortunately, an ever-expanding body of empirical literature is currently guiding improvements in use of this prevention strategy. Recent advances include improved measurement of condom use behaviors, advances in condom effectiveness research, innovations in the design of condoms, and greater intervention efficiency for high-risk populations. After reviewing each of these four areas of research, this article will offer speculation about the future of condom use for HIV prevention.

Interviews with senegalese commercial sex trade workers and implications for social programming.

PubMed

Homaifar, Nazaneen; Wasik, Suzan Zuljani

2005-02-01

The purpose of the study was to assess the efficacy of the Senegalese pubic policy toward registered sex workers through an interview process examining their backgrounds and evaluating their knowledge of sexual health. Sixty registered sex workers in Dakar, Senegal, were interviews at the Institute d'Hygiene Social (IHS) to investigate patient knowledge of contraceptives and sexually transmitted infections (STIs). Ninety-eight percent of the women reported that, as a result of their visits to the clinic, they had increased precaution in their trade by demanding their clients use condoms and refusing clients who did not comply. Nearly 96% of the women were able to define the three main ways by which HIV is contracted, while 100% of the women reported that they used male condoms with their clients and would refuse clients who rejected the use of condoms. Senegal's proactive policy toward the safeguarding of women's health and the containment of HIV/AIDS through the legalization and monitoring of sex workers can serve as an example for successful strategies in the fight against the global spread of HIV/AIDS.

Do Safer Sex Self-Efficacy, Attitudes toward Condoms, and HIV Transmission Risk Beliefs Differ among Men who have Sex with Men, Heterosexual Men, and Women Living with HIV?

PubMed Central

Widman, Laura; Golin, Carol E.; Grodensky, Catherine A.; Suchindran, Chirayath

2013-01-01

To understand sexual decision-making processes among people living with HIV, we compared safer sex self-efficacy, condom attitudes, sexual beliefs, and rates of unprotected anal or vaginal intercourse with at-risk partners (UAVI-AR) in the past 3 months among 476 people living with HIV: 185 men who have sex with men (MSM), 130 heterosexual men, and 161 heterosexual women. Participants were enrolled in SafeTalk, a randomized, controlled trial of a safer sex intervention. We found 15% of MSM, 9% of heterosexual men, and 12% of heterosexual women engaged in UAVI-AR. Groups did not differ in self-efficacy or sexual attitudes/beliefs. However, the associations between these variables and UAVI-AR varied within groups: greater self-efficacy predicted less UAVI-AR for MSM and women, whereas more positive condom attitudes – but not self-efficacy – predicted less UAVI-AR for heterosexual men. These results suggest HIV prevention programs should tailor materials to different subgroups. PMID:22252475

Social development of commercial sex workers in India: an essential step in HIV/AIDS prevention.

PubMed

Chattopadhyay, Amit; McKaig, Rosemary G

2004-03-01

India has the highest number of HIV/AIDS cases in the world. Current HIV/AIDS prevention strategies are based on regular and appropriate condom use. However, most commercial sex workers (CSWs), who form the core/high-risk groups toward whom the prevention strategy is directed, are disempowered and socioeconomically marginalized. This does not allow them to insist on condom use by the client, especially in absence of governmental structural support. This paper discusses HIV/AIDS prevention issues that relate to CSWs in India; issues that play a vital role in initiation, perpetuation, and expansion of economic activity of CSWs; and those factors that influence the HIV/AIDS preventive practices of CSWs. This paper argues that CSWs can be empowered and emancipated; that HIV/AIDS control and prevention efforts in India must recognize that ad hoc promotion of condom use or similar such programs will not be effective to control HIV/AIDS; and that more extensive developmental work aimed at betterment of living conditions of CSWs is required for effective HIV/AIDS prevention.

Systematic review of HIV prevention interventions in China: a health communication perspective.

PubMed

Xiao, Zhiwen; Noar, Seth M; Zeng, Lily

2014-02-01

To examine whether communication strategies and principles have been utilized in the HIV prevention intervention programs conducted in China. Comprehensive literature searches were conducted using PsycINFO, Medline, and Academic Search Complete with combinations of a number of keywords. Studies were included if they (1) were conducted in China and published prior to October 2011; (2) tested interventions promoting HIV/sexual risk reduction; and (3) reported empirical outcome evaluations on HIV knowledge, condom use and other condom-related variables. Data on 11 dimensions were extracted and analyzed, including formative research, theory, message targeting, messenger and channels, process evaluation, evaluation design, outcome measures. The majority of the 45 intervention studies were not theory-based, did not report conducting formative research or process evaluation, used pretest-posttest control group designs, combined nonmedia channels, printed and visual materials, and employed HIV knowledge and condom use as outcome measures. Many HIV prevention interventions in China have been successful in reducing HIV risk-related outcomes. This literature has its weaknesses; however, the current review illuminates gaps in the literature and points to important future directions for research.

AIDS-related knowledge and risks and contraceptive practices in Ghana: the early 1990s.

PubMed

Takyi, B K

2000-04-01

HIV/AIDS in Africa is transmitted primarily through heterosexual contact. This mode of disease transmission places sexually active childbearing women at high risk of contracting the disease. In this study, data from the 1993/94 Ghana Demographic Health Survey were used to explore the relationship between AIDS-related knowledge and family planning practices, specifically the use of contraceptives and condoms. While the study finds high levels of AIDS-related knowledge among Ghanaian women, this knowledge is yet to translate into increased condom use. It is suggested that the use of rational choice models in AIDS prevention programs may not be adequate to change people's sexual behaviour, especially in societies where the prevailing cultural practices and norms encourage large families and discourage the use of contraceptives of any type. In such settings, there is the need to find appropriate mechanisms that could help increase the use of all types of contraceptives. As contraceptive use increases, it is likely that the use of condoms for AIDS prevention and also for family planning purpose would increase in sub-Saharan Africa.

The connection between young women's body esteem and sexual assertiveness.

PubMed

Auslander, Beth A; Baker, Jaqwiana; Short, Mary B

2012-04-01

Healthy sexuality includes having positive feelings about one's body and developing positive romantic relationships. Previous research predicts that women dissatisfied with their bodies may be less likely to enforce their rights of sexual autonomy (i.e., sexual assertiveness). We assessed whether the body esteem of young women was related to their reports of sexual assertiveness. Young women from local colleges (N = 127) completed a questionnaire that included demographics, self reported weight and height, sexual history, along with body esteem and sexual assertiveness. Overall, body esteem was related to sexual assertiveness regarding condom use when controlling for other variables. Women with less body esteem were less likely to insist that their partner use a condom. Individual components of body esteem did not independently predict insistence of condom use. Body esteem was not related to initiation of sex or refusal of unwanted sex. The current study found relationships between body esteem and sexual assertiveness regarding STI prevention behaviors. Given these findings, implications for STI prevention programs are discussed. Copyright © 2012 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

HIV/STI associated risk behaviors among self-identified lesbian, gay, bisexual, and transgender college students in the United States.

PubMed

Lindley, Lisa L; Nicholson, Thomas J; Kerby, Molly B; Lu, Ning

2003-10-01

An Internet survey was conducted during the 2001-2002 academic year to examine the health risk behaviors, including HIV/STI associated behaviors, of self-identified lesbian, gay, bisexual, and transgender (LGBT) college students in the United States. A total of 450 LGBT college students completed the entire online survey. Most respondents attended a 4-year (96.9%), coeducational (98.6%), non-religiously affiliated (87.5%), public (68.6%) institution. Eighty-nine percent reported having sex with someone of the same sex and 45% had multiple (6 or more) sex partners during their lifetime. Most reported using a condom consistently during penile-vaginal (61%) and anal sex (63%). However, only 4% used a condom or other barrier consistently during oral sex and 28% used a condom or other barrier during their last sexual encounter. Injection drug use and needle-sharing behavior was low (2.1% and 1.1%, respectively). Comparisons with heterosexual college students' HIV/STI associated risk behaviors are included. Results may be useful for HIV/STI prevention programs targeting LGBT college students.

Improved Contraceptive Use Among Teen Mothers in a Patient-Centered Medical Home.

PubMed

Lewin, Amy; Mitchell, Stephanie; Beers, Lee; Schmitz, Kristine; Boudreaux, Michel

2016-08-01

The Generations program, a patient-centered medical home, providing primary medical care, social work, and mental health services to teen mothers and their children, offers a promising approach to pregnancy prevention for teen mothers. This study tested whether the Generations intervention was associated with improved rates of contraceptive and condom use among participants 12 months after program entry. This study compared teen mothers enrolled in Generations to those receiving standard community-based pediatric primary care over 12 months. Participants included African-American mothers ages 19 and younger, with infants under 6 months, living in Washington DC. A total of 83% of the baseline sample (150 mother-child dyads) was retained at follow-up. Generations participants had over three times the odds of contraceptive use, with an odds ratio (OR) of 3.35, and twice the odds of condom use (OR = 2.29) after 12 months, compared to participants receiving standard pediatric care. The odds remained comparable and significant when adjusting for differences in baseline use. Once additional covariates were entered into the model, the association was reduced to OR = 2.59 because being in a relationship with the baby's father was significantly associated with reduced contraceptive use. The same pattern was evident for condom use. Mothers in Generations had steady use of contraceptives over time, but there was a decline in use among comparison mothers, indicating that Generations prevented contraceptive discontinuation. Findings from this study suggest that the Generations program is an effective intervention for improving contraceptive use among teen mothers, a group at especially high risk for pregnancy. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

A qualitative study of condom use among married couples in Kampala, Uganda.

PubMed

Williamson, Nancy E; Liku, Jennifer; McLoughlin, Kerry; Nyamongo, Isaac K; Nakayima, Flavia

2006-11-01

Twenty-five years into the HIV/AIDS epidemic, condom use among married/stable couples remains low and under-researched in developing countries, even countries with high HIV prevalence. Introducing condoms into a long-standing relationship, in spite of HIV risk, is likely to be awkward. We conducted a qualitative study in Kampala, Uganda, with 39 couples reporting 100% condom use in the previous three months. The women were recruited from among women in a clinical trial who were using condoms and whose partners also agreed to participate. Twenty-two of the women and six of the men reported having taken the initiative to suggest condom use; the remaining couples disagreed who raised the subject first. Women used insistence, refusal to have sex, persuasion, and condoms for family planning or to protect children, which helped to deflect distrust and get their partner to agree. Some men resisted initially but their reactions were often more positive than expected. Men's reasons for accepting condoms were to please their partner, protect her from HIV, protect their children, protect themselves and, in some cases, continue having other partners. Although condom use is a couple behaviour, an encouraging environment and condom availability are all crucial to increasing condom use by couples in settings like Uganda.

Debe cuidarse en la calle: Normative influences on condom use among the steady male partners of female sex workers in the Dominican Republic

PubMed Central

Barrington, Clare; Kerrigan, Deanna

2014-01-01

Encouragement to use condoms reflects the injunctive norm, or idea that you should use condoms. In our previous research with the regular male partners of female sex workers in the Dominican Republic, we found that encouragement to use condoms with female sex workers from individuals in their personal social networks was not directly associated with condom use. In the current study, we used qualitative interviews to further explore the influence of social network norms on men's sexual risk behaviours. We interviewed eleven steady male partners of female sex workers; participants completed two interviews to achieve greater depth. We analysed data using analytic summaries and systematic thematic coding. All men perceived that the prevailing injunctive norm was that they should use condoms with sex workers. Men received encouragement to use condoms but did not articulate a link between this encouragement and condom use. Additionally, men who did not use condoms lied to their friends to avoid social sanction. Findings highlight that the influence of a pro-condom injunctive norm is not always health promoting and can even be negative. HIV prevention efforts seeking to promote condom use should address the alignment between injunctive and descriptive norms to strengthen their collective influence on behaviour. PMID:24555440

Male acceptance of condoms in Japan.

PubMed

Uchida, Y

1981-01-01

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.

Condom promotion and use: family planning versus HIV protection.

PubMed

Mundigo, A I

1989-12-01

Condoms have been used since the 16th century as a prophylactic agent against sexually transmitted diseases. With regards to family planning, condoms are used for spacing and prevention of pregnancy. However, after the invention of more reliable contraceptives, condoms lost their popularity as a contraceptive agent, only to regain it in the wake of the AIDS epidemic. The main concern in using condoms has always been the high failure rate, which tends to be a complicated issue given that it's efficacy is affected by the motivation and characteristic of the user. Irrespective of the numerous advantages of the condom, at present there is little incentive to use them on a routine basis. Reasons for this objection include the fact that condoms not only interfere with sex, but are unnatural and leave the man very unsatisfied. Promoting condoms in developing countries is both a cultural and political issue, stemming from the misleading preconception of the man's role in family planning. For instance, condoms are infamous for their use in illicit sex, and as such cannot be used on a relatively respectable individual. The challenge in condom promotion is the creation of a new image based on family planning, reliability aspects of condoms, noninterference with pleasure concept and the added value of protection against STD's.

Reasons for non-use of condoms among men who have sex with men: a comparison of receptive and insertive role in sex and online and offline meeting venue.

PubMed

Ostergren, Jenny E; Rosser, B R Simon; Horvath, Keith J

2011-02-01

This study examined reasons for non-use of condoms among an online survey sample of 462 non-condom using men who have sex with men to: (1) identify major domains, themes and categories encompassing reasons for non-use of condoms and (2) examine whether reasons varied by role-in-sex (insertive or receptive) and meeting venue (online or offline). A thematic analysis was completed on participant responses to an open-ended question about reasons for non-condom use. Preference for not using condoms and contextual factors were the top two reasons given for not using condoms, followed by a reasoned judgment based on risk assessment, relationship status and interpersonal communication. No major differences were found between men who reported non-condom use at last receptive and insertive anal intercourse. By contrast when meeting online, men were more likely to report reasons for non-condom use that corresponded to individual preference and mutual agreement not to use condoms. When meeting offline, men were more likely to cite reasons related to context and relationships. In developing HIV-prevention interventions for this population, researchers should address both venues separately, as reasons why men engage in non-use of condoms appear to differ.

Reasons for Non-use of Condoms among Men-who-have-Sex-with-Men: A Comparison of Receptive and Insertive Role-in-Sex and Online and Offline Meeting Venue

PubMed Central

Ostergren, Jenny E.; Rosser, B.R. Simon; Horvath, Keith J.

2010-01-01

This study examined reasons for non-use of condoms among an online survey sample of 462 non-condom using MSM to 1) identify major domains, themes and categories encompassing reasons for non-use of condoms, and 2) examine whether reasons varied by role-in-sex (insertive or receptive) and meeting venue (online or offline). A thematic analysis was completed on participant responses to an open-ended question about reasons for non-condom use. Preference for not using condoms and contextual factors were the top two reasons given for not using condoms, followed by a reasoned judgment based on risk assessment, relationship status and interpersonal communication. No major differences were found between men who reported non-condom use at last receptive and insertive anal intercourse. By contrast when meeting online, men were more likely to report reasons for non-condom use that corresponded to individual preference and mutual agreement not to use condoms. When meeting offline, men were more likely to cite reasons related to context and relationships. In developing HIV prevention interventions for this population, researchers should address both venues separately, as reasons why men engage in non-use of condoms appear to differ. PMID:20967649

HIV/STI Prevention Among Heterosexually Active Black Adolescents With Mental Illnesses: Focus Group Findings for Intervention Development.

PubMed

Brawner, Bridgette M; Jemmott, Loretta Sweet; Wingood, Gina; Reason, Janaiya; Mack, Niya

Heterosexually active Black adolescents with mental illnesses are at increased risk for sexually transmitted infections (STIs), including HIV. However, few HIV/STI prevention interventions exist for this demographic. We held seven focus groups (N = 33) to elucidate social, cultural, and psychological factors that influence HIV/STI risk-related sexual behaviors in this understudied population. Seven themes emerged: (a) Blackness and media portrayals, (b) Blackness as a source of cultural resilience and pride, (c) psychosocial determinants of condom use, (d) consequences of engaging in sexual activity, (e) attitudes and beliefs toward sexual behaviors, (f) benefits of sexual activity, and (g) coping mechanisms. Participants also supported the feasibility of and interest in HIV/STI prevention programs integrated with mental health treatment. Transportation, potential breaches of confidentiality, and time were noted barriers to participation. Psychoeducational, skills-based programs are needed to address the sequelae of mental illnesses as they relate to the sexual decision-making process in adolescents. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Executive summary: Pre-exposure prophylaxis for prevention of HIV infection in adults in Spain: July 2016.

PubMed

Moreno, Santiago; Antela, Antonio; García, Felipe; Del Amo, Julia; Boix, Vicente; Coll, Pep; Fortuny, Claudia; Sirvent, Juan L Gómez; Gutiérrez, Félix; Iribarren, José A; Llibre, Josep M; Quirós, Juan C López Bernaldo de; Losa, Juan Emilio; Lozano, Ana; Meulbroek, Michael; Olalla, Julián; Pujol, Ferran; Pulido, Federico; Crespo Casal, Manuel; García, Juan González; Aldeguer, José López; Molina, Jose A Pérez; Podzamczer Palter, Daniel; Román, Antonio Rivero

Administration of antiretroviral drugs to individuals exposed to, but not infected by, HIV has been shown to reduce the risk of transmission. The efficacy of pre-exposure prophylaxis (PrEP) makes it obligatory to include it in an integral program of prevention of HIV transmission, together with other measures, such as use of the condom, training, counseling, and appropriate treatment of infected individuals. In this document, the AIDS Study Group (GeSIDA) of the Spanish Society of Infectious Diseases and Clinical Microbiology (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica [SEIMC]) provides its views on this important subject. The available evidence on the usefulness of PrEP in the prevention of transmission of HIV is presented, and the components that should make up a PrEP program and whose development and implementation are feasible in Spain are set out. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Preventing Unintended Pregnancy and HIV Transmission: Effects of the HIV Treatment Cascade on Contraceptive Use and Choice in Rural KwaZulu-Natal

PubMed Central

Raifman, Julia; Chetty, Terusha; Tanser, Frank; Mutevedzi, Tinofa; Matthews, Philippa; Herbst, Kobus; Pillay, Deenan

2014-01-01

Background: For women living with HIV, contraception using condoms is recommended because it prevents not only unintended pregnancy but also acquisition of other sexually transmitted infections and onward transmission of HIV. Dual-method dual-protection contraception (condoms with other contraceptive methods) is preferable over single-method dual-protection contraception (condoms alone) because of its higher contraceptive effectiveness. We estimate the effect of progression through the HIV treatment cascade on contraceptive use and choice among HIV-infected women in rural South Africa. Methods: We linked population-based surveillance data on contraception collected by the Wellcome Trust Africa Centre for Health and Population Studies to data from the local antiretroviral treatment (ART) program in Hlabisa subdistrict, KwaZulu-Natal. In bivariate probit regression, we estimated the effects of progressing through the cascade on contraceptive choice among HIV-infected sexually active women aged 15–49 years (N = 3169), controlling for a wide range of potential confounders. Findings: Contraception use increased across the cascade from <40% among HIV-infected women who did not know their status to >70% among women who have been on ART for 4–7 years. Holding other factors equal (1) awareness of HIV status, (2) ART initiation, and (3) being on ART for 4–7 years increased the likelihood of single-method/dual-method dual protection by the following percentage points (pp), compared with women who were unaware of their HIV status: (1) 4.6 pp (P = 0.030)/3.5 pp (P = 0.001), (2) 10.3 pp (P = 0.003)/5.2 pp (P = 0.007), and (3) 21.6 pp (P < 0.001)/11.2 pp (P < 0.001). Conclusions: Progression through the HIV treatment cascade significantly increased the likelihood of contraception in general and contraception with condoms in particular. ART programs are likely to contribute to HIV prevention through the behavioral pathway of changing contraception use and choice. PMID:25436821

Preventing unintended pregnancy and HIV transmission: effects of the HIV treatment cascade on contraceptive use and choice in rural KwaZulu-Natal.

PubMed

Raifman, Julia; Chetty, Terusha; Tanser, Frank; Mutevedzi, Tinofa; Matthews, Philippa; Herbst, Kobus; Pillay, Deenan; Bärnighausen, Till

2014-12-01

For women living with HIV, contraception using condoms is recommended because it prevents not only unintended pregnancy but also acquisition of other sexually transmitted infections and onward transmission of HIV. Dual-method dual-protection contraception (condoms with other contraceptive methods) is preferable over single-method dual-protection contraception (condoms alone) because of its higher contraceptive effectiveness. We estimate the effect of progression through the HIV treatment cascade on contraceptive use and choice among HIV-infected women in rural South Africa. We linked population-based surveillance data on contraception collected by the Wellcome Trust Africa Centre for Health and Population Studies to data from the local antiretroviral treatment (ART) program in Hlabisa subdistrict, KwaZulu-Natal. In bivariate probit regression, we estimated the effects of progressing through the cascade on contraceptive choice among HIV-infected sexually active women aged 15-49 years (N = 3169), controlling for a wide range of potential confounders. Contraception use increased across the cascade from <40% among HIV-infected women who did not know their status to >70% among women who have been on ART for 4-7 years. Holding other factors equal (1) awareness of HIV status, (2) ART initiation, and (3) being on ART for 4-7 years increased the likelihood of single-method/dual-method dual protection by the following percentage points (pp), compared with women who were unaware of their HIV status: (1) 4.6 pp (P = 0.030)/3.5 pp (P = 0.001), (2) 10.3 pp (P = 0.003)/5.2 pp (P = 0.007), and (3) 21.6 pp (P < 0.001)/11.2 pp (P < 0.001). Progression through the HIV treatment cascade significantly increased the likelihood of contraception in general and contraception with condoms in particular. ART programs are likely to contribute to HIV prevention through the behavioral pathway of changing contraception use and choice.

Condom vending machines in Canada's secondary schools.

PubMed

Kerr, D L

1990-03-01

A case study of 1 of the 3 school boards approving in 1989 installation of condom machines is presented: The Lisgar Collegiate Institute, Ottawa, Canada. The school is characterized as having 1000 college preparatory students from middle and upper middle class homes and university educated parents. The project was student initiated and involved 1) meeting with communication consultants to determine feasibility, 2) conducting an informal peer consultation to seek out interest and support, 3) meeting with public health officials to gain support and ideas, and 4) conducting research. Condom machine installation (2) was only 1 component; a pilot sexuality education program was included as well. The student proposal was presented and rejected by the principal and the Superintendent of Student Services. Students then lobbied the school board trustees. 2 students lobbies each school board member. Letters of support were obtained from parents' advisory groups, parents, the student council, and other influential people. The media provided coverage in a popular morning television show. The student proposal was submitted to the Board of Education's Education Committee in June 1989; students were assisted by teachers and the Parents Advisory Committee. The school board approved. In the fall of 1989, sexuality awareness week was designated as October 30-November 3. Parents were asked for comments on the designated program, but only 50 contributed in a supportive way. During this week lunch-hour displays and videos, peer-facilitated discussion groups, informal talks by experts, and student theater presentations were sponsored activities. Following this event, the school board arranged for the installment of machines in the men's and women's washrooms near where social events were held and in toilet cubicles in order to provide privacy, as requested by students. The individual cost is US$1/condom. Evaluation is planned. Students have been amused by the amount of public response to this action. Other participating schools include Qualicum School District in Vancouver Island, British Columbia, and Toronto's 36 secondary schools.

Unlocking the condoms: The effect on sales and theft.

PubMed

Ashwood, Daniel; Farris, Karen B; Campo, Shelly; Aquilino, Mary L; Losch, Mary

2011-01-01

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.

Beyond traditional gender roles and identity: does reconceptualisation better predict condom-related outcomes for African-American women?

PubMed

Nguyen, Anh B; Clark, Trenette T; Hood, Kristina B; Corneille, Maya A; Fitzgerald, Angela Y; Belgrave, Faye Z

2010-08-01

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.

Presenting the female condom to men: a dyadic analysis of effect of the woman's approach.

PubMed

Penman-Aguilar, Ana; Hall, Jeffrey; Artz, Lynn; Crawford, Myra A; Peacock, Nadine; van Olphen, Juliana; Parker, Lutissa; Macaluso, Maurizio

2002-01-01

Although male partner resistance to female condom use has been reported, little is understood about circumstances under which partners will agree to female condom use. This study documents the experiences of couples who have worked together to achieve female condom use. As part of a prospective female condom efficacy study, female participants (age 18-34) received a behavioral intervention and an assortment of take-home items. Selected women and their partners were recruited for a qualitative interview focusing on their experience with the female condom. Interviews were transcribed, double-coded, and verified using a standard retrieval coding system. Twenty-six pairs of linked interviews were analyzed dyadically: 9 couples who used the female condom "consistently," 12 "experimenters," and 5 "non-users." Women who successfully promoted the female condom to their partners used multiple presentation strategies. Initial male partner reaction did not predict continued use beyond the first trial. In conclusion, employment of multiple strategies facilitates successful introduction of the female condom into a sexual partnership.

Correlates of condom breakage and slippage among university undergraduates.

PubMed

Yarber, William L; Graham, Cynthia A; Sanders, Stephanie A; Crosby, Richard A

2004-07-01

An anonymous questionnaire was used to explore relationships between condom breakage, slippage and possible correlates in a sample of 428 single, never married college men and women. Specific condom use errors and problems that could lead to breakage and slippage were also examined. A three-month recall period was used. Breakage/slippage was found to be associated with never receiving instruction on correct condom use (P = 0.001), more than one sex partner (P = 0.001), more frequent use of condoms (P = 0.001), and partner(s) being less than highly motivated to use condoms (P = 0.02). Those reporting that condoms had contacted a sharp object were three times as likely to report breakage (P = 0.001). Those using condoms without proper lubrication (P = 0.006) and those experiencing loss of erection during sex (P = 0.001) were more likely to report slippage. Further research should investigate the efficacy of instruction addressing specific factors that may reduce the incidence of breakage/slippage, thereby enhancing condom effectiveness.

Behavioral and Psychosocial Interventions for HIV Prevention in Floating Populations in China over the Past Decade: A Systematic Literature Review and Meta-Analysis

PubMed Central

Liu, Xiaona; Erasmus, Vicki; Wu, Qing; Richardus, Jan Hendrik

2014-01-01

Background Floating populations have been repeatedly characterized as “the tipping point” for the HIV epidemic in China. This study aims to systematically summarize and assess the effectiveness of HIV prevention interventions in floating populations in China over the past decade. Methods We conducted a systematic search in three international databases for literature published between 2005 and 2012 with condom use as the primary outcome, and knowledge about HIV transmission and prevention and stigma towards HIV-infected individuals as secondary outcomes. The impact of interventions on changing the primary and secondary outcomes was calculated by risk difference (RD). We also performed subgroup analyses and meta-regression based on different study characteristics, using Stata 12.0, for the primary outcome. Results Sixteen studies (out of 149) involved 19 different programs and a total of 10,864 participants at entry from 11 provinces in China. The pooled effect estimate of all studies indicated that people participating in HIV-related interventions were 13% more likely to use condoms (95%CI: 0.07, 0.18), however, the effects on increasing condom use exhibited significant heterogeneity across programs (P<0.01, I 2 = 0.93). The meta-regression results suggest that interventions have been significantly less successful in changing condom use in more recent studies (β, 0.14; 95%CI: 0.01, 0.27), adjusted for sexual relationship, study design and follow-up period. Regarding the secondary outcomes, HIV-related interventions were successful at improving knowledge about HIV transmission and prevention (RD, −0.26; 95%CI: −0.36, −0.16 and RD, −0.25; 95%CI: −0.33, −0.16, respectively), and decreasing stigma (RD, 0.18; 95%CI: 0.09, 0.27). Conclusions The included studies between 2005 and 2012 indicate that HIV prevention interventions among Chinese floating populations in the past decade were only marginally effective at increasing condom use, but relatively successful at increasing HIV knowledge and decreasing stigma. To avert new infections, novel sexual risk-reduction interventions taking into account the changing socio-economic and cultural situation of Chinese floating populations are urgently needed. PMID:24963669

Changes in risk behaviours and prevalence of sexually transmitted infections following HIV preventive interventions among female sex workers in five districts in Karnataka state, south India.

PubMed

Ramesh, B M; Beattie, Tara S H; Shajy, Isac; Washington, Reynold; Jagannathan, Latta; Reza-Paul, Sushena; Blanchard, James F; Moses, Stephen

2010-02-01

To examine the impact of a large-scale HIV prevention programme for female sex workers (FSW) in Karnataka state, south India, on the prevalence of HIV/sexually transmitted infections (STI), condom use and programme coverage. Baseline and follow-up integrated biological and behavioural surveys were conducted on random samples of FSW in five districts in Karnataka between 2004 and 2009. 4712 FSW participated in the study (baseline 2312; follow-up 2400), with follow-up surveys conducted 28-37 months after baseline. By follow-up, over 85% of FSW reported contact by a peer educator and having visited a project STI clinic. Compared with baseline, there were reductions in the prevalence of HIV (19.6% vs 16.4%, adjusted odds ratio (AOR) 0.81, 95% CI 0.67 to 0.99, p=0.04); high-titre syphilis (5.9% vs 3.4%, AOR 0.53, 95% CI 0.37 to 0.77, p=0.001); and chlamydia and/or gonorrhoea (8.9% vs 7.0%, AOR 0.72, 95% CI 0.54 to 0.94, p=0.02). Reported condom use at last sex increased significantly for repeat clients (66.1% vs 84.1%, AOR 1.98, 95% CI 1.58 to 2.48, p<0.001) and marginally for occasional clients (82.9% vs 88.0%, AOR 1.22, 95% CI 0.89 to 1.66, p=0.2), but remained stable for regular partners (32%). Compared with street and home-based FSW, brothel-based FSW were at highest risk of HIV and STI, despite high levels of reported condom use. This large-scale HIV prevention programme for FSW achieved reductions in HIV and STI prevalence, high rates of condom use with clients and high rates of programme coverage. Improved strategies to increase condom use with regular partners and reduce the vulnerability of brothel-based FSW to HIV are required.

[Sensitisation about condom use in Gabon (1999): evaluation of the impact of a comic book].

PubMed

Milleliri, Jean-Marie; Krentel, Alison; Rey, Jean-Loup

2003-01-01

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.

Condoms -- if you care.

PubMed

Paalman, M

1992-01-01

All barrier methods except the IUD offer some protection against both unwanted pregnancy and disease. Male and female condoms, however, are the most reliable barrier methods. While they occasionally leak, tear, or slip off and may not protect against syphilis, herpes, and genital warts if lesions are located on a body site not covered by the condom, condoms do reduce the risk of HIV transmission. Condom use to prevent HIV infection and other sexually transmitted diseases should not be promoted in isolation, but should be part of a national prevention and control strategy incorporating other elements such as information, blood safety, clean injection equipment, surveillance, counseling, and care and treatment. A well- developed condom promotion plan will be sensitive to policy, psychosocial, behavioral, and programmatic issues. Condom promoters and users should not ignore the reality that condoms interfere with love-making and contrast directly with the desired and expected carefree notion of the process. While acknowledging the negative aspects of condom use, the positive side of condoms can nonetheless be stressed. Just as car safety belts reduce the risk of adverse consequence in case of a crash, condoms should be worn as protection during sexual intercourse; once on, sex may be had with far less worry of pregnancy and disease. Finally, steps need to be taken to create social conditions in which people are comfortable discussing sexuality and past experiences with peers and prospective sex partners. Marketing professionals also need to be called upon to help make condom use a desirable social norm.

Egocentric Network and Condom Use Among Mid-Age Female Sex Workers in China: A Multilevel Modeling Analysis.

PubMed

Liu, Hongjie

2016-04-01

The epidemics of sexually transmitted infections (STIs) have spread among older adults in the world, including China. This study addresses the deficiency of studies about the multiple contextual influences on condom use among mid-age female sex workers (FSWs) over 35 years old. A combination of an egocentric network design and multilevel modeling was used to investigate factors of condom use over mid-age FSWs (egos) particular relationships with sexual partners (alters). Of the 1245 mid-age FSWs interviewed, 73% (907) reported having at least one sexual partner who would provide social support to egos. This generated a total of 1300 ego-alter sex ties in egos' support networks. Condoms were consistently used among one-third of sex ties. At the ego level, condoms were more likely to be used consistently if egos received a middle school education or above, had stronger perceived behavioral control for condom use, or consistently used condoms with other sex clients who were not in their support networks. At the alter level, condoms were not consistently used over spousal ties compared to other ties. Condoms were less likely to be used among alters whom ego trusted and provided emotional support. Cross-level factors (egos' attitudes toward condom use and emotional support from alters) documented a significant positive interaction on consistent condom use. Given the low frequency of condom use, future interventions should focus on mid-age FSWs and their partners within and beyond their support networks.

Egocentric Network and Condom Use Among Mid-Age Female Sex Workers in China: A Multilevel Modeling Analysis

PubMed Central

2016-01-01

Abstract The epidemics of sexually transmitted infections (STIs) have spread among older adults in the world, including China. This study addresses the deficiency of studies about the multiple contextual influences on condom use among mid-age female sex workers (FSWs) over 35 years old. A combination of an egocentric network design and multilevel modeling was used to investigate factors of condom use over mid-age FSWs (egos) particular relationships with sexual partners (alters). Of the 1245 mid-age FSWs interviewed, 73% (907) reported having at least one sexual partner who would provide social support to egos. This generated a total of 1300 ego–alter sex ties in egos' support networks. Condoms were consistently used among one-third of sex ties. At the ego level, condoms were more likely to be used consistently if egos received a middle school education or above, had stronger perceived behavioral control for condom use, or consistently used condoms with other sex clients who were not in their support networks. At the alter level, condoms were not consistently used over spousal ties compared to other ties. Condoms were less likely to be used among alters whom ego trusted and provided emotional support. Cross-level factors (egos' attitudes toward condom use and emotional support from alters) documented a significant positive interaction on consistent condom use. Given the low frequency of condom use, future interventions should focus on mid-age FSWs and their partners within and beyond their support networks. PMID:27028182

Should condoms be free?

PubMed

1995-01-01

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.

Knowledge and practice of condom use as well as perceived barriers among street adolescents in Cameroon

PubMed Central

Cumber, Samuel Nambile

2016-01-01

Introduction Street children in Cameroon are adolescents, vulnerable to sexually transmitted infections (STIs) and HIV and/or AIDS. The level of knowledge and practice of condom use among this population is unknown. Objective of the study To assess the knowledge, practice and barriers to condom use in Cameroon. Materials and methods The study was an analytical cross-sectional survey conducted in 2015. Questionnaires were administered to street children in a quiet location. Recruitment was made using the snowball technique with the help of peers. Results More than 90% of participants knew of condoms, but only about 6% reported to have used a condom during their last sexual encounter. Most of the participants did not know that condoms could prevent HIV; only a few (15.5%) knew about this. Conclusion Street adolescents in Cameroon seem to know about condoms, but have insufficient information on the importance of their regular use. The main barriers for the low practice of condom use reported by this population were the following: condoms hinder sexual pleasure; are costly; and it is embarrassing to buy, use or propose to use a condom. PMID:29568619

Minority College Women's Views on Condom Negotiation.

PubMed

McLaurin-Jones, TyWanda; Lashley, Maudry-Beverly; Marshall, Vanessa

2015-12-22

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 < 0.001) as well as endorsed items more strongly on the "direct request" subscale of the CIS (4.63 vs. 3.82, p < 0.05) than never users. A thematic analysis of open discussions identified overarching themes. Similarly, refusing sex and/or having direct communications with partner emerged as primary strategies. Threats to 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.

Non-use of condoms by prostitute women.

PubMed

Cusick, L

1998-04-01

Ethnographic research among Glasgow female prostitutes working in street, sauna, flat, escort agency and "sugar daddy" sectors investigated prostitutes' accounts of the occasions in which condoms were not used for penetrative sexual encounters. Such occasions were a minority of commercial sex encounters and a majority of private sex encounters. Although prostitutes saw condom use as inappropriate in private sexual relationships this was not, as has been suggested, an aid to relationship interpretation as either private or commercial. Condoms in commercial sex were seen as routine tools of the trade, and hence emerged as emblems of prostitution. These emblematic qualities were found in turn to produce both challenges to condom use from customers and opportunities for prostitutes to manipulate customer relations by judicious suspension of condom application. Both norms of gendered role-play and prostitute status were highlighted as threatening condom use in some situations, while prostitute status could also be used as the basis of rational argument for condom use in others. Relational issues such as familiarity or a desire to communicate trust were at the forefront in explanations of condom non-use. Perceptions of physical power and the authority to permit or withhold sexual service or profit were determining influences crucial in condom use negotiation.

Predictors of consistent condom use among Portuguese women attending family planning clinics.

PubMed

Costa, Eleonora C V; Oliveira, Rosa; Ferreira, Domingos; Pereira, M Graça

2016-01-01

Women account for 30% of all AIDS cases reported to the Health Ministry in Portugal and most infections are acquired through unprotected heterosexual sex with infected partners. This study analyzed socio-demographic and psychosocial predictors of consistent condom use and the role of education as a moderator variable among Portuguese women attending family planning clinics. A cross-sectional study using interviewer-administered fully structured questionnaires was conducted among 767 sexually active women (ages 18-65). Logistic regression analyses were used to explore the association between consistent condom use and the predictor variables. Overall, 78.7% of the women were inconsistent condom users. The results showed that consistent condom use was predicted by marital status (being not married), having greater perceptions of condom negotiation self-efficacy, having preparatory safer sexual behaviors, and not using condoms only when practicing abstinence. Living with a partner and having lack of risk perception significantly predicted inconsistent condom use. Less educated women were less likely to use condoms even when they perceive being at risk. The full model explained 53% of the variance in consistent condom use. This study emphasizes the need for implementing effective prevention interventions in this population showing the importance of taking education into consideration.

Adolescent Sexual Health Education: Parents Benefit Too!

PubMed

Dinaj-Koci, Veronica; Deveaux, Lynette; Wang, Bo; Lunn, Sonya; Marshall, Sharon; Li, Xiaoming; Stanton, Bonita

2015-10-01

The inclusion of parents in adolescent-targeted interventions is intended to benefit the adolescent. Limited research has explored whether parents participating in these programs also benefit directly. We examined the impact of Caribbean Informed Parents and Children Together, the parenting portion of an adolescent-targeted HIV prevention intervention, on parent-reported measures. Bahamian parent-youth dyads (N = 1,833) participating in the randomized control trial were assigned to receive one of four conditions. Parents were assessed longitudinally at baseline and 6 and 12 months later. Through 12 months follow-up, parents exposed to Caribbean Informed Parents and Children Together showed higher knowledge of condom use skills, perceptions of improved condom use competence on the part of their youth, and perceived improved parent-child communication about sex-related information. Although youth were the targeted beneficiary, parents also benefited directly from the sexual risk reduction parenting program. Parents demonstrated improved perceptions and knowledge that would enable them to more effectively guide their child and also protect themselves from sexual risk. © 2015 Society for Public Health Education.

The effects of gender, ethnicity, and a close relationship theme on perceptions of persons introducing a condom.

PubMed

Castaneda, D M; Collins, B E

1998-09-01

Perceptions of persons who introduce condoms in an ongoing sexual interaction, and the effects of gender and ethnicity on these perceptions, were explored in a study involving 243 students at a large, urban university in the western US. 133 of these students identified themselves as Mexican American; the remaining students indicated they were White. A vignette methodology was used to elicit perceptions of condom introducers on six scales (Nice, Exciting, Sexually Attractive, Promiscuous, Good Relationship Partner, Unpersonable/Personable). Data were analyzed in a 2 (gender of participant) x 2 (gender of condom introducer) x 3 (low acculturated Mexican American, high acculturated Mexican American, White) x 2 (presence/absence of close relationship theme) analysis of variance and covariance. In terms of the Nice Scale, women rated condom introducers significantly higher than men, female condom introducers were rated significantly higher than male introducers, and condom introducers who expressed a care and responsibility theme while introducing a condom were rated significantly higher than those who expressed no theme. On the Exciting Scale, women condom introducers were rated significantly higher than men. Condom introducers who expressed a care and responsibility theme were rated significantly higher than those who expressed no theme on the Good Relationship Partner scale. Men rated the female condom introducer significantly higher than women on the Promiscuous scale. Low acculturated Mexicans rated the female condom introducer significantly higher than the male introducer on the Promiscuous scale and rated the condom introducer significantly higher than Whites on the Sexually Attractive scale. These findings attest that many often contradictory interpersonal gender- and ethnicity-related perceptions operate in sexual encounters.

Consistency of Condom Use During Receptive Anal Intercourse Among Women and Men Who Have Sex With Men: Findings From the Safe in the City Behavioral Study.

PubMed

DʼAnna, Laura Hoyt; Warner, Lee; Margolis, Andrew D; Korosteleva, Olga A; OʼDonnell, Lydia; Rietmeijer, Cornelis A; Klausner, Jeffrey D; Malotte, C Kevin

2015-07-01

Unprotected receptive anal intercourse poses HIV risk for men who have sex with men (MSM) and heterosexual women. Little is known about differences in consistent condom use during anal intercourse among these populations. Data were analyzed from a nested study conducted from 2004 to 2005 within a behavioral intervention trial of approximately 40,000 urban US sexually transmitted disease clinic patients. Analyses were restricted to women and MSM who reported receptive anal intercourse with at least 1 partner in the prior 3 months at baseline, or 3-month follow-up surveys. Condom use was categorized as consistent (100% of receptive acts) or inconsistent/nonuse (0-99% of receptive acts). Multivariable regression with general estimating equations was used to identify factors associated with consistent condom use within each population. Approximately 31% of women and 70% of MSM reported receptive anal intercourse at least once in the past 3 months. Men who have sex with men were significantly more likely to report consistent condom use compared with women. For women, intention to use condoms, partner support for condom use, the belief they could stop having sex when condoms were unavailable, and believing their partner had not given them a sexually transmitted infection (STI) were associated with using condoms consistently. For MSM, intention to use condoms, condom use self-efficacy, perceived partner support for condom use, having a nonmain partner, believing their partner had not given them an STI, and fewer sex acts were associated with consistent condom use. Findings confirm the importance of considering anal intercourse when assessing STI/HIV risk in MSM and heterosexual women.

Do condoms cause rape and mayhem? The long-term effects of condoms in New South Wales' prisons.

PubMed

Yap, Lorraine; Butler, Tony; Richters, Juliet; Kirkwood, Kristie; Grant, Luke; Saxby, Max; Ropp, Frederick; Donovan, Basil

2007-06-01

Concerns raised by opponents to condom provision in prisons have not been objectively examined and the issue continues to be debated. The long-term effects of the introduction of condoms and dental dams into New South Wales (NSW) prisons in 1996 was examined, focusing on particular concerns raised by politicians, prison officers, prison nurses and prisoners. These groups were worried that (a) condoms would encourage prisoners to have sex, (b) condoms would lead to an increase in sexual assaults in prisons, (c) prisoners would use condoms to hide and store drugs and other contraband and (d) prisoners would use condoms as weapons. Data sources included the NSW Inmate Health Survey (IHS) from 1996 and 2001 and official reports from the NSW Department of Corrective Services. The 1996 IHS involved 657 men and 132 women randomly selected from all prisons, with a 90% response rate. The 2001 survey involved 747 men and 167 women inmates, with an 85% response rate. There was a decrease in reports of both consensual male-to-male sex and male sexual assaults 5 years after the introduction of condoms into prisons in 1996. The contents of condom kits were often used for concealing contraband items and for other purposes, but this was not associated with an increase in drug injecting in prison. Only three incidents of a condom being used in assaults on prison officers were recorded between 1996 and 2005; none was serious. There exists no evidence of serious adverse consequences of distributing condoms and dental dams to prisoners in NSW. Condoms are an important public health measure in the fight against HIV and sexually transmitted diseases; they should be made freely available to prisoners as they are to other high-risk groups in the community.

Effects of condom social marketing on condom use in developing countries: a systematic review and meta-analysis, 1990-2010.

PubMed

Sweat, Michael D; Denison, Julie; Kennedy, Caitlin; Tedrow, Virginia; O'Reilly, Kevin

2012-08-01

To examine the relationship between condom social marketing programmes and condom use. Standard systematic review and meta-analysis methods were followed. The review included studies of interventions in which condoms were sold, in which a local brand name(s) was developed for condoms, and in which condoms were marketed through a promotional campaign to increase sales. A definition of intervention was developed and standard inclusion criteria were followed in selecting studies. Data were extracted from each eligible study, and a meta-analysis of the results was carried out. Six studies with a combined sample size of 23,048 met the inclusion criteria. One was conducted in India and five in sub-Saharan Africa. All studies were cross-sectional or serial cross-sectional. Three studies had a comparison group, although all lacked equivalence in sociodemographic characteristics across study arms. All studies randomly selected participants for assessments, although none randomly assigned participants to intervention arms. The random-effects pooled odds ratio for condom use was 2.01 (95% confidence interval, CI: 1.42-2.84) for the most recent sexual encounter and 2.10 (95% CI: 1.51-2.91) for a composite of all condom use outcomes. Tests for heterogeneity yielded significant results for both meta-analyses. The evidence base for the effect of condom social marketing on condom use is small because few rigorous studies have been conducted. Meta-analyses showed a positive and statistically significant effect on increasing condom use, and all individual studies showed positive trends. The cumulative effect of condom social marketing over multiple years could be substantial. We strongly encourage more evaluations of these programmes with study designs of high rigour.

To use or not to use: a stage-based approach to understanding condom use among homeless youth.

PubMed

Tucker, Joan S; Ober, Allison; Ryan, Gery; Golinelli, Daniela; Ewing, Brett; Wenzel, Suzanne L

2014-01-01

This study used a stage-based approach to understand condom use behavior in a representative sample of 309 sexually active homeless youth recruited from shelters, drop-in centers, and street sites in Los Angeles County. Focusing on the youth's most recent sexual event, the three stages of condom use examined were: (1) whether the partners decided prior to the event about using condoms; (2) whether a condom was available at the event; and (3) whether a condom was used at the event. Logistic regression analysis was used to identify attitudinal, relationship, and contextual correlates of each of these three stages. Deciding ahead of time about condom use was associated with being Hispanic, level of education, condom attitudes, and various relationship characteristics (e.g., partner type, monogamy, relationship abuse), with the nature of these associations varying depending on the type of decision (i.e., deciding to use, deciding to not use). Condom availability was more likely to be reported by males, if the event was described as being special in some way, or if the event lacked privacy. Condom use was more likely among youth with more positive condom attitudes and among youth who decide ahead of time to use a condom, but less likely among those in monogamous relationships or when hard drugs were used prior to sex. Whether sexual intercourse is protected or unprotected is the end result of a series of decisions and actions by sexual partners. Results from this study illustrate how condom use can be better understood by unpacking the stages and identifying influential factors at each stage. Each stage may, in and of itself, be an important target for intervention with homeless youth.

Effects of condom social marketing on condom use in developing countries: a systematic review and meta-analysis, 1990–2010

PubMed Central

Denison, Julie; Kennedy, Caitlin; Tedrow, Virginia; O'Reilly, Kevin

2012-01-01

Abstract Objective To examine the relationship between condom social marketing programmes and condom use. Methods Standard systematic review and meta-analysis methods were followed. The review included studies of interventions in which condoms were sold, in which a local brand name(s) was developed for condoms, and in which condoms were marketed through a promotional campaign to increase sales. A definition of intervention was developed and standard inclusion criteria were followed in selecting studies. Data were extracted from each eligible study, and a meta-analysis of the results was carried out. Findings Six studies with a combined sample size of 23 048 met the inclusion criteria. One was conducted in India and five in sub-Saharan Africa. All studies were cross-sectional or serial cross-sectional. Three studies had a comparison group, although all lacked equivalence in sociodemographic characteristics across study arms. All studies randomly selected participants for assessments, although none randomly assigned participants to intervention arms. The random-effects pooled odds ratio for condom use was 2.01 (95% confidence interval, CI: 1.42–2.84) for the most recent sexual encounter and 2.10 (95% CI: 1.51–2.91) for a composite of all condom use outcomes. Tests for heterogeneity yielded significant results for both meta-analyses. Conclusion The evidence base for the effect of condom social marketing on condom use is small because few rigorous studies have been conducted. Meta-analyses showed a positive and statistically significant effect on increasing condom use, and all individual studies showed positive trends. The cumulative effect of condom social marketing over multiple years could be substantial. We strongly encourage more evaluations of these programmes with study designs of high rigour. PMID:22893745

Effects of communication with important social referents on beliefs and intentions to use condoms.

PubMed

Strader, M K; Beaman, M L; McSweeney, M

1992-06-01

Data from a 1989 survey using the condom attitude and belief instrument with 310 clients from two sexually transmitted disease clinics identified significant social referents who influence condom-use intentions. They are sexual partner, father and friends. The present study found that communication with these referents had a positive net effect on beliefs about and intentions to use condoms. Implications applicable for intervention programmes to increase condom use are to promote talking about condoms between the sexual partners and important social referents and to develop such communication skills.