Prevalence of unsafe sex with one's steady partner either HIV-negative or of unknown HIV status and associated determinants in Cameroon (EVAL ANRS12-116 survey).

PubMed

Dia, Aïssata; Marcellin, Fabienne; Bonono, Renée-Cécile; Boyer, Sylvie; Bouhnik, Anne-Déborah; Protopopescu, Camelia; Koulla-Shiro, Sinata; Carrieri, Maria Patrizia; Abé, Claude; Spire, Bruno

2010-04-01

Our study aimed at estimating the prevalence of inconsistent condom use and at identifying its determinants in steady partnerships among people living with HIV/AIDS (PLWHA) in Cameroon. Analyses were based on data collected during the national cross-sectional multicentre survey EVAL (ANRS 12-116), which was conducted in Cameroon between September 2006 and March 2007 among 3151 adult PLWHA diagnosed HIV-positive for at least 3 months. The study population consisted of the 907 survey participants who reported sexual activity during the previous 3 months, with a steady partner either HIV-negative or of unknown HIV status. Logistic regression was used to identify factors associated with individuals' report of inconsistent condom use during the previous 3 months. Inconsistent condom use was reported by 35.3% of sexually active PLWHA. In a multivariate analysis adjusted for socio-demographic characteristics, not receiving antiretroviral therapy (OR (95% CI): 2.28 (1.64 to 3.18)) was independently associated with inconsistent condom use. The prevalence of unsafe sex remains high among sexually active PLWHA in Cameroon. Treatment with antiretroviral therapy is identified as a factor associated with safer sex, which further encourages the continuation of the national policy for increasing access to HIV treatment and care, and underlines the need to develop counselling strategies for all patients.

Men's Alcohol Intoxication and Condom Use during Sexual Assault Perpetration

ERIC Educational Resources Information Center

Davis, Kelly Cue; Kiekel, Preston A.; Schraufnagel, Trevor J.; Norris, Jeanette; George, William H.; Kajumulo, Kelly F.

2012-01-01

We assessed the association between alcohol consumption and condom use during penetrative sexual assault acts perpetrated by young adult men. Men aged 21 to 35 who reported inconsistent condom use and heavy episodic drinking (N = 225) completed a questionnaire assessing their perpetration of sexual assault since the age of 15, their consumption of…

Sexual risk taking among patients on antiretroviral therapy in an urban informal settlement in Kenya: a cross-sectional survey.

PubMed

Ragnarsson, Anders; Ekström, Anna Mia; Carter, Jane; Ilako, Festus; Lukhwaro, Abigail; Marrone, Gaetano; Thorson, Anna

2011-04-18

Our intention was to analyze demographic and contextual factors associated with sexual risk taking among HIV-infected patients on antiretroviral treatment (ART) in Africa's largest informal urban settlement, Kibera in Nairobi, Kenya. We used a cross-sectional survey in a resource-poor, urban informal settlement in Nairobi; 515 consecutive adult patients on ART attending the African Medical and Research Foundation clinic in Kibera in Nairobi were included in the study. Interviewers used structured questionnaires covering socio-demographic characteristics, time on ART, number of sexual partners during the previous six months and consistency of condom use. Twenty-eight percent of patients reported inconsistent condom use. Female patients were significantly more likely than men to report inconsistent condom use (aOR 3.03; 95% CI 1.60-5.72). Shorter time on ART was significantly associated with inconsistent condom use. Multiple sexual partners were more common among married men than among married women (adjusted OR 4.38; 95% CI 1.82-10.51). Inconsistent condom use was especially common among women and patients who had recently started ART, i.e., when the risk of HIV transmission is higher. Having multiple partners was quite common, especially among married men, with the potential of creating sexual networks and an increased risk of HIV transmission. ART needs to be accompanied by other preventive interventions to reduce the risk of new HIV infections among sero-discordant couples and to increase overall community effectiveness.

Dimensions of poverty and inconsistent condom use among youth in urban Kenya.

PubMed

Davidoff-Gore, Alena; Luke, Nancy; Wawire, Salome

2011-10-01

To date, research on the link between poverty and unsafe sexual behaviors has utilized limited measures of socioeconomic status and has overlooked key dimensions of poverty at the individual level. This study explored how various dimensions of socioeconomic status are associated with inconsistent condom use and how these associations vary by gender. We analyzed unique life history survey data from 261 young men and women in Kisumu, Kenya, and conducted analyses based on 959 person-months in which respondents had been sexually active in nonmarital relationships. Dependent variables were inconsistent condom use (not always using a condom) and never use of condoms. Condoms were used inconsistently in 57% of months and were never used in 31%. Corroborating existing literature, lower household wealth and lower educational attainment were associated with inconsistent condom use. Lower individual economic status (lower earned income, food insufficiency, and larger material transfers from partners) were also important determinants of inconsistent condom use. There were no significant differences in these associations by gender, with the exception of food insufficiency, which increased the risk of inconsistent condom use for young women but not for young men. None of these individual measures of socioeconomic status were associated with never use of a condom. The findings suggest that both household- and individual-level measures of socioeconomic status are important correlates of condom use and that individual economic resources play a crucial role in negotiations over the highest level of usage. The results highlight the importance of poverty in shaping sexual behavior, and, in particular, that increasing individual access to resources beyond the household, including ensuring access to food and providing educational and work opportunities, could prove to be effective strategies for decreasing the risk of HIV among youth.

Sex trade in a male-to-female transgender population: psychosocial correlates of inconsistent condom use.

PubMed

Clements-Nolle, Kristen; Guzman, Robert; Harris, Susan G

2008-03-01

Research suggests that because of economic necessity, many male-to-female (MTF) transgender individuals trade sex for money, drugs, housing, and other things they may need. To date, no studies have quantitatively assessed psychosocial correlates of condom use with this population. We conducted a cross sectional study with 190 MTF transgender individuals involved in sex trade in San Francisco, California. Multivariate logistic regression was used to determine factors independently associated with inconsistent condom use during receptive anal sex with exchange partners. About one fifth of our participants reported inconsistent condom use during receptive anal sex in the past 6 months. In the multivariate model, low self-esteem [adjusted odds ratio (AOR)=3.09; 95% confidence interval (CI) (1.28, 7.47)], a history of forced sex or rape [AOR=2.91; 95% CI (1.06, 8.01)], and use of crack-cocaine [AOR=2.59; 95% CI (1.09, 6.13)] were independently associated with inconsistent condom use. Our findings highlight an urgent need for multilevel risk reduction interventions for MTF transgender individuals involved in sex trade. Such interventions will be most effective if they address the psychosocial context of sexual risk taking by focusing on issues such as low self-esteem, sexual violence, and illicit drug use.

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.

Association between Self-Reported Academic Performance and Risky Sexual Behavior among Ugandan University Students- A Cross Sectional Study

PubMed Central

Mehra, Devika; Kyagaba, Emmanuel; Östergren, Per-Olof; Agardh, Anette

2014-01-01

Little is known about the association between self-reported academic performance and risky sexual behaviors and if this differs by gender, among university students. Academic performance can create psychological pressure in young students. Poor academic performance might thus potentially contribute to risky sexual behavior among university students. The aim of this study was to investigate the association between self-reported academic performance and risky sexual behaviors, and whether gender affects this relationship among Ugandan university students. In 2010, 1,954 students participated in a cross-sectional survey, conducted at Mbarara University of Science and Technology in southwestern Uganda (72% response rate). Multivariate logistic regression analysis was used for the analysis. 1,179 (60.3%) students in our study sample reported having debuted sexually. Of these 440 (42.2%) used condoms inconsistently with new sexual partners, and 344 (33.6%) had had multiple sexual partners. We found a statistically significant association between poor academic performance and inconsistent condom use with a new sex partner and this association remained significant even after adjusting for all the potential confounders. There was no such association detected regarding multiple sexual partners. We also found that gender modified the effect of poor academic performance on inconsistent condom use. Females, who were poor academic performers, were found to be at a higher risk of inconsistent condom use than their male counterparts. Interventions should be designed to provide extra support to poor academic performers, which may improve their performance and self-esteem, which in turn might reduce their risky sexual behaviors. PMID:24999121

Association between self-reported academic performance and risky sexual behavior among Ugandan university students- a cross sectional study.

PubMed

Mehra, Devika; Kyagaba, Emmanuel; Ostergren, Per-Olof; Agardh, Anette

2014-04-16

Little is known about the association between self-reported academic performance and risky sexual behaviors and if this differs by gender, among university students. Academic performance can create psychological pressure in young students. Poor academic performance might thus potentially contribute to risky sexual behavior among university students. The aim of this study was to investigate the association between self-reported academic performance and risky sexual behaviors, and whether gender affects this relationship among Ugandan university students. In 2010, 1,954 students participated in a cross-sectional survey, conducted at Mbarara University of Science and Technology in southwestern Uganda (72% response rate). Multivariate logistic regression analysis was used for the analysis. 1,179 (60.3%) students in our study sample reported having debuted sexually. Of these 440 (42.2%) used condoms inconsistently with new sexual partners, and 344 (33.6%) had had multiple sexual partners. We found a statistically significant association between poor academic performance and inconsistent condom use with a new sex partner and this association remained significant even after adjusting for all the potential confounders. There was no such association detected regarding multiple sexual partners. We also found that gender modified the effect of poor academic performance on inconsistent condom use. Females, who were poor academic performers, were found to be at a higher risk of inconsistent condom use than their male counterparts. Interventions should be designed to provide extra support to poor academic performers, which may improve their performance and self-esteem, which in turn might reduce their risky sexual behaviors.

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.

Mobile phones and sex work in South India: the emerging role of mobile phones in condom use by female sex workers in two Indian states.

PubMed

Navani-Vazirani, Sonia; Solomon, Davidson; Gopalakrishnan; Heylen, Elsa; Srikrishnan, Aylur Kailasom; Vasudevan, Canjeevaram K; Ekstrand, Maria L

2015-01-01

The aim of this study was to examine female sex workers' solicitation of clients using mobile phones and the association between this and condom use with clients. Cross-sectional data were utilised to address the study's aim, drawing on data collected from female sex workers in Calicut, Kerala, and Chirala, Andhra Pradesh. Use of mobile phone solicitation was reported by 46.3% (n = 255) of Kerala participants and 78.7% (n = 464) of those in Andhra Pradesh. Kerala participants reporting exclusive solicitation using mobile phones demonstrated 1.67 times higher odds (95% CI: 1.01-2.79) of inconsistent condom use than those reporting non-use of mobile phones for solicitation. However, those reporting exclusive solicitation through mobile phones in Andhra Pradesh reported lower odds of inconsistent condom use (OR: 0.03; 95% CI: 0.01-0.26) than those not using mobile phones for solicitation. Findings indicate that solicitation of clients using mobile phones facilitates or hampers consistency in condom use with clients depending on the context, and how mobile phones are incorporated into solicitation practices. Variations in sex work environments, including economic dependence on sex work or lack thereof may partially account for the different effects found.

Mobile phones and sex work in South India: The emerging role of mobile phones in condom use by female sex workers in two Indian states

PubMed Central

Navani-Vazirani, S; Solomon, D; Krishnan, G; Heylen, E; Srikrishnan, AK; Vasudevan, CK; Ekstrand, ML

2014-01-01

The aim of this study was to examine female sex workers’ solicitation of clients using mobile phones and the association between this and condom use with clients. Cross-sectional data were utilised to address the study's aim, drawing on data collected from female sex workers in Calicut, Kerala and Chirala, Andhra Pradesh. Use of mobile phone solicitation was reported by 46.3% (n = 255) of Kerala participants and 78.7% (n = 464) of those in Andhra Pradesh. Kerala participants reporting exclusive solicitation using mobile phones demonstrated 1.67 times higher odds (95% CI: 1.01–2.79) of inconsistent condom use than those reporting non-use of mobile phones for solicitation. However, those reporting exclusive solicitation through mobile phones in Andhra Pradesh reported lower odds of inconsistent condom use (OR: 0.03; 95% CI: 0.01–0.26) than those not using mobile phones for solicitation. Findings indicate that solicitation of clients using mobile phones facilitates or hampers consistency in condom use with clients depending on the context, and how mobile phones are incorporated into solicitation practices. Variations in sex work environments, including economic dependence on sex work or lack thereof may partially account for the different effects found. PMID:25301669

Sex tourist risk behaviour--an on-site survey among Swedish men buying sex in Thailand.

PubMed

Manieri, Marco; Svensson, Hampus; Stafström, Martin

2013-06-01

Thailand is not only a popular destination for Swedish tourists, it is also the foreign country where the largest numbers of Swedish males contract HIV. This study investigated sexual risk-behaviour of Swedish men who have sex with commercial sex workers (CSW) in Thailand. Eligible men were approached on location in red-light districts of Pattaya and Bangkok with a self-administered multiple-choice questionnaire in December 2010. The data collected was analysed using SPSS version 18 generating cross-tabs, independent sample t-test, univariate and multivariate logistic regression. In total, 158 questionnaires were included in the analyses. The results indicated that 63% of the study sample had lifetime experience of sexual intercourse with CSWs, while 48% of the respondents indicated that they were likely to pay for sex during their present trip. 71% of the lifetime sex-buyers reported consistent use of condoms in the past. Out of the men that were planning to have sex with a CSW in the near future, 80% reported that they would use condoms consistently. While most of these men always use, and plan on always using a condom when having sex with a CSW, some do so inconsistently or not at all. The study found that those reporting inconsistent condom use when engaging in sexual intercourse with Thai CSWs assessed the risk of becoming infected with HIV to be significantly lower than those who used condoms consistently (p < 0.005). Inconsistent condom use by Swedish male tourists to Thailand when having sex with CSWs puts them at risk of contracting HIV and other STIs, and seems to be associated with a lower assessment of the risk of becoming infected with HIV.

Masculinities and condom use patterns among young rural South Africa men: a cross-sectional baseline survey.

PubMed

Shai, N Jama; Jewkes, R; Nduna, M; Dunkle, K

2012-06-20

Notions of ideal manhood in South Africa are potentially prescriptive of male sexuality thus accounting for the behaviors which may lead to men being at greater HIV risk. We tested the hypothesis that gender and relationship constructs are associated with condom use among young men living in rural South Africa. 1219 men aged 15-26 years completed a cross-sectional baseline survey from an IsiXhosa questionnaire asking about sexual behaviour and relationships. Univariate and bivariate analyses described condom use patterns and explanatory variables, and multinomial regression modeling assessed the factors associated with inconsistent versus consistent and non-condom use. 47.7% of men never used condoms, when 36.9% were inconsistent and 15.4% were consistent with any partner in the past year. Condom use patterns differed in association with gender relations attitudes: never users were significantly more conservative than inconsistent or consistent users. Three gender positions emerged indicating that inconsistent users were most physically/sexually violent and sexually risky; never users had more conservative gender attitudes but were less violent and sexually risky; and consistent users were less conservative, less violent and sexually risky with notably fewer sexual partners than inconsistent users. The confluence of conservative gender attitudes, perpetration of violence against women and sexual risk taking distinguished inconsistent condom users as the most risky compared to never condom users, and rendered inconsistent use one of the basic negative attributes of dominant masculinities in the Eastern Cape, South Africa. This finding is important for the design of HIV prevention and gender equity interventions and emphasizes the need for a wider roll-out of interventions that promote progressive and healthy masculine practices in the country.

Masculinities and condom use patterns among young rural South Africa men: a cross-sectional baseline survey

PubMed Central

2012-01-01

Background Notions of ideal manhood in South Africa are potentially prescriptive of male sexuality thus accounting for the behaviors which may lead to men being at greater HIV risk. We tested the hypothesis that gender and relationship constructs are associated with condom use among young men living in rural South Africa. Methods 1219 men aged 15–26 years completed a cross-sectional baseline survey from an IsiXhosa questionnaire asking about sexual behaviour and relationships. Univariate and bivariate analyses described condom use patterns and explanatory variables, and multinomial regression modeling assessed the factors associated with inconsistent versus consistent and non-condom use. Results 47.7% of men never used condoms, when 36.9% were inconsistent and 15.4% were consistent with any partner in the past year. Condom use patterns differed in association with gender relations attitudes: never users were significantly more conservative than inconsistent or consistent users. Three gender positions emerged indicating that inconsistent users were most physically/sexually violent and sexually risky; never users had more conservative gender attitudes but were less violent and sexually risky; and consistent users were less conservative, less violent and sexually risky with notably fewer sexual partners than inconsistent users. Conclusions The confluence of conservative gender attitudes, perpetration of violence against women and sexual risk taking distinguished inconsistent condom users as the most risky compared to never condom users, and rendered inconsistent use one of the basic negative attributes of dominant masculinities in the Eastern Cape, South Africa. This finding is important for the design of HIV prevention and gender equity interventions and emphasizes the need for a wider roll-out of interventions that promote progressive and healthy masculine practices in the country. PMID:22892159

HIV Risky Sexual Behaviors and HIV Infection Among Immigrants: A Cross-Sectional Study in Lisbon, Portugal

PubMed Central

Dias, Sónia; Marques, Adilson; Gama, Ana; Martins, Maria O.

2014-01-01

This study aimed to examine risky sexual behavior, its associated factors and HIV infection among immigrants. A participatory cross-sectional survey was conducted with 1187 immigrants at the National Immigrant Support Centre, in Lisbon (52.2% female; 34.0% Africans, 33.8% Brazilians, 32.2% Eastern Europeans). About 38% of participants reported ≥2 sexual partners in the previous year, 16.2% both regular and occasional sexual partners (last 12 months), 33.1% inconsistent condom use with occasional partners, and 64% no condom use in the last sexual intercourse. Unprotected sex in the last sexual intercourse was more likely among women, Africans, those older, with elementary education, those married and those who didn’t receive free condoms in the previous year. No condom use was less likely among those having only occasional sexual partners and both regular and occasional sexual partners. One third of participants had never been tested for HIV. Those never tested reported more frequently inconsistent condom use than those ever tested. Overall, 2.0% reported being HIV positive (2.5% of men; 4.4% of Africans); 4.3% admitted having a STI in previous year. HIV-positive immigrants reported high-risk sexual behaviors. Tailored interventions to promote awareness of HIV serostatus among immigrants as well as culturally adapted risk reduction strategies should be strengthened. PMID:25141001

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.

The Effects of Condom Availability on College Women's Sexual Discounting.

PubMed

Lemley, Shea M; Jarmolowicz, David P; Parkhurst, Daniel; Celio, Mark A

2018-04-01

College students commonly engage in risky sexual behaviors, such as casual sexual encounters and inconsistent condom use. Discounting paradigms that examine how individuals devalue rewards due to their delay or uncertainty have been used to improve our understanding of behavioral problems, including sexual risk. The current study assessed relations between college women's sexual partners discounting and risky sexual behavior. In this study, college women (N = 42) completed two sexual partners delay discounting tasks that assessed how choices among hypothetical sexual partners changed across a parametric range of delays in two conditions: condom availability and condom unavailability. Participants also completed two sexual partners probability discounting tasks that assessed partner choices across a parametric range of probabilities in condom availability and unavailability conditions. Additionally, participants reported risky sexual behavior on the Sexual Risk Survey (SRS). Participants discounted delayed partners more steeply in the condom availability condition, but those differences were significant only for those women with three or fewer lifetime sexual partners. There were no consistent differences in discounting rate across condom availability conditions for probability discounting. Sexual partners discounting measures correlated with risky sexual behaviors as measured by the SRS, but a greater number of significant relations were observed with the condoms-unavailable delay discounting task. These findings suggest the importance of examining the interaction of inconsistent condom use and multiple partners in examinations of sexual decision-making.

Relationship between reported prior condom use and current self-perceived risk of acquiring HIV among mobile female sex workers in southern India

PubMed Central

2011-01-01

Background With the evolution of Health Belief Model, risk perception has been identified as one of several core components of public health interventions. While female sex workers (FSWs) in India continue to be at most risk of acquiring and transmitting HIV, little is known about their perception towards risk of acquiring HIV and how this perception depends upon their history of consistent condom use behavior with different type of partners. The objective of this study is to fill this gap in the literature by examining this relationship among mobile FSWs in southern India. Methods We analyzed data for 5,413 mobile FSWs from a cross-sectional behavioral survey conducted in 22 districts from four states in southern India. This survey assessed participants’ demographics, condom use in sex with different types of partners, continuation of sex while experiencing STI symptoms, alcohol use before having sex, and self-perceived risk of acquiring HIV. Descriptive analyses and multilevel logistic regression models were used to examine the associations between risky sexual behaviors and self-perceived risk of acquiring HIV; and to understand the geographical differences in HIV risk perception. Results Of the total mobile FSWs, only two-fifths (40%) perceived themselves to be at high risk of acquiring HIV; more so in the state of Andhra Pradesh (56%) and less in Maharashtra (17%). FSWs seem to assess their current risk of acquiring HIV primarily on the basis of their past condom use behavior with occasional clients and less on the basis of their past condom use behaviors with regular clients and non-paying partners. Prior inconsistent condom use with occasional clients was independently associated with current perception of high HIV risk (adjusted odds ratio [aOR)] = 2.1, 95% confidence interval [CI]: 1.7-2.6). In contrast, prior inconsistent condom use with non-paying partners was associated with current perception of low HIV risk (aOR= 0.7, 95% CI: 0.5-0.9). The congruence between HIV risk perception and condom use with occasional clients was high: only 12% of FSWs reported inconsistent condom use with occasional clients but perceived themselves to be at low risk of acquiring HIV. Conclusion The association between high risk perception of acquiring HIV and inconsistent condom use, especially with regular clients and non-paying partners, has not been completely internalized by this high risk group of mobile FSWs in India. Motivational efforts to prevent HIV should emphasize the importance of accurately assessing an individual’s risk of acquiring HIV based on condom use behavior with all types of partners: occasional and regular clients as well as non-paying partners; and encourage behavior change based on an accurate self-assessment of HIV risk. PMID:22375731

Work-related violence and inconsistent condom use with non-paying partners among female sex workers in Adama City, Ethiopia.

PubMed

Mooney, Alyssa; Kidanu, Aklilu; Bradley, Heather M; Kumoji, Evelyn Kuor; Kennedy, Caitlin E; Kerrigan, Deanna

2013-08-23

Although reported condom use between female sex workers and their clients is high in Ethiopia, condom use with regular, non-paying partners remains low, posing a substantial risk of HIV infection to sex workers, their partners and the general population. Previous studies have identified the synergistic effects of substance abuse, violence and HIV risk, but few have examined these inter-relationships among female sex workers and their regular, non-paying partners. This study explored the associations between work-related violence, alcohol abuse and inconsistent condom use among establishment-based female sex workers and their regular, non-paying partners in Adama City, Ethiopia. A cross-sectional survey was conducted with 350 establishment-based female sex workers, aged 15-35, at 63 bars, hotels and nightclubs. Multivariate logistic regression analysis was conducted to test the association between work-related violence and condom use with regular, non-paying partners, controlling for age, overall income, education and sex workers' total number of sexual partners in the past week. Alcohol abuse was explored as an effect modifier. Respondents reported a high prevalence of work-related violence (59%) and alcohol abuse (51%). Work-related violence was statistically significantly associated with unprotected sex with regular, non-paying partners among those who abused alcohol (OR: 6.34, 95% CI: 2.43-16.56) and among those who did not (OR: 2.98, 95% CI: 1.36-6.54). Alcohol abuse was not associated with inconsistent condom use within these partnerships, though it may strengthen the effect of work-related violence on unprotected sex. Findings suggest violence against establishment-based female sex workers is associated with HIV risk within regular, non-paying partnerships. Qualitative work is needed to better understand the links between a violent work environment and condom use with regular, non-paying partners and how interventions can be implemented in this context to prevent violence against sex workers and reduce HIV transmission.

Condom use among criminally-involved adolescents.

PubMed

Magura, S; Shapiro, J L; Kang, S Y

1994-01-01

Condom use was studied for 421 sexually active, minority male adolescents who were currently in jail in New York City. Over three-quarters of the youths were users of alcohol and marijuana and about one-quarter were users of cocaine or crack, but drug injectors were rare. In the six months before arrest they had multiple sexual partners and about one-third had engaged in anal intercourse. Inconsistent condom use was the norm, with 17% reporting that they never used condoms and only 15% reporting that they used condoms every time for insertive sex. In multivariate analysis, more frequent condom use was independently predicted by gay/bisexual preference, greater acceptability and accessibility of condoms, partners' receptivity to use, self-initiation of use, and self-efficacy of avoiding AIDS. Condoms were used less frequently with steady than with causual partners, and rarely for anal or oral sex. AIDS prevention curricula addressing these factors should be delivered to high risk adolescents while they are temporarily accessible in jail.

Sexual power and HIV risk, South Africa.

PubMed

Pettifor, Audrey E; Measham, Diana M; Rees, Helen V; Padian, Nancy S

2004-11-01

Gender power inequities are believed to play a key role in the HIV epidemic through their effects on women's power in sexual relationships. We hypothesized that lack of sexual power, measured with a four-point relationship control scale and by a woman's experience of forced sex with her most recent partner, would decrease the likelihood of consistent condom use and increase the risk for HIV infection among sexually experienced, 15- to 24-year-old women in South Africa. While limited sexual power was not directly associated with HIV, it was associated with inconsistent condom use: women with low relationship control were 2.10 times more likely to use condoms inconsistently (95% confidence interval [CI] 1.17-3.78), and women experiencing forced sex were 5.77 times more likely to use condoms inconsistently (95% CI 1.86-17.91). Inconsistent condom use was, in turn, significantly associated with HIV infection (adjusted odds ratio 1.58, 95% CI 1.10-2.27).

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

Accounting for failures may improve precision: evidence supporting improved validity of self-reported condom use.

PubMed

Crosby, Richard; Salazar, Laura F; DiClemente, Ralph J; Yarber, William L; Caliendo, Angela M; Staples-Horne, Michelle

2005-08-01

To determine whether a measure of unprotected vaginal sex that is adjusted for condom failures would produce improved accuracy in predicting biologically confirmed STDs (chlamydia and gonorrhea) among female teens. Self-reported measures were collected using audio-computer-assisted self-interviewing. DNA amplification for the presence of Chlamydia trachomatis and Neisseria gonorrhoeae was conducted. The unadjusted measure of unprotected vaginal sex was not significantly associated with biologically confirmed prevalence of STDs (prevalence ratio [PR] = 1.51; 95% CI = 0.71-3.21; P = 0.28). Alternatively, the adjusted measure achieved significance (PR = 3.59; 95% CI = 1.13-11.38; P = 0.014). More than one quarter (25.6%) of teens using condoms inconsistently and/or incorrectly tested positive for an STD compared to 7.1% among those reporting the consistent and correct use of condoms. Findings demonstrate that studies of condom effectiveness should use an adjusted measure of condom use to achieve precision and rigor.

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

Use of AUDIT, and measures of drinking frequency and patterns to detect associations between alcohol and sexual behaviour in male sex workers in Kenya.

PubMed

Luchters, Stanley; Geibel, Scott; Syengo, Masila; Lango, Daniel; King'ola, Nzioki; Temmerman, Marleen; Chersich, Matthew F

2011-05-25

Previous research has linked alcohol use with an increased number of sexual partners, inconsistent condom use and a raised incidence of sexually transmitted infections (STIs). However, alcohol measures have been poorly standardised, with many ill-suited to eliciting, with adequate precision, the relationship between alcohol use and sexual risk behaviour. This study investigates which alcohol indicator--single-item measures of frequency and patterns of drinking ( > = 6 drinks on 1 occasion), or the Alcohol Use Disorders Identification Test (AUDIT)--can detect associations between alcohol use and unsafe sexual behaviour among male sex workers. A cross-sectional survey in 2008 recruited male sex workers who sell sex to men from 65 venues in Mombasa district, Kenya, similar to a 2006 survey. Information was collected on socio-demographics, substance use, sexual behaviour, violence and STI symptoms. Multivariate models examined associations between the three measures of alcohol use and condom use, sexual violence, and penile or anal discharge. The 442 participants reported a median 2 clients/week (IQR = 1-3), with half using condoms consistently in the last 30 days. Of the approximately 70% of men who drink alcohol, half (50.5%) drink two or more times a week. Binge drinking was common (38.9%). As defined by AUDIT, 35% of participants who drink had hazardous drinking, 15% harmful drinking and 21% alcohol dependence. Compared with abstinence, alcohol dependence was associated with inconsistent condom use (AOR = 2.5, 95%CI = 1.3-4.6), penile or anal discharge (AOR = 1.9, 95%CI = 1.0-3.8), and two-fold higher odds of sexual violence (AOR = 2.0, 95%CI = 0.9-4.9). Frequent drinking was associated with inconsistent condom use (AOR = 1.8, 95%CI = 1.1-3.0) and partner number, while binge drinking was only linked with inconsistent condom use (AOR = 1.6, 95%CI = 1.0-2.5). Male sex workers have high levels of hazardous and harmful drinking, and require alcohol-reduction interventions. Compared with indicators of drinking frequency or pattern, the AUDIT measure has stronger associations with inconsistent condom use, STI symptoms and sexual violence. Increased use of the AUDIT tool in future studies may assist in delineating with greater precision the explanatory mechanisms which link alcohol use, drinking contexts, sexual behaviours and HIV transmission.

Patterns of reasoning and decision making about condom use by urban college students.

PubMed

Patel, V L; Gutnik, L A; Yoskowitz, N A; O'sullivan, L F; Kaufman, D R

2006-11-01

HIV infection rates are rapidly increasing among young heterosexuals, making it increasingly important to understand how these individuals make decisions regarding risk in sexual encounters. Our objective in this study was to characterize young adults' safer sex behaviour and associate this behaviour with patterns of reasoning, using cognitive, information processing methods to understand the process of sexual risk taking. Sixty urban college students from NYC maintained diaries for two weeks and then were interviewed regarding lifetime condom use and sexual history. Using cognitive analysis, we characterized four patterns of condom use behaviour: consistent condom use (35.0%), inconsistent condom use (16.7%), shifting from consistent to inconsistent condom use (35.0%), and shifting from inconsistent to consistent condom use (13.3%). Directionality of reasoning (i.e. data-driven and hypothesis-driven reasoning) was analysed in the explanations provided for condom use decisions. The consistent and inconsistent patterns of condom use were associated with data-driven heuristic reasoning, where behaviour becomes automated and is associated with a high level of confidence in one's judgment. In the other two patterns, the shift in behaviour was due to a significant event that caused a change in type of reasoning to explanation-based reasoning, reflecting feelings of uncertainty and willingness to evaluate their decisions. We discuss these results within the framework of identifying potentially high-risk groups (e.g. heterosexual young adults) as well as intervention strategies for risk reduction. Further, our findings not only identify different patterns of condom use behaviour, but our investigation of the cognitive process of decision-making characterizes the conditions under which such behaviour and reasoning change.

Indian men's use of commercial sex workers: prevalence, condom use, and related gender attitudes

PubMed Central

Decker, Michele R.; Miller, Elizabeth; Raj, Anita; Saggurti, Niranjan; Donta, Balaiah; Silverman, Jay G.

2013-01-01

Background/Objectives Commercial sex represents a critical context for HIV transmission within India and elsewhere. Despite research and programmatic attention to commercial sex workers (CSWs), less is known concerning the male CSW clients considered a bridge population for HIV transmission to the general population and thought to drive demand for the sex trafficking of women and girls. The current study assesses the prevalence of past-year CSW contact, condom non-use therein, and associations with demographic characteristics and gendered attitudes among a national sample of Indian men. Methods The nationally representative Indian National Family Health Survey-3 (NFHS-3) was conducted across all Indian states in 2005-2006; the current sample was limited to 46,961 sexually active men. Analyses calculated the prevalence of past-year CSW contact and inconsistent condom use; adjusted logistic regression models were used to evaluate associations of demographic characteristics, sexual entitlement and justification of wife abuse with past-year CSW contact and inconsistent condom use. Results Approximately 1 in 100 ( 0.9%) Indian men reported past-year CSW contact; over half of such men reported inconsistent condom use with CSWs. CSW contact was most common among men ages 15-24 (3.6%) and never-married men (9.9%). Men's CSW contact related to higher levels of sexual entitlement (AOR=1.64; 95% CI 1.24, 2.17) and justification of violence against wives (AOR=1.41; 95% CI 1.03, 1.93). Conclusions Men's past-year CSW contact was concentrated among young and unmarried Indian men; condom non-use with CSWs was common. Traditional gender ideologies appeared to support men's CSW contact, bolstering consideration of this behavior as a gendered form of HIV risk. Findings provide direction for interventions to reduce men's CSW contact in the Indian context by describing high-risk sub-populations and indicating that gender ideologies should be addressed. PMID:19904213

Indian men's use of commercial sex workers: prevalence, condom use, and related gender attitudes.

PubMed

Decker, Michele R; Miller, Elizabeth; Raj, Anita; Saggurti, Niranjan; Donta, Balaiah; Silverman, Jay G

2010-02-01

Commercial sex represents a critical context for HIV transmission within India and elsewhere. Despite research and programmatic attention to commercial sex workers (CSWs), less is known concerning the male CSW clients considered a bridge population for HIV transmission to the general population and thought to drive demand for the sex trafficking of women and girls. The current study assesses the prevalence of past year CSW contact, condom nonuse therein, and associations with demographic characteristics and gendered attitudes among a national sample of Indian men. The nationally representative Indian National Family Health Survey-3 was conducted across all Indian states in 2005-2006; the current sample was limited to 46,961 sexually active men. Analyses calculated the prevalence of past year CSW contact and inconsistent condom use; adjusted logistic regression models were used to evaluate associations of demographic characteristics, sexual entitlement and justification of wife abuse with past year CSW contact, and inconsistent condom use. Approximately 1 in 100 Indian men (0.9%) reported past year CSW contact; over half of such men reported inconsistent condom use with CSWs. CSW contact was most common among men ages 15-24 (3.6%) and never married men (9.9%). Men's CSW contact related to higher levels of sexual entitlement (adjusted odds ratio = 1.64; 95% confidence interval 1.24 to 2.17) and justification of violence against wives (adjusted odds ratio = 1.41; 95% confidence interval: 1.03 to 1.93). Men's past year CSW contact was concentrated among young and unmarried Indian men; condom nonuse with CSWs was common. Traditional gender ideologies seemed to support men's CSW contact, bolstering consideration of this behavior as a gendered form of HIV risk. Findings provide direction for interventions to reduce men's CSW contact in the Indian context by describing high-risk subpopulations and indicating that gender ideologies should be addressed.

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.

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.

Sexual behaviour, structural vulnerabilities and HIV prevalence among female sex workers in Pakistan

PubMed Central

Mishra, Sharmistha; Thompson, Laura H; Sonia, Altaf; Khalid, Nosheen; Emmanuel, Faran; Blanchard, James F

2013-01-01

Background We sought to describe differences in individual and structural vulnerabilities faced by female sex workers (FSWs) in Pakistan between 2006 and 2011, and to characterise risk factors for inconsistent condom use and HIV prevalence in this population. Methods To describe differences in vulnerabilities, we analysed behavioural data from serial cross-sectional surveys conducted across nine cities in 2006 and 2011. Using data from 12 cities in 2011, we used logistic regression to characterise risk factors for (a) inconsistent condom use in the past month (N=6987), and (b) HIV (N=4301). Results Compared to FSWs in 2006, FSWs in 2011 were significantly more likely to solicit clients via cell phones, and to report a larger client volume and anal sex with clients, but also consistent condom use with clients (30.0% vs 23.6% in 2006). In 2011, independent risk factors for inconsistent condom use with clients included: recent sexual violence, recent sex with a person who injects drugs, and absence of programme exposure. HIV prevalence was 0.63% (95% CI 0.43% to 0.92%) in 2011, and was associated with a recent history of injection drug use and absence of programme exposure. Conclusions While condom use with clients was higher in 2011, protective behaviours remained low and vulnerabilities related to sex work may have risen. HIV is emerging in this population and an adaptive HIV prevention programme that addresses different vulnerabilities and the intersection of sexual networks with injection drug use is needed. PMID:23413402

[Inconsistent condom use among Mexican women living with HIV: a challenge for health services].

PubMed

Kendall, Tamil; Castillo, Anabel; Herrera, Cristina; Campero, Lourdes

2015-01-01

To describe condom use among Mexican women living with HIV and analyze factors that facilitate or impede its utilization. Qualitative analysis of 55 interviews with women of reproductive age living with HIV. Inconsistent condom use and non-use at last sexual intercourse was common, and not clearly related to the male partners' HIV-status. Factors that influenced condom use included perceptions of health benefits, symbolic meaning assigned to the condom within the relationship, and the transformation or persistence of inequitable gender norms. Gender norms and male partners' attitudes strongly influence condom use among women living with HIV. To increase consistent condom use the health system must implement counseling and service delivery with a gender perspective and innovative actions to involve male partners.

How can psychological theory help to promote condom use in sub-Saharan African developing countries?

PubMed

Campbell, T

1997-06-01

Condom use for HIV prevention has been very inconsistent in most sub-Saharan African countries. Studies from around the continent report that knowledge about HIV transmission is variable and seems to be related to gender, socioeconomic and educational status. There is a large body of psychological knowledge about HIV prevention which has been applied to condom promotion campaigns in developed countries. These approaches to condom promotion, based on formal theory, have not been used on a wide scale in African countries and this paper explores ways in which psychological theory might be appropriately applied in a situation of high HIV prevalence.

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.

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

CHANGES IN CONDOM USE OVER TIME AMONG FEMALE SEX WORKERS AND THEIR MALE NONCOMMERCIAL PARTNERS AND CLIENTS

PubMed Central

Tracas, Ashley; Bazzi, Angela Robertson; Artamonova, Irina; Rangel, M. Gudelia; Staines, Hugo; Ulibarri, Monica D.

2017-01-01

Female sex workers (FSWs) often report inconsistent condom use with clients and noncommercial male partners, yet changes in condom use with various partner types during participation in observation studies remains underexplored. This longitudinal study of 214 FSWs and their male, noncommercial partners in the Mexico-U.S. border region, where HIV prevalence among FSWs continues to be high, utilized negative binomial regressions to examine changes in condom use with intimate partners and clients (regular and nonregular) over 24 months. Condom use decreased over time among couples in Ciudad Juarez, but there was no change in condom use among couples in Tijuana. FSWs’ condom use with regular and nonregular clients significantly increased over time, which is consistent with previous research finding behavioral changes when participating in observational studies. Findings suggest the need for continued efforts to promote condom use among FSWs and their noncommercial male partners in addition to clients. PMID:27427926

Determinants of Heterosexual Adolescents Having Sex with Female Sex Workers in Singapore

PubMed Central

Ng, Junice Y. S.; Wong, Mee-Lian

2016-01-01

Objectives We assessed the proportion of and socio-ecological factors associated with ever having had sex with female sex workers (FSWs) among heterosexual adolescents. We also described the characteristics of the adolescents who reported inconsistent condom use with FSWs. Methods This is a cross-sectional study (response rate: 73%) of 300 heterosexually active male adolescents of 16 to 19 years attending a national STI clinic in Singapore between 2009 and 2014. We assessed the ecological factors (individual, parental, peer, school and medial influences) and sexual risk behaviors using a self-reported questionnaire. Poisson regression was used to obtain the adjusted prevalence ratios (aPR) and confidence intervals (CI). Results The proportion of heterosexual male adolescents who had ever had sex with FSWs was 39%. Multivariate analysis showed that significant factors associated with ever having had sex with FSWs were sex initiation before 16 years old (aPR 1.79 CI: 1.30–2.46), never had a sexually active girlfriend (aPR 1.75 CI 1.28–2.38), reported lower self-esteem score (aPR 0.96 CI: 0.93–0.98), higher rebelliousness score (aPR 1.03 CI: 1.00–1.07) and more frequent viewing of pornography (aPR 1.47 CI: 1.04–2.09). Lifetime inconsistent condom use with FSWs was 30%. Conclusions A significant proportion of heterosexual male adolescents attending the public STI clinic had ever had sex with FSWs. A targeted intervention that addresses different levels of influence to this behavior is needed. This is even more so because a considerable proportion of adolescents reported inconsistent condom use with FSWs, who may serve as a bridge of STI transmission to the community. National surveys on adolescent health should include the assessment of frequency of commercial sex visits and condom use with FSWs for long-term monitoring and surveillance. PMID:26808561

Infidelity, trust, and condom use among Latino youth in dating relationships.

PubMed

Brady, Sonya S; Tschann, Jeanne M; Ellen, Jonathan M; Flores, Elena

2009-04-01

Latino youth in the United States are at greater risk for contracting sexually transmitted infections (STIs) in comparison with non-Hispanic white youth. Sexually active heterosexual Latino youth aged 16 to 22 years (N = 647) were recruited for interviews through a large health maintenance organization or community clinics. Adjusting for gender, age, ethnic heritage, and recruitment method, woman's consistent use of hormonal contraceptives, ambivalence about avoiding pregnancy, longer length of sexual relationship, and greater overall trust in main partner were independently associated with inconsistent condom use and engagement in a greater number of sexual intercourse acts that were unprotected by condom use. Perception that one's main partner had potentially been unfaithful, but not one's own sexual concurrency, was associated with consistent condom use and fewer acts of unprotected sexual intercourse. Sexually concurrent youth who engaged in inconsistent condom use with other partners were more likely to engage in inconsistent condom use and a greater number of unprotected sexual intercourse acts with main partners. Increasing attachment between youth may be a risk factor for the transmission of STIs via normative declines in condom use. Perception that one's partner has potentially been unfaithful may result in greater condom use. However, many Latino adolescents and young adults who engage in sexual concurrency may not take adequate steps to protect their partners from contracting STIs. Some youth may be more focused on the emotional and social repercussions of potentially revealing infidelity by advocating condom use than the physical repercussions of unsafe sex.

Correlates of HIV infection among female sex workers in Vietnam: injection drug use remains a key risk factor.

PubMed

Le, Linh-Vi N; Nguyen, Tuan A; Tran, Hoang V; Gupta, Nisha; Duong, Thanh C; Tran, Ha T T; Nadol, Patrick; Sabin, Keith; Maher, Lisa; Kaldor, John M

2015-05-01

Women who sell sex and use drugs have dual risks for HIV infection. Despite increasing reports of drug use among female sex workers (FSW) in Vietnam, FSW HIV interventions remain focused mainly on sexual risk reduction. We assessed the impact of drug use and inconsistent condom use on HIV infection among FSW in Vietnam, which few studies have quantified. We surveyed 5298 women aged ≥18 years who had sold sex in the past month from ten geographically dispersed provinces. We performed multivariate logistic regression on data from provinces with high (≥10%) or low (<10%) HIV prevalence among FSW. Compared to FSW who never used illicit drugs, the odds of HIV infection among FSW who had ever injected drugs and those who reported non-injection drug use were 3.44 (CI 2.32-5.09) and 1.76 (CI 1.14-2.71), respectively, in high-prevalence provinces. FSW who always used condoms with clients had lower odds of HIV infection than those who did not (AOR=0.71; CI 0.52-0.98). In low-prevalence provinces lifetime injection drug use (AOR 22.05, CI 12.00-40.49), but not non-injecting drug use or inconsistent condom use, was significantly associated with HIV infection. Because injection drug use and inconsistent condom use were key risk factors for HIV infection in high-prevalence provinces, drug injection risk reduction should be as much a focus of HIV prevention as sexual risk reduction. Where HIV prevalence remains low in FSW, a more general emphasis on harm reduction for all drug users will benefit FSW. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Condom use, intervention service utilization and HIV knowledge among female sex workers in China: results of three consecutive cross-sectional surveys in Shandong Province with historically low HIV prevalence.

PubMed

Liao, M; Bi, Z; Liu, X; Kang, D; Fu, J; Song, Q; Freeman, J; Jiang, B; Jia, Y

2012-03-01

Heterosexual transmission of HIV through contact with female sex workers (FSWs) is a growing concern for the HIV/AIDS epidemic in China. Using consecutive cross-sectional surveys, we examined the prevalence of HIV and sexually transmitted infections (STIs), risk behaviours, HIV knowledge and the utilization of intervention services among FSWs in Shandong Province. Of 3460 participants, half reported ever having STI-related symptoms, 57.8% had ≥7 clients in the last week, half reported inconsistent use of condoms with clients and 11.2% reported ever using illicit drugs. Consistent use of condoms with clients was associated with higher education, being 20-24 years of age, being recruited from hotels, having ever received free condoms and was inversely associated with STI-related symptoms. HIV-related knowledge was associated with higher education, ever testing for HIV and inversely associated with self-reported STI-related symptoms. The low rates of condom use, high number and frequent turnover of clients, high prevalence of self-reported STIs and drug use highlight the urgency for more effective intervention in these FSWs.

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.

Targeted expansion project for outreach and treatment for substance abuse and HIV risk behaviors in Asian and Pacific Islander communities.

PubMed

Nemoto, Tooru; Iwamoto, Mariko; Kamitani, Emiko; Morris, Anne; Sakata, Maria

2011-04-01

Access to culturally competent HIV/AIDS and substance abuse treatment and prevention services is limited for Asian and Pacific Islanders (APIs). Based on the intake data for a community outreach project in the San Francisco Bay Area (N = 1,349), HIV risk behaviors were described among the targeted API risk groups. The self-reported HIV prevalence was 6% among MSM. Inconsistent condom use for vaginal sex with casual partners in the past 6 months was reported among substance users (43%) and incarcerated participants (60%), whereas 26% of men who have sex with men reported inconsistent condom use for anal sex with casual partners. Overall, 56% and 29% had engaged in sex with casual partners under the influence of alcohol and drugs in the past 6 months, respectively. Although API organizations in the Bay Area have spearheaded HIV prevention, future programs must address substance use issues in relation to sexual risk behaviors, specific to API risk groups.

Factors associated with non-use of condoms in an online community of frequent travellers.

PubMed

Alcedo, Sami; Kossuth-Cabrejos, Stefano; Piscoya, Alejandro; Mayta-Tristán, Percy

2014-01-01

Millions of travellers around the world have gathered together into online communities. The objective is to analyse the factors associated with risky sexual behaviour among travellers. Cross-sectional study was conducted within an online community of travellers using an online survey; we included travellers who had engaged in sexual activity while on their last trip. Risky sexual behaviour was defined as inconsistent condom use (<100%), and the factors associated were evaluated using the prevalence ratio (PR). Of the 468 participants, 245 had sex during their last trip. 59.7% did not consistently use condoms, and one out of every four participants reported never using condoms. Having a travel destination of Latin America or the Caribbean was significantly associated with inconsistent condom use. This association was maintained (PR 1.37, CI 95% 1.06–1.77) after adjusting for gender, age, migration, the presence of travel partners, and the use of drugs and alcohol prior to sexual activity. An association was observed between travel destination (specifically Latin America or the Caribbean) and risky sexual behaviour. For this reason, tourists should be educated in STI transmission and regional STI and HIV incidences both before and during their travels; public health systems ought to work together with travel agencies, international airports, etc., in order to distribute this information and ensure a responsible travel experience.

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.

Young Men's Aggressive Tactics to Avoid Condom Use: A Test of a Theoretical Model

ERIC Educational Resources Information Center

Davis, Kelly Cue; Logan-Greene, Patricia

2012-01-01

Although research has demonstrated that men's aggression against women and inconsistent condom use are related phenomena, little is known about what factors increase risk for aggression to avoid condom use. The present article tests a theory-based model of condom avoidance through use of sexual aggression. Adult male participants (N = 289) were…

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.

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.

Sexual Relationship Power, Intimate Partner Violence, and Condom Use Among Minority Urban Girls

PubMed Central

Teitelman, Anne M.; Ratcliffe, Sarah J.; Morales-Aleman, Mercedes M.; Sullivan, Cris M.

2011-01-01

This study examined the association between sexual relationship power, intimate partner violence, and condom use among African American and Hispanic urban girls. In this sample of 56 sexually active girls, 50% did not use condoms consistently and therefore were at higher risk for acquiring HIV or sexually transmitted diseases (STDs). Teens who experienced more intimate partner violence had a significantly higher likelihood of inconsistent condom use and therefore a greater risk for HIV/STDs. Girls' sense of sexual control in their relationships was not directly associated with inconsistent condom use but was inversely related to verbal and emotional abuse. Interventions aimed at reducing HIV/STD risk for adolescent girls need to address patterns of dominance and control in adolescent relationships as well as multiple forms of partner violence. This suggests the need for multilevel intervention approaches that promote girls' agency and multiple ways to keep girls safe from perpetrators of partner abuse. PMID:18349344

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.

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.

Sexual behaviors and risk for sexually transmitted infections among teenage men who have sex with men.

PubMed

Zou, Huachun; Prestage, Garrett; Fairley, Christopher K; Grulich, Andrew E; Garland, Suzanne M; Hocking, Jane S; Bradshaw, Catriona S; Cornall, Alyssa M; Tabrizi, Sepehr N; Morrow, Andrea; Chen, Marcus Y

2014-08-01

To report on sexual behaviors and sexually transmitted infections (STIs) among men who have sex with men (MSM) in their teens, when many MSM engage in their first sexual experiences. MSM aged 16 to 20 years were recruited via community and other sources. Men completed a questionnaire about their sexual behaviors and were screened for gonorrhea, chlamydia, syphilis, and HIV. Two hundred men were included. The median age was 19 years. The median age at first insertive or receptive anal intercourse was 17 years. Half of men reported sex with mainly older men: these men were more likely to engage in receptive anal intercourse (48% vs. 25%, p < .001) than other men. Most men had engaged in insertive (87%) and receptive (85%) anal intercourse in the prior 12 months with 60% and 53% reporting inconsistent condom use with insertive and receptive anal intercourse partners, respectively. The median number of insertive anal intercourse partners was 3 and 1.5 (p < .001) among men reporting inconsistent and consistent condom use with insertive anal intercourse over the prior 12 months. The median number of receptive anal intercourse partners was 3 and 2 (p = .006) among men reporting inconsistent and consistent condom use with receptive anal intercourse over the prior 12 months. Pharyngeal gonorrhea, rectal gonorrhea, urethral chlamydia, rectal chlamydia, and syphilis were detected in 3.0%, 5.5%, 3.0%, 4%, and 2.0% of men, respectively. All men were HIV negative. Many of the teenage MSM in this study were at risk for STI. Preventative messages and STI screening interventions that are age appropriate need to be developed to reduce HIV and STI risk in this under-recognized group. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Patterns and Correlates of Sexual Activity and Condom Use Behavior in Persons 50-Plus Years of Age Living with HIV/AIDS

PubMed Central

Heckman, Timothy G.; Sikkema, Kathleen J.; Hansen, Nathan B.; Kochman, Arlene; Suhr, Julie A.; Garske, John P.; Johnson, Christopher J.

2008-01-01

This study characterized rates of sexual activity and identified psychosocial and behavioral correlates of sexual activity and condom use in a metropolitan sample of 290 HIV-infected adults 50-plus years of age. Thirty-eight percent of participants were sexually active in the past three months, 33% of whom had at least one occasion of anal or vaginal intercourse that was not condom protected. Rates and correlates of sexual activity and condom use differed between gay/bisexual men, heterosexual men, and heterosexual women. In the past three months, 72% of heterosexual men were sexually active compared to only 36% of gay/bisexual men and 21% of heterosexual women. However, among sexually active persons, only 27% of heterosexual men reported inconsistent condom use compared to 37% of gay/bisexual men and 35% of heterosexual women. As the number of older adults living with HIV/AIDS in the U.S. continues to increase, age-appropriate secondary risk-reduction interventions are urgently needed. PMID:18389361

Sexual health and use of condoms among local and international sex workers in Sydney.

PubMed

O'Connor, C C; Berry, G; Rohrsheim, R; Donovan, B

1996-02-01

To compare indicators of sexual health and predictors of condom use for commercial sex among local and international female sex workers first attending an STD clinic. A public STD clinic in Sydney, Australia. All sex workers first attending between June 1991 and May 1993. Cross-sectional analysis of demographic, behavioural and morbidity data from proforma medical records. 91 local sex workers and 123 international sex workers (predominantly from Thailand, Malaysia and China) first presented during the study period. There were significantly higher prevalences of chlamydia (0 v. 15%, p = 0.0002), gonorrhoea (0 v. 14%, p = 0.0006), syphilis (0 v. 10%, p = 0.006) and clinical genital herpes (0 v. 5%, p = 0.04) among international sex workers. The only case of HIV infection was in an international sex worker. Inconsistent condom use for commercial sex was significantly more common among international sex workers (RR = 4.5; 95% CI 3.1-6.5). On multivariate analysis, inconsistent condom use in international sex workers was associated with a recent history of prostitution outside Australia (p = 0.04), while inconsistent condom usage among local sex workers was associated with increasing age (p = 0.003). These data illustrate the efficacy of condoms and the success of targeted education programmes in local sex workers in Sydney. By contrast, international sex workers continued to be at high risk of STDs. The international sex industry in Sydney requires enhanced culture-specific interventions. Immigration laws as they affect sex workers should also be reviewed.

Optimizing Prevention of HIV and Unplanned Pregnancy in Discordant African Couples.

PubMed

Wall, Kristin M; Kilembe, William; Vwalika, Bellington; Haddad, Lisa B; Khu, Naw Htee; Brill, Ilene; Onwubiko, Udodirim; Chomba, Elwyn; Tichacek, Amanda; Allen, Susan

2017-08-01

Dual method use, which combines condoms with a more effective modern contraceptive to optimize prevention of HIV and unplanned pregnancy, is underutilized in high-risk heterosexual couples. Heterosexual HIV-discordant Zambian couples were enrolled from couples' voluntary HIV counseling and testing services into an open cohort with 3-monthly follow-up (1994-2012). Relative to dual method use, defined as consistent condom use plus modern contraception, we examine predictors of (1) condom-only use (suboptimal pregnancy prevention) or (2) modern contraceptive use with inconsistent condom use (effective pregnancy prevention and suboptimal HIV prevention). Among 3,049 couples, dual method use occurred in 28% of intervals in M+F- and 23% in M-F+, p < 0.01; condom-only use in 56% in M+F- and 61% in M-F+, p < 0.01; and modern contraceptive use with inconsistent condom use in 16% regardless of serostatus. Predictors (p < 0.05) of condom-only use included the man being HIV+ (adjusted hazard ratio, aHR = 1.15); baseline oral contraceptive pill (aHR = 0.76), injectable (aHR = 0.48), or implant (aHR = 0.60) use; woman's age (aHR = 1.04 per 5 years) and lifetime number of sex partners (aHR = 1.01); postpartum periods (aHR = 1.25); and HIV stage of the index partner III/IV versus I (aHR = 1.10). Predictors (p < 0.05) of modern contraceptive use with inconsistent condom use included woman's age (aHR = 0.94 per 5 years) and HIV+ male circumcision (aHR = 1.51), while time-varying implant use was associated with more consistent condom use (aHR = 0.80). Three-quarters of follow-up intervals did not include dual method use. This highlights the need for counseling to reduce unintended pregnancy and HIV transmission and enable safer conception.

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

Parental support and condom use among transgender female youth

PubMed Central

Wilson, Erin C.; Iverson, Ellen; Garofalo, Robert; Belzer, Marvin

2011-01-01

Evidence suggests that transgender female youth (TFY), much like their adult transgender female peers, are at high risk for HIV. Yet little attention has been given to important developmental experiences of TFY that may impact HIV risk for this youth population. The overall purpose of this study was to explore HIV risk in TFY. A re-occurring theme from the qualitative data was the importance of parents. To better understand the impact of parents on HIV risk among TFY, in-depth individual interview data from 21 TFY in Los Angeles and Chicago were analyzed, suggesting a potential link between HIV-related risk behavior and parental support. Youth with parental support in this sample reported regular condom use, while those without such support reported inconsistent condom use. Implications for the unique research and interventions needs of TFY related to parental support and sexual risk behaviors are discussed. PMID:22079675

Mixed Messages: Inconsistent Sexual Scripts in Australian Teenage Magazines and Implications for Sexual Health Practices

ERIC Educational Resources Information Center

Burns, Melanie C.

2018-01-01

Condom use among Australian adolescents has been shown to be variable, despite good knowledge among this group about sexual health risks and the promotion of condoms as a simple way to reduce the spread of sexually transmitted infections. This study explores dominant constructions of condom use within two Australian lifestyle magazines targeted…

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.

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.

Risky Decisions Despite Counter Evidence: Modeling a Culture of Safer Sexual Practices

PubMed Central

Patel, Vimla L.; Yoskowitz, Nicole A.; Kaufman, David R.; Gutnik, Lily A.; Shortliffe, Edward H.

2005-01-01

To create a culture of safe practices, we need to understand how and under what conditions the public makes risky decisions about their health. Because risky sexual behaviors are known to be common in young adults, we investigated their decision making regarding sexual activities that could incur a high risk of HIV infection. Sixty young urban adults maintained journals for two weeks and were interviewed regarding condom use and sexual history. We characterized four patterns of condom use behavior: consistent (35.0%), inconsistent (16.7%), consistent to inconsistent (35.0%), and inconsistent to consistent (13.3%). Directionality of reasoning was analyzed in the explanations provided for condom use decisions. The consistent and inconsistent patterns were associated with data-driven heuristic reasoning, where behavior becomes automated and is associated with a high level of confidence in one’s judgment. In the other two patterns, the shift in behavior was due to a significant event that influenced a change in directionality to explanation-based reasoning. We discuss these results within the framework of identifying potentially high-risk groups for whom customized intervention strategies (such as computer-based educational programs) can be used to reduce risk, thereby creating a culture of safer sexual practices. PMID:16779109

Risky decisions despite counter evidence: modeling a culture of safer sexual practices.

PubMed

Patel, Vimla L; Yoskowitz, Nicole A; Kaufman, David R; Gutnik, Lily A; Shortliffe, Edward H

2005-01-01

To create a culture of safe practices, we need to understand how and under what conditions the public makes risky decisions about their health. Because risky sexual behaviors are known to be common in young adults, we investigated their decision making regarding sexual activities that could incur a high risk of HIV infection. Sixty young urban adults maintained journals for two weeks and were interviewed regarding condom use and sexual history. We characterized four patterns of condom use behavior: consistent (35.0%), inconsistent (16.7%), consistent to inconsistent (35.0%), and inconsistent to consistent (13.3%). Directionality of reasoning was analyzed in the explanations provided for condom use decisions. The consistent and inconsistent patterns were associated with data-driven heuristic reasoning, where behavior becomes automated and is associated with a high level of confidence in one's judgment. In the other two patterns, the shift in behavior was due to a significant event that influenced a change in directionality to explanation-based reasoning. We discuss these results within the framework of identifying potentially high-risk groups for whom customized intervention strategies (such as computer-based educational programs) can be used to reduce risk, thereby creating a culture of safer sexual practices.

Condom use as part of the wider HIV prevention strategy: experiences from communities in the North West Province, South Africa.

PubMed

Versteeg, Marije; Murray, Montagu

2008-07-01

Correct and consistent condom usage remains a pivotal strategy in reaching the target set by the South African government to reduce new HIV infections by 50% in the next 5 years. Studies have found that there has been an increase in condom usage by some categories of the population, but usage has not yet reached the desired levels in order to meet the target. This article reports on the findings of a study on condom usage in eight communities in the North West Province, which was part of a wider HIV and AIDS programme evaluation commissioned by the North West Provincial Department of Health. The main aim was to assess accessibility to condoms, and knowledge, attitudes and practices around condom use by four sampled communities in the North West Province. Eight focus group discussions were held and 50 households were interviewed. The study found positive results regarding accessibility and awareness of condoms. However, this often did not lead to the desired behavioural change of using condoms in risky sexual interactions. The majority of respondents still resisted condom usage, used condoms inconsistently, or were not in a position to negotiate protected sexual intercourse. The main reasons reported for this were: reduced pleasure, perceived and real physical side-effects, myths, lack of information, status, financial reasons, distrust in the efficacy of condoms, family planning, cultural reasons, gender-related reasons and trust. Many of the barriers to consistent condom use cannot be overcome by strategies that target the individual. Interventions need to address underlying developmental factors such as the non-biological factors that increase the susceptibility of women to HIV infection. As this falls outside of the scope of the mandate of the Department of Health, various partnerships with other key role players need to be established and/or strengthened, such as with local government, non-governmental organisations and faith-based organisations.

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.

Negative mood and sexual behavior among non-monogamous men who have sex with men in the context of methamphetamine and HIV.

PubMed

Bousman, C A; Cherner, M; Ake, C; Letendre, S; Atkinson, J H; Patterson, T L; Grant, I; Everall, I P

2009-12-01

Research comparing the independent and combined contextual effects of methamphetamine dependence (METH) and HIV-infection (HIV) on mood and sexual behavior among men who have sex with men (MSM) has been sparse and inconsistent. This study examined the contextual influence of METH, HIV-infection and their combination on mood states and sexual behavior. 175 non-monogamous MSM concordant or discordant for METH and HIV were included. Multivariate analysis was conducted to examine mood and sexual behavior differences between groups, as well as to elucidate the relationship between mood and sexual risk behavior and explore the potential moderator (i.e. contextual) effects of METH and/or HIV on this relationship. METH+/HIV+ participants reported condom use less than 25% of the time whereas METH-/HIV+ participants reported condom use 51-75% of the time. METH+ and HIV+ status were associated with higher depression and confusion scores. Univariate regressions revealed negative relationships between mood states (depression, tension, anger, fatigue and confusion) and condom use. Neither METH nor HIV status moderated the relationships between negative mood and condom use. Results are derived from cross-sectional data, sample sizes for each of the four groups were relatively small, and condom use could not be linked to specific sexual practices and/or partner types. METH dependence, HIV seropositivity, and negative moods are associated with reduced condom use among non-monogamous MSM. Independent effects of METH dependence and negative mood on condom use suggest that sexual risk reduction interventions for MSM should incorporate multi-faceted approaches, including substance abuse and mental health treatment.

Progress and challenges to male and female condom use in South Africa.

PubMed

Beksinska, Mags E; Smit, Jennifer A; Mantell, Joanne E

2012-03-01

South Africa has responded to the sexually transmissible infection and HIV epidemic with a rapid expansion of its national-level public sector condom program. Male condoms are available widely at no cost in the public sector, with expanded access via social marketing and the private sector. The female condom program is one of the largest and best established globally. National surveys show progressive increases in rates of condom use at last sex. However, inconsistent and incorrect condom use and the likelihood that condoms are discontinued in longer-term partnerships are some of the challenges impeding the condom program's successes in the fight against sexually transmissible infections and HIV. This article reviews the current condom program, related guidelines and policies, and the existing data on male and female condom use, including distribution and uptake. We discuss the main challenges to condom use, including both user and service-related issues and finally how these challenges could be addressed.

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.

Correlates of consistent condom use among men who have sex with men recruited through the Internet in Huzhou city: a cross-sectional survey.

PubMed

Jin, Meihua; Yang, Zhongrong; Dong, Zhengquan; Han, Jiankang

2013-12-01

There is growing evidence that men who have sex with men (MSM) are currently a group at high risk of HIV infection in China. Our study aims to know the factors affecting consistent condom use among MSM recruited through the internet in Huzhou city. An anonymous cross-sectional study was conducted by recruiting 410 MSM living in Huzhou city via the Internet. The socio-demographic profiles (age, education level, employment status, etc.) and sexual risk behaviors of the respondents were investigated. Bivariate logistic regression analyses were performed to compare the differences between consistent condom users and inconsistent condom users. Variables with significant bivariate between groups' differences were used as candidate variables in a stepwise multivariate logistic regression model. All statistical analyses were performed using SPSS for Windows 17.0, and a p value < 0.05 was considered to be statistically significant. According to their condom use, sixty-eight respondents were classified into two groups. One is consistent condom users, and the other is inconsistent condom users. Multivariate logistic regression showed that respondents who had a comprehensive knowledge of HIV (OR = 4.08, 95% CI: 1.85-8.99), who had sex with male sex workers (OR = 15.30, 95% CI: 5.89-39.75) and who had not drunk alcohol before sex (OR = 3.10, 95% CI: 1.38-6.95) were more likely to be consistent condom users. Consistent condom use among MSM was associated with comprehensive knowledge of HIV and a lack of alcohol use before sexual contact. As a result, reducing alcohol consumption and enhancing education regarding the risks of HIV among sexually active MSM would be effective in preventing of HIV transmission.

[Contraceptive practices among university students: the use of emergency contraception].

PubMed

Borges, Ana Luiza Vilela; Fujimori, Elizabeth; Hoga, Luiza Akiko Komura; Contin, Marcelo Vieira

2010-04-01

This study investigated contraceptive practices and especially the use of emergency contraception by 487 young students at a public university in São Paulo State. A structured questionnaire was sent by e-mail and completed online in December 2007. Contraceptive methods and use of emergency contraception were investigated. Female and male students reported a high proportion of contraceptive use, mainly condoms and the pill. Half of the students had already used emergency contraception, often when already using some other highly effective method. Among female students, multiple regression analysis showed that current age, age at sexual initiation, not having used condoms in sexual relations, condom failure, and knowing someone that has used emergency contraception were associated with use of the latter. The option for emergency contraception proved to be more closely related to inconsistencies in the use of regular methods than to lack of their use, and can thus be considered a marker for discontinuity in regular contraception.

Population attributable risk for chlamydia infection in a cohort of young international travellers (backpackers) and residents in Australia

PubMed Central

Guy, Rebecca; Donovan, Basil; McNulty, Anna

2011-01-01

Aim To estimate the population attributable risk (PAR) for Chlamydia trachomatis infection in young men and women in Sydney, Australia. Method Multivariate logistic regression was used to examine the association between demographic, sexual behaviour and other potential risk factors and chlamydia positivity in young (≤30 years) heterosexual international travellers (backpackers) and Australian residents attending a sexual health clinic. Point and interval estimates of PAR were calculated to quantify the proportion of chlamydia infections that can theoretically be prevented if a combination of risk factors is eliminated from a target population. Results In males, the PAR associated with inconsistent condom use in the past 3 months was 65% (95% CI 56% to 71%) in backpackers compared to 50% (95% CI 41% to 56%) in non-backpackers and the PAR associated with reporting three or more female sexual partners in the past 3 months was similar between male backpackers and non-backpackers (33% (95% CI 28% to 40%) and 36% (95% CI 32% to 41%), respectively). In females, the PAR associated with inconsistent condom use in the past 3 months was 51% (95% CI 42% to 59%) in backpackers compared to 41% (95% CI 31% to 51%) in non-backpackers, and the PAR associated with reporting three or more male sexual partners in the past 3 months was 14% (95% CI 11% to 18%) in backpackers compared to 30% (95% CI 25% to 37%) in non-backpackers. Conclusion These findings suggest that the largest number of chlamydia infections could be avoided by increasing condom use, particularly in backpackers. Reporting multiple partners was also associated with a large proportion of infections and the risk associated with this behaviour should be considered in health promotion strategies. PMID:22021720

Population attributable risk for chlamydia infection in a cohort of young international travellers (backpackers) and residents in Australia.

PubMed

Wand, Handan; Guy, Rebecca; Donovan, Basil; McNulty, Anna

2011-02-23

To estimate the population attributable risk (PAR) for Chlamydia trachomatis infection in young men and women in Sydney, Australia. Multivariate logistic regression was used to examine the association between demographic, sexual behaviour and other potential risk factors and chlamydia positivity in young (≤ 30 years) heterosexual international travellers (backpackers) and Australian residents attending a sexual health clinic. Point and interval estimates of PAR were calculated to quantify the proportion of chlamydia infections that can theoretically be prevented if a combination of risk factors is eliminated from a target population. In males, the PAR associated with inconsistent condom use in the past 3 months was 65% (95% CI 56% to 71%) in backpackers compared to 50% (95% CI 41% to 56%) in non-backpackers and the PAR associated with reporting three or more female sexual partners in the past 3 months was similar between male backpackers and non-backpackers (33% (95% CI 28% to 40%) and 36% (95% CI 32% to 41%), respectively). In females, the PAR associated with inconsistent condom use in the past 3 months was 51% (95% CI 42% to 59%) in backpackers compared to 41% (95% CI 31% to 51%) in non-backpackers, and the PAR associated with reporting three or more male sexual partners in the past 3 months was 14% (95% CI 11% to 18%) in backpackers compared to 30% (95% CI 25% to 37%) in non-backpackers. These findings suggest that the largest number of chlamydia infections could be avoided by increasing condom use, particularly in backpackers. Reporting multiple partners was also associated with a large proportion of infections and the risk associated with this behaviour should be considered in health promotion strategies.

Effect of Alcohol Use on Injection and Sexual Behavior among People Who Inject Drugs in Tehran, Iran: A Coarsened Exact Matching Approach.

PubMed

Noroozi, Mehdi; Marshall, Brandon D L; Noroozi, Alireza; Armoon, Bahram; Sharifi, Hamid; Qorbani, Mostafa; Abbasi, Mohammad; Bazrafshan, Mohammad Rafi

2018-05-19

Many studies have recognized the importance of sexual and injection risk behaviors in HIV transmission among people who inject drugs (PWID). We aimed to examine effect of alcohol use on sexual and injection risky behavior using coarsened exact matching (CEM) approach among PWID in Tehran, Iran. A cross-sectional study. This study was conducted from Mar to Aug 2016 in Tehran, Iran. PWID were recruited by a convenience and snowball sampling from five of Drop-in Centers (DICs) in Tehran. We assessed three outcomes of interest, all treated as binary variables, including distributive and receptive sharing and inconsistent condom use with any type of sexual partner. We applied coarsened exact matching (CEM) to estimate the independent effect of alcohol use on injection and sexual risk behaviours. All data analysis was performed using Stata v.11. Overall, 550 PWID (all male) were enrolled. The prevalence of receptive sharing, distributive sharing, and inconsistent condom use was 32%, 15% and 55%, respectively. In the matched samples, last month drinkers were more likely to report receptive sharing (OR=2.12 95% CI: 1.31, 3.81; P=0.022), as compared to abstainer participants. Distributive sharing in last 30 d, was also significantly higher among last month drinkers group (OR=2.72 95% CI 1.72, 4.21; P=0.011), compared last month abstainers group. Finally, there was a statistically significant relationship between alcohol use and inconsistent condom use (OR=4.21 95% CI: 2.71, 7.52; P=0.013). The findings emphasize importance of addressing alcohol use in risk reduction interventions for Iranian PWID with alcohol use.

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.

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.

Gender power control, sexual experiences, safer sex practices, and potential HIV risk behaviors among young Asian-American women.

PubMed

Hahm, Hyeouk Chris; Lee, Jieha; Rough, Kathryn; Strathdee, Steffanie A

2012-01-01

We examined the prevalence of three domains of sexual behaviors among young Asian-American women: sexual experiences, safer sex practices, and potential HIV risk behaviors. We also investigated the impact of gender power control on these domains. Among sexually experienced women, 51% reported using condoms during their most recent sex act, 63% reported inconsistent condom use, and 18% reported ever having forced sex. Multiple logistic regression analyses revealed that women's perceived lower relationship power control was not associated with vaginal sex or safer sex practices, but it was powerfully associated with forced sex and all three potential HIV risk behaviors. This study demonstrates that control within young Asian-American women's intimate relationships exerts different associations depending on the type of sexual behavior. The application of the Theory of Gender and Power should be employed with prudence when designing HIV interventions for this population.

Gender Power Control, Sexual Experiences, Safer Sex Practices, and Potential HIV Risk Behaviors Among Young Asian-American Women

PubMed Central

Lee, Jieha; Rough, Kathryn; Strathdee, Steffanie A.

2012-01-01

We examined the prevalence of three domains of sexual behaviors among young Asian-American women: sexual experiences, safer sex practices, and potential HIV risk behaviors. We also investigated the impact of gender power control on these domains. Among sexually experienced women, 51% reported using condoms during their most recent sex act, 63% reported inconsistent condom use, and 18% reported ever having forced sex. Multiple logistic regression analyses revealed that women’s perceived lower relationship power control was not associated with vaginal sex or safer sex practices, but it was powerfully associated with forced sex and all three potential HIV risk behaviors. This study demonstrates that control within young Asian-American women’s intimate relationships exerts different associations depending on the type of sexual behavior. The application of the Theory of Gender and Power should be employed with prudence when designing HIV interventions for this population. PMID:21259042

Exploring Risk Behaviors and Vulnerability for HIV among Men Who Have Sex with Men in Abidjan, Cote d′Ivoire: Poor Knowledge, Homophobia and Sexual Violence

PubMed Central

Aho, Josephine; Hakim, Avi; Vuylsteke, Bea; Semde, Gisèle; Gbais, Honorat G.; Diarrassouba, Mamadou; Thiam, Marguerite; Laga, Marie

2014-01-01

Men who have sex with men (MSM) are at high risk of HIV. Few data are available on MSM and HIV-related risk behaviors in West Africa. We aimed to describe risk behaviors and vulnerability among MSM in Abidjan, Cote d′Ivoire. We conducted a cross-sectional respondent-driven sampling survey with 601 MSM in 2011–2012. Sociodemographic and behavioural data as well as data related to emotional state and stigma were collected. Population estimates with 95% confidence intervals were produced. Survey weighted logistic regression was used to assess factors associated with inconsistent condom use in the prior 12 months. Most MSM were 24 years of age or younger (63.9%) and had attained at least primary education (84.4%). HIV risk behaviors such as low condom and water-based lubricant use, high numbers of male and female sex partners, and sex work were frequently reported as well as verbal, physical and sexual abuse. Inconsistent condom use during anal sex with a male partner in the prior 12 months was reported by 66.0% of the MSM and was positively associated with history of forced sex, alcohol consumption, having a regular partner and a casual partner, having bought sex, and self-perception of low HIV risk. MSM in Abidjan exhibit multiple and frequent HIV-related risk behaviors. To address those behaviours, a combination of individual but also structural interventions will be needed given the context of stigma, homophobia and violence. PMID:24959923

Exploring risk behaviors and vulnerability for HIV among men who have sex with men in Abidjan, Cote d'Ivoire: poor knowledge, homophobia and sexual violence.

PubMed

Aho, Josephine; Hakim, Avi; Vuylsteke, Bea; Semde, Gisèle; Gbais, Honorat G; Diarrassouba, Mamadou; Thiam, Marguerite; Laga, Marie

2014-01-01

Men who have sex with men (MSM) are at high risk of HIV. Few data are available on MSM and HIV-related risk behaviors in West Africa. We aimed to describe risk behaviors and vulnerability among MSM in Abidjan, Cote d'Ivoire. We conducted a cross-sectional respondent-driven sampling survey with 601 MSM in 2011-2012. Sociodemographic and behavioural data as well as data related to emotional state and stigma were collected. Population estimates with 95% confidence intervals were produced. Survey weighted logistic regression was used to assess factors associated with inconsistent condom use in the prior 12 months. Most MSM were 24 years of age or younger (63.9%) and had attained at least primary education (84.4%). HIV risk behaviors such as low condom and water-based lubricant use, high numbers of male and female sex partners, and sex work were frequently reported as well as verbal, physical and sexual abuse. Inconsistent condom use during anal sex with a male partner in the prior 12 months was reported by 66.0% of the MSM and was positively associated with history of forced sex, alcohol consumption, having a regular partner and a casual partner, having bought sex, and self-perception of low HIV risk. MSM in Abidjan exhibit multiple and frequent HIV-related risk behaviors. To address those behaviours, a combination of individual but also structural interventions will be needed given the context of stigma, homophobia and violence.

Understanding the Broader Sexual and Reproductive Health Needs of Female Sex Workers in Dhaka, Bangladesh.

PubMed

Katz, Karen R; McDowell, Misti; Green, Mackenzie; Jahan, Shamim; Johnson, Laura; Chen, Mario

2015-12-01

Little is known about the sexual and reproductive health care needs of female sex workers in Dhaka, Bangladesh. Survey data were collected from 354 hotel-based and 323 street-based female sex workers using a venue-based stratified cluster sampling approach. In addition, in-depth interviews were conducted with 20 female sex workers recruited from drop-in centers. We calculated unmet need for family planning and examined fertility desires, use of condoms and other contraceptive methods, experiences with gender-based violence, sexual and reproductive health service needs, and preferences on where to receive services. The prevalence of unmet need was 25% among hotel-based female sex workers and 36% among street-based female sex workers. Almost all participants reported having used condoms in the past 30 days, and 44% of hotel-based sex workers and 30% of street-based sex workers reported dual method use during that period. Condom use was inconsistent, however, and condom breakage and nonuse for extra money were common. Many women reported experiencing gender-based violence. Sexual and reproductive health services had been obtained by 64% of hotel-based and 89% of street-based sex workers in the past six months; drop-in centers were their preferred site for receiving health services. Female sex workers in Dhaka need family planning and other sexual and reproductive health services and prefer receiving them from drop-in centers.

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.

Violence as a Barrier for HIV Prevention among Female Sex Workers in Argentina

PubMed Central

Pando, María A.; Coloccini, Romina S.; Reynaga, Elena; Rodriguez Fermepin, Marcelo; Gallo Vaulet, Lucia; Kochel, Tadeusz J.; Montano, Silvia M.; Avila, María M.

2013-01-01

Background Violence against female sex workers (FSWs) has been increasingly reported as an important determinant of HIV infection risk. This study explores the frequency of different violent experiences (sexual abuse, rejection, beating and imprisonment) among FSWs in Argentina and its association with condom use and HIV and T. pallidum prevalence. Methods A convenience sample of 1255 FSWs was included in a cross-sectional study conducted between October 2006 and November 2009. Results Sexual abuse was reported by 24.1% (219/907) of women. A total of 34.7% (42/1234) reported rejection experiences, 21.9% (267/1215) reported having been beaten and 45.4% (561/1236) stated having been arrested because of their sex work activity. There was a higher frequency of inconsistent condom use with clients among FSWs who had experienced sexual abuse, rejection, and police detention. A higher frequency of HIV and T. pallidum infection was detected among FSWs who reported having been arrested by the police. Conclusion The study shows for the first time the frequency of different violent situations among FSWs in Argentina. The association between violence against sex workers, condom use and STI prevalence demonstrated here calls for measures to reduce stigma and violence against FSWs. Such violent experiences may increase vulnerability to STI through coerced unprotected sex. PMID:23342092

HIV-related risk behaviors among female sex workers in Ho Chi Minh City, Vietnam.

PubMed

Nemoto, Tooru; Iwamoto, Mariko; Colby, Donn; Witt, Samantha; Pishori, Alefiyah; Le, Mai Nhung; Vinh, Dang Thi Nhat; Giang, Le Truong

2008-10-01

This study quantitatively and qualitatively described HIV risk behaviors among Vietnamese female sex workers (FSWs) who work at three distinct venues in Ho Chi Minh City: street, massage parlors, and bars/clubs. Although 35% of the participants had never been tested for HIV, 18% of street and 7% of bar/club FSWs reported being positive. Almost all massage parlor FSWs had never used a condom for oral sex. Inconsistent condom use for vaginal sex with customers was more prevalent among bar/club FSWs (85%) than massage parlor (72%) and street FSWs (68%). Many participants reported difficulties in negotiating condom use with customers because of economic pressure, maintaining relationships, and lack of bargaining power. Bar/club FSWs revealed a difficult situation where drinking is part of their work. Thirty percent of street FSWs had injected drugs and reported addiction to heroin in relation to their helpless condition as FSWs. Street FSWs had the lowest levels of self-esteem and norms toward practicing safe sex and the highest levels of economic pressure. This study recommends future HIV prevention programs for FSWs in Vietnam that target their specific risk behaviors and work environments.

Patterns of condom use and associated factors among adult HIV positive clients in North Western Ethiopia: a comparative cross sectional study.

PubMed

Yalew, Estifanos; Zegeye, Desalegn T; Meseret, Solomon

2012-04-26

The introduction of antiretroviral therapy (ART) has sharply decreased morbidity and mortality rates among HIV infected patients. Due to this, more and more people with HIV live longer and healthier lives. Yet if they practice sex without condom, those with high viral load have the potential to infect their sero-negative sexual partner or at risk of acquiring drug resistant viral strains from their sexual partner who are already infected. Hence, we aimed to assess practice of condom use and associated factors among HIV positive clients at Felege Hiwot Referral Hospital in North Western Ethiopia. Hospital based comparative cross sectional study was conducted at Felege Hiwot Referral Hospital in northwest Ethiopia. Systematic random sampling technique was used to select 466 study participants from the ART and pre ART clinic of the Hospital. A structured interview administered questionnaire first prepared in English then translated into Amharic was used to collect data. Nurses who were working in the hospital but not in the HIV clinic were recruited and trained as data collectors. A total of 454 (224 respondents from ART naive and 230 ART experienced groups) were included in the study. Females constitute 151 (67.4%) and 133 (57.8%) of pre ART and ART group respectively. The ages of the participants ranged from 18 to 72 years. The average age was 31.7 years for women and 36.6 years for the men. About half of the participants (47.4% of ART group and 50.4% of the pre ART group) were sexually active. Inconsistent condom use was reported by 61(56%) ART and 50 (44.2%) of the pre ART sexually active study participants. The study found that those who are on ART were at lower risk of using condom inconsistently as compared to the ART naïve patients living with HIV. Therefore, these results are of high importance in order to design tailored interventions.

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.

The impact of socio-cultural context on young people's condom use: evidence from two Pacific Island countries.

PubMed

McMillan, Karen; Worth, Heather

2011-03-01

Young people are a key group for HIV prevention in the Pacific region where levels of STIs are high and condom use is low. During 2008, 62 in-depth interviews were conducted with people aged between 18 and 25 years in Tonga and Vanuatu. The research was aimed at understanding factors impacting on young peoples' condom use in two Pacific Island nations. The data show a marked disjuncture between attitudes and practice with regard to condoms. This paper discusses factors underpinning that inconsistency and directs attention to the effect of social and cultural influences on young people's condom use. The authors conclude that individual-level approaches to improving rates of condom use will be inadequate unless they are informed by an understanding of the role of identity, culture and tradition in young peoples' decisions around condom use. The findings also underline the need for country-specific approaches to condom promotion efforts in the Pacific.

Correlates of risky sexual behaviors in recently traditionally circumcised men from initiation lodges in the Eastern Cape, South Africa.

PubMed

Nyembezi, Anam; Sifunda, Sibusiso; Funani, Itumeleng; Ruiter, Robert A C; Van Den Borne, Bart; Reddy, Priscilla S

This exploratory quantitative study examines past risky sexual behaviors among young men who were circumcised as part of a rite of passage to adulthood embedded within a cultural and traditional belief system in the Eastern Cape Province in South Africa. Following permission from the Eastern Cape House of Traditional Leaders (ECHOTL), individual face-to-face interviews using a structured questionnaire were conducted among 114 initiates. The mean age of the participants was 18.9 years, ranging from 15 to 32 years old. About 79.8% reported already having had sex with a woman prior to initiation. Of those, 89% reported that they ever used condoms when having sex, and 61% reported consistent use. Logistic regression analysis showed that consistent condom use increased with higher educational levels. Those involved in other risky health behaviors (specifically, smoking) were also more likely to report inconsistent condom use. Most participants had positive beliefs about male circumcision and STI/HIV transmission. This study provides a first look at the sexual behaviors of young men at the time of their initiation in adulthood, a process that is intended to make it socially acceptable to initiate sexual relations and highlights a major public health challenge in integrating the protective health benefits of circumcision with indigenous cultural practices.

Motivational brief intervention for the prevention of sexually transmitted infections in travelers: a randomized controlled trial

PubMed Central

2011-01-01

Background Sexually transmitted infections (STIs) are among the frequent risks encountered by travelers. Efficient interventions are needed to improve the understanding of the risks of STIs. We investigated the potential benefits of a motivational brief intervention (BI) and the provision of condoms on the engagement in unprotected casual sex. Methods 3-arm randomized controlled trial performed among single travelers aged 18-44 years visiting a travel clinic in Switzerland. The main outcomes were the prevalence of casual unprotected sexual intercourse and their predictors. Results 5148 eligible travelers were seen from 2006 to 2008. 1681 agreed to participate and 1115 subjects (66%) completed the study. 184/1115 (17%) had a casual sexual relationship abroad and overall 46/1115 (4.1%) had inconsistently protected sexual relations. Women (adjusted OR 2.7 [95%CI 1.4-5.6]) and travelers with a history of past STI (adjusted OR 2.8 [95%CI 1.1-7.4]) had more frequent casual sexual relationships without consistent protection. Regarding the effect of our intervention, the prevalence of subjects using condoms inconsistently was 28% (95%CI16-40) in the motivational BI group, 24% (95%CI10-37) in the condoms group and 24% (95%CI14-33) in the control group (p = 0.7). Conclusion This study showed that a motivational brief intervention and/or the provision of free condoms did not modify risky sexual behavior of young travelers. The rate of inconsistently protected sexual relationships during travel was however lower than expected Trial Registration Number ClinicalTrials.gov: NCT01056536 PMID:22044609

Motivational brief intervention for the prevention of sexually transmitted infections in travelers: a randomized controlled trial.

PubMed

Senn, Nicolas; de Valliere, Serge; Berdoz, Didier; Genton, Blaise

2011-11-01

Sexually transmitted infections (STIs) are among the frequent risks encountered by travelers. Efficient interventions are needed to improve the understanding of the risks of STIs. We investigated the potential benefits of a motivational brief intervention (BI) and the provision of condoms on the engagement in unprotected casual sex. 3-arm randomized controlled trial performed among single travelers aged 18-44 years visiting a travel clinic in Switzerland. The main outcomes were the prevalence of casual unprotected sexual intercourse and their predictors. 5148 eligible travelers were seen from 2006 to 2008. 1681 agreed to participate and 1115 subjects (66%) completed the study. 184/1115 (17%) had a casual sexual relationship abroad and overall 46/1115 (4.1%) had inconsistently protected sexual relations. Women (adjusted OR 2.7 [95%CI 1.4-5.6]) and travelers with a history of past STI (adjusted OR 2.8 [95%CI 1.1-7.4]) had more frequent casual sexual relationships without consistent protection. Regarding the effect of our intervention, the prevalence of subjects using condoms inconsistently was 28% (95%CI16-40) in the motivational BI group, 24% (95%CI10-37) in the condoms group and 24% (95%CI14-33) in the control group (p = 0.7). This study showed that a motivational brief intervention and/or the provision of free condoms did not modify risky sexual behavior of young travelers. The rate of inconsistently protected sexual relationships during travel was however lower than expected ClinicalTrials.gov: NCT01056536.

Effect of Condom Use on Per-act HSV-2 Transmission Risk in HIV-1, HSV-2-discordant Couples.

PubMed

Magaret, Amalia S; Mujugira, Andrew; Hughes, James P; Lingappa, Jairam; Bukusi, Elizabeth A; DeBruyn, Guy; Delany-Moretlwe, Sinead; Fife, Kenneth H; Gray, Glenda E; Kapiga, Saidi; Karita, Etienne; Mugo, Nelly R; Rees, Helen; Ronald, Allan; Vwalika, Bellington; Were, Edwin; Celum, Connie; Wald, Anna

2016-02-15

The efficacy of condoms for protection against transmission of herpes simplex virus type 2 (HSV-2) has been examined in a variety of populations with different effect measures. Often the efficacy has been assessed as change in hazard of transmission with consistent vs inconsistent use, independent of the number of acts. Condom efficacy has not previously measured on a per-act basis. We examined the per-act HSV-2 transmission rates with and without condom use among 911 African HSV-2 and human immunodeficiency virus type 1 (HIV-1) serodiscordant couples followed for an average of 18 months in an HIV prevention study. Infectivity models were used to associate the log10 probability of HSV-2 transmission over monthly risk periods with reported numbers of protected and unprotected sex acts. Condom efficacy was computed as the proportionate reduction in transmission risk for protected relative to unprotected sex acts. Transmission of HSV-2 occurred in 68 couples, including 17 with susceptible women and 51 with susceptible men. The highest rate of transmission was from men to women: 28.5 transmissions per 1000 unprotected sex acts. We found that condoms were differentially protective against HSV-2 transmission by sex; condom use reduced per-act risk of transmission from men to women by 96% (P < .001) and marginally from women to men by 65% (P = .060). Condoms are recommended as an effective preventive method for heterosexual transmission of HSV-2. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Prevalence of consistent condom use with various types of sex partners and associated factors among money boys in Changsha, China.

PubMed

Wang, Lian-Hong; Yan, Jin; Yang, Guo-Li; Long, Shuo; Yu, Yong; Wu, Xi-Lin

2015-04-01

Money boys with inconsistent condom use (less than 100% of the time) are at high risk of infection by human immunodeficiency virus (HIV) or sexually transmitted infection (STI), but relatively little research has examined their risk behaviors. We investigated the prevalence of consistent condom use (100% of the time) and associated factors among money boys. A cross-sectional study using a structured questionnaire was conducted among money boys in Changsha, China, between July 2012 and January 2013. Independent variables included socio-demographic data, substance abuse history, work characteristics, and self-reported HIV and STI history. Dependent variables included the consistent condom use with different types of sex partners. Among the participants, 82.4% used condoms consistently with male clients, 80.2% with male sex partners, and 77.1% with female sex partners in the past 3 months. A multiple stepwise logistic regression model identified four statistically significant factors associated with lower likelihoods of consistent condom use with male clients: age group, substance abuse, lack of an "employment" arrangement, and having no HIV test within the prior 6 months. In a similar model, only one factor associated significantly with lower likelihoods of consistent condom use with male sex partners was identified in multiple stepwise logistic regression analyses: having no HIV test within the prior six months. As for female sex partners, two significant variables were statistically significant in the multiple stepwise logistic regression analysis: having no HIV test within the prior 6 months and having STI history. Interventions which are linked with more realistic and acceptable HIV prevention methods are greatly warranted and should increase risk awareness and the behavior of consistent condom use in both commercial and personal relationship. © 2015 International Society for Sexual Medicine.

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.

Men who have sex with men and women in Bangalore, South India, and potential impact on the HIV epidemic.

PubMed

Phillips, A E; Lowndes, C M; Boily, M C; Garnett, G P; Gurav, K; Ramesh, B M; Anthony, J; Moses, S; Alary, M

2010-06-01

The aim of this study was to quantify differences in patterns of sexual behaviour among men who have sex with men and women (MSMW) compared with men who have sex with men only (MSMO), and to examine the extent to which bisexual behaviour may act as a bridge for introducing HIV infection into the general population. A cross-sectional survey in Bangalore city in 2006, which sampled men seeking sex with men in public places and hammams (bath houses where transgender individuals sell sex to men). Among a sample of 357 men reporting same-sex behaviour; 41% also reported sex with a woman in the past year and 14% were currently married to a woman, only two of whom had informed their wives about having sex with men. Condom use was very inconsistent with all male partners, while 98% reported unprotected vaginal sex with their wives. MSMW reported lower rates of risky behaviour with other men than MSMO: fewer reported selling sex (17% vs 58%), or receptive anal sex with known (28% vs 70%) or unknown (30% vs 59%) non-commercial partners. Bisexual behaviour was common among men seeking sex with men sampled in this survey. Although MSMW reported lower rates of risky sexual behaviour with male partners than MSMO, inconsistent condom use with both male and female partners indicates a potential means of HIV transmission into the general population. HIV prevention programmes and services should reach bisexual men who potentially expose their male and female partners to HIV.

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.

Social and Structural Factors Associated with Consistent Condom Use Among Female Entertainment Workers Trading Sex in the Philippines

PubMed Central

Morisky, Donald E.; Hernandez, Laufred I.; Strathdee, Steffanie A.

2014-01-01

This paper examined socio-structural factors of consistent condom use among female entertainment workers at high risk for acquiring HIV in Metro Manila, Quezon City, Philippines. Entertainers, aged 18 and over, from 25 establishments (spa/saunas, night clubs, karaoke bars), who traded sex during the previous 6 months, underwent cross-sectional surveys. The 143 entertainers (42% not always using condoms, 58% always using condoms) had median age (23), duration in sex work (7 months), education (9 years), and 29% were married/had live-in boyfriends. In a logistic multiple regression model, social-structural vs. individual factors were associated with inconsistent condom use: being forced/deceived into sex work, less manager contact, less STI/HIV prevention knowledge acquired from medical personnel/professionals, not following a co-workers’ condom use advice, and an interaction between establishment type and alcohol use with establishment guests. Interventions should consider the effects of physical (force/deception into work), social (peer, manager influence), and policy (STI/HIV prevention knowledge acquired from medical personnel/professionals) environments on consistent condom use. PMID:22223297

Social and structural factors associated with consistent condom use among female entertainment workers trading sex in the Philippines.

PubMed

Urada, Lianne A; Morisky, Donald E; Hernandez, Laufred I; Strathdee, Steffanie A

2013-02-01

This paper examined socio-structural factors of consistent condom use among female entertainment workers at high risk for acquiring HIV in Metro Manila, Quezon City, Philippines. Entertainers, aged 18 and over, from 25 establishments (spa/saunas, night clubs, karaoke bars), who traded sex during the previous 6 months, underwent cross-sectional surveys. The 143 entertainers (42% not always using condoms, 58% always using condoms) had median age (23), duration in sex work (7 months), education (9 years), and 29% were married/had live-in boyfriends. In a logistic multiple regression model, social-structural vs. individual factors were associated with inconsistent condom use: being forced/deceived into sex work, less manager contact, less STI/HIV prevention knowledge acquired from medical personnel/professionals, not following a co-workers' condom use advice, and an interaction between establishment type and alcohol use with establishment guests. Interventions should consider the effects of physical (force/deception into work), social (peer, manager influence), and policy (STI/HIV prevention knowledge acquired from medical personnel/professionals) environments on consistent condom use.

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.

Alcohol Consumption, Drug Use, and Condom Use Among STD Clinic Patients*

PubMed Central

Scott-Sheldon, Lori A. J.; Carey, Michael P.; Vanable, Peter A.; Senn, Theresa E.; Coury-Doniger, Patricia; Urban, Marguerite A.

2009-01-01

Objective: Research on the association between substance use and sexual risk behavior has yielded a complex pattern of findings. Such inconsistent findings may reflect method variance, including factors such as gender of the participant, nature of the sexual event, partner characteristics, and type of substance used. The purpose of this study was to investigate the association between substance use and unprotected sex independently for alcohol, drugs, or combined substance use and to examine partner characteristics as a moderator of this association. Method: Participants (N = 1,419; 48% women) were recruited from a publicly funded sexually transmitted disease clinic and were asked to complete an audio computer-assisted self-interview regarding their most recent sexual experience, including nature of the event, substance use, and partner characteristics. Results: Analyses showed that alcohol use was related to condom use when gender and partner type were considered; thus, for women, but not for men, partner type interacted with alcohol consumption such that condom use was less likely when alcohol consumption preceded sex with nonprimary partners (drinking was unrelated to condom use with primary partners). Subsequent analyses examining partner substance use showed that women, but not men, who reported both they and their nonprimary partners were drinking during sex were less likely to use a condom. Conclusions: At the event level, alcohol consumption among sexually transmitted disease clinic patients is associated with condom use, but this association differs by gender and partner characteristics. Findings suggest the need to strengthen substance-use components in sexual risk reduction interventions for women and their partners. PMID:19737501

HIV knowledge, risk perception, and safer sex practices among female sex workers in Port Moresby, Papua New Guinea

PubMed Central

Bruce, Eunice; Bauai, Ludwina; Sapuri, Mathias; Kaldor, John M; Fairley, Christopher K; Keogh, Louise A

2011-01-01

Sex workers are considered a high-risk group for sexually transmitted infections, including human immunodeficiency virus (HIV), and are often targeted by prevention interventions with safer sex messages. The purpose of this study was to explore the extent to which knowledge of HIV and perception of risk influence safer sex practices among female sex workers (FSWs) in Port Moresby, Papua New Guinea. FSWs (n = 174) were recruited from 19 sites to participate in the study. Qualitative data were collected using semistructured interviews with FSWs (n = 142) through focus group discussions and (n = 32) individual interviews. In addition, quantitative data were collected from all FSWs using a short structured, demographic questionnaire. Data were analyzed using recurring themes and calculations of confidence intervals. Despite some common misperceptions, overall, most FSWs were basically aware of the risks of HIV and informed about transmission and prevention modalities but used condoms inconsistently. Most reported using condoms ‘sometimes’, almost one-sixth ‘never’ used condoms, only a fraction used condoms ‘always’ with clients, and none used condoms ‘always’ with regular sexual partners (RSPs). Among these FSWs, being knowledgeable about the risks, transmission, and prevention of HIV did not translate into safe sex. The findings suggest that certain contextual barriers to safer sex practices exist. These barriers could heighten HIV vulnerability and possibly may be responsible for infection in FSWs. Specific interventions that focus on improving condom self-efficacy in FSWs and simultaneously target clients and RSPs with safer sex messages are recommended. PMID:21445375

A Cognitive Analysis of College Students’ Explanations for Engaging in Unprotected Sexual Intercourse

PubMed Central

O’Sullivan, Lucia F.; Udell, Wadiya; Montrose, Vernique A.; Antoniello, Patricia; Hoffman, Susie

2011-01-01

Young adults, including college students, engage in high levels of unprotected sexual activity despite relatively high rates of HIV/STI and pregnancy-related knowledge. Little is known about the cognitive strategies young people use to explain this inconsistency. The current study examined young people’s explanations for engaging in unprotected sexual activity in their committed relationships. Sixty-three young adults (32 women and 31 men) completed daily diaries over a three-week period, providing a total of 1,284 daily reports tracking their condom use and non-use during intercourse. Diary collection was followed by in-depth interviews designed to explore participants’ decision-making regarding their participation in sexual intercourse unprotected against infection or unwanted pregnancy. Less than one-quarter (24%) used condoms consistently; similar rates used contraception consistently. Participants primarily viewed condoms as a means of preventing pregnancy; few described disease prevention as a main motivation for their use. Analysis of the cognitions underlying their explanations for condom and contraception non-use were classified as (1) general biased risk evaluation, (2) biased evidence evaluation, (3) endorsement of poor alternatives, (4) focus on spurious justifications, (5) dismissing risk, and (6) ignoring risk. Prevention interventions should incorporate methods to challenge young people to acknowledge personal risk and commit themselves to taking steps to reduce this risk. PMID:19365717

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.

Patterns of alcohol consumption and risky sexual behavior: a cross-sectional study among Ugandan university students.

PubMed

Choudhry, Vikas; Agardh, Anette; Stafström, Martin; Östergren, Per-Olof

2014-02-06

As reflected in elevated rates of sexually transmitted infections, there is a high prevalence of risky sexual behavior among Ugandan university students. It has been assumed that alcohol contributes to risky sexual behavior. However, perhaps owing to methodological issues, this relationship has found only mixed support in empirical research. The present study analyzes the association between alcohol use and risky sexual behavior at the global, situational, and event level among Uganda university students with sexual experience. A cross-sectional survey was carried out in 2010 among 1954 students at Mbarara University of Science and Technology, Uganda, using a self-administered questionnaire. Alcohol use was measured as consumption over the previous 12 months, during situations related to sexual activity and on the most recent occasion of sexual intercourse. Risky sexual behavior was defined as having two or more sexual partners in the previous 12 months or inconsistent condom use with new partners. Bivariate and multivariate logistic regression was performed to analyze the association between alcohol use and risky sexual behavior separately for males and females. Even after adjusting for confounders, the odds ratio (OR) of having two or more sexual partners in the past year indicated a statistically significant association with alcohol use on all levels (global, situational, and event) for both males and females. The ORs of inconsistent condom use with a new partner were significant for males who often consumed alcohol in relation to sexual activity--even after adjusting for potential confounders (OR, 1.75; confidence interval, 1.01-3.08). The risk of inconsistent condom use with a new partner was twice as high for females who often consumed alcohol in relation to sexual activity, although this association was not statistically significant. The study supports previous research that alcohol consumption is associated with having multiple sexual partners. Inconsistent condom use was associated with the situational use of alcohol in relation to sexual activity and was similar for both genders. Interventions to reduce alcohol-related risky sexual behavior should target both male and female drinkers, particularly subgroups of students, who often consume alcohol in relation to sexual activity.

Patterns of alcohol consumption and risky sexual behavior: a cross-sectional study among Ugandan university students

PubMed Central

2014-01-01

Background As reflected in elevated rates of sexually transmitted infections, there is a high prevalence of risky sexual behavior among Ugandan university students. It has been assumed that alcohol contributes to risky sexual behavior. However, perhaps owing to methodological issues, this relationship has found only mixed support in empirical research. The present study analyzes the association between alcohol use and risky sexual behavior at the global, situational, and event level among Uganda university students with sexual experience. Methods A cross-sectional survey was carried out in 2010 among 1954 students at Mbarara University of Science and Technology, Uganda, using a self-administered questionnaire. Alcohol use was measured as consumption over the previous 12 months, during situations related to sexual activity and on the most recent occasion of sexual intercourse. Risky sexual behavior was defined as having two or more sexual partners in the previous 12 months or inconsistent condom use with new partners. Bivariate and multivariate logistic regression was performed to analyze the association between alcohol use and risky sexual behavior separately for males and females. Results Even after adjusting for confounders, the odds ratio (OR) of having two or more sexual partners in the past year indicated a statistically significant association with alcohol use on all levels (global, situational, and event) for both males and females. The ORs of inconsistent condom use with a new partner were significant for males who often consumed alcohol in relation to sexual activity—even after adjusting for potential confounders (OR, 1.75; confidence interval, 1.01–3.08). The risk of inconsistent condom use with a new partner was twice as high for females who often consumed alcohol in relation to sexual activity, although this association was not statistically significant. Conclusions The study supports previous research that alcohol consumption is associated with having multiple sexual partners. Inconsistent condom use was associated with the situational use of alcohol in relation to sexual activity and was similar for both genders. Interventions to reduce alcohol-related risky sexual behavior should target both male and female drinkers, particularly subgroups of students, who often consume alcohol in relation to sexual activity. PMID:24502331

Use of the male condom by heterosexual adolescents and young people: literature review.

PubMed

East, Leah; Jackson, Debra; O'Brien, Louise; Peters, Kathleen

2007-07-01

This paper is a report of a literature review to explore issues influencing condom use in heterosexual adolescents and young people. Sexually transmitted infections (STIs) are a major international health issue and adolescents and young people are particularly vulnerable. Efforts to address the rapid spread of STIs have largely focused on promoting the use of condoms as a protective 'safer sex' measure. However, use of the male condom is still inconsistent and the incidence of STIs continues to increase. A search of the literature using EBSCO Host databases was undertaken in 2006, with a focus on women, young people, condoms and STIs. Papers published in English from 1992 to 2006 were sought. Only research papers are included in this review. Factors impeding decisions to use protection by young people include lack of knowledge about prevalence of STIs, ambiguity around contraception and safer sex practices, and the difficulty faced by young women in particular in negotiating safer sex. The notion of romantic love confounds the assessment of risk and can render young people, particularly young women, ineffective in negotiating safer sex practices. Adolescents and young adults are particularly vulnerable in relation to STIs. There is a need to ensure that accurate messages are delivered about safer sex and contraception to this very vulnerable group. Furthermore, it is important to recognize that romantic love comprises strong emotions that have a role in decision-making and options for reducing personal-health risk during sexual activity.

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

Perpetration of Intimate Partner Violence Associated With Sexual Risk Behaviors Among Young Adult Men

PubMed Central

Raj, Anita; Santana, M. Christina; La Marche, Ana; Amaro, Hortensia; Cranston, Kevin; Silverman, Jay G.

2006-01-01

Objective. We assessed the association between intimate partner violence (IPV) perpetration and sexual risk behaviors and fatherhood (having fathered children) among young men. Methods. Sexually active men aged 18 to 35 years who visited an urban community health center and who reported having sexual intercourse with a steady female partner during the past 3 months (N = 283) completed a brief self-administered survey about sexual risk behaviors, IPV perpetration, and demographics. We conducted logistic regression analyses adjusted for demographics to assess associations between IPV and sexual risk behaviors and fatherhood. Results. Participants were predominantly Hispanic (74.9%) and Black (21.9%). Participants who reported IPV perpetration during the past year (41.3%) were significantly more likely to report (1) inconsistent or no condom use during vaginal and anal sexual intercourse, (2) forcing sexual intercourse without a condom, (3) having sexual intercourse with other women, and (4) having fathered 3 or more children. Conclusion. IPV perpetration was common among our sample and was associated with increased sexual risk behaviors. Urban community health centers may offer an important venue for reaching this at-risk population. PMID:16670216

HIV prevalence and behavioral studies in female sex workers in Togo: a decline in the prevalence between 2005 and 2011.

PubMed

Pitché, Palokinam; Gbetoglo, Komi; Saka, Bayaki; Akakpo, Séfako; Landoh, Dadja Essoya; d'Alméida, Stéphane; Banla, Abiba Kere; Sodji, Dométo; Deku, Kodzo

2013-01-01

We determined the sero-prevalence of HIV among female sex workers (FSWs) in Togo identified their sexual risk behaviors. We conducted a cross-sectional study from 17 to 27 December, 2011 on 1106 FSWs in Togo. Venous sample were collected to estimate HIV prevalence as per national algorithms. Behavior data were collected by interviewer-administered questionnaires. Of the 1106 FSWs (mean age = 27.6 years) surveyed, 17% and 63% had their first sexual intercourse before the age of 15 and 18 years respectively. Overall, 43.4% of the FSWs had more than seven clients per week. Most FSWs (95%) said they had sex using a condom in their lifetime while 8.8% had used a condom during their last sexual intercourse. About 79% of FSWs used a condom during their sexual encounters the previous week and 11.6% had used a condom during each of their sexual encounters the previous day. Most FSWs (62.2%) reported to have been tested for HIV. Of these, 145 (13.1%) were HIV positive. HIV sero-prevalence decreased from 19.4% in the south to 7.5% in the north of the country. Behaviors associated with FSW being HIV positive included: FSW having more than 7 clients per week (p < 0.001), not using condoms at every intercourse act (p = 0.003) or during the last sexual encounter (p = 0.006) and trading sex in brothels (p < 0.001). We estimate HIV sero-prevalence among FSWs in 2011 to be 13.1% in Togo, significantly lower than a prevalence of 29.5% estimated previously in 2005. Inconsistent use of condoms was identified as associated with high risk factor for acquiring HIV.

The Contribution of Emotional Partners to Sexual Risk Taking and Violence among Female Sex Workers in Mombasa, Kenya: A Cohort Study

PubMed Central

Bosire, Wilkister; Nelson, Gill; Kingola, Nzioki; Zhang, Xu-Dong; Temmerman, Marleen; Chersich, Matthew F.

2013-01-01

Objectives To assess sexual risk-taking of female sex workers (FSWs) with emotional partners (boyfriends and husbands), compared to regular and casual clients. Experiences of violence and the degree of relationship control that FSWs have with emotional partners are also described. Design Cohort study with quarterly follow-up visit over 12-months. Methods Four hundred HIV-uninfected FSWs older than 16 years were recruited from their homes and guesthouses in Mombasa, Kenya. A structured questionnaire assessed participant characteristics and study outcomes at each visit, and women received risk-reduction counselling, male and female condoms, and HIV testing. Results Four or more unprotected sex acts in the past week were reported by 21.3% of women during sex with emotional partners, compared to 5.8% with regular and 4.8% with casual clients (P<0.001). Total number of unprotected sex acts per week was 5–6-fold higher with emotional partners (603 acts with 259 partners) than with regular or casual clients (125 acts with 456, and 98 acts with 632 clients, respectively; P<0.001). Mostly, perceptions of “trust” underscored unprotected sex with emotional partners. Low control over these relationships, common to many women (36.9%), was linked with higher partner numbers, inconsistent condom use, and being physically forced to have sex by their emotional partners. Half experienced sexual or physical violence in the past year, similarly associated with partner numbers and inconsistent condom use. Conclusions High-risk sexual behaviour, low control and frequent violence in relationships with emotional partners heighten FSWs' vulnerability and high HIV risk, requiring targeted interventions that also encompass emotional partners. PMID:23950879

Sexual Self-Efficacy and Gender: A Review of Condom Use and Sexual Negotiation Among Young Men and Women in Sub-Saharan Africa.

PubMed

Closson, Kalysha; Dietrich, Janan J; Lachowsky, Nathan J; Nkala, Busiwe; Palmer, Alexis; Cui, Zishan; Beksinska, Mags; Smit, Jennifer A; Hogg, Robert S; Gray, Glenda; Miller, Cari L; Kaida, Angela

Sexual self-efficacy (SSE), one's perceived control of or confidence in the ability to perform a given sexual outcome, predicts sexual behavior; however, important questions remain regarding whether gender modifies observed associations. In a comprehensive review of peer-reviewed HIV-prevention literature focusing on youth (ages 10 to 25) in sub-Saharan Africa, we measured and assessed the influence of SSE on condom use and sexual refusal, overall and by gender. Our results, after reviewing 63 publications, show that SSE is inconsistently measured. Most studies measured condom use self-efficacy (CUSE) (96.8%) and/or sexual refusal self-efficacy (SRSE) (63.5%). On average, young men had higher CUSE than young women, while young women had higher SRSE than young men. While cross-sectional studies reported an association between high SSE and sexual behaviors, this association was not observed in interventions, particularly among young women who face a disproportionate risk of HIV acquisition. In all, 25% of intervention studies demonstrated that fostering CUSE increased condom use among young men only, and one of two studies demonstrated that higher SRSE led to reduced frequency of sexual activity for both men and women. Future research and HIV-prevention interventions must be gender targeted, consider improving CUSE for young men, and move beyond limited individual-level sexual behavior change frameworks.

Assessing the Accuracy of Adherence and Sexual Behaviour Data in the MDP301 Vaginal Microbicides Trial Using a Mixed Methods and Triangulation Model

PubMed Central

Pool, Robert; Montgomery, Catherine M.; Morar, Neetha S.; Mweemba, Oliver; Ssali, Agnes; Gafos, Mitzy; Lees, Shelley; Stadler, Jonathan; Nunn, Andrew; Crook, Angela; Hayes, Richard; McCormack, Sheena

2010-01-01

Background Accurate data on adherence and sexual behaviour are crucial in microbicide (and other HIV-related) research. In the absence of a “gold standard” the collection of such data relies largely on participant self-reporting. The Microbicides Development Programme has developed a mixed method/triangulation model for generating more accurate data on adherence and sexual behaviour. Methodology/Principal Findings Data were collected from a random subsample of 725 women using structured case record form (CRF) interviews, coital diaries (CD) and in-depth interviews (IDI). Returned used and unused gel applicators were counted and additional data collected through focus group discussions and ethnography. The model is described in detail in a companion paper [1]. When CRF, CD and IDI are compared there is some inconsistency with regard to reporting of sexual behaviour, gel or condom use in more than half. Inaccuracies are least prevalent in the IDI and most prevalent in the CRF, where participants tend to under-report frequency of sex and gel and condom use. Women reported more sex, gel and condom use than their partners. IDI data on adherence match the applicator-return data more closely than the CRF. The main reasons for inaccuracies are participants forgetting, interviewer error, desirability bias, problems with the definition and delineation of key concepts (e.g. “sex act”). Most inaccuracies were unintentional and could be rectified during data collection. Conclusions/Significance The CRF – the main source of self-report data on behaviour and adherence in many studies – was the least accurate with regard to measuring sexual behaviour, gel and condom use. This has important implications for the use of structured questionnaires for the collection of data on sexual behaviour and adherence. Integrating in-depth interviews and triangulation into clinical trials could increase the richness and accuracy of behavioural and adherence data. PMID:20657774

Cross-sectional comparative study of risky sexual behaviours among HIV-infected persons initiated and waiting to start antiretroviral therapy in rural Rakai, Uganda.

PubMed

Nakiganda, Lydia Jacenta; Nakigozi, Gertrude; Kagaayi, Joseph; Nalugoda, Fred; Serwadda, David; Sewankambo, Nelson; Gray, Ronald; Ndyanabo, Anthony; Muwanika, Richard; Asamoah, Benedict Oppong

2017-09-11

To compare risky sexual behaviours between HIV-positive persons initiated on antiretroviral therapy (ART) (ART-experienced) and persons waiting to start on ART (ART-naive) and assess predictors of risky sexual behaviours among HIV-infected patients in rural Rakai district, Uganda. This is a cross-sectional study that used data from the Rakai Community Cohort Study (RCCS) database between 2013 and 2014. A structured questionnaire was used for data collection. We used stepwise logistic regression as an index to estimate the adjusted ORs for the association between risky sexual behaviours and ART treatment status. This study was conducted in Rakai district, located in south-western Uganda. The data for this study were extracted from the RCCS. RCCS is an open prospective cohort of approximately 15 000 consenting participants aged 15-49 years. HIV-positive participants aged 18-49 years who had sex at least once a month with any partner prior to the start of the study. Inconsistent/no condom use in the last 12 months, alcohol use at last sexual encounter, and two or more sexual partners. ART-naive participants were more likely to report inconsistent condom use (OR=1.74, 95% CI 1.11 to 2.73) and more likely to drink alcohol at last sexual encounter (OR=1.65, 95% CI 1.11 to 2.46), compared with ART-experienced patients. ART treatment status (p<0.001) was a significant predictor of risky sexual behaviours. Both marital status (p=0.016) and occupation level (p=0.009) were positively associated with inconsistent condom use, while sex (p<0.001) correlated with alcohol use at last sexual encounter. ART-naive participants were more likely to exhibit risky sexual behaviours than the ART-experienced participants. The intensity of risk reduction counselling should be increased for HIV-positive persons waiting to start ART but already in HIV care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Police-related experiences and HIV risk among female sex workers in Andhra Pradesh, India.

PubMed

Erausquin, Jennifer Toller; Reed, Elizabeth; Blankenship, Kim M

2011-12-01

Research suggests experiences with police are related to human immunodeficiency virus (HIV) sexual risk among women working as sex workers. However, little is known about the links between specific police-related behaviors and HIV vulnerability. We examine whether 5 police-related experiences are associated with measures of HIV risk and violence among a sample of female sex workers (FSWs) in Andhra Pradesh, India, and consider the implications for HIV prevention. FSWs at least 18 years of age (n = 835) were recruited through respondent-driven sampling for a cross-sectional survey conducted as part of Avahan, the India AIDS Initiative. Using logistic regression models adjusted for age, age at start of sex work, and sex work venue, we assessed police-related experiences reported by FSWs in relation to HIV risk behaviors and violence. Results showed having sex with police to avoid trouble, giving gifts to police to avoid trouble, having police take condoms away, experiencing a workplace raid, and being arrested were associated with sexually transmitted infection symptoms, inconsistent condom use, acceptance of more money for sex without a condom, and experience of client violence. These findings suggest a need for interventions targeting police-FSW interactions to reduce HIV vulnerability among FSWs.

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.

High prevalence of rectal gonorrhoea among men reporting contact with men with gonorrhoea: Implications for epidemiological treatment.

PubMed

Dutt, Krishneel; Chow, Eric P F; Huffam, Sarah; Klassen, Karen; Fairley, Christopher K; Bradshaw, Catriona S; Denham, Ian; Chen, Marcus Y

2015-07-14

This study aimed to determine the prevalence of gonorrhoea and factors associated with rectal gonorrhoea among men reporting sexual contact with men with gonorrhoea. Men who presented to Melbourne Sexual Health Centre reporting sexual contact with a male with gonorrhoea were prospectively identified between March 2011 and December 2013. These men were screened for pharyngeal and rectal gonorrhoea using culture. The prevalence of gonorrhoea among contacts was compared to that among all men who have sex with men (MSM) screened at the clinic over the same period. Among 363 contacts of gonorrhoea the prevalence of rectal gonorrhoea was 26.4% (95% CI: 21.8%-31.0%) compared to 3.9% (95% CI: 3.7%-4.2%) among clinic attendees (p < 0.001). The prevalence of pharyngeal gonorrhoea among contacts was 9.4% (95% CI: 6.4%-12.4%) compared to 2.1% (95% CI: 1.9%-2.4%) among clinic attendees (p < 0.001). Among contacts who reported not always using condoms during receptive anal sex with casual partners, rectal gonorrhoea was cultured in 42.4% compared with 12.7% among contacts reporting no receptive anal sex (p < 0.001) and 20.2% among those reporting always using condoms (p < 0.001). On multivariate analysis rectal gonorrhoea was associated with inconsistent condom use during receptive anal sex with casual partners (adjusted odds ratio (AOR): 4.16; 95% CI: 1.87-9.26) and a reported past history of gonorrhoea (AOR: 1.77; 95% CI: 1.01-3.14). The high proportion of positive cases of gonorrhoea among contacts in this study supports epidemiological treatment of MSM presenting as contacts of gonorrhoea.

Exploring dynamics of anal sex among female sex workers in Andhra Pradesh.

PubMed

Tucker, Saroj; Krishna, Rama; Prabhakar, Parimi; Panyam, Swarup; Anand, Pankaj

2012-01-01

The anal sex among heterosexual couples is on the rise as reported in many scientific studies. Considering that unprotected anal sex has higher risk of human immunodeficiency virus (HIV) transmission than the vaginal sex, we undertook a study to understand the anal sex practices among Female Sex Workers (FSW). The study was conducted among FSW attending 11 randomly selected sexually transmitted infection (STI) clinics in Bill and Melinda Gates supported targeted interventions in Andhra Pradesh. A structured questionnaire was administered to the 555 FSW attending these clinics by project clinic counselors. Informed consent was obtained from all the study participants. Engaging in anal sex was self reported by 22% of sex workers, though demand from clients was reported to be much higher (40%). The reasons for anal sex practices included more money (61%), clout/influence of the client (45%), risk of losing client (27%), and forced sex (1.2%). Factors associated with anal sex were higher number of clients, higher duration of sex work, higher income, and older age group. Associated risks perceived by FSW were bleeding and injury to anal canal (98%) while only 28% associated it with higher HIV transmission risk. Reported Condom and lubricant use was about 88% and 39% respectively. The study shows that there is frequent anal sex, inconsistent condom and infrequent lubricant usage, economic and physical coercion, and low awareness of STI/HIV transmission risk among FSW, which have serious implications for HIV prevention programmes. There is a need to focus on anal sex education and use of lubricants along with condoms during anal sex in FSW-targeted interventions in AP.

The challenge of promoting safe sex at sites where persons meet new sex partners in Jamaica: results of the Kingston PLACE randomized controlled trial.

PubMed

Figueroa, J Peter; Weir, Sharon S; Byfield, Lovette; Hall, Alison; Cummings, Stirling M; Suchindran, Chirayath M

2010-08-01

To determine whether a site-based Priorities for Local AIDS Control Efforts (PLACE) HIV prevention intervention in Kingston, Jamaica increased condom use among persons with new or multiple sex partners. A total of 147 sites where persons go to meet new sex partners were grouped into 50 geographic clusters and randomized to receive or not receive a multilevel PLACE prevention intervention. Baseline cross-sectional surveys of sites and patrons at sites were conducted in 2005 to determine the nature of social activities at sites to better plan the intervention and to ensure that the two arms of the trial were similar. The intervention was delivered by 50 trained outreach workers between January and June 2006. After the intervention two cross-sectional surveys were conducted to assess the extent of intervention implementation and to estimate the proportion of patrons at sites with recent new or concurrent partnerships and inconsistent condom use. Characteristics of sites and patrons were similar for most variables at intervention and control sites at both baseline and post-intervention. A total of 1535 patrons (723 men, 812 women) were interviewed at intervention sites and 1324 patrons (661 men, 663 women) at control sites 6-9 months after the intervention. There were no significant differences between intervention and control groups in the proportions of men (37.8% and 31.6%) and women (24.6% and 22.6%) who reported new or multiple relationships in the past year and inconsistent condom use. There was no significant difference in the proportion of men or women showing a condom at interview, having a HIV test in the past 12 months or being exposed to the intervention. An intent-to-treat analysis did not show any intervention effect. This was probably because of difficulty in implementing the intervention, the extent of patron mixing among sites, the intensity of national education campaigns, delay in conducting the post-intervention survey and evidence of other interventions at some control sites.

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.

[Inconsistent condom use among sexual workers in Ecuador: results from a behavior survey].

PubMed

Gutiérrez, Juan Pablo; Molina-Yépez, Diana; Samuels, Fiona; Bertozzi, Stefano Michele

2006-01-01

Whilst existing data suggests that the HIV epidemic in Ecuador is concentrated amongst men who have sex with men (MSM), there is very little available information on the situation of key populations, i.e. those most at risk of HIV infection and/or transmitting the infection. In particular, there is very little known about sex workers (SWs), their rate of condom use and other behaviors and characteristics with respect to the risk of acquiring sexually transmitted infections (STIs). This study presents findings from a survey carried out with SWs in eight cities in Ecuador. Using a cross-sectional design, a questionnaire focusing on behaviours, attitudes and socio-economic and demographic characteristics was administered to SWs in eight cities in Ecuador. These eight cities together account for the majority of the population in the country, and they were also identified as the locations with high reported levels of HIV. Information from a total of 2867 SWs was obtained, the majority were captured in their workplaces. Most of SWs interviewed carry out their activities in closed settings dedicated to sex work (i.e. not in the street). The average age of respondents was 28 (95%CI 27-29), and around half of them live with a male partner (married or not). The rate of condom use with the last client was 88% (82% consistently with the last three), whilst with regular partners it was 6%. A high index of life-skills, high socio-economic status and having an official document that allows them to work, were positively associated with condom use with clients (PR [CI95%] 1.40 [1.40-1.40], 1.37 [1.36-1.37], y 7.26 [6.87-7.46], respectively). Whilst condom use with clients amongst Ecuadorian SWs is high, this diminishes if one analyzes consistent condom use and is notably low with respect to regular partners. Condom use appears to be related to variables that can be linked to interventions, e.g. life-skills and official permission to carry out sex work. It is, therefore, important to tailor interventions for this population so they maximize the likelihood to increase consistent condom use.

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.

Sexual behavior, knowledge of STI prevention, and prevalence of serum markers for STI among tour guides in Cuzco/Peru.

PubMed

Cabada, Miguel M; Maldonado, Fernando; Bauer, Irmgard; Verdonck, Kristien; Seas, Carlos; Gotuzzo, Eduardo

2007-01-01

Sexual behavior during travel has increasingly become a focus of travel medicine research. The perceived freedom when away from home can lead to increased casual sexual activities, often unprotected. Local sexual partners, particularly those who are in close contact with tourists due to their occupation, need to be considered more in research. The purpose of this study was to explore the sexual behavior, knowledge of STI prevention, and prevalence of serum markers of selected STIs in tour guides in Cuzco/Peru. In this cross-sectional study, 161 tour guides completed a questionnaire consisting of information on demographics, sexual behavior, and knowledge about STI prevention. Blood samples of the participants were tested for antibodies against HSV2, Chlamydia trachomatis, and Treponema pallidum using commercial enzyme-linked immunosorbent assay kits. The majority of guides (65%) were sexually active during the year prior to the study and 10% had foreign partners. Consistent condom use was reported by 38.1%, but almost 42% did not use condoms. In total, 27.6% reported symptoms compatible with STI. Three quarters of the participants had previously received information on STI prevention, predominantly from health professionals. In total, 22% considered themselves at high risk for STI. Antibodies against C trachomatis were prevalent in 15%, while 88.2% were against HSV2. None had antibodies against T pallidum. There is an inconsistency in reported sexual behavior and reported knowledge about STI prevention. Because of the tour guides' bridging position between potential STI carriers in tourists and the local population, the reported nonuse of condoms is of concern. The prevalence of serum markers supports this concern, which is aggravated by the potential of noncurable infections. Current sexual health education strategies seem unsatisfactory, and major modifications are highly recommended.

Sensation seeking, self-esteem, and unprotected sex in college students.

PubMed

Gullette, Donna L; Lyons, Margaret A

2006-01-01

This descriptive correlational study examined the relationships of sexual sensation seeking, self-esteem, and self-efficacy in condom use, stages of change, and alcohol consumption to HIV risk-taking behaviors among college students. A total of 159 students completed an online survey in 2004. Instruments included the Sexual Sensation Seeking Scale, College Alcohol Problems Scale, Condom Use Scale, and Rosenberg Self-Esteem Scale. High sensation seekers had higher self-esteem, more self-efficacy in condom usage, fewer problems associated with alcohol consumption, and belonged to Greek organizations (F [1,158] = 12.54; p < .0005). Women who were high sensation seekers perceived more advantages (F [1, 116] = 1.67; p = .05) than disadvantages (F [1, 116] = 2.01; p = .01) to using condoms. Men consumed significantly more alcohol and had more social problems related to alcohol use than women (F [1, 158] = 5.04; p < .03). Students in Greek organizations had significantly more positive attitudes (X(2) [1] = 4.55; p < .03) and more respect for themselves (X(2) [1] = 11.22; p < .0008) than other students and were more likely to be tested for HIV (X(2) [1] = 3.85; p < .05). Students with low self-esteem consumed more alcohol, had more sexual partners, and had more HIV risk-taking behaviors than other students. Even though students were reported to be efficacious in condom usage, they used them inconsistently with their sexual partners and were in the earlier stages of change. Interventions are needed in the community to help sexually active individuals take responsibility for their sexual health and to increase the awareness of the need to be tested for HIV.

Expanding Access to Non-Medicalized Community-Based Rapid Testing to Men Who Have Sex with Men: An Urgent HIV Prevention Intervention (The ANRS-DRAG Study)

PubMed Central

Lorente, Nicolas; Preau, Marie; Vernay-Vaisse, Chantal; Mora, Marion; Blanche, Jerome; Otis, Joanne; Passeron, Alain; Le Gall, Jean-Marie; Dhotte, Philippe; Carrieri, Maria Patrizia; Suzan-Monti, Marie; Spire, Bruno

2013-01-01

Background Little is known about the public health benefits of community-based, non-medicalized rapid HIV testing offers (CBOffer) specifically targeting men who have sex with men (MSM), compared with the standard medicalized HIV testing offer (SMOffer) in France. This study aimed to verify whether such a CBOffer, implemented in voluntary counselling and testing centres, could improve access to less recently HIV-tested MSM who present a risk behaviour profile similar to or higher than MSM tested with the SMOffer. Method This multisite study enrolled MSM attending voluntary counselling and testing centres’ during opening hours in the SMOffer. CBOffer enrolees voluntarily came to the centres outside of opening hours, following a communication campaign in gay venues. A self-administered questionnaire was used to investigate HIV testing history and sexual behaviours including inconsistent condom use and risk reduction behaviours (in particular, a score of “intentional avoidance” for various at-risk situations was calculated). A mixed logistic regression identified factors associated with access to the CBOffer. Results Among the 330 participants, 64% attended the CBOffer. Percentages of inconsistent condom use in both offers were similar (51% CBOffer, 50% SMOffer). In multivariate analyses, those attending the CBOffer had only one or no test in the previous two years, had a lower intentional avoidance score, and met more casual partners in saunas and backrooms than SMOffer enrolees. Conclusion This specific rapid CBOffer attracted MSM less recently HIV-tested, who presented similar inconsistent condom use rates to SMOffer enrolees but who exposed themselves more to HIV-associated risks. Increasing entry points for HIV testing using community and non-medicalized tests is a priority to reach MSM who are still excluded. PMID:23613817

Expanding access to non-medicalized community-based rapid testing to men who have sex with men: an urgent HIV prevention intervention (the ANRS-DRAG study).

PubMed

Lorente, Nicolas; Preau, Marie; Vernay-Vaisse, Chantal; Mora, Marion; Blanche, Jerome; Otis, Joanne; Passeron, Alain; Le Gall, Jean-Marie; Dhotte, Philippe; Carrieri, Maria Patrizia; Suzan-Monti, Marie; Spire, Bruno

2013-01-01

Little is known about the public health benefits of community-based, non-medicalized rapid HIV testing offers (CBOffer) specifically targeting men who have sex with men (MSM), compared with the standard medicalized HIV testing offer (SMOffer) in France. This study aimed to verify whether such a CBOffer, implemented in voluntary counselling and testing centres, could improve access to less recently HIV-tested MSM who present a risk behaviour profile similar to or higher than MSM tested with the SMOffer. This multisite study enrolled MSM attending voluntary counselling and testing centres' during opening hours in the SMOffer. CBOffer enrolees voluntarily came to the centres outside of opening hours, following a communication campaign in gay venues. A self-administered questionnaire was used to investigate HIV testing history and sexual behaviours including inconsistent condom use and risk reduction behaviours (in particular, a score of "intentional avoidance" for various at-risk situations was calculated). A mixed logistic regression identified factors associated with access to the CBOffer. Among the 330 participants, 64% attended the CBOffer. Percentages of inconsistent condom use in both offers were similar (51% CBOffer, 50% SMOffer). In multivariate analyses, those attending the CBOffer had only one or no test in the previous two years, had a lower intentional avoidance score, and met more casual partners in saunas and backrooms than SMOffer enrolees. This specific rapid CBOffer attracted MSM less recently HIV-tested, who presented similar inconsistent condom use rates to SMOffer enrolees but who exposed themselves more to HIV-associated risks. Increasing entry points for HIV testing using community and non-medicalized tests is a priority to reach MSM who are still excluded.

Risk-taking behaviours and HIV infection among sex workers in Portugal: results from a cross-sectional survey.

PubMed

Dias, Sónia; Gama, Ana; Fuertes, Ricardo; Mendão, Luís; Barros, Henrique

2015-08-01

Sex workers (SW) are key populations at an increased risk of HIV infection. This study aimed to characterise risk-taking behaviours and assess HIV prevalence among SW in Portugal. A cross-sectional survey was conducted with 1040 SW using a participatory research approach. SW were recruited in sex-work locations and community-based organisation offices. Data were collected through a questionnaire with trained interviewers. An HIV rapid test was performed in 213 respondents. Reported HIV prevalence was 8%: 17.6% of man-to-woman transgenders, 7.4% of women and 5% of men. Of SW reportedly living with HIV, 52.2% reported ever injecting drug use. Inconsistent condom use with clients in the last month was higher among male SW (26.5%) and with non-paying partners in the last year was higher among women (71.3%). Among reported HIV-positive SW, the proportions of inconsistent condom use were high. In multivariate regression analysis, reported HIV infection remained significantly higher among transgenders (OR 6.4; 95% CI 1.7 to 24.3), those older (OR 5.1; 95% CI 1.3 to 21.1), working outdoors (OR 5.4; 95% CI 1.9 to 15.6), having ever used psychoactive substances (OR 4.1; 95% CI 2.2 to 7.7) and earning ≤€1000 per month (OR 2.6; 95% CI 1.2 to 5.9). Of those who had an HIV rapid test, 8.9% were reactive; 73.7% were unaware of their seropositivity. The HIV infection burden in SW is high. Efforts to promote HIV testing must be sustained in order to reduce undiagnosed infection. The diverse risk profiles of SW must be addressed in targeted HIV interventions. Prevention interventions should be systematically implemented within most-at-risk subgroups of SW. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Prevalence and Correlates of Use of Safer Conception Methods in a Prospective Cohort of Ugandan HIV-Affected Couples with Fertility Intentions.

PubMed

Wagner, Glenn J; Linnemayr, Sebastian; Goggin, Kathy; Mindry, Deborah; Beyeza-Kashesya, Jolly; Finocchario-Kessler, Sarah; Robinson, Eric; Birungi, Josephine; Wanyenze, Rhoda K

2017-08-01

We examined the prevalence and correlates of safer conception methods (SCM) use in HIV-affected couples with fertility intentions. A prospective cohort of 400 HIV clients in Uganda who had fertility intentions with their partner was surveyed every 6 months for 24 months. Logistic regression analysis was used to determine individual, relationship and provider level predictors of SCM use. Over one-third (35%) reported any use of timed unprotected intercourse (TUI) during the study; use of other SCM was rare. Baseline predictors of any TUI use included lower social support, greater perceived provider stigma of childbearing, greater SCM awareness, greater control over sexual decision making in the relationship, inconsistent condom use, and the belief that a desire for childbearing impedes condom use. These findings highlight the need for policy and provider training regarding integration of safer conception counselling into family planning and reproductive health services for people living with HIV.

Sexual risk among African American girls: psychopathology and mother-daughter relationships.

PubMed

Donenberg, Geri R; Emerson, Erin; Mackesy-Amiti, Mary Ellen

2011-04-01

To examine the associations among mental health problems, maternal monitoring and permissiveness, mother-daughter communication and attachment, and sexual behaviors among African American girls receiving outpatient psychiatric care. Youths with mental health problems report higher rates of HIV-risk behavior than do their peers, and African American girls have higher rates of sexually transmitted infections than do girls of all other racial groups. A sample of 12- to 16-year-old African American girls (N = 266, mean age = 14.46 years) and their female caregivers (73% biological mothers) completed computerized assessments of girls' mental health symptoms, maternal monitoring and permissiveness, and mother-daughter communication and attachment. Girls indicated their sexual risk behaviors (vaginal/anal sex, consistent condom use, number of partners). African American girls who reported clinically significant externalizing problems, more permissive parenting, less open mother-daughter sexual communication, and more frequent mother-daughter communication were more likely to report having had vaginal and/or anal sex. Sexually active girls with greater maternal attachment were less likely to report inconsistent condom use. Findings revealed important risk and protective factors for African American girls in psychiatric care. HIV-prevention programs may be strengthened by improving mother-daughter relationships and communication and by reducing girls' mental health problems. (c) 2011 APA, all rights reserved.

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.

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

Condom use preferences among Latinos in Miami-Dade: emerging themes concerning men’s and women’s culturally-ascribed attitudes and behaviours

PubMed Central

Sastre, Francisco; De La Rosa, Mario; Ibanez, Gladys E.; Whitt, Elaine; Martin, Steven S.; O’Connell, Daniel J.

2014-01-01

Among Latinos, cultural values such as machismo and marianismo may promote inconsistent condom use representing a significant risk factor for HIV infection. Yet, there continues to be a need for additional research to explore the influence these cultural values have on Latino men and women’s condom use attitudes and behaviours given increasing HIV rates of HIV infection among Latinos. The purpose of this study was to explore further Latino traditional culturally-ascribed attitudes and behaviour for emerging themes toward condom use among a diverse group of adult Latino men and women living in Miami-Dade County, Florida (USA). The study used a qualitative study-design and collected data from sixteen focus groups with a total of 67 Latino men and women. Finding from the focus groups described attitudes and behaviours that counter traditional gender roles towards sex and expected sexual behaviours informed by machismo and marianismo. Common attitudes noted in the study include men’s classification of women as clean/dirty to determine condom use and women’s assertiveness during sexual encounters negotiating condom use-in favour and against it. As the findings of this study suggest, the process differ greatly between Latino men and women, having an impact on the risk behaviours in which each engage. PMID:25530309

Condom use preferences among Latinos in Miami-Dade: emerging themes concerning men's and women's culturally-ascribed attitudes and behaviours.

PubMed

Sastre, Francisco; De La Rosa, Mario; Ibanez, Gladys E; Whitt, Elaine; Martin, Steven S; O'Connell, Daniel J

2015-01-01

Among Latinos, cultural values such as machismo and marianismo may promote inconsistent condom use representing a significant risk factor for HIV infection. Yet there continues to be a need for additional research to explore the influence these cultural values have on Latino men and women's condom use attitudes and behaviours given increasing HIV rates of HIV infection among Latinos. The purpose of this study was to explore further Latino traditional culturally-ascribed attitudes and behaviour for emerging themes toward condom use among a diverse group of adult Latino men and women living in Miami-Dade County, Florida, USA. The study used a qualitative study-design and collected data from 16 focus groups with a total of 67 Latino men and women. Findings from the focus groups described attitudes and behaviours that counter traditional gender roles towards sex and expected sexual behaviours informed by machismo and marianismo. Common attitudes noted in the study include men's classification of women as dirty-clean to determine condom use and women's assertiveness during sexual encounters negotiating condom use--in favour and against it. As the findings of this study suggest, the process differ greatly between Latino men and women, having an impact on the risk behaviours in which each engage.

Police-Related Experiences and HIV Risk Among Female Sex Workers in Andhra Pradesh, India

PubMed Central

Reed, Elizabeth; Blankenship, Kim M.

2011-01-01

Research suggests experiences with police are related to human immunodeficiency virus (HIV) sexual risk among women working as sex workers. However, little is known about the links between specific police-related behaviors and HIV vulnerability. We examine whether 5 police-related experiences are associated with measures of HIV risk and violence among a sample of female sex workers (FSWs) in Andhra Pradesh, India, and consider the implications for HIV prevention. FSWs at least 18 years of age (n = 835) were recruited through respondent-driven sampling for a cross-sectional survey conducted as part of Avahan, the India AIDS Initiative. Using logistic regression models adjusted for age, age at start of sex work, and sex work venue, we assessed police-related experiences reported by FSWs in relation to HIV risk behaviors and violence. Results showed having sex with police to avoid trouble, giving gifts to police to avoid trouble, having police take condoms away, experiencing a workplace raid, and being arrested were associated with sexually transmitted infection symptoms, inconsistent condom use, acceptance of more money for sex without a condom, and experience of client violence. These findings suggest a need for interventions targeting police–FSW interactions to reduce HIV vulnerability among FSWs. PMID:22043036

Agency, lapse in condom use and relationship intimacy among female sex workers in Jamaica.

PubMed

Bailey, Althea E; Figueroa, John Peter

2018-05-01

This paper explores barriers to consistent condom use among female sex workers in Jamaica in a qualitative study using grounded theory. Multiple perspectives were sought through 44 in-depth interviews conducted with female sex workers, clients, the partners of sex workers and facilitators of sex work. Poverty and lack of education or skills, severely limited support systems as well as childhood abuse served to push the majority of participants into sex work and created vulnerability to HIV and other STIs. Despite these constraints, women found ways to exercise agency, ensure condom use, adopt protective measures and gain economic advantage in various aspects of the Jamaican sex trade. Perceived relationship intimacy between sex workers and their clients and/or their main partners emerged as the main factor contributing to reduced risk perception and inconsistent condom use. Relationship intimacy, with associated trust and affirmation of self, is the most important factor influencing sexual decision-making with respect to lapse in condom use among female sex workers in Jamaica. Study findings provide important insights that can enhance individual psychosocial, interpersonal and community-based interventions as well as inform environmental, structural and policy interventions to reduce risk and vulnerability among female sex workers.

Correlates of amphetamine-type stimulants use and associations with HIV-related risks among young women engaged in sex work in Phnom Penh, Cambodia

PubMed Central

Couture, Marie-Claude; Evans, Jennifer L.; Sothy, Neth San; Stein, Ellen S.; Sichan, Keo; Maher, Lisa; Page, Kimberly

2011-01-01

Background Amphetamine-type stimulant (ATS) use has increased in Cambodia and emerged as a significant problem among female sex workers (FSWs), potentially contributing to increased risk of HIV. We examined the prevalence of ATS use and its effect on sexual risk behaviors, and sexually transmitted infections (STI) among FSWs in Phnom Penh, Cambodia. Methods A one-year prospective study among young women engaged in sex work in brothels, entertainment establishments and on a freelance basis. Socio-demographics, sexual risks, and recent ATS use were assessed by self-report. Blood and urine samples were collected to detect HIV, Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC). Bivariate and multivariate longitudinal analyses were conducted to assess the effects of ATS use on number of sex partners, inconsistent condom use with paying partners and incident STI. Results ATS use was higher among women working freelance (35.6%) and in brothels (34.8%) compared to women working in entertainment establishments (17.7%) or in multiple venues (14.8%). ATS users reported more sex partners and days drunk in the previous month. In multivariate longitudinal analysis, ATS use was associated with having a higher number of sex partners (Adjusted Risk Ratio 1.49; 95% CI: 1.00–2.21) and incident STI (Adjusted Odds Ratio 5.41; 95% CI: 1.15–25.48), but not inconsistent condom use with paying partner. Conclusion ATS users had more sex partners, high level of alcohol use, and were at increased risk of STI. Our findings underscore ATS use as an important emerging risk exposure that should be integrated into HIV prevention interventions targeting this population. PMID:21820251

Prevalence of HIV, syphilis, and HCV infection and associated risk factors among male clients of low-paying female sex workers in a rural county of Guangxi, China: a cross-sectional study.

PubMed

Zhang, Chen; Li, Xiaoming; Su, Shaobing; Zhang, Liying; Zhou, Yuejiao; Shen, Zhiyong; Tang, Zhenzhu

2014-05-01

The purpose of this study was to examine prevalence of HIV, syphilis and hepatitis C virus (HCV) infection as well as related risk factors among a group of male clients of low-paying female sex workers (FSW) (eg, women who usually encounter their clients on the street or small establishments in rural or less developed areas, or who charge low fees for each sexual service) in a rural county of China. Cross-sectional study conducted in 2011 in a rural county of Guangxi in China. A total of 102 clients who reported information on demographics and HIV risks (eg, inconsistent condom use) and provided blood sample to test for HIV, HCV and syphilis were included in the data analysis. Both bivariate and multivariate analyses were employed to explore risk factors of HIV, HCV and syphilis infection. Most of participants were of Han ethnicity with a mean age of 61.8 years. The majority of them lived in rural areas and worked as farmers with limited disposable cash incomes. The sample reported a high rate of unprotected sex with FSW in the last sex episode (83.7%) and inconsistent condom use in the last 6 months (95.9%). The overall prevalence of HIV, HCV and syphilis was 1.9%, 1.0% and 18.4%, respectively. Findings suggest that male clients, especially the elderly ones, are at a high risk of HIV infection given prevalent unprotected sex and high prevalence of syphilis. Culturally-appropriate, age-specific interventions are urgently needed to curb the HIV/sexually transmitted infection epidemic among this at-risk population in China.

Male condom use, multiple sexual partners and HIV: a prospective case-control study in Kinshasa (DRC).

PubMed

Carlos, Silvia; Lopez-Del Burgo, Cristina; Burgueño, Eduardo; Martinez-Gonzalez, Miguel Angel; Osorio, Alfonso; Ndarabu, Adolphe; Passabosc, Clément; de Irala, Jokin

2017-06-01

In the Democratic Republic of Congo no previous studies have assessed the factors associated with different patterns of condom use and with multiple sexual partners, and the association between condom use simultaneously taking into account multiple sexual partnerships, and HIV infection. We carried out a prospective case-control study. From December 2010 until June 2012, 1630 participants aged 15-49 getting HIV Voluntary Counseling and Testing in a hospital in Kinshasa were selected. Cases were new HIV diagnosis and controls were HIV-negative participants detected along the study period. We recruited 274 cases and 1340 controls that were interviewed about HIV-related knowledge, attitudes and behaviours. Among cases there was a high prevalence of multiple lifetime and concurrent sexual partnerships (89.8% and 20.4%, respectively) and most cases never used condoms with only 1.5% using them consistently. Condom use and multiple partnerships were associated with male, single and high-educated participants. An association was found between multiple lifetime partners and 'any condom use' (OR = 2.99; 95%CI: 2.14-4.19) but not with consistent use. Both having two or more multiple concurrent sexual partners or not using condoms were variables similarly and highly associated to HIV risk. The association found between having two or more concurrent sexual partners and HIV was slightly higher (OR = 3.58, 95%CI:2.31-5.56) than the association found between never condom use and HIV (OR = 3.38, 95%CI:1.15-9.93). We found a high prevalence of multiple lifetime sexual partners and an extremely high prevalence of inconsistent condom use, both strongly associated with HIV seropositivity. Local programmes would benefit from comprehensive interventions targeting all behavioural and sociocultural determinants.

Student Sex: More or Less Risky than Other Young Adults?

ERIC Educational Resources Information Center

Burke, Lorraine; Nic Gabhainn, Saoirse; Young, Honor

2015-01-01

Sexually active young adults are at an increased risk of acquiring sexually transmitted infections (STIs) or experiencing an unplanned pregnancy. Sexual behaviours such as inconsistent condom use, multiple partners and casual sex are known risk factors for negative sexual health outcomes. Sexually active higher education students are classified as…

Prevalence of lifetime abortion and methods of contraception among female sex workers in Bogota, Colombia.

PubMed

Bautista, Christian T; Mejía, Alfredo; Leal, Luis; Ayala, Claudia; Sanchez, Jose L; Montano, Silvia M

2008-03-01

The primary objective was to estimate the lifetime prevalence of abortion and the secondary objective was to describe the use of contraceptive methods among female sex workers (FSW) in Bogota, Colombia. A cross-sectional survey was conducted among FSW. Information on sociodemographic characteristics, contraceptive methods, number of abortions, reasons for abortions and sexual practices was collected. A total of 514 FSW were enrolled. Of these, 264 (53%) had a lifetime abortion. Age, years in sex work and a previous sexually transmitted infection were associated with abortion. A total of 89 FSW(17%) reported no contraception method. Oral contraceptives, use of condoms, female sterilization and intrauterine device insertion were the most common methods of contraception. Women who were poorer, who initiated sex work at a younger age and who reported use of illegal drugs were associated with inconsistent contraception. A high lifetime prevalence of abortion and inconsistent contraception was found among FSW in Bogota. There is a need for effective and practical contraceptive methods of family health planning among FSW in Colombia.

Discordance in monogamy beliefs, sexual concurrency, and condom use among young adult substance-involved couples: implications for risk of sexually transmitted infections.

PubMed

Riehman, Kara S; Wechsberg, Wendee M; Francis, Shelley A; Moore, Melvin; Morgan-Lopez, Antonio

2006-11-01

The objectives of this study were to examine the association between individual and partnership characteristics with condom use, sexual concurrency, and discordance in monogamy perceptions among out-of-treatment, young adult, drug-involved couples to gain a better understanding of how discordance in monogamy beliefs may influence HIV/sexually transmitted infection risk. Data were collected from 94 predominantly black heavy alcohol and/or drug users (AOD) and their steady partners recruited through street outreach in Durham, North Carolina, and a methadone clinic in Raleigh, North Carolina. One third was wrong about partners' monogamy intentions. Greater lifetime number of substances, longer relationship duration, and at least weekly relationship conflict were associated with inconsistent condom use, and discordant monogamy beliefs were associated with consistent condom use. Many individuals misperceive their partners' monogamy intentions, although this misperception may be reflective of greater HIV/sexually transmitted infection protection. Interventions for couples should focus on strategies appropriate for committed long-term relationships, including increasing awareness of partner risk behavior, negotiating safety, and conflict resolution skills.

Religiosity and Risky Sexual Behaviors among an African American Church-based Population

PubMed Central

Hawes, Starlyn M.; Berkley-Patton, Jannette Y.

2014-01-01

African Americans are disproportionately burdened by STDs and HIV in the US. This study examined the relationships between demographics, religiosity, and sexual risk behaviors among 255 adult African American church-based participants. Although participants were highly religious, they reported an average of seven lifetime sex partners and most inconsistently used condoms. Several demographic variables and religiosity significantly predicted lifetime HIV-related risk factors. Taken together, findings indicated that this population is at risk for HIV. Future research should continue to identify correlates of risky sexual behavior among African American parishioners to facilitate the development of HIV risk reduction interventions in their church settings. PMID:23054481

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.

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

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

To know that we know what we know: perceived knowledge and adolescent sexual risk behavior.

PubMed

Rock, E M; Ireland, M; Resnick, M D

2003-12-01

To examine the relationship between perceived knowledge about sex and adolescent sexual behaviors. Secondary analysis of the 2001 Minnesota Student Survey. Bivariate and multivariate relationships between perceived knowledge about sex and sexual behaviors were examined. Minnesota. 83,481 9(th) and 12(th) grade public school students. Students' report of sexual experience and sexual behaviors. Students with low perceived knowledge were less likely to be sexually experienced (OR=0.22, CI=0.17-0.29, females, OR=0.70, CI=0.59-0.82, males, P=0.00). Among sexually active students, those with low perceived knowledge also had significantly higher odds of engaging in risky sexual behaviors. Sexually experienced females with low perceived knowledge were more likely to report not talking with their partners about STIs (OR=1.83, CI=1.1-3.16, P=0.02), a history of pregnancy (OR=2.87, CI=1.59-5.18, P=0.00), and had higher numbers of male (P=0.03) and female (P=0.00) sexual partners. Sexually experienced males with low perceived knowledge were more likely to report not talking with their partners about pregnancy (OR=1.43, CI=1.11-1.84, P=0.01), pregnancy involvement (OR=2.22, CI=1.65-2.95, P=0.00), inconsistent use of birth control (OR=1.30, CI= 1.01-1.68, P=0.04), inconsistent use of condoms (OR=1.79, CI=1.38-2.32, P=0.00), not using a condom at last intercourse (OR=1.58, CI=1.22-2.04, P=0.00), and had a higher numbers of male (P=0.00) and female (P=0.00) sexual partners. Perceived knowledge may be a salient antecedent of adolescent sexual risk behavior. Health care providers and programs should incorporate the construct of perceived knowledge into their assessments of and interventions targeted at adolescents.

Sexual behavior as a function of stigma and coping with stigma among people with HIV/AIDS in rural New England.

PubMed

Varni, Susan E; Miller, Carol T; Solomon, Sondra E

2012-11-01

The relationship between coping with HIV/AIDS stigma and engaging in risky sexual behavior (i.e., inconsistent condom use) was examined in HIV-positive adults living in rural areas. Participants answered questions about their experiences with HIV/AIDS prejudice and discrimination (enacted stigma) and their perceptions of felt HIV/AIDS stigma (disclosure concerns, negative self-image, and concern with public attitudes). They were also asked about how they coped with HIV/AIDS stigma, and about their sexual activity during the past 90 days. We hypothesized that using disengagement coping to manage the stress of HIV/AIDS stigma would be related to risky sexual behavior. Multinomial logistic regression results showed that using disengagement coping (avoidance, denial, and wishful thinking) coupled with high levels of enacted stigma was associated with less risky rather than more risky sexual behavior. That is, disengagement coping coupled with high stigma increased the odds of not having vaginal or anal sex versus inconsistently using condoms. Implications for people with HIV/AIDS who use disengagement coping to manage stress to deal with HIV/AIDS stigma are discussed.

Condom utilization and sexual behavior of female sex workers in Northwest Ethiopia: A cross-sectional study.

PubMed

Tamene, Masresha Molla; Tessema, Gizachew Assefa; Beyera, Getahun Kebede

2015-01-01

Sexually transmitted infections are among the most important public health problems in the world. People who indulge in unsafe sex, such as female sex workers are the most at risk population groups due to multiple sexual partners and inconsistent condom use. The aim of this study was to assess condom utilization and sexual behavior of female sex workers in Gondar town, Northwest Ethiopia. A quantitative cross-sectional study triangulated with qualitative method was conducted from March 20 - April 10, 2014 in Gondar town. The quantitative data were collected through interviewing 488 female sex workers while in-depth interview was administered to collect qualitative data from 10 female sex workers. The collected data were entered into EPI-INFO version 3.5.3 and exported to SPSS version 20.0 software for analysis. Logistic regression analysis was done to determine the association between condom utilization and independent variables. This study revealed that less than half (47.7%) of the respondents utilized condom with any type of client. Secondary education or above, perceiving themselves at risk of HIV/AIDS infection, having awareness that sexually transmitted infections could increase HIV infection, being tested for HIV/AIDS in the last 12 months, and having lower number of clients in a month were positively associated with condom utilization. This finding depicted that condom utilization was low among female sex workers. Thus, developing and implementing target oriented behavioral change and communication strategies are needed to prevent the risk of acquiring HIV/AIDS and other sexually transmitted infections in female sex workers.

Pre-exposure Prophylaxis adherence measured by plasma drug level in MTN-001: comparison between vaginal gel and oral tablets in two geographic regions

PubMed Central

Minnis, Alexandra M.; van der Straten, Ariane; Salee, Parichat; Hendrix, Craig W.

2016-01-01

Despite strong evidence that daily oral pre-exposure prophylaxis (PrEP) reduces HIV risk, effectiveness across studies has varied. Inconsistent adherence constitutes one explanation. Efforts to examine adherence are limited when they rely on self-reported measures. We examined recent adherence as measured by plasma tenofovir (TFV) concentration in participants of MTN-001, a phase 2 cross-over trial comparing oral tablet and vaginal gel formulations of TFV among 144 HIV-uninfected women at sites in the United States (US) and sub-Saharan Africa (SSA). Adherence to daily product use was higher in the US than in the SSA sites. Within region, however, adherence was similar between products. In the US, gel adherence was higher among married women, and lower among women using male condoms and injectable contraceptives. At the SSA sites, gel adherence was lower for younger women. Inconsistent adherence points to challenges in use of daily PrEP, even during a trial of short duration. PMID:25969178

The Role of Sex Work Pay in Moderating the Effect of Mobile Phone Solicitation on Condom Practices: An Analysis of Female Sex Workers in India

PubMed Central

Navani-Vazirani, S; Heylen, E; Deardorff, J; Srikrishnan, AK; Vasudevan, CK; Solomon, D; Ekstrand, ML

2017-01-01

Mobile phones remain a largely untapped resource in the ongoing challenge to address Female Sex Worker (FSW) health, including HIV prevention services, in India. An important step towards designing effective mobile phone-based initiatives for FSWs is clarifying the contextual influences of mobile phone solicitation on sexual risk behavior. In this paper, we extend previously identified associations between mobile phone solicitation and condom practices by examining whether this association is moderated by sex work pay and offer key considerations for future research and implementation. Specifically, we conducted an analysis among 589 Indian FSWs, where FSWs who did not use mobile phones to solicit clients had the lowest mean sex work pay (INR 394/ USD 6.54) compared to FSWs who used both mobile and traditional strategies (INR 563/ USD 9.34). Our analysis indicate low paid FSWs who used mobile phones concurrently with traditional strategies had 2.46 times higher odds of inconsistent condom use compared to low paid FSWs who did not use mobile phones for client solicitation. No such effect was identified among high paid FSWs. These findings also identified group level differences among FSWs reporting different mobile phone solicitation strategies, including violence, client condom use and HIV status. Our results indicate that low pay does moderate the association between mobile phone solicitation and condom practices, but only among a sub-set of low paid FSWs. These findings also demonstrate the utility of classification by different mobile phone solicitation strategies for accurate assessment of sexual risk among mobile phone soliciting FSWs. In turn, this paves the way for novel approaches to utilize mobile phones for FSW HIV prevention. We discuss one such example, a mobile phone-based rapid screening tool for acute HIV infection targeting Indian FSWs. PMID:29202126

The Role of Sex Work Pay in Moderating the Effect of Mobile Phone Solicitation on Condom Practices: An Analysis of Female Sex Workers in India.

PubMed

Navani-Vazirani, S; Heylen, E; Deardorff, J; Srikrishnan, A K; Vasudevan, C K; Solomon, D; Ekstrand, M L

2017-01-01

Mobile phones remain a largely untapped resource in the ongoing challenge to address Female Sex Worker (FSW) health, including HIV prevention services, in India. An important step towards designing effective mobile phone-based initiatives for FSWs is clarifying the contextual influences of mobile phone solicitation on sexual risk behavior. In this paper, we extend previously identified associations between mobile phone solicitation and condom practices by examining whether this association is moderated by sex work pay and offer key considerations for future research and implementation. Specifically, we conducted an analysis among 589 Indian FSWs, where FSWs who did not use mobile phones to solicit clients had the lowest mean sex work pay (INR 394/ USD 6.54) compared to FSWs who used both mobile and traditional strategies (INR 563/ USD 9.34). Our analysis indicate low paid FSWs who used mobile phones concurrently with traditional strategies had 2.46 times higher odds of inconsistent condom use compared to low paid FSWs who did not use mobile phones for client solicitation. No such effect was identified among high paid FSWs. These findings also identified group level differences among FSWs reporting different mobile phone solicitation strategies, including violence, client condom use and HIV status. Our results indicate that low pay does moderate the association between mobile phone solicitation and condom practices, but only among a sub-set of low paid FSWs. These findings also demonstrate the utility of classification by different mobile phone solicitation strategies for accurate assessment of sexual risk among mobile phone soliciting FSWs. In turn, this paves the way for novel approaches to utilize mobile phones for FSW HIV prevention. We discuss one such example, a mobile phone-based rapid screening tool for acute HIV infection targeting Indian FSWs.

Cultural practices, gender inequality and inconsistent condom use increase vulnerability to HIV infection: narratives from married and cohabiting women in rural communities in Mpumalanga province, South Africa.

PubMed

Madiba, Sphiwe; Ngwenya, Nomsa

Women in sub-Saharan Africa bear the brunt of the human immunodeficiency virus (HIV) epidemic, and older married women and those in cohabiting relationships are regarded as the largest HIV risk group. Although preventing HIV infection in married or stable relationships is an international HIV prevention priority, little is known about the influence of sociocultural contexts on safe-sex practice by women, particularly older women in rural communities in South Africa. This study aimed to examine how older women in a rural patriarchal society negotiate safer sex within marital and long-term cohabitation relationships, and their perceptions and experiences of barriers that influence condom use. Focus group discussions were conducted with married and cohabiting women aged 40-60 years recruited from primary health facilities in a rural district in Mpumalanga province, South Africa. A thematic analysis approach was used to analyse the data. We found that although women reported negotiating safe sex in their relationships, they dreaded the possible consequences of suggesting condom use with their partners. Many factors made negotiating safe sex complex for these women: living in a patriarchal society where women play no part in sexual decision making, the fear of possible consequences of insisting on condom use, women's inferior social position in marital relationships, cultural practices such as bride price, and gender inequality were the main barriers to practising safer sex. Older married and cohabiting women dreaded negotiating safer sex in this patriarchal society where women's subordination is legitimized. The findings suggest that the women were at high risk of HIV infection because of their inability to negotiate condom use, or to reject forced sex and non-consensual sex. There is a need for interventions targeting older married and cohabiting couples and key stakeholders within communities to create awareness about cultural practices and beliefs that undermine women and HIV prevention efforts.

Truths and myths that influence the sexual decision-making process among young multiethnic college women.

PubMed

Kennedy, Barbara L; Roberts, Susan T

2009-10-01

In the United States, half of all new human immunodeficiency virus (HIV) cases are among 13- to 24-year-old women. Heterosexual contact is the primary route of transmission (73%). Young African Americans account for 56% of reported HIV cases. In an earlier study, S. T. Roberts and B. L. Kennedy (2006) studied sexual decision making among 100 young multiethnic college women (YMCW). Participants reported high condom use intention (84%) but inconsistent condom use (64%). Participants perceived their risk of acquiring HIV and sexually transmitted diseases (STDs) as low; however, their actual risk was assessed as high. YMCW reported that alcohol and drugs impaired their judgment to practice safer sex. The YMCW concurrently reported that alcohol and drugs were a routine part of their sexual experiences. The current study examined a group of YMCW to elucidate the reasons that the knowledge of safer-sex practices was not put into practice. The authors sought insight into the lived experiences of YMCW's sexual behavioral choices. The qualitative study recruited 15 participants. Focus groups were conducted, and quantitative HIV and STD knowledge questionnaires were administered. The YMCW verbalized high knowledge of HIV, STDs, and safer-sex practices. The questionnaire scores evidenced significant knowledge deficit in these same categories. Themes emerged from the narrative date. Two beliefs or myths explained why women engaged in sex without a condom. The first belief was that YMCW were not in control of their sexual behavior when "being in the moment." The second belief was "not remembering what happened" secondary to alcohol use. The women reported that the myths were culturally accepted in their peer group; however, the YMCW knew that the myths were untrue. The YMCW expressed a strong desire for someone to teach them "real information" on sexuality as this information was missing in their health education courses.

Biological validation of self-reported condom use among sex workers in Guinea.

PubMed

Aho, Joséphine; Koushik, Anita; Diakité, Soumaïla Laye; Loua, Kovana Marcel; Nguyen, Vinh-Kim; Rashed, Sélim

2010-12-01

Self-reported condom use may be prone to social desirability bias. Our aim was to assess the validity of self-reported condom use in a population of female sex workers using prostate specific antigen (PSA) as a gold standard biomarker of recent unprotected vaginal intercourse. We collected data on 223 sex-workers in Conakry, Guinea in order to assess the sensitivity and specificity of self-reported condom use as well as to examine the predictors of discordance between self-report and PSA presence. PSA was detected in 38.4% of samples. Sensitivity of self-reported condom use was 14.6% and its specificity was 94.7%. Self-perceived high risk of HIV infection was the only significant independent predictor of misreported condom use. PSA could be useful to validate self-reported condom use in surveys and to allow a better understanding of factors associated with social desirability in sexual behaviour reporting.

Psychosocial Pathways to Sexually Transmitted Infection (STI) Risk Among Youth Transitioning Out of Foster Care: Evidence from a Longitudinal Cohort Study

PubMed Central

McCarty, Cari; Simoni, Jane; Dworsky, Amy; Courtney, Mark E.

2013-01-01

Purpose To test the fit of a theoretically driven conceptual model of pathways to STI risk among foster youth transitioning to adulthood. The model included: 1) historical abuse and foster care experiences, 2) mental health and attachment style in late adolescence, and 3) STI risk in young adulthood. Methods We used path analysis to analyze data from a longitudinal study of 732 youth transitioning out of foster care. Covariates included gender, race and an inverse probability weight. We also performed moderation analyses comparing models constrained and unconstrained by gender. Results Thirty percent reported they or a partner had been diagnosed with an STI. Probability of other measured STI risk behaviors ranged from 9% (having sex for money) to 79% (inconsistent condom use). Overall model fit was good (Standardized Root Mean Squared Residual of 0.026). Increased risk of oppositional/delinquent behaviors mediated an association between abuse history and STI risk, via increased inconsistent condom use. There was also a borderline association with having greater than 5 partners. Having a very close relationship with a caregiver and remaining in foster care beyond age 18 decreased STI risk. Moderation analysis revealed better model fit when coefficients were allowed to vary by gender versus a constrained model, but few significant differences in individual path coefficients were found between male and female-only models. Conclusions Interventions/policies that: 1) address externalizing trauma sequelae, 2) promote close, stable substitute caregiver relationships, and 3) extend care to age 21 years have the potential to decrease STI risk in this population. PMID:23859955

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.

HIV Infection, risk factors and health services use among male-to-female transgender sex workers: a cross-sectional study in Portugal.

PubMed

Gama, Ana; Martins, Maria Rosário Oliveira; Mendão, Luís; Barros, Henrique; Dias, Sónia

2018-01-01

Male-to-female transgender sex workers (TSW) have been identified as a key population at risk for HIV. This study examined risk behaviors and HIV prevalence among TSW, and described health services use. A participatory cross-sectional survey was conducted with 125 TSW recruited in locations and networks where sex workers congregate. HIV-risk behaviors were common among participants. Inconsistent condom use with clients in the previous month was reported by 12.0% of participants and was associated with Portuguese nationality, inconsistent condom use with non-paying partners and not been reached by HIV prevention programs in the previous year. Ever use of psychoactive substances was reported by 61.6% of participants and was associated with being non-employed, doing full-time sex work, having higher number of non-paying partners and having never used health services. Also, ever use of psychoactive substances was negatively associated with older age and Portuguese nationality. About 34% of the participants reported having not been tested in the previous 12 months; 20.2% never used the health services. Overall, 14.9% (95%CI: 8.0-21.0%) reported being HIV-positive. Of those, 22.2% (95%CI: 1.0-43.5%) had unprotected sex with clients in the previous month, 26.7% (95%CI: 1.3-52.0%) had unprotected sex with non-paying partners in the previous year, 13.3% (95%CI: 0.0-33.0%) had ever injected drugs, 60.0% (95%CI: 23.0-97.0%) reported a past STI and 33.3% (95%CI: 2.0-64.6%) had currently HIV/STI co-infection. The socioeconomic, relational or partnering, and structural contexts conducive to increased risk are warranting further investigation. This knowledge would be valuable to inform prevention programs. HIV interventions, including secondary prevention, should address specific needs of TSW. Outreach initiatives aimed to reach TSW who are difficult to access can play a role in promoting access to health services and reducing HIV infection and transmission.

HIV risk behaviors among African American men in Los Angeles County who self-identify as heterosexual.

PubMed

Wohl, Amy Rock; Johnson, Denise F; Lu, Sharon; Jordan, Wilbert; Beall, Gildon; Currier, Judith; Simon, Paul A

2002-11-01

There are limited data on high-risk behaviors among heterosexual African American men with HIV infection. Risk behaviors were examined in a case-control study of HIV-infected (n = 90) and uninfected (n = 272) African American men who self-identified as heterosexual. Of men who self-identified as heterosexual, 31% (n = 28) of the infected men and 16% (n = 43) of the uninfected men reported having had anal sex with men. Among the heterosexual men reporting anal sex with men, 100% of the infected and 67% of the uninfected men reported inconsistent condom use during anal sex with men. Few of the infected (12%) and uninfected (2%) men reported oral sex with other men. Of the men who self-identified as heterosexual, 46% of those who were HIV-positive and 37% of those who were HIV-negative reported anal sex with women with infrequent condom use. An increasing risk for HIV was associated with decreasing age at first sexual experience (chi2, 9.3; p = .002). A history of injecting drugs (odds ratio [OR], 3.1; 95% confidence intervals [CIs], 1.8, 5.4) and amphetamine (OR, 4.3; 95% CIs, 1.1, 16.7) and methamphetamine (OR, 2.9; 95% CIs, 1.4, 6.3) use were associated with HIV. Innovative HIV prevention strategies are needed that move beyond the traditional gay versus straight model to effectively access hard-to-reach African American men who self-identify as heterosexual.

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.

The Impact of Recent Stressful Experiences on HIV-Risk Related Behaviors

ERIC Educational Resources Information Center

Wong, Carolyn F.; Kipke, Michele D.; Weiss, George; McDavitt, Bryce

2010-01-01

Limited research has captured the wide varieties of distinct, but interrelated, life stressors that young men who have sex with men (YMSM) experience as emerging adults. We examined the way recent experiences of a diverse set of stressors predict illicit drug use, alcohol misuse, and inconsistent condom use (i.e., unprotected anal intercourse)…

Empowering HIV testing as a prevention tool: targeting interventions for high-risk men who have sex with men.

PubMed

Lorente, Nicolas; Suzan-Monti, Marie; Vernay-Vaisse, Chantal; Mora, Marion; Blanche, Jérôme; Fugon, Lionel; Dhotte, Philippe; Le Gall, Jean-Marie; Rovera, Patrick; Carrieri, Maria Patrizia; Préau, Marie; Spire, Bruno

2012-01-01

In France, HIV testing can be easily performed in free and anonymous voluntary counselling testing (VCT) centres. The recent national study among French men who have sex with men (MSM) showed that 73% of those already tested for HIV had been tested in the previous two years. Nothing is known about the risk behaviours of MSM attending VCT centres. This study aimed to characterize sexual risk behaviours of MSM tested for HIV in such centres and identify factors associated with inconsistent condom use (ICU). A cross-sectional study was conducted from March to December 2009 in four VCT centres where a self-administered questionnaire was proposed to all MSM about to have a HIV test. ICU was defined as reporting non-systematic condom use during anal intercourse with casual male partners. Among the 287 MSM who fully completed their questionnaire, 44% reported ICU in the previous six months. Among those who had been already tested, 63% had had their test in the previous two years. Factors independently associated with ICU included: never avoiding one-night stands, not having been recently HIV tested, experiencing difficulty in using condoms when with a HIV negative partner or when under the influence of drugs or alcohol and finally, reporting to have had a large number of casual male partners in the previous six months. The rate of recently tested MSM was high in our study. Nevertheless, this rate was lower than that found in the last national study. Furthermore those not recently tested were significantly more likely to report high risk behaviours. We therefore recommend that further efforts be made to adapt the offer of both HIV testing and counselling to meet the specific needs of hard-to-reach MSM. Accordingly, an additional community-based offer of HIV testing to reach most-at-risk MSM is forthcoming in France.

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.

Risk perception and condom-use among Thai youths: findings from Kanchanaburi Demographic Surveillance System site in Thailand.

PubMed

Haque, Mohammad Raisul; Soonthorndhada, Amara

2009-12-01

Youths, aged 15-24 years, comprise a large fragment of the total population in Thailand, and unsafe sexual behaviours are increasing, nowadays, among young people. The study was conducted to explore the characteristics of youths and other conducive, facilitating and reinforcing factors associated with risk perception of sexually transmitted infections (STIs) among the study population. Data employed in this study were derived from the site of the Kanchanaburi Demographic Surveillance System of Thailand 2004 using a stratified systemic design. The study population was mainly young current condom-users aged 15-24 years, and cross-sectional analysis was done on this populace. The findings revealed that youths who fell into the single (unmarried) category having temporary partners were more likely to perceive the risks associated with STIs in relation to using condom. A greater proportion of unmarried youths was engaged in sexual activity before the age of 20 years and that condom-use was also inconsistent. Youths having temporary partners were more likely to perceive risk and reason for using a condom than when with their regular partner. Education played a significant role in risk perception of STIs. Risk perception was increasing with the increasing level of education. Other conducive and facilitating factors, such as household wealth, living in urban or semi-urban areas, and access to mass media such as television, also had a positive influence on risk perception. The odds ratio showed that condom-users who had indulgence in liquor were less likely to perceive the risk of STIs. Overall, socioeconomic status had a great influence on risk perception of STIs. Finally, youths exhibiting high-risk sexual behaviour need realistic risk assessments and positive ways of incorporating condom into their sexual lives.

Context matters: The moderating role of bar context in the association between substance use during sex and condom use among male clients of female sex workers in Tijuana, Mexico

PubMed Central

Pitpitan, Eileen V.; Wagner, Karla D.; Goodman, David; Semple, Shirley J.; Chavarin, Claudia; Strathdee, Steffanie A.; Patterson, Thomas L.

2013-01-01

Tijuana is situated on Mexico’s northern border with the U.S., where sex work is quasi-legal. Whereas previous work has focused on the risk behaviors of female sex workers (FSWs), less is known about the risk behaviors of their male clients. Further, research has not examined structural factors as moderators of the association between substance use and condom use, including the contexts in which sex takes place. The purpose of the current study is to examine whether having sex with FSWs in a bar moderates the link between alcohol intoxication during sex and condom use. We recruited 375 male clients of FSWs in Tijuana, Mexico from San Diego, California and Tijuana. Using computer assisted interviewing, we surveyed participants on their alcohol use, condom use, and physical contexts of sex with FSWs in the past four months. Results showed that more frequent intoxication during sex with FSWs is associated with more unprotected sex, but only among clients having sex with FSWs in a bar context. Results point to potential reasons for inconsistent condom use with FSWs in this context, including lower risk perceptions of sex with FSWs in bars. Future research should examine structural factors that underlie clients’ risk behavior in bars in order to inform structural-level HIV prevention interventions. PMID:23640653

Context matters: the moderating role of bar context in the association between substance use during sex and condom use among male clients of female sex workers in Tijuana, Mexico.

PubMed

Pitpitan, Eileen V; Wagner, Karla D; Goodman-Meza, David; Semple, Shirley J; Chavarin, Claudia; Strathdee, Steffanie A; Patterson, Thomas L

2013-10-01

Tijuana is situated on Mexico's northern border with the U.S., where sex work is quasi-legal. Whereas previous work has focused on the risk behaviors of female sex workers (FSWs), less is known about the risk behaviors of their male clients. Further, research has not examined structural factors as moderators of the association between substance use and condom use, including the contexts in which sex takes place. The purpose of the current study is to examine whether having sex with FSWs in a bar moderates the link between alcohol intoxication during sex and condom use. We recruited 375 male clients of FSWs in Tijuana, Mexico from San Diego, California and Tijuana. Using computer assisted interviewing, we surveyed participants on their alcohol use, condom use, and physical contexts of sex with FSWs in the past 4 months. Results showed that more frequent intoxication during sex with FSWs is associated with more unprotected sex, but only among clients having sex with FSWs in a bar context. Results point to potential reasons for inconsistent condom use with FSWs in this context, including lower risk perceptions of sex with FSWs in bars. Future research should examine structural factors that underlie clients' risk behavior in bars in order to inform structural-level HIV prevention interventions.

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

Doing worse but knowing better: an exploration of the relationship between HIV/AIDS knowledge and sexual behavior among adolescents in Flemish secondary schools.

PubMed

Berten, Hans; Van Rossem, Ronan

2009-10-01

Most studies on sexual behavior have approached the relationship between AIDS knowledge and sexual behavior unidirectionally. This paper sets out to examine a reciprocal relationship between AIDS knowledge and sexual behavior, in which it is possible that adolescents who enter into sexuality may start to actively seek out information on sex. Additionally, the effects of various sources for AIDS-related information and condom use are analyzed. Data from the Flemish Educational Assessment project, which surveyed a sample of adolescents from the 3rd and 5th years of secondary school, were used. Results indicate that the relationship between AIDS knowledge and sexual behavior is quite complex. On one hand, we find that better knowledge leads to a later onset of sexuality and more consistent condom use; on the other hand, we find that adolescents who start sex earlier and use condoms inconsistently tend to be more knowledgeable about AIDS.

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.

Sexual Values and Risky Sexual Behaviors Among Latino Youths

PubMed Central

Deardorff, Julianna; Tschann, Jeanne M.; Flores, Elena; Ozer, Emily J.

2010-01-01

CONTEXT Understanding Latino youths’ sexual values is key to informing HIV prevention efforts. Few studies have examined associations between culturally based sexual values and behaviors among Latinos. METHODS A sample of 839 sexually active Latinos aged 16–22 residing in San Francisco were interviewed in 2003–2006. Multiple regression and multinomial logistic regression analyses were conducted to examine associations between sexual values and behaviors, while adjusting for language use (a proxy for acculturation) and other covariates. RESULTS The importance attached to female virginity was negatively associated with the number of sexual partners women had had in their lifetime (odds ratio, 0.8) and in the past year (0.9), and was positively associated with women’s nonuse of condoms, rather than consistent use, during the first month of their current relationships (1.8). For men, the importance of satisfying sexual needs increased with the numbers of lifetime and recent sexual partners (1.4 and 1.1, respectively), and with inconsistent condom use in the first month of their relationships (1.9). Comfort with sexual communication was positively associated with inconsistent use or nonuse of condoms in the last month of both men’s and women’s current relationships (2.0–2.2). For women, considering satisfaction of sexual needs important was associated with more sexual partners only among those who attached little value to female virginity. CONCLUSIONS It is important to integrate themes of virginity and sexual desire into intervention curricula so youth can better understand how these sexual norms influence their developing sexual identities and behaviors. PMID:20415881

Sexual Behavior as a Function of Stigma and Coping with Stigma Among People with HIV/AIDS in Rural New England

PubMed Central

Solomon, Sondra E.

2012-01-01

The relationship between coping with HIV/AIDS stigma and engaging in risky sexual behavior (i.e., inconsistent condom use) was examined in HIV-positive adults living in rural areas. Participants answered questions about their experiences with HIV/AIDS prejudice and discrimination (enacted stigma) and their perceptions of felt HIV/AIDS stigma (disclosure concerns, negative self-image, and concern with public attitudes). They were also asked about how they coped with HIV/AIDS stigma, and about their sexual activity during the past 90 days. We hypothesized that using disengagement coping to manage the stress of HIV/AIDS stigma would be related to risky sexual behavior. Multinomial logistic regression results showed that using disengagement coping (avoidance, denial, and wishful thinking) coupled with high levels of enacted stigma was associated with less risky rather than more risky sexual behavior. That is, disengagement coping coupled with high stigma increased the odds of not having vaginal or anal sex versus inconsistently using condoms. Implications for people with HIV/AIDS who use disengagement coping to manage stress to deal with HIV/AIDS stigma are discussed. PMID:22782789

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.

Prevalence of Human Immunodeficiency Virus and Sexually Transmitted Infections Among Cisgender and Transgender Women Sex Workers in Greater Kuala Lumpur, Malaysia: Results From a Respondent-Driven Sampling Study.

PubMed

Wickersham, Jeffrey A; Gibson, Britton A; Bazazi, Alexander R; Pillai, Veena; Pedersen, Courtney J; Meyer, Jaimie P; El-Bassel, Nabila; Mayer, Kenneth H; Kamarulzaman, Adeeba; Altice, Frederick L

2017-11-01

Sex workers face a disproportionate burden of human immunodeficiency virus (HIV) and sexually transmitted infections (STI) worldwide. For cisgender women sex workers (CWSW), global HIV prevalence is over 10%, whereas transgender women sex workers (TWSW) face an HIV burden of 19% to 27%. We used respondent-driven sampling to recruit 492 sex workers, including CWSW (n = 299) and TWSW (n = 193) in Greater Kuala Lumpur, Malaysia. Participants completed an in-depth survey and were screened for HIV, syphilis, Chlamydia trachomatis, and Neisseria gonorrhoeae. Sample characteristics stratified by gender identity and interview site are presented. Bivariate analyses comparing CWSW and TWSW were conducted using independent samples t tests for continuous variables and χ tests for categorical variables. Pooled HIV prevalence was high (11.7%; 95% confidence interval [CI], 8.8-14.5), and was similar for CWSW (11.1%) and TWSW (12.4%). Rates of syphilis 25.5% (95% CI, 21.6-29.5), C. trachomatis (14.8%; 95% CI, 11.6-18.0) and N. gonorrhoeae (5.8%; 95% CI, 3.7-7.9) were also concerning. Both groups reported lifetime HIV testing (62.4%), but CWSW were less likely to have ever been HIV tested (54.5%) than TWSW (74.6%). Median time since last HIV test was 24 months. Previous screening for STI was low. Inconsistent condom use and drug use during sex work were not uncommon. High HIV and STI prevalence, coupled with infrequent HIV and STI screening, inconsistent condom use, and occupational drug use, underscore the need for expanded HIV and STI prevention, screening, and treatment efforts among CWSW and TWSW in Malaysia.

Psychosocial pathways to sexually transmitted infection risk among youth transitioning out of foster care: evidence from a longitudinal cohort study.

PubMed

Ahrens, Kym R; McCarty, Cari; Simoni, Jane; Dworsky, Amy; Courtney, Mark E

2013-10-01

To test the fit of a theoretically driven conceptual model of pathways to sexually transmitted infection (STI) risk among foster youth transitioning to adulthood. The model included (1) historical abuse and foster care experiences; (2) mental health and attachment style in late adolescence; and (3) STI risk in young adulthood. We used path analysis to analyze data from a longitudinal study of 732 youth transitioning out of foster care. Covariates included gender, race, and an inverse probability weight. We also performed moderation analyses comparing models constrained and unconstrained by gender. Thirty percent reported they or a partner had been diagnosed with an STI. Probability of other measured STI risk behaviors ranged from 9% (having sex for money) to 79% (inconsistent condom use). Overall model fit was good (Standardized Root Mean Square Residual of .026). Increased risk of oppositional/delinquent behaviors mediated an association between abuse history and STI risk, via increased inconsistent condom use. There was also a borderline association with having greater than five partners. Having a very close relationship with a caregiver and remaining in foster care beyond age 18 years decreased STI risk. Moderation analysis revealed better model fit when coefficients were allowed to vary by gender versus a constrained model, but few significant differences in individual path coefficients were found between male and female-only models. Interventions/policies that (1) address externalizing trauma sequelae; (2) promote close, stable substitute caregiver relationships; and (3) extend care to age 21 years have the potential to decrease STI risk in this population. Copyright © 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Perceived peer engagement in HIV-related sexual risk behaviors and self-reported risk-taking among female sex workers in Guangxi, China.

PubMed

Chen, Yiyun; Li, Xiaoming; Zhou, Yuejiao; Wen, Xiaoqing; Wu, Deren

2013-01-01

Searching for modifiable perceptions that are associated with sexual risk behaviors among female sex workers (FSWs) are considered a priority in HIV/sexually transmitted disease preventions. Perception of peers' involvement in risk behaviors, a key correlate of individual risk behaviors, has barely been studied among FSWs. A self-administered questionnaire was completed by 1022 FSWs in Guangxi, China, a country with rapid growth in both HIV epidemic and commercial sex. Multiple imputation using chained equation (MICE) was applied to handle missing values (1-10%) in the data-set. Regression analysis that focused on relationship between perceived peers' risk involvement and FSWs' risk-taking was performed on full data-sets generated by MICE. FSWs who perceived more peer alcohol use was significantly more likely to have sex under the influence of alcohol. Those who perceived more unprotected sex among peers had a higher likelihood to use condom inconsistently with both stable and casual partners. Perceiving more peers engaging in sex after using alcohol was positively associated with having sex with clients who were intoxicated and/or high on drugs, and with having sex under the influence of alcohol. Perceived peer promiscuity, defined as having sex with any types of clients at any price offered, was positively associated with inconsistent condom use with casual partners, but negatively associated with having sex under the influence of alcohol. These data suggest that the potential for intervention programs to address behavioral change among FSWs through modifying perceptions of peer involvement in sexual risk behaviors. Longitudinal studies are needed to confirm these findings and qualitative researches will be essential for the clarification of mechanisms behind associations found in the current study and for the actual design of effective norm-based interventions among FSWs.

Food Insufficiency Is Associated with High-Risk Sexual Behavior among Women in Botswana and Swaziland

PubMed Central

Weiser, Sheri D; Leiter, Karen; Bangsberg, David R; Butler, Lisa M; Percy-de Korte, Fiona; Hlanze, Zakhe; Phaladze, Nthabiseng; Iacopino, Vincent; Heisler, Michele

2007-01-01

Background Both food insufficiency and HIV infection are major public health problems in sub-Saharan Africa, yet the impact of food insufficiency on HIV risk behavior has not been systematically investigated. We tested the hypothesis that food insufficiency is associated with HIV transmission behavior. Methods and Findings We studied the association between food insufficiency (not having enough food to eat over the previous 12 months) and inconsistent condom use, sex exchange, and other measures of risky sex in a cross-sectional population-based study of 1,255 adults in Botswana and 796 adults in Swaziland using a stratified two-stage probability design. Associations were examined using multivariable logistic regression analyses, clustered by country and stratified by gender. Food insufficiency was reported by 32% of women and 22% of men over the previous 12 months. Among 1,050 women in both countries, after controlling for respondent characteristics including income and education, HIV knowledge, and alcohol use, food insufficiency was associated with inconsistent condom use with a nonprimary partner (adjusted odds ratio [AOR] 1.73, 95% confidence interval [CI] 1.27–2.36), sex exchange (AOR 1.84, 95% CI 1.74–1.93), intergenerational sexual relationships (AOR 1.46, 95% CI 1.03–2.08), and lack of control in sexual relationships (AOR 1.68, 95% CI 1.24–2.28). Associations between food insufficiency and risky sex were much attenuated among men. Conclusions Food insufficiency is an important risk factor for increased sexual risk-taking among women in Botswana and Swaziland. Targeted food assistance and income generation programs in conjunction with efforts to enhance women's legal and social rights may play an important role in decreasing HIV transmission risk for women. PMID:17958460

Food insufficiency is associated with high-risk sexual behavior among women in Botswana and Swaziland.

PubMed

Weiser, Sheri D; Leiter, Karen; Bangsberg, David R; Butler, Lisa M; Percy-de Korte, Fiona; Hlanze, Zakhe; Phaladze, Nthabiseng; Iacopino, Vincent; Heisler, Michele

2007-10-01

Both food insufficiency and HIV infection are major public health problems in sub-Saharan Africa, yet the impact of food insufficiency on HIV risk behavior has not been systematically investigated. We tested the hypothesis that food insufficiency is associated with HIV transmission behavior. We studied the association between food insufficiency (not having enough food to eat over the previous 12 months) and inconsistent condom use, sex exchange, and other measures of risky sex in a cross-sectional population-based study of 1,255 adults in Botswana and 796 adults in Swaziland using a stratified two-stage probability design. Associations were examined using multivariable logistic regression analyses, clustered by country and stratified by gender. Food insufficiency was reported by 32% of women and 22% of men over the previous 12 months. Among 1,050 women in both countries, after controlling for respondent characteristics including income and education, HIV knowledge, and alcohol use, food insufficiency was associated with inconsistent condom use with a nonprimary partner (adjusted odds ratio [AOR] 1.73, 95% confidence interval [CI] 1.27-2.36), sex exchange (AOR 1.84, 95% CI 1.74-1.93), intergenerational sexual relationships (AOR 1.46, 95% CI 1.03-2.08), and lack of control in sexual relationships (AOR 1.68, 95% CI 1.24-2.28). Associations between food insufficiency and risky sex were much attenuated among men. Food insufficiency is an important risk factor for increased sexual risk-taking among women in Botswana and Swaziland. Targeted food assistance and income generation programs in conjunction with efforts to enhance women's legal and social rights may play an important role in decreasing HIV transmission risk for women.

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.

[Profile of transvestites and transgender women: tuberculosis and HIV/AIDS in the city of São Paulo].

PubMed

Ferreira, Sérgio; Francisco, Priscila Maria Stolses Bergamo; Nogueira, Péricles Alves

2016-12-01

To characterize the profile of transvestites and transgender women participating in a survey regarding tuberculosis and HIV/Aids in the city of São Paulo. This cross-sectional study employed the Knowledge, Attitudes and Practices (KAP) questionnaire adapted for data collection. Sociodemographic aspects as well as aspects related to history of imprisonment, process of gender transition, use of condoms, previous treatment of sexually transmitted diseases and tuberculosis and knowledge regarding HIV/Aids were addressed. The study included 58 transvestites and 66 transgender women. There were differences between the two groups regarding schooling (P = 0.008), prostitution (P < 0.001), imprisonment (P < 0.001), silicone injections (P = 0.005), and hormone therapy without medical guidance (P = 0.004). All trans women (100%) and 80% of transvestites mentioned treatment of syphilis; 25.9% of transvestites reported tuberculosis/HIV co-infection. The investigation regarding knowledge of HIV/AIDS revealed inconsistent use of condoms and mistaken beliefs related to modes of transmission. The present results show that transvestites and trans women were vulnerable to tuberculosis and HIV/AIDS. The differences observed between the two groups suggest the need for different approaches to transvestites and transgender women in future studies.

HIV prevalence and factors associated with HIV infection among men who have sex with men in Cameroon

PubMed Central

Park, Ju Nyeong; Papworth, Erin; Kassegne, Sethson; Moukam, Laure; Billong, Serge Clotaire; Macauley, Issac; Yomb, Yves Roger; Nkoume, Nathalie; Mondoleba, Valentin; Eloundou, Jules; LeBreton, Matthew; Tamoufe, Ubald; Grosso, Ashley; Baral, Stefan D

2013-01-01

Introduction Despite men who have sex with men (MSM) being a key population for HIV programming globally, HIV epidemiologic data on MSM in Central Africa are sparse. We measured HIV and syphilis prevalence and the factors associated with HIV infection among MSM in Cameroon. Methods Two hundred and seventy-two and 239 MSM aged ≥18 from Douala and Yaoundé, respectively, were recruited using respondent-driven sampling (RDS) for this cross-sectional surveillance study in 2011. Participants completed a structured questionnaire and HIV and syphilis testing. Statistical analyses, including RDS-weighted proportions, bootstrapped confidence intervals and logistic regressions, were used. Results Crude and RDS-weighted HIV prevalence were 28.6% (73/255) and 25.5% (95% CI 19.1–31.9) in Douala, and 47.3% (98/207) and 44.4% (95% CI 35.7–53.2) in Yaoundé. Active syphilis prevalence in total was 0.4% (2/511). Overall, median age was 24 years, 62% (317/511) of MSM identified as bisexual and 28.6% (144/511) identified as gay. Inconsistent condom use with regular male partners (64.1%; 273/426) and casual male and female partners (48.5%; 195/402) was common, as was the inconsistent use of condom-compatible lubricants (CCLs) (26.3%; 124/472). In Douala, preferring a receptive sexual role was associated with prevalent HIV infection [adjusted odds ratio (aOR) 2.33, 95% CI 1.02–5.32]. Compared to MSM without HIV infection, MSM living with HIV were more likely to have ever accessed a health service targeting MSM in Douala (aOR 4.88, 95% CI 1.63–14.63). In Yaoundé, MSM living with HIV were more likely to use CCLs (aOR 2.44, 95% CI 1.19–4.97). Conclusions High HIV prevalence were observed and condoms and CCLs were used inconsistently indicating that MSM are a priority population for HIV prevention, treatment and care services in Douala and Yaoundé. Building the capacity of MSM community organizations and improving the delivery and scale-up of multimodal interventions for MSM that are sensitive to concerns about confidentiality and the complex individual, social, community-level and policy challenges are needed to successfully engage young MSM in the continuum of HIV care. In addition to scaling up condom and CCL access, evaluating the feasibility of novel biomedical interventions, including antiretroviral pre-exposure prophylaxis and early antiretroviral therapy for MSM living with HIV in Cameroon, is also warranted. PMID:24321114

Frequent condom use with casual partners varies by sexual position among younger gay and bisexual men in New Zealand: national behavioural surveillance 2006-2011.

PubMed

Lachowsky, Nathan J; Saxton, Peter J W; Hughes, Anthony J; Dickson, Nigel P; Milhausen, Robin R; Dewey, Cate E; Summerlee, Alastair J S

2016-02-01

Background Condom promotion remains a cornerstone of HIV/STI control, but must be informed by evidence of uptake and address disparities in use. This study sought to determine the prevalence of, and demographic, behavioural and relational factors associated with, condom use during insertive and receptive anal intercourse with casual partners among younger gay, bisexual and other men who have sex with men (YMSM) in New Zealand. The 2006-2011 national HIV behavioural surveillance data for YMSM aged 16-29 years was pooled. Separately for each sexual position, frequent (always/almost always) versus infrequent condom use was regressed onto explanatory variables using manual backward stepwise multivariable logistic regression analysis. Three-quarters of YMSM reported frequent condom use during insertive (76.0%) and receptive (73.8%) anal intercourse. YMSM who were exclusively insertive were more likely to report frequent condom use than versatile YMSM. Factors positively associated with frequent condom use, irrespective of sexual position were: in-person versus web-based recruitment, testing HIV negative versus never testing or testing HIV positive, having no recent sex with women, reporting two to five versus one male sexual partner in the past 6 months, reporting no current regular partner, but if in a regular relationship, reporting a boyfriend-type versus fuckbuddy-type partner, and frequent versus infrequent regular partner condom use. Pacific ethnicity and less formal education were negatively associated with frequent condom use only during receptive anal intercourse. The findings from this study demonstrate that condom norms can be actively established and maintained among YMSM. Condom promotion efforts must increase YMSM's capacity, agency and skills to negotiate condom use, especially for the receptive partner.

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.

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.

Structural factors associated with an increased risk of HIV and sexually transmitted infection transmission among street-involved youth

PubMed Central

Marshall, Brandon DL; Kerr, Thomas; Shoveller, Jean A; Montaner, Julio SG; Wood, Evan

2009-01-01

Background The prevalence of HIV and sexually transmitted infections (STIs) among street-involved youth greatly exceed that of the general adolescent population; however, little is known regarding the structural factors that influence disease transmission risk among this population. Methods Between September 2005 and October 2006, 529 street-involved youth were enroled in a prospective cohort known as the At Risk Youth Study (ARYS). We examined structural factors associated with number of sex partners using quasi-Poisson regression and consistent condom use using logistic regression. Results At baseline, 415 (78.4%) were sexually active, of whom 253 (61.0%) reported multiple sex partners and 288 (69.4%) reported inconsistent condom use in the past six months. In multivariate analysis, self-reported barriers to health services were inversely associated with consistent condom use (adjusted odds ratio [aOR] = 0.52, 95%CI: 0.25 – 1.07). Structural factors that were associated with greater numbers of sex partners included homelessness (adjusted incidence rate ratio [aIRR] = 1.54, 95%CI: 1.11 – 2.14) and having an area restriction that affects access to services (aIRR = 2.32, 95%CI: 1.28 – 4.18). Being searched or detained by the police was significant for males (aIRR = 1.36, 95%CI: 1.02 – 1.81). Conclusion Although limited by its cross-sectional design, our study found several structural factors amenable to policy-level interventions independently associated with sexual risk behaviours. These findings imply that the criminalization and displacement of street-involved youth may increase the likelihood that youth will engage in sexual risk behaviours and exacerbate the negative impact of resultant health outcomes. Moreover, our findings indicate that environmental-structural interventions may help to reduce the burden of these diseases among street youth in urban settings. PMID:19134203

Reducing sexual risk behavior among high-risk couples in Northern India.

PubMed

Jones, Deborah; Bagga, Rashmi; Nehra, Ritu; Deepika; Sethi, Sunil; Walia, Kamini; Kumar, Mahendra; Villar-Loubet, Olga; Lopez, Maria; Weiss, Stephen M

2013-09-01

With a population of 1.1 billion, India is considered to be a country in which effective prevention interventions could contain the development of a human immunodeficiency virus (HIV) epidemic. Heterosexual transmission accounts for 85 % of the extant HIV infections. This study sought to assess the feasibility of conducting a group, culturally tailored behavioral intervention and its impact on sexual barrier use, self-efficacy, knowledge, conflict resolution, and coping among high-risk heterosexual couples in Northern India. This pilot study was conducted at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India from February 2008 to January 2009. Thirty sexually active high-risk couples were drawn from a convenience sample of PGIMER patients attending infectious disease and family planning clinics. Couples participated in 1 month of three weekly gender-concordant behavioral intervention groups and were individually administered assessments preintervention and post-intervention. The intervention was tailored to the Northern Indian context and addressed sexual barrier use, human immunodeficiency virus (HIV)/sexually transmitted infection transmission, and cognitive behavioral skill building focusing on sexual negotiation and communication. The participants had a mean age of 32 years (men) and 29 years (women), and the majority had at least 10 years of education. At baseline, the majority reported inconsistent condom use (<100 % of the time; 64 % of women, 59 % of men). Post-intervention, nearly all participants reported consistent condom use (100 % of the time; 100 % of men, 97 % of women). Participants also reported decreased verbal aggression, increased self-efficacy, and increased HIV-related knowledge, and women increased their use of positive coping tactics. The results highlight the potential to successfully utilize a group intervention to discuss sensitive issues such as sexual risk behavior among both men and women. Strategies to improve condom use and communication without increasing intimate partner violence in high-risk couples may be an important adjunct to preventing the development of a generalized epidemic in India.

Intimate partner violence and HIV risk among urban minority women in primary health care settings.

PubMed

Wu, Elwin; El-Bassel, Nabila; Witte, Susan S; Gilbert, Louisa; Chang, Mingway

2003-09-01

This study describes the associations between intimate partner violence (IPV) and HIV risk among urban, predominantly minority women. Interviews were conducted with 1,590 women, predominantly African American and Latina, attending hospital-based health care clinics. Approximately 1 in 5 women reported experiencing IPV in their current primary heterosexual relationships; about 1 in 8 women reported experiencing IPV in the preceding 6 months. Compared to women who reported no IPV in their primary relationships, women reporting past or current IPV perpetrated by their primary partners were more likely to report having multiple sexual partners, a past or current sexually transmitted infection (STI), inconsistent use or nonuse of condoms, and a partner with known HIV risk factors. These findings indicate that urban minority women experiencing IPV are at elevated risk for HIV infection, results that carry important implications in the efforts to improve HIV and IPV risk assessment protocols and intervention/prevention strategies for women in primary health care settings.

Love moderates the relationship between partner type and condom use among women engaging in transactional vaginal sex.

PubMed

Roth, Alexis M; Rosenberger, Joshua G; Hensel, Devon J; Wiehe, Sarah E; Fortenberry, J Dennis; Wagner, Karla D

2016-04-01

Background Relationship characteristics and day-to-day variation in affective state have been associated with HIV risk behaviour. However, no research has assessed the impact of these factors on event-level condom use among women engaging in transactional sex. Twenty-six women engaging in transactional sex were enrolled in a prospective study of their sexual health. They completed diaries about multi-level predictors of condom use during vaginal sex twice, daily. Over 4 weeks, 18 participants reported 87 paid/traded vaginal intercourse events. Of these, 51.7% were condom protected. The majority of paid/traded events (81.5%) occurred with a non-romantic partner. After controlling for partner type, feeling in love on a given day was associated with higher odds of condom use during paid/traded sexual events, while having sex on the weekend and at night were associated with lower odds of condom use (all P≤0.05). There was a significant interaction between being in love and using condoms during transactional sex (P<0.01). In paid/traded sexual events with romantic partners, the frequency of condom use was 71.4% (5/7) when women did not report love and 40% (4/10) when love was reported. In sexual events with non-romantic partners, the frequency of condom use was 43.8% (14/32) when women did not report love and 59.5% (22/37) when love was reported. Women were less likely to report protected sex with romantic partners and more likely to report protected sex with non-romantic partners when they are in love. Interventions focusing on the link between day-to-day variation in affective state on condom use may help women with risk management across partner types.

Association between treatment for gonorrhoea and chlamydia and lower condom use in a cross-sectional study of female sex workers in southern India.

PubMed

Legendre-Dugal, Marianne; Bradley, Janet; Rajaram, Subramanian Potty; Lowndes, Catherine M; Ramesh, Banadakoppa M; Washington, Reynold; Moses, Stephen; Blanchard, James; Alary, Michel

2016-05-18

To assess whether having received grey packets containing treatment for gonorrhoea and chlamydia was associated with condom use among female sex workers (FSWs) in 5 districts of southern India covered by the Avahan programme where both periodic presumptive treatment (PPT) and syndromic management were used to control these sexually transmitted infections (STIs) among FSWs. Cross-sectional study of FSWs recruited in the field in 5 districts of southern India (Bangalore, Belgaum, Bellary, Guntur and Mumbai) in 2006-2007. 1378 self-identified FSWs out of 1442 were approached to participate in the study (participation rate: 95.6%). The only exclusion criterion was to be aged <18 years. Consistent condom use (CCU) with new or occasional clients, and with the most recent repeat client as assessed using a questionnaire administered through face-to-face interviews. Using the Poisson regression to model the association between the number of grey packets received in the past 3-12 months and reported CCU, adjusting for factors associated with condom use and other potential confounders in our data, CCU was lowest among FSWs who had received ≥3 grey packets in the past 3-12 months with their new or occasional clients (adjusted prevalence ratio (APR): 0.70, 95% CI 0.57 to 0.84, p<0.001) and with the most recent repeat client (APR 0.63, 95% CI 0.51 to 0.78, p<0.001). Tests for trends showed that CCU with both types of clients decreased with the number of grey packets received (p<0.001). Since we could not distinguish grey packets used for PPT from those given for syndromic management, these results could be either due to a perception of protection conferred by PPT or by the fact that inconsistent condom users are more at risk for STIs. Further research on the potential disinhibiting effect of PPT is warranted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Association between treatment for gonorrhoea and chlamydia and lower condom use in a cross-sectional study of female sex workers in southern India

PubMed Central

Legendre-Dugal, Marianne; Bradley, Janet; Rajaram, Subramanian Potty; Lowndes, Catherine M; Ramesh, Banadakoppa M; Washington, Reynold; Moses, Stephen; Blanchard, James

2016-01-01

Objectives To assess whether having received grey packets containing treatment for gonorrhoea and chlamydia was associated with condom use among female sex workers (FSWs) in 5 districts of southern India covered by the Avahan programme where both periodic presumptive treatment (PPT) and syndromic management were used to control these sexually transmitted infections (STIs) among FSWs. Setting Cross-sectional study of FSWs recruited in the field in 5 districts of southern India (Bangalore, Belgaum, Bellary, Guntur and Mumbai) in 2006–2007. Participants 1378 self-identified FSWs out of 1442 were approached to participate in the study (participation rate: 95.6%). The only exclusion criterion was to be aged <18 years. Primary and secondary outcome measures Consistent condom use (CCU) with new or occasional clients, and with the most recent repeat client as assessed using a questionnaire administered through face-to-face interviews. Results Using the Poisson regression to model the association between the number of grey packets received in the past 3–12 months and reported CCU, adjusting for factors associated with condom use and other potential confounders in our data, CCU was lowest among FSWs who had received ≥3 grey packets in the past 3–12 months with their new or occasional clients (adjusted prevalence ratio (APR): 0.70, 95% CI 0.57 to 0.84, p<0.001) and with the most recent repeat client (APR 0.63, 95% CI 0.51 to 0.78, p<0.001). Tests for trends showed that CCU with both types of clients decreased with the number of grey packets received (p<0.001). Conclusions Since we could not distinguish grey packets used for PPT from those given for syndromic management, these results could be either due to a perception of protection conferred by PPT or by the fact that inconsistent condom users are more at risk for STIs. Further research on the potential disinhibiting effect of PPT is warranted. PMID:27194314

Cultural practices, gender inequality and inconsistent condom use increase vulnerability to HIV infection: narratives from married and cohabiting women in rural communities in Mpumalanga province, South Africa

PubMed Central

Madiba, Sphiwe; Ngwenya, Nomsa

2017-01-01

ABSTRACT Background: Women in sub-Saharan Africa bear the brunt of the human immunodeficiency virus (HIV) epidemic, and older married women and those in cohabiting relationships are regarded as the largest HIV risk group. Although preventing HIV infection in married or stable relationships is an international HIV prevention priority, little is known about the influence of sociocultural contexts on safe-sex practice by women, particularly older women in rural communities in South Africa. Objectives: This study aimed to examine how older women in a rural patriarchal society negotiate safer sex within marital and long-term cohabitation relationships, and their perceptions and experiences of barriers that influence condom use. Methods: Focus group discussions were conducted with married and cohabiting women aged 40–60 years recruited from primary health facilities in a rural district in Mpumalanga province, South Africa. A thematic analysis approach was used to analyse the data. Results: We found that although women reported negotiating safe sex in their relationships, they dreaded the possible consequences of suggesting condom use with their partners. Many factors made negotiating safe sex complex for these women: living in a patriarchal society where women play no part in sexual decision making, the fear of possible consequences of insisting on condom use, women’s inferior social position in marital relationships, cultural practices such as bride price, and gender inequality were the main barriers to practising safer sex. Conclusions: Older married and cohabiting women dreaded negotiating safer sex in this patriarchal society where women’s subordination is legitimized. The findings suggest that the women were at high risk of HIV infection because of their inability to negotiate condom use, or to reject forced sex and non-consensual sex. There is a need for interventions targeting older married and cohabiting couples and key stakeholders within communities to create awareness about cultural practices and beliefs that undermine women and HIV prevention efforts. PMID:28678650

Susceptibility to transmitting HIV in patients initiating antiretroviral therapy in rural district hospitals in Cameroon (Stratall ANRS 12110/ESTHER Trial).

PubMed

Ndziessi, Gilbert; Cohen, Julien; Kouanfack, Charles; Marcellin, Fabienne; Carrieri, Maria Patrizia; Carierri, Maria Patrizia; Laborde-Balen, Gabrièle; Protopopescu, Camélia; Aghokeng, Avelin Fobang; Moatti, Jean-Paul; Spire, Bruno; Delaporte, Eric; Laurent, Christian; Boyer, Sylvie

2013-01-01

Using cohort data nested in a randomized trial conducted in Cameroon, this study aimed to investigate time trends and predictors of the susceptibility to transmitting HIV during the first 24 months of treatment. The outcome, susceptibility to transmitting HIV, was defined as reporting inconsistent condom use and experiencing incomplete virological suppression. Mixed logistic regressions were performed to identify predictors of this outcome among 250 patients reporting to have had sexual relationships either with HIV-negative or unknown HIV status partner(s). Despite an initial decrease from 76% at M0 to 50% at M6, the rate of inconsistent condom use significantly increased from M12 (59%) to M24 (66%) (p = 0.017). However, the proportion of patients susceptible to transmitting HIV significantly decreased over follow-up from 76% at M0, to 50% at M6, 31% at M12 and 27% at M24 (p<0.001). After controlling for age, gender and intervention group, we found that perceiving healthcare staff's readiness to listen as poor (adjusted odds ratios (AOR) [95% Confidence Interval (CI)] = 1.87 [1.01-3.46]), reporting to have sexual relationships more than once per week (AOR [95%CI] = 2.52 [1.29-4.93]), having more than one sexual partner (AOR [95%CI] = 2.53 [1.21-5.30]) and desiring a/another child (AOR [95%CI] = 2.07 [1.10-3.87]) were all associated with a higher risk of being susceptible to transmitting HIV. Conversely, time since ART initiation (AOR [95%CI] = 0.66 [0.53-0.83] for an extra 6 months and ART adherence (AOR [95%CI] = 0.33 [0.15-0.72]) were significantly associated with a lower risk of being susceptible to transmitting HIV. The decrease observed in the susceptibility to transmitting HIV suggests that fear of behavioural disinhibition should not be a barrier to universal access to ART. However, developing adequate preventive interventions matching patients' expectations -like the desire to have children- and strengthening healthcare staff's counselling skills are urgently needed to maximize the impact of ART in slowing the HIV epidemic.

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.

Sex and Condom Use in a Large Jail Unit for Men Who Have Sex with Men (MSM) and Male-to-Female Transgenders

PubMed Central

Harawa, Nina T.; Sweat, Jeffery; George, Sheba; Sylla, Mary

2013-01-01

Few data are available on factors contributing to sexual activity and condom use in custody settings, particularly among self-identified sexual minority prisoners. To address this gap, we undertook a study of sexual behavior and condom use of 101 randomly-selected men who have sex with men (MSM) and male-to-female transgender inmates in a segregated Los Angeles jail unit that has weekly condom access. Most survey participants (53%) reported anal sex during custody. Although 65% of these reported using condoms, 75% also reported having sex without condoms. Qualitative interviews (n=17) indicate a wide range of reasons for participating in protected and unprotected sex during custody, the use of cues within the custody environment to assess potential partners’ HIV status, and support for increased condom availability. Findings also indicate that high-risk sex occurs frequently in this unit and that condom distribution likely prevents a substantial amount of related HIV/STD risk. PMID:20693745

HIV/STI Risk behaviors among Latino migrant workers in New Orleans post-Hurricane Katrina disaster.

PubMed

Kissinger, Patricia; Liddon, Nicole; Schmidt, Norine; Curtin, Erin; Salinas, Oscar; Narvaez, Alfredo

2008-11-01

A rapid influx of Latino migrant workers came to New Orleans after Hurricane-Katrina. Many of these men were unaccompanied by their primary sex partner potentially placing them at high-risk for HIV/STIs. The purpose of this study was to assess HIV/STI sexual risk behavior of these men. A venue-based sample of Latinos who came to New Orleans post-Hurricane Katrina were administered an anonymous, structured interview in Spanish in a mobile unit and urine tested for Chlamydia trachomatis (CT) and Neisseria gonorrhea (GC) using the nucleic acid amplification technique. Participants (n = 180) had a mean age of 33 (range, 18-79), did not speak or understand English very well (93.9%), were undocumented (91.2%), were married (63.5%), and had children (67.4%), though the percent living with spouse and children was 6.1% and 4.9%, respectively. Although most men were born in Honduras (49.7%) and Mexico (25.4%), 61.9% came to New Orleans from another US state. The majority drank alcohol in the past week (75.5%), and of those, 68.7% engaged in binge drinking. A lower percentage used marijuana (16.6%) and cocaine (5.5%) at least once in the prior week. No men reported injection drug use. Self-reported history of HIV was 10%. No men tested positive for GC and 5 (2.8%) tested positive for CT. In the last month, 68.9% engaged in sex with high-risk sex partners, 30.0% were in potential bridge position, 50.0% used condoms inconsistently, 30.6% did not use a condom the last time they had sex, and 21.1% were abstinent. Since arriving, 9.4% reported leaving and returning to New Orleans. Latino migrant workers in New Orleans reported risky sexual behaviors and low condom use within a potential bridge position. Although a low prevalence of CT and GC was found, there was a high percent of self-reported HIV infection. The cultural and contextual factors that place these migrant workers and their sex partner(s) at risk for HIV/STI need further investigation.

Retrospective Assessment of the Association Between Drinking and Condom Use*

PubMed Central

Leigh, Barbara C.; Morrison, Diane M.; Hoppe, Marilyn J.; Beadnell, Blair; Gillmore, Mary Rogers

2008-01-01

Objective: Retrospective reports of the association between drinking and high-risk sexual behavior can be biased by implicit theories of the effects of drinking or may represent post hoc justifications instead of accurate reports of behavior. Using data from a daily diary study, we compared daily reports of condom use when drinking and not drinking with the same participants' reports of these behaviors from a retrospective questionnaire administered after diary collection was complete. Method: Participants included adolescents (n = 145), adult sexually transmitted disease clinic clients (n = 167), college students (n = 145), and men who have sex with men (n = 147). All participants reported their alcohol consumption and sexual activity daily for 8 weeks and then completed a retrospective questionnaire about their behavior over the diary period. Results: Participants' retrospective judgments about whether they used condoms more or less when drinking were not significantly related to their behavior as reported in the diary. Fewer than two thirds of the participants were accurate in their recollection of the association of condom use and drinking. Teenagers and men who have sex with men were more likely to retrospectively overestimate the negative effect of alcohol on condom use. Conclusions: Retrospective questions about the association between drinking and condom use were consistent with actual behavior only among people who consistently either never or always used condoms. These individuals correctly reported that drinking had no effect on their condom use. For people whose condom use varies, questions about associations between drinking and sex may be difficult to answer, owing to their conditional nature, and may lead to error. PMID:18781253

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.

Does condom social marketing improve health outcomes and increase usage and equitable access?

PubMed

Knerr, Wendy

2011-05-01

Condom social marketing (CSM) has increased condom supplies, broadened commercial markets for condoms and introduced marketing innovations in developing countries. Yet rigorous and reliable evidence of the impact on condom usage and disease prevention is limited, as is evidence of the impact on equity of access to condoms for poor populations, women and people living with HIV. One strand of research on CSM reports mostly on output (e.g. sales and processes) and market growth; but these have been found to be highly unreliable measures of condom usage. Another strand of research reports primarily on changes in sexual behaviour, attitude or condom usage, using survey data. While random sampling is rare, these studies often use representative samples, which provide some measure of validity. There have been attempts to improve the reliability or results to good effect, but challenges remain for researchers, scholars and donors, including the need to supplement output data with measures of behaviour change, use rigorous designs which are built into programmes a priori, report on equity measures, report on potential harms of CSM programmes, and encourage external and systematic reviews. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Sexual behavior, stages of condom use, and self-efficacy among college students in Taiwan.

PubMed

Tung, Wei-Chen; Cook, Daniel M; Lu, Minggen

2011-01-01

The purposes of this study were: (1) to assess sexual behaviors and condom use behaviors; (2) to compare sexual behaviors and condom use behaviors between gender groups; and (3) to explore differences in specific items of self-efficacy to practicing condom use by the transtheoretical model stages of readiness to change among college students in Taiwan. A survey of students at two universities yielded 996 valid responses. The survey questions collected reports of demographic information, sexual history, condom use in general, and likely condom use in specific situations in relation to self-efficacy. Only 27.8% (n=277) reported ever having had sex, of these only 31.4% used condoms every time (those in action and maintenance). Condom use among women was lower than among men with men 5.1 times more likely to use condoms to prevent sexually transmitted infections (OR=5.1, 95% CI: 2.14-12.16, p=0.0002). The stages of change model with reported attitudes (self-efficacy) toward condom use in specific situations. The Tukey-Kramer multiple comparisons showed that participants in the maintenance stage reported significantly higher scores than those in the pre-contemplation, contemplation, and preparation stages for all 10 self-efficacy items (p<0.0001). Circumstances that are the most challenging for condom adherence across the stages are: partner preference to forego use, situations involving alcohol and drug use, and perceived low-risk scenarios. College students in Taiwan would benefit from targeted interventions that link risky sex to alcohol, and that address the interpersonal pressure within relationships that compel women students to practice unsafe sex.

Improving condom use intentions and behavior by changing perceived partner norms: an evaluation of condom promotion videos for college students.

PubMed

Sanderson, Catherine A; Yopyk, Darren J A

2007-07-01

To examine the effectiveness of 2 condom promotion videotapes on self-efficacy, intentions, and behavior. Two hundred twenty college students completed social-cognitive and behavioral measures and were then randomly assigned to receive one of two 30-min condom promotion videotapes (male or female student presenters) or to a wait-list control condition. Participants who watched 1 of the videotapes completed immediate posttest measures, and 85% of participants completed a 4-month follow-up. Self-efficacy for condom use, intentions to use condoms, use of condom during last sex, and consistent condom use over the last month. Participants who received either video reported greater self-efficacy to refuse to have unprotected sex and intentions than controls at follow-up. Individuals who received either video were more likely than controls to report using a condom during last sex with a regular partner, and those who watched the female presenter were more likely to report consistent condom use. Participants benefited in terms of self-efficacy and intentions from receiving either video, but both men and women benefited more in terms of condom use behavior from receiving the female video. Future research is needed to determine whether opposite-sex speaker videos could be beneficial with a larger (and more sexually active) sample and whether these effects are maintained over time. Copyright 2007 APA.

Predictors of condom use among sexually active persons involved in compulsory national service in Ibadan, Nigeria.

PubMed

Sunmola, Adegbenga M; Olley, Benjamin O; Oso, Grace E

2007-08-01

Migration is known to increase the risk of heterosexual transmission of human immunodeficiency virus (HIV) in sub-Saharan Africa, but little attention has been paid to fresh graduates of tertiary institutions who are on migration for compulsory national assignment in Nigeria. In July and August 2004, a survey was conducted on sexually active men (n = 344) and women (n = 373) to investigate determinants of condom use during national service. Sixty-eight percent of men and 41% of women reported condom use at last intercourse before the survey. For both men and women, condom use was common if they had one or more regular sex partners and if they were purchasing condoms. In addition, women's condom use was predicted by being single and having intention to use condoms in next intercourse. The findings further showed that there was high risk of HIV transmission in the sample population as consistent condom use was 15% for men and 4% for women. Twelve percent of men and 8% of women reported STI diagnoses in the last 12 months before the survey. Four percent of men and 2% of women reported they already had HIV diagnoses. Only 1% of men and 2% of women reported they would receive voluntary HIV test if offered free by the government. The study findings suggest the need to extend the existing condom social marketing services in the country to the youth on national service and promote condom education messages among them prior to commencing national service.

Sexual practices of HIV-positive individuals attending antiretroviral treatment (ART) in Addis Ababa public hospitals: findings from in-depth interview.

PubMed

Dessie, Yadeta; Deresa, Merga

2012-01-01

The rollout of Antiretroviral Treatment (ART) and improved health care services contributed in recuperating the quality of life and the functional status of HIV-positive people. These clinical effects of the treatment and cares are believed to bring a change on their sexual practices. The objective of this study was to explore the sexual practices of the HIV-positive people who were getting ART in selected Addis Ababa public hospitals. A qualitative in-depth interview was conducted. The interviews were made by trained nurse counselors of the same sex and were tape recorded. Verbatim transcription was made before the analysis. Thematic categorizations were made to present the findings. Most participants expressed regained sexual desires with initiation of ART while some others didn't appreciate the regains. Not using condoms or inconsistently using them was identified risky sexual practices. Sero-discordances and sero-status non-disclosure were common issues among the partners. Sero-status non-disclosure, non-use of condom and inconsistent using them were common sexual issues. These hinder the efforts that are being made to reduce new HIV infections and re-infections. Interventions against these problems can be made when clients come for their ART treatment and clinical care follow up.

Sexual health of adults working in pornographic films.

PubMed

Coyne, K M; Banks, A; Heggie, C; Scott, C J; Grover, D; Evans, C; Mandalia, S; McLean, K A; Cohen, C E

2009-07-01

We report the frequency of sexually transmitted infections (STIs) diagnosed in performers in the adult pornographic film industry. Over a 13 month period, 445 STI screens were performed in 115 patients, 56 women and 59 men. All reported unprotected sex during filming. Seventy-five percent (86) had at least one sexual partner outside work, and 90% used condoms inconsistently with them. Women worked exclusively with women (23%), men only (38%) or both genders (39%). Almost all men (97%) worked exclusively heterosexually. Thirty-eight percent (44/115) were diagnosed with 77 STIs, including non-specific urethritis (51), gonorrhoea (10), chlamydia (6) and genital warts (6). Gonorrhoea was found exclusively at the pharynx in three heterosexual men. There were no cases of HIV, syphilis, hepatitis B or hepatitis C. Monthly screening and certification is a working requirement for this population but STIs are common in an industry where unprotected sex is the norm.

The moderating role of love in the relationship between partner type and condom use among women engaging in paid vaginal sex

PubMed Central

Roth, Alexis M.; Rosenberger, Joshua G.; Hensel, Devon J.; Wiehe, Sarah E.; Fortenberry, J. Dennis; Wagner, Karla D.

2017-01-01

Background Relationship characteristics and day-to-day variation in affective state have been associated with HIV risk behavior. However, no research has assessed the impact of these factors on event-level condom use among women engaging in transactional sex. Methods We enrolled twenty-six women engaging in transactional sex in a prospective study and collected information about their paid/traded sexual experiences twice daily on cell phones. Results Over 4-weeks, 18 participants reported 87 paid/traded vaginal intercourse events. Of these, 51.7% were condom protected. The majority of paid/traded events (81.5%) occurred with a non-romantic partner. After controlling for partner type, feeling in love on a given day was associated with higher odds of condom use during paid/traded sexual events, while having sex and on the weekend were associated with lower odds of condom use (all p=<.05). There was a significant interaction between being in love and using condoms during transactional sex (p<0.01). In paid/traded sexual events with romantic partners, the frequency of condom use was 71.4% (5/7) when women did not report love and 40% (4/10) when love was reported. In sexual events with non-romantic partners, the frequency of condom use was 43.8% (14/32) when women did not report love and 59.5% (22/37) when love was reported. Conclusions Women were less likely to reported protected sex with romantic partners and more likely to report protected sex with non-romantic partners when they are in love. Interventions focusing on the link between day-to-day variation in affective state on condom use may help women with risk management across partner types. PMID:26615499

The influence of perceived behaviour control, attitude and empowerment on reported condom use and intention to use condoms among adolescents in rural Tanzania.

PubMed

Kalolo, Albino; Kibusi, Stephen Matthew

2015-11-13

Despite the declining trends of Human immunodeficiency virus (HIV) infection in Sub-Saharan Africa (SSA), unsafe sexual behaviours among adolescents still represent a public health challenge. It is important to understand factors acting at different levels to influence sexual behaviour among adolescents. This study examined the influence of perceived behaviour control, subjective norms, attitudes and empowerment on intention to use condoms and reported use of condoms among adolescents in rural Tanzania. We used a questionnaire to collect data from 403 adolescents aged 14 through 19 years from nine randomly selected secondary schools in the Newala district located in the Southern part of Tanzania. The self-administered questionnaire collected information on sexual practices and factors such as attitudes, subjective norms, perceived behaviour control and empowerment. Binary logistic regression was performed to identify factors associated with intention to use and reported use of condoms. Sexually active adolescents constituted 40.6 % of the sample, among them 49.7 % did not use a condom at last sexual intercourse and 49.8 % had multiple sex partners. Many (85 %) of sexually active respondents had their sexual debut between the ages of 14 to 17 years. Girls became sexually active earlier than boys. Perceived behaviour control predicted intentions to use condoms (AOR = 3.059, 95 % CI 1.324-7.065), thus demonstrating its importance in the decision to use a condom. Empowerment (odds ratio = 3.694, 95 % CI 1.295-10.535) and a positive attitude (AOR = 3.484, 95 % CI 1.132-10.72) predicted reported condom use, thus turning the decision to actions. Subjective norms had only indirect effects on intention and reported use of condoms. The findings suggest that unsafe sex practices are prevalent among school adolescents in rural areas of Tanzania. Perceived behaviour control and positive attitudes predict intensions to use condoms whereas empowerment predicts reported condom use. The findings may imply that safe sex promotion interventions that simultaneously address socio-cognitive and ecological determinants of sexual behaviours may improve adolescents' safe sex behaviours.

Young African American Men Having Sex with Multiple Partners Are More Likely to Use Condoms Incorrectly: A Clinic-Based Study

PubMed Central

Crosby, Richard; DiClemente, Ralph J.; Yarber, William L.; Snow, Gregory; Troutman, Adewale

2009-01-01

This study tested the research hypothesis that men’s errors using condoms would be associated with having multiple sex partners. Specifically, men engaging in sex with three or more women were compared to those having sex with two or fewer women. Recruitment (N=271) occurred in a publicly-funded STD clinic located in a metropolitan area of the Southern U.S. All men were clinically diagnosed with a STD. Men completed a self-reported questionnaire (using a three-month recall period). Those reporting sex with men were excluded from the analysis leaving an analytic sample of 264 men. About one-half of the men (48.5%) reporting penetrative sex with three or more women during the recall period. Compared to those men reporting sex with two or fewer women, men having ≥3 women sex partners were significantly more likely to report: 1) not using condoms from start to finish of sex (P=.005); 2) that condoms slipped off during sex or withdrawal (P=.04); and 3) that condoms broke during sex (P=.03). A summary measure of condom use errors indicated that men with ≥3 women partners reported significantly greater numbers of errors than their counterparts reporting sex with ≤ 2 sex partners (Mean difference 1.7; P=.009). Among young African American men, newly diagnosed with an STD, reporting recent (past three months) sex with multiple partners may be emblematic of condom errors. These men may benefit from, clinic-based, targeted counseling and education designed to foster improved quality of condom use. PMID:19477797

Associations Between Sexual Risk-Related Behaviors and School-Based Education on HIV and Condom Use for Adolescent Sexual Minority Males and Their Non-Sexual-Minority Peers.

PubMed

Rasberry, Catherine N; Condron, D Susanne; Lesesne, Catherine A; Adkins, Susan Hocevar; Sheremenko, Ganna; Kroupa, Elizabeth

2018-01-01

With HIV and sexually transmitted disease (STD) rates disproportionately high among adolescent sexual minority males (ASMM), it is important to understand how school-based sexual health education may relate to sexual risk-related behavior among this population. This analysis explores reported HIV/AIDS- and condom-related education and sexual risk-related behaviors among ASMM and their adolescent non-sexual-minority male (non-ASMM) peers. Students (n = 11,681) from seven Florida high schools completed paper-and-pencil questionnaires. A matched analytic sample of ASMM and non-ASMM students was created by using propensity score-matching techniques (n = 572). Logistic regressions controlling for individual and school characteristics examined reporting having been taught about AIDS or HIV in school, having been taught in school about using condoms, condom use at last sex, HIV/STD testing, and associations between these variables. Compared with matched non-ASMM peers, ASMM students were less likely to report having been taught about AIDS or HIV in school (odds ratio [OR] = 0.58, P = 0.04) and having used a condom at last sex (OR = 0.39, P < 0.01), but were more likely to report having been tested for HIV or STDs (OR = 1.88, P = 0.02). There were no significant differences for reporting having been taught in school about using condoms. Among non-ASMM, reporting having been taught in school about using condoms was associated with a greater likelihood of condom use at last sex (OR = 4.78, P < 0.01); this was not seen for ASMM. Differential reports of receiving HIV/AIDS education and differential associations between condom-related education and condom use in ASMM and non-ASMM suggest that sexual health education in schools may not be resonating with ASMM and non-ASMM in the same way.

The role of cues, self-efficacy, level of worry, and high-risk behaviors in college student condom use.

PubMed

Mahoney, C A

1995-01-01

A sample of 879 undergraduate students were recruited from a public university in western New York state during the 1993-94 academic year in order to study condom use among sexually active young people 18-24 years old. A 104-item questionnaire was administered consisting of 5 instruments and single-item measures of sexual behavior and demographics. The instruments were: the Condom Use Self-Efficacy Scale (CUSES), the Perceived Barriers to Condom Use, the Perceived Susceptibility to HIV/AIDS and other STDs, the Cues to Condom Action Scale, and the Perceived Norms scale. 92% of students reported having had sexual intercourse in the past, while 86.75 reported having sexual intercourse in the previous year. About 61% reported having 1 sex partner in the previous 12 months, whereas 35.2% reported having 3 or more partners. 22.4% reported 2 or more 1-night stands. 54.5% reported worrying about HIV/AIDS occasionally, while 23.1% reported doing so frequently. 17.2% (99) of the students were classified as non-users of condoms, 50.2% (289) as sporadic users, and 32.6% (188) as consistent users. 78 (12%) could not be classified. A multiple discriminant function analysis was also conducted to distinguish among the 3 condom user groups totalling 576 cases. The variables were age, gender, frequency of drunkenness during sexual intercourse, number of sex partners, and number of 1-night stands in the past 12 months, perceived barriers, worrying about HIV/AIDS, perceived susceptibility, condom use self-efficacy, and cues to condom action. Two significant functions emerged. Function 1 clearly separated the sporadic users from the consistent users (p 0.001), while Function 2 clearly separated the sporadic users from the non-users (p 0.001). The discriminating variables correctly classified 64.58% of the respondents into the 3 condom user groups. The variables were most effective at correctly classifying non-users (68.7%), consistent users (67.8%), and sporadic users (61.2%). Sporadic users were more diverse with respect to condom use than the other 2 groups.

Factors associated with induced abortion among female entertainment workers: a cross-sectional study in Cambodia

PubMed Central

Yi, Siyan; Tuot, Sovannary; Chhoun, Pheak; Pal, Khuondyla; Tith, Khimuy; Brody, Carinne

2015-01-01

Objective To explore risk factors associated with induced abortion among sexually active female entertainment workers (FEWs) in Cambodia. Design Cross-sectional study. Setting Phnom Penh and Siem Reap, Cambodia. Participants This study included 556 FEWs aged 18–47 years randomly selected from entertainment establishments in the two cities in 2014 using a two-stage cluster sampling method. Data were collected through face-to-face interviews using a structured questionnaire. Primary outcome measure History of induced abortion during the time working as a FEW. Results Of the total sample, 45.6% reported currently using a contraceptive method with condom (42.4%) being the most common method, followed by pills (25.6%). One-fourth (25%) of the respondents reported having been pregnant at least once, and 21.4% reported having at least one induced abortion during the time working as a FEW. After controlling for other covariates in a multivariate logistic regression model, FEWs with a history of induced abortion remained significantly more likely to be currently working in a karaoke bar (AOR=1.75, 95% CI 1.10 to 2.78), to have worked longer as a FEW (AOR=1.42, 95% CI 1.06 to 1.43), to have had a greater number of sexual partners in the past 12 months (AOR=1.86, 95% CI 1.02 to 1.54), to be currently using a contraceptive method (AOR=1.52, 95% CI 1.01 to 2.29), to be able to find condoms when they needed them (AOR=2.03, 95% CI 1.09 to 3.82), and to report inconsistent condom use with non-commercial partners in the past 3 months (AOR=1.62, 95% CI 1.06 to 3.44). Conclusions This study highlights the high rates of unwanted pregnancies that ended in induced abortions among FEWs in Cambodia. Access of FEWs to quality sexual and reproductive healthcare services is deemed a high priority. Integrated interventions to improve sexual and reproductive health among these vulnerable women should be tailored to reach the most-at-risk groups. PMID:26231754

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.

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.

Prevalence and correlates of anal sex among secondary school students in Cape Town, South Africa.

PubMed

Ybarra, Michele; Price-Feeney, Myeshia; Mwaba, Kelvin

2018-07-01

Research efforts have overlooked anal sex as a risk factor for adolescents' acquisition of HIV despite the high rates of HIV among South African youth. Here, we report findings from a survey conducted in 2012 among secondary school youth, ages 16-24, in Cape Town. 937 adolescents completed a pencil-and-paper survey. Eleven and 31% of female and male youth, respectively, reported ever having anal sex. By comparison, 59% and 78% of female and male youth reported ever having vaginal sex. The percentage of youth reporting lifetime rates of anal sex increased with age: 32% of 20-to-24 year olds had anal sex compared to 16% of 16-to-17-year olds. When the sample was stratified by sex, this difference appeared to be driven by older male, but not female, sexual behavior. Despite noted differences in prevalence rates by sex, both boys and girls who had anal sex were more likely than their same-sex peers who had vaginal sex to report sexual coercion victimization and perpetration experiences and inconsistent condom use. Interestingly, some differences in HIV motivation, information, and behavioral skills were noted for youth who had vaginal sex versus youth who had never had sex; scores were largely similar for youth who had anal sex versus youth who had never had sex however. Together, these findings suggest that anal sex is not uncommon and may be an important marker for other HIV risk behaviors in at least one lower income South African community. Anal sex needs to be explicitly discussed in adolescent HIV prevention and healthy sexuality programing, incorporating age-relevant scenarios about negotiating condoms and other healthy relationship behaviors (e.g., refusing sex when it is not wanted).

[HIV/AIDS and other sexually transmitted infections among military members of the Armed Forces of Serbia].

PubMed

Jadranin, Zeljko; Suljagić, Vesna; Todorović, Veljko; Trkuljić, Miroljub; Vucetić, Dusan

2012-01-01

Military personnel is a population group at special risk of exposure to sexually transmitted diseases (STD). In peacetime, STD infection rates among service members are generally 2 to 5 times higher than among civilian population. In time of conflict, the differences can be 50 or more times greater. This study describes sexual behavior as a risk factor for STD in the Armed Forces of Serbia. The sample of 5 617 voluntary blood donors from the Armed Forces of Serbia gave blood and filled World Health Organization Questionnaire about sexual behavior within January 2007 - December 2008 period. The mandatory testing of voluntary blood donors was performed in the Institute of Transfusiology Military Medical Academy in Belgrade, by the specific immunoenzyme tests and polymerasa chain reaction tests for HIV, hepatitis B, C and syphilis. Statistical analysis of data was done using State for Windows 93, USA, 1996. We identified 36 soldiers with some form of STDs. This study showed that 1 668 (29.7%) tested soldiers reported always using condoms, 1 725 (30.72%) almost always, 1 238 (20.04%) sometimes, 495 (8.81%) almost never and 490 (8.73%) never. Among the sample, 449 (7.99%) soldiers reported sexual contacts with partners with high risk of sexual behavior, whilst 22 (0.37%) of them reported homosexual and bisexual contacts. This study reported STDs found in voluntary blood donors among the service members of the Armed Forces of Serbia, but none of them was identified to be HIV positive. Soldiers with the most frequent risk behavior were reported to be those with inconsistent condom use. In the future, the STD Control and Prevention Program should be more intensively conducted among the members of the Armed Forces of Serbia.

Prevalence, type, and correlates of trauma exposure among adolescent men and women in Soweto, South Africa: implications for HIV prevention.

PubMed

Closson, Kalysha; Dietrich, Janan Janine; Nkala, Busi; Musuku, Addy; Cui, Zishan; Chia, Jason; Gray, Glenda; Lachowsky, Nathan J; Hogg, Robert S; Miller, Cari L; Kaida, Angela

2016-11-25

Youth trauma exposure is associated with syndemic HIV risk. We measured lifetime prevalence, type, and correlates of trauma experience by gender among adolescents living in the HIV hyper-endemic setting of Soweto, South Africa. Using data from the Botsha Bophelo Adolescent Health Survey (BBAHS), prevalence of "ever" experiencing a traumatic event among adolescents (aged 14-19) was assessed using a modified Traumatic Event Screening Inventory-Child (TESI-C) scale (19 items, study alpha = 0.63). We assessed self-reported number of potentially traumatic events (PTEs) experienced overall and by gender. Gender-stratified multivariable logistic regression models assessed independent correlates of 'high PTE score' (≥7 PTEs). Overall, 767/830 (92%) participants were included (58% adolescent women). Nearly all (99.7%) reported experiencing at least one PTE. Median PTE was 7 [Q1,Q3: 5-9], with no gender differences (p = 0.19). Adolescent men reported more violent PTEs (e.g., "seen an act of violence in the community") whereas women reported more non-violent HIV/AIDS-related PTEs (e.g., "family member or someone close died of HIV/AIDS"). High PTE score was independently associated with high food insecurity among adolescent men and women (aOR = 2.63, 95%CI = 1.36-5.09; aOR = 2.57, 95%CI = 1.55-4.26, respectively). For men, high PTE score was also associated with older age (aOR = 1.40/year, 95%CI = 1.21-1.63); and recently moving to Soweto (aOR = 2.78, 95%CI = 1.14-6.76). Among women, high PTE score was associated with depression using the CES-D scale (aOR = 2.00, 95%CI = 1.31-3.03,) and inconsistent condom use vs. no sexual experience (aOR = 2.69, 95%CI = 1.66-4.37). Nearly all adolescents in this study experienced trauma, with gendered differences in PTE types and correlates, but not prevalence. Exposure to PTEs were distributed along social and gendered axes. Among adolescent women, associations with depression and inconsistent condom use suggest pathways for HIV risk. HIV prevention interventions targeting adolescents must address the syndemics of trauma and HIV through the scale-up of gender-transformative, youth-centred, trauma-informed integrated HIV and mental health services.

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.

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.

Habitual condom use across partner type and sexual position among younger gay and bisexual men: findings from New Zealand HIV behavioural surveillance 2006-2011.

PubMed

Lachowsky, N J; Dewey, C E; Dickson, N P; Saxton, P J W; Hughes, A J; Milhausen, R R; Summerlee, A J S

2015-09-01

Our objectives were to investigate demographic and behavioural factors associated with condom use and to examine how habitual condom use was across partner types and sexual positions among younger men who have sex with men (YMSM), aged 16-29, surveyed in New Zealand. We analysed the 2006-2011 national HIV behavioural surveillance data from YMSM who reported anal intercourse in four scenarios of partner type and sexual position: casual insertive, casual receptive, regular insertive and regular receptive. For each, respondents' condom use was classified as frequent (always/almost always) or otherwise, with associated factors identified with multivariate mixed-effect logistic regression. Habitual condom use across scenarios was examined using a latent variable technique that estimated the intraclass correlation coefficient (ICC). Frequent condom use was reported for 63.6% of 5153 scenarios reported from 2412 YMSM. Frequent use increased from boyfriend to fuckbuddy to casual partners. Infrequent use was associated with online recruitment, Pacific ethnicity, less education, HIV positivity, sex with women, having ≥20 sexual partners versus 1 and reporting insertive and receptive sexual positions. Frequent condom use was associated with having two to five sexual partners versus one and shorter regular partnerships. The ICC=0.865 indicated highly habitual patterns of use; habitual infrequent condom use was most prevalent with regular partners (53.3%) and habitual frequent condom use was most prevalent with casual partners (70.2%) and for either sexual position (50.5% and 49.1%). Habitual condom use among YMSM highlights the value of early, engaging and sustained condom promotion. Public health should provide better and more compelling condom education, training and promotion for YMSM. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Kenyan female sex workers' use of female-controlled nonbarrier modern contraception: do they use condoms less consistently?

PubMed

Yam, Eileen A; Okal, Jerry; Musyoki, Helgar; Muraguri, Nicholas; Tun, Waimar; Sheehy, Meredith; Geibel, Scott

2016-03-01

To examine whether nonbarrier modern contraceptive use is associated with less consistent condom use among Kenyan female sex workers (FSWs). Researchers recruited 579 FSWs using respondent-driven sampling. We conducted multivariate logistic regression to examine the association between consistent condom use and female-controlled nonbarrier modern contraceptive use. A total of 98.8% reported using male condoms in the past month, and 64.6% reported using female-controlled nonbarrier modern contraception. In multivariate analysis, female-controlled nonbarrier modern contraceptive use was not associated with decreased condom use with clients or nonpaying partners. Consistency of condom use is not compromised when FSWs use available female-controlled nonbarrier modern contraception. FSWs should be encouraged to use condoms consistently, whether or not other methods are used simultaneously. Copyright © 2016 Elsevier Inc. All rights reserved.

Sexual coercion, verbal aggression, and condom use consistency among college students.

PubMed

Fair, Cynthia D; Vanyur, Jennifer

2011-01-01

The relationship between condom use and 2 less visible categories of intimate partner violence (IPV), sexual coercion and verbal aggression, was examined among college students. In March 2007 a random cross-sectional sample of undergraduates from the southeast region of the United States was taken to collect information about sexual coercion and verbal aggression, in addition to condom use consistency. Alcohol use was also assessed. Of the 142 participants, 31.7% reported being victims of sexual coercion, and 78% reported having verbally aggressive partners. Participants who reported experiencing sexual coercion in their relationship were significantly less likely to consistently use condoms. Additionally, alcohol use before or during episodes of verbal aggression was negatively associated with condom use. Alcohol use was also significantly associated with heightened incidents of coercion and aggression. Results indicate that among college students, the presence of sexual coercion adversely affects condom use, as does alcohol use.

Alcohol Use, HIV Treatment Adherence, and Sexual Risk Among People with a History of Injecting Drug Use in Vietnam.

PubMed

Li, Li; Luo, Sitong; Lan, Chiao-Wen; Lin, Chunqing; Tuan, Le Anh; Feng, Nan; Tuan, Nguyen Anh

2017-11-01

Alcohol use can limit the effectiveness of antiretroviral therapy (ART) for people living with HIV (PLH) who have a history of injecting drug use. This study described the patterns of alcohol use among PLH with a history of injecting drug use in Vietnam and examined the relationships between alcohol use, adherence to ART, and sexual risks. We utilized cross-sectional data of 109 PLH on ART collected from a randomized controlled intervention trial in Vietnam. Approximately 30 and 46% of the participants were frequent and occasional drinkers, respectively. Frequent drinkers reported the highest number of missed medication days. About 61% of frequent drinkers reported having sex after using alcohol. Additionally, 23, 34, and 24% of nondrinkers, occasional drinkers, and frequent drinkers, respectively, reported inconsistent condom use during sex. Future intervention programs should address the issues of alcohol use and sexual risks to maximize the effectiveness of HIV treatment programs in Vietnam.

Remaining Gap in HIV Testing Uptake Among Female Sex Workers in Iran.

PubMed

Shokoohi, Mostafa; Noori, Atefeh; Karamouzian, Mohammad; Sharifi, Hamid; Khajehkazemi, Razieh; Fahimfar, Noushin; Hosseini-Hooshyar, Samira; Kazerooni, Parvin Afsar; Mirzazadeh, Ali

2017-08-01

We estimated the prevalence of recent HIV testing (i.e., having an HIV test during the last 12 months and knew the results) among 1295 HIV-negative Iranian female sex workers (FSW) in 2015. Overall, 70.4% (95% confidence intervals: 59.6, 79.3) of the participants reported a recent HIV testing. Concerns about their HIV status (83.2%) was reported as the most common reason for HIV testing. Incarceration history, having >5 paying partners, having >1 non-paying partner, receiving harm reduction services, utilizing healthcare services, and knowing an HIV testing site were significantly associated with recent HIV testing. In contrast, outreach participants, having one non-paying sexual partner, and self-reported inconsistent condom use reduced the likelihood of recent HIV testing. HIV testing uptake showed a ~2.5 times increase among FSW since 2010. While these findings are promising and show improvement over a short period, HIV testing programs should be expanded particularly through mobile and outreach efforts.

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.

Short-Term Acceptability of the Woman's Condom among Married Couples in Shanghai

PubMed Central

Wu, Junqing; Huang, Zirong

2016-01-01

Background. The Woman's Condom, a second-generation female condom designed for acceptability, is poised for introduction in China. Method. This single-arm study was conducted among 60 couples in China in 2010 to assess acceptability of the Woman's Condom. Results. Male participants reported that ease of handling, inserting, and removing the device improved significantly from first to fourth use. Female and male participants reported that comfort during insertion, feel of lubricant during insertion, comfort/fit of outer ring during use, and overall comfort improved significantly from first to fourth use. Further, at fourth use, female participants reported significant improvement in the comfort of the feel of the condom material and lubricant. Female and male participants reported that satisfaction with stability and sensation during sex and ability to achieve orgasm improved significantly from first to fourth use. At fourth use, female participants reported statistically significant improvement in sensation compared to using nothing. A majority of participants (78%) stated that they would use the Woman's Condom in the future, primarily due to its dual protection profile. Conclusion. This study has shown that, in China, the Woman's Condom appears to be acceptable to married couples. User experience contributes to improvement in many aspects of device acceptability. PMID:27547481

Prevalence of Chlamydia trachomatis Infection and Its Association with Sexual Behaviour and Alcohol Use in the Population Living in Separated and Segregated Roma Settlements in Eastern Slovakia

PubMed Central

Babinská, Ingrid; Kalinová, Zuzana; Čechová, Lenka; Čisláková, Lýdia

2017-01-01

The aim of the study was to explore sexual behaviour and the occurrence of Chlamydia trachomatis (CT) infection in the population living in Roma settlements compared to the majority population in Slovakia and to assess the association between alcohol use and sexual behaviour within both populations. A cross-sectional population-based Hepa-Meta study was conducted in Slovakia in 2011. The final sample comprised 452 Roma and 403 non-Roma respondents. The occurrence of CT was detected by direct proof of the pathogen by PCR. The association between alcohol use and the prevalence of risky sexual behaviour were assessed using a logistic regression. First intercourse at age 15 or younger was reported by 27.9% of Roma (vs. 4.5% of non-Roma); 93.4% of Roma (vs. 77.9% of non-Roma) used condom inconsistently, 22.8% of Roma (vs. 43.9% of non-Roma) used a condom for protection from unwanted pregnancies and only 8.8% of Roma (vs. 21.8% of non-Roma) due to protection against infectious diseases. However, Roma reported having had five or more sexual partners less often compared to the majority (11.5% of Roma vs. 20.6% of non-Roma). Binge drinking at least once a month was associated with a higher number of sexual partners in both groups, but not with condom non-use. The prevalence of CT infection in the Roma population was higher (3.8%) compared to non-Roma (2.7%); however, the difference was not statistically significant. Our study found no differences in the prevalence of CT infection between Roma and non-Roma despite differences in sexual behaviour. Roma begin their sexual life earlier and have unprotected sex more often, but on the other hand, they seem to be much more restrained in terms of the number of sexual partners compared to the majority population. PMID:29240704

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.

Prevalence of Chlamydia trachomatis Infection and Its Association with Sexual Behaviour and Alcohol Use in the Population Living in Separated and Segregated Roma Settlements in Eastern Slovakia.

PubMed

Babinská, Ingrid; Halánová, Monika; Kalinová, Zuzana; Čechová, Lenka; Čisláková, Lýdia; Madarasová Gecková, Andrea

2017-12-14

The aim of the study was to explore sexual behaviour and the occurrence of Chlamydia trachomatis (CT) infection in the population living in Roma settlements compared to the majority population in Slovakia and to assess the association between alcohol use and sexual behaviour within both populations. A cross-sectional population-based Hepa-Meta study was conducted in Slovakia in 2011. The final sample comprised 452 Roma and 403 non-Roma respondents. The occurrence of CT was detected by direct proof of the pathogen by PCR. The association between alcohol use and the prevalence of risky sexual behaviour were assessed using a logistic regression. First intercourse at age 15 or younger was reported by 27.9% of Roma (vs. 4.5% of non-Roma); 93.4% of Roma (vs. 77.9% of non-Roma) used condom inconsistently, 22.8% of Roma (vs. 43.9% of non-Roma) used a condom for protection from unwanted pregnancies and only 8.8% of Roma (vs. 21.8% of non-Roma) due to protection against infectious diseases. However, Roma reported having had five or more sexual partners less often compared to the majority (11.5% of Roma vs. 20.6% of non-Roma). Binge drinking at least once a month was associated with a higher number of sexual partners in both groups, but not with condom non-use. The prevalence of CT infection in the Roma population was higher (3.8%) compared to non-Roma (2.7%); however, the difference was not statistically significant. Our study found no differences in the prevalence of CT infection between Roma and non-Roma despite differences in sexual behaviour. Roma begin their sexual life earlier and have unprotected sex more often, but on the other hand, they seem to be much more restrained in terms of the number of sexual partners compared to the majority population.

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

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

The Association between Noncommercial Partnerships and Risk of HIV among Female Sex Workers: Evidences from a Cross-Sectional Behavioral and Biological Survey in Southern India

PubMed Central

Somanath, Renuka Pulikallu; Mishra, Ram Manohar; Saggurti, Niranjan; Parimi, Prabhakar

2013-01-01

This paper examines the association between female sex workers' (FSWs) noncommercial partnerships with risk of HIV in Andhra Pradesh, India. Data were drawn from a cross-sectional behavioral and biological survey conducted in 2009 among 3225 FSWs from Andhra Pradesh. Participants were asked about their sexual partnerships, condom use, and vulnerability factors and tested for HIV and sexually transmitted infections. The key independent variables considered were presence of a noncommercial sexual partner (no, yes) and the nature of such partnerships (regular, nonregular). FSWs who reported husband as noncommercial partner were considered to have a regular partner, while the rest were defined as having nonregular partners. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated to measure the associations between variables of interest. Almost three-fourths (74.8%) of FSWs reported having noncommercial partners (regular: 55.6%; nonregular: 19.3%). FSWs in nonregular partnerships were more likely to be HIV positive (13.1% versus 10.9%, adjusted OR: 1.4, 95% CI: 1.1–1.8), have syphilis (10.3% versus 4.2%, adjusted OR: 2.3, 95% CI: 1.6–3.3), use condoms inconsistently with occasional clients (21.0% versus 16.5%, adjusted OR: 1.5, 95% CI: 1.2–1.9), and report forced sex (25.1% versus 14.1%, adjusted OR: 1.9, 95% CI: 1.5–2.4) as compared to those in regular partnerships. HIV prevention programs need to emphasize safe sex behaviors, particularly among FSWs who have nonregular partners. PMID:23533729

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.

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

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

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.

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

Female condoms scheduled to reach U.S. market this year.

PubMed

1991-08-01

3 female condoms, or "vaginal pouches" as they are called by the FDA (US Food and Drug Administration) are expected to be marketed in the US in 1991, the Bikini Condom from International Prophylactics Inc., Princeton NJ; Women's Choice from M.D. Personal Products, Hayward CA; and Reality from Wisconsin Pharmacal Co., Jackson, WI. The advantages of the female condoms are control for women over contraception and sexually transmitted diseases (STDs), availability over the counter, no need for spermicides, thicker than male condoms with better barrier effectiveness and less breakage and slippage, and reported heightened sensation for women. The disadvantages are difficulty for inexperienced women to insert, unappealing appearance of part of device protruding from vagina, interference with foreplay, cost of $1.50-$2.40 each, few reports of vaginal irritation. The Bikini Condom looks like a G-string panty with a condom pouch that is automatically introduced into the vagina with coitus. Bikini had a breakage rate of 0.5%, compared to 1-2% for male condoms, an acceptance level of 56%, and can be used 5-10 times. It effectively blocked STDs and HIV (human immunodeficiency virus). Women's Choice has a 2-inch diameter flexible ring that covers the introitus, and a thickened dome of latex resembling a diaphragm at the deep end, lubricated with silicone. 20% of women reported increased clitoral and labial sensation during use. It prevented transfer of semen acid phosphatase, and enzyme smaller than STDs and viruses. Reality condom is a polyurethane sheath with an inner ring similar to a diaphragm, but fitting more loosely, and an outer ring covering part of the vulva, all inserted with an applicator. It had a leakage rate of 0.6% compared to 3.5% for male condoms, and a slippage rate of 2.7% compared to 8.1% slippage and breakage of male condoms. 5% of users reported vaginal irritation. 65% of women and 80% of men liked Reality. Generally people in female condom trials either strongly liked or disliked them. They are so novel that they appeal to people with an "open mind," and to those with experience with condoms and other barrier methods.

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.

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

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.

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

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.

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 Use Self-Efficacy among Younger Rural Adolescents: The Influence of Parent-Teen Communication, and Knowledge of and Attitudes toward Condoms

ERIC Educational Resources Information Center

Ritchwood, Tiarney D.; Penn, Dolly; Peasant, Courtney; Albritton, Tashuna; Corbie-Smith, Giselle

2017-01-01

This study examines the role of condom use knowledge and attitudes, and parent-teen communication about sex and relationship quality on reports of condom use self-efficacy among rural, African American youth. Participants were 465 North Carolinian youth (10-14 years). Results indicated that greater condom use self-efficacy was predicted by greater…

Falling short of universal access to reproductive health: unintended pregnancy and contraceptive use among Mexican women with HIV.

PubMed

Kendall, Tamil

2013-01-01

A favourable context for women with HIV to prevent unintended pregnancy is a cornerstone of reproductive rights and will contribute to achieving universal access to reproductive health, a Millennium Development Goal target. This analysis explores the reproductive trajectories of Mexican women with HIV post-diagnosis and their access to reproductive counselling and use of contraceptives. In-depth interviews and short surveys were conducted with women of reproductive age living with HIV. Results indicate that sexual and reproductive health counselling in HIV care focuses on the male condom and does not routinely address reproductive desires or provide information about or access to other contraceptive methods. Unintended pregnancies result from inconsistent condom use and condom breakage. Women experienced discriminatory denial of and pressure to accept particular contraceptive methods because of their HIV status. Mexican women with HIV are not enjoying their constitutionally guaranteed right to freely choose the number and spacing of their children. Mexico's commitment to reproductive rights and the Popular Health Insurance offer policy and financial frameworks for providing family planning services in public HIV clinics. To ensure respectful implementation, rights-based training for HIV healthcare providers and careful monitoring and evaluation will be needed.

Exploring AIDS-related knowledge, attitudes, and behaviors of female Mexican migrant workers.

PubMed

Organista, P B; Organista, K C; Soloff, P R

1998-05-01

AIDS-related knowledge, attitudes, and behaviors were assessed in female Mexican migrant laborers. Thirty-two women were administered a modified version of the Hispanic Condom Questionnaire. Respondents were knowledgeable about the major modes of HIV transmission, but one-third to one-half of the women believed that they could contract AIDS from unlikely casual sources. Although respondents reported few negative beliefs about condom use, actual condom use with sex partners was low and knowledge of proper condom use was problematic. Consequently, 75 percent reported never carrying condoms. Implications of these findings for future research and provision of services for female Mexican migrants are discussed.

Women and postfertilization effects of birth control: consistency of beliefs, intentions and reported use.

PubMed

Dye, Huong M; Stanford, Joseph B; Alder, Stephen C; Kim, Han S; Murphy, Patricia A

2005-11-28

This study assesses the consistency of responses among women regarding their beliefs about the mechanisms of actions of birth control methods, beliefs about when human life begins, the intention to use or not use birth control methods that they believe may act after fertilization or implantation, and their reported use of specific methods. A questionnaire was administered in family practice and obstetrics and gynecology clinics in Salt Lake City, Utah, and Tulsa, Oklahoma. Participants included women ages 18-50 presenting for any reason and women under age 18 presenting for family planning or pregnancy care. Analyses were based on key questions addressing beliefs about whether specific birth control methods may act after fertilization, beliefs about when human life begins, intention to use a method that may act after fertilization, and reported use of specific methods. The questionnaire contained no information about the mechanism of action of any method of birth control. Responses were considered inconsistent if actual use contradicted intentions, if one intention contradicted another, or if intentions contradicted beliefs. Of all respondents, 38% gave consistent responses about intention to not use or to stop use of any birth control method that acted after fertilization, while 4% gave inconsistent responses. The corresponding percentages for birth control methods that work after implantation were 64% consistent and 2% inconsistent. Of all respondents, 34% reported they believed that life begins at fertilization and would not use any birth control method that acts after fertilization (a consistent response), while 3% reported they believed that life begins at fertilization but would use a birth control method that acts after fertilization (inconsistent). For specific methods of birth control, less than 1% of women gave inconsistent responses. A majority of women (68% or greater) responded accurately about the mechanism of action of condoms, abstinence, sterilization, and abortion, but a substantial percentage of women (between 19% and 57%) were uncertain about the mechanisms of action of oral contraceptives, intrauterine devices (IUDs), Depo-Provera, or natural family planning. Women who believe that life begins at fertilization may not intend to use a birth control method that could have postfertilization effects. More research is needed to understand the relative importance of postfertilization effects for women in other populations, and in relation to other properties of and priorities for birth control methods. However, many women were uncertain about the mechanisms of action of specific methods. To respect the principles of informed consent, some women may need more education about what is known and not known about the mechanisms of action of birth control methods.

The use of alcohol and condoms during sexual assault.

PubMed

Davis, Kelly Cue; Schraufnagel, Trevor J; George, William H; Norris, Jeanette

2008-09-01

Sexual assault remains an important public health issue due to the violence involved as well as the potential for health risks such as sexually transmitted infections. Alcohol has been associated with both violent and risky sexual behavior. This study assessed the frequency of sexual assault perpetration, alcohol use, and condom use during sexual assault in a community sample of young, heterosexual male social drinkers. Participants completed measures of their sexual assault perpetration. More than 50% reported sexual assault perpetration; 60% of these reported repeat perpetration. Almost one half of perpetrators reported alcohol consumption prior to every sexual assault incident. Never having used a condom during penetrative sexually aggressive acts was reported by 41.2% of perpetrators. Alcohol use and condom nonuse were positively correlated for acts of forcible rape. Findings provide information about the infrequent use of condoms during sexual assault incidents and support prior evidence of the association between alcohol and sexual assault.

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.

Satisfaction and Condomless Anal Sex at Sexual Debut and Sexual Risk among Young Black Same-Sex Attracted Men (YBSSAM)

PubMed Central

Oidtman, J; Sherman, SG; Morgan, A; German, D; Arrington-Sanders, R

2017-01-01

First sex may be a sentinel event crucial to understanding sexual health trajectories of young Black same-sex attracted men (YBSSAM). We sought to understand whether satisfaction, condomless anal sex, and contextual factors during first sex are associated with sexual risk and recent condom use in YBSSAM. 201 YBSSAM aged 15–24 completed an Internet survey exploring first sex, current condom use, and sexual risk. High risk was defined as ≥3 of the following: new/concurrent sex partners, STI history, and no/inconsistent condom use. Multivariate logistic regression assessed the association between predictor (satisfaction and first condomless anal sex) and outcome (sexual risk and condomless sex in the past 3 months) variables. Mean age at first sex was 15.2 (SD=2.9) years, and emotional satisfaction (51.7%), physical satisfaction (63.7%), and condomless first anal sex (55.2%) were common. YBSSAM describing high levels of satisfaction were no more likely to be at high risk or engage in recent condomless sex. Condomless first sex (AOR=4.57, P=0.001), younger age (AOR=3.43, p=0.02), and having a partner >5years older (AOR=2.78, p=0.03) at first sex were significantly associated with increased risk. Only condomless first sex (AOR=4.28, p<0.001) was associated with condomless recent sex. Satisfaction at first sex may not influence later sexual risk in YBSSAM. However, context of first sex, including condom use at first sex, may play an important role in subsequent risk. Prevention strategies on condom negotiation prior to first sex may help to mitigate HIV burden in YBSSAM. PMID:27649695

Satisfaction and Condomless Anal Sex at Sexual Debut and Sexual Risk Among Young Black Same-Sex Attracted Men.

PubMed

Oidtman, Jessica; Sherman, Susan G; Morgan, Anthony; German, Danielle; Arrington-Sanders, Renata

2017-05-01

First sex may be a sentinel event crucial to understanding sexual health trajectories of young Black same-sex attracted men (YBSSAM). We sought to understand whether satisfaction, condomless anal sex, and contextual factors during first sex were associated with sexual risk and recent condom use in YBSSAM. A total of 201 YBSSAM aged 15-24 years completed an Internet survey exploring first sex, current condom use, and sexual risk. High risk was defined as ≥3 of the following: new/concurrent sex partners, STI history, and no/inconsistent condom use. Multivariate logistic regression assessed the association between predictor (satisfaction and first condomless anal sex) and outcome (sexual risk and condomless sex in the past 3 months) variables. Mean age at first sex was 15.2 (SD = 2.9) years, and emotional satisfaction (51.7 %), physical satisfaction (63.7 %), and condomless first anal sex (55.2 %) were common. YBSSAM describing high levels of satisfaction were no more likely to be at high risk or engage in recent condomless sex. Condomless first sex (AOR = 4.57, p = .001), younger age (AOR = 3.43, p = .02), and having a partner >5 years older (AOR = 2.78, p = .03) at first sex were significantly associated with increased risk. Only condomless first sex (AOR = 4.28, p < .001) was associated with condomless recent sex. Satisfaction at first sex may not influence later sexual risk in YBSSAM. However, context of first sex, including condom use at first sex, may play an important role in subsequent risk. Prevention strategies on condom negotiation prior to first sex may help to mitigate HIV burden in YBSSAM.

Factors Associated With Condom Use Among Sexually Active US Adults, National Survey of Family Growth, 2006-2010 and 2011-2013.

PubMed

Nasrullah, Muazzam; Oraka, Emeka; Chavez, Pollyanna R; Johnson, Christopher H; DiNenno, Elizabeth

2017-04-01

Condom-less sex can increase the risk of acquiring or transmitting HIV. To characterize the prevalence of condom use at the most recent sex act and identify factors associated with use of a condom at the most recent sex act in adults in the United States. Data from the cross-sectional National Survey of Family Growth from cycles 2006 through 2010 and 2011 through 2013 were analyzed for sexually active men and women 18 to 44 years old who reported having sex (vaginal, anal, or oral) with an opposite-sex partner in the past 12 months. HIV-related sexual risk behaviors (SRBs) in the past 12 months included sex with at least four opposite-sex partners; exchanging sex for money or drugs; sex with an injection drug user; sex with an HIV-positive person; sex with a man who previously had sex with a man (women only); sex with a man (men only); or sex with a partner who had sex with other partners. The outcome for this analysis was condom use at the most recent anal or vaginal sex act. Overall prevalence of condom use was 24.8%; only 33.8% of adults with at least one SRB reported the use of a condom. Only 46.4% of unmarried or single men (vs 14.7% married or cohabitating men) and 32.3% unmarried or single women (vs 14.1% married or cohabitating women) with SRBs reported using a condom at the most recent sexual encounter and were less likely to use a condom at the most recent sexual encounter compared with those who did not report SRBs. We did not find a significant relation between using a condom and SRBs in married or cohabitating men and women. Our analysis adds to the literature on how condom use varies by marital status. We measured the use of condoms at the most recent sexual act, which might not reflect an individual's previous behavior of condom use. Nonetheless, condom use at the most recent sexual act has been documented in previous studies as a valid proxy of condom use over time. Continued efforts are needed to promote condom use in heterosexual adults in the United States, particularly those at high risk for HIV, namely individuals engaging in anal sexual acts and with multiple sex partners. Nasrullah M, Oraka E, Chavez PR, et al. Factors Associated With Condom Use Among Sexually Active US Adults, National Survey of Family Growth, 2006-2010 and 2011-2013. J Sex Med 2017;14:541-550. Published by Elsevier Inc.

Black Women with Multiple Sex Partners

PubMed Central

Campos, Stephanie; Benoit, Ellen; Dunlap, Eloise

2017-01-01

Motivations of low-income substance using heterosexual Black women in New York City for having multiple sexual partners are explored in this paper. Analysis of in-depth interviews with 50 study participants demonstrates that their relationships consisted of those who had: (1) a main sex partner and a secondary sex partner; or (2) two or more “casual” partners. Individual-level motivations for extra relational sex fell into four dominant themes: sexual pleasure, partner infidelity, sex exchange and past main partners. Using a Black feminist framework, we describe how participants displayed considerable autonomy by actively forming and withdrawing from sexual relationships with men. However, women described low rates of condom use with main partners and inconsistent use of condoms with more casual sexual partners. This contradiction becomes an important area for sexual health interventions. Women who had sexual relations with only one current mate in the past two years were recruited as a monogamous comparison group. PMID:28730162

Syphilis infection among female sex workers in Colombia.

PubMed

Mejia, Alfredo; Bautista, Christian T; Leal, Luis; Ayala, Claudia; Prieto, Franklyn; de la Hoz, Fernando; Alzate, Martha L; Acosta, Jacqueline; Sanchez, Jose L

2009-04-01

To study the epidemiology of Treponema pallidum (syphilis) among female sex workers (FSW) in Santa Fe de Bogotá, Colombia. A cross-sectional study was conducted. Participants were interviewed using a standardized questionnaire, which collected socio-demographic characteristics and risk behavior information. Blood samples were screened for syphilis using the VDRL test and the MHATP assay. The prevalence of syphilis was 10.3% (53/514). Adjusted risk factors significantly associated with syphilis were: age (linear increase), education (primary or no education), monthly income (or=4 years), number of clients per week (>or=22), main workplace (street), inconsistent (never) condom use in sex work, previous STI history, and use of illegal drugs. Effective health education programs for improving the level of knowledge of STI and the promotion of consistent condom use activities along with other appropriate harm reduction activities are urgently required among FSW in Colombia.

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.

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.

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.

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.

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

Susceptibility to Transmitting HIV in Patients Initiating Antiretroviral Therapy in Rural District Hospitals in Cameroon (Stratall ANRS 12110/ESTHER Trial)

PubMed Central

Ndziessi, Gilbert; Cohen, Julien; Kouanfack, Charles; Marcellin, Fabienne; Carierri, Maria Patrizia; Laborde-Balen, Gabrièle; Protopopescu, Camélia; Aghokeng, Avelin Fobang; Moatti, Jean-Paul; Spire, Bruno; Delaporte, Eric; Laurent, Christian; Boyer, Sylvie; Biwolé-Sida, M.; Kouanfack, C.; Koulla-Shiro, S.; Bourgeois, A.; Delaporte, E.; Laurent, C.; Peeters, M.; Laborde-Balen, G.; Dontsop, M.; Kazé, S.; Mben, J-M.; Aghokeng, A.; Edoul, M.G.; Mpoudi-Ngolé, E.; Tongo, M.; Boyer, S.; Carrieri, M.P.; Marcellin, F.; Moatti, J-P.; Spire, B.; Abé, C.; Abega, S-C.; Bonono, C-R.; Mimcheu, H.; Ngo Yebga, S.; Paul Bile, C.; Abada, S.; Abanda, T.; Baga, J.; Bilobi Fouda, P.; Etong Mve, P.; Fetse Tama, G.; Kemo, H.; Ongodo, A.; Tadewa, V.; Voundi, HD.; Ambani, A.; Atangana, M.; Biaback, J-C.; Kennedy, M.; Kibedou, H.; Kounga, F.; Maguip Abanda, M.; Mamang, E.; Mikone, A.; Tang, S.; Tchuangue, E.; Tchuenko, S.; Yakan, D.; Assandje, J.; Ebana, S.; Ebo’o, D.; Etoundi, D.; Ngama, G.; Mbarga Ango, P.; Mbezele, J.; Mbong, G.; Moung, C.; Ekotto, N.; Nguemba Balla, G.; Ottou, G.; Tigougmo, M.; Beyala, R.; Ebene, B.; Effemba, C.; Eyebe, F.; Hadjaratou, M-M.; Mbarga, T.; Metou, M.; Ndam, M.; Ngoa, B.; Ngock, EB.; Obam, N.; Abomo, A. M.; Angoula, G.; Ekassi, E.; Essama; Lentchou, J.J.; Mvilongo, I.; Ngapou, J.; Ntokombo, F.; Ondoua, V.; Palawo, R.; Sebe, S.; Sinou, E.; Wankam, D.; Zobo, I.; Akono, B.; Ambani, A. L.; Bilock, L.; Bilo’o, R.; Boombhi, J.; Fouda, F.X.; Guitonga, M.; Mad’aa, R.; Metou’ou, D.R.; Mgbih, S.; Noah, A.; Tadena, M.; Ntcham; Ambassa Elime, G.; Bonongnaba, A.A.; Foaleng, E.; Heles, R.M.; Messina, R.; Nana Ndankou, O.; Ngono, S.A.; Ngono Menounga, D.; Sil, S.S.; Tchouamou, L.; Zambou, B.; Abomo, R.; Ambomo, J.; Beyomo, C.; Eloundou, P.; Ewole, C.; Fokom, J.; Mvoto, M.; Ngadena, M.; Nyolo, R.; Onana, C.; Oyie, A.; Antyimi, P.; Bella Mbatonga, S.; Bikomo, M.; Molo Bodo, Y.; Ndi Ntang, S.; Ndoudoumou, P.; Ndzomo, L.; Ngolo, S.O.; Nkengue, M.; Nkoa; Tchinda, Y.

2013-01-01

Objectives Using cohort data nested in a randomized trial conducted in Cameroon, this study aimed to investigate time trends and predictors of the susceptibility to transmitting HIV during the first 24 months of treatment. Methods The outcome, susceptibility to transmitting HIV, was defined as reporting inconsistent condom use and experiencing incomplete virological suppression. Mixed logistic regressions were performed to identify predictors of this outcome among 250 patients reporting to have had sexual relationships either with HIV-negative or unknown HIV status partner(s). Results Despite an initial decrease from 76% at M0 to 50% at M6, the rate of inconsistent condom use significantly increased from M12 (59%) to M24 (66%) (p = 0.017). However, the proportion of patients susceptible to transmitting HIV significantly decreased over follow-up from 76% at M0, to 50% at M6, 31% at M12 and 27% at M24 (p<0.001). After controlling for age, gender and intervention group, we found that perceiving healthcare staff’s readiness to listen as poor (adjusted odds ratios (AOR) [95% Confidence Interval (CI)] = 1.87 [1.01–3.46]), reporting to have sexual relationships more than once per week (AOR [95%CI] = 2.52 [1.29–4.93]), having more than one sexual partner (AOR [95%CI] = 2.53 [1.21–5.30]) and desiring a/another child (AOR [95%CI] = 2.07 [1.10–3.87]) were all associated with a higher risk of being susceptible to transmitting HIV. Conversely, time since ART initiation (AOR [95%CI] = 0.66 [0.53–0.83] for an extra 6 months and ART adherence (AOR [95%CI] = 0.33 [0.15–0.72]) were significantly associated with a lower risk of being susceptible to transmitting HIV. Conclusions The decrease observed in the susceptibility to transmitting HIV suggests that fear of behavioural disinhibition should not be a barrier to universal access to ART. However, developing adequate preventive interventions matching patients’ expectations -like the desire to have children- and strengthening healthcare staff’s counselling skills are urgently needed to maximize the impact of ART in slowing the HIV epidemic. PMID:23638126

Condom Use and Intimacy among Tajik Male Migrants and their Regular Female Partners in Moscow

PubMed Central

Polutnik, Chloe; Jonbekov, Jonbek; Shoakova, Farzona; Bahromov, Mahbat; Weine, Stevan

2014-01-01

This study examined condom use and intimacy among Tajik male migrants and their regular female partners in Moscow, Russia. This study included a survey of 400 Tajik male labour migrants; and longitudinal ethnographic interviews with 30 of the surveyed male migrants and 30 of their regular female partners. 351 (88%) of the surveyed male migrants reported having a regular female partner in Moscow. Findings demonstrated that the migrants’ and regular partners’ intentions to use condoms diminished with increased intimacy, yet each party perceived intimacy differently. Migrants’ intimacy with regular partners was determined by their familiarity and perceived sexual cleanliness of their partner. Migrants believed that Muslim women were cleaner than Orthodox Christian women and reported using condoms more frequently with Orthodox Christian regular partners. Regular partners reported determining intimacy based on the perceived commitment of the male migrant. When perceived commitment faced a crisis, intimacy declined, and regular partners renegotiated condom use. The association between intimacy and condom use suggests that HIV prevention programmes should aim to help male migrants and female regular partners to dissociate their approaches to condom use from their perceptions of intimacy. PMID:25033817

Everywhere You Go, Everyone Is Saying Condom, Condom. but Are They Being Used Consistently? Reflections of South African Male Students about Male and Female Condom Use

ERIC Educational Resources Information Center

Mantell, Joanne E.; Smit, Jennifer A.; Beksinska, Mags; Scorgie, Fiona; Milford, Cecilia; Balch, Erin; Mabude, Zonke; Smith, Emily; Adams-Skinner, Jessica; Exner, Theresa M.; Hoffman, Susie; Stein, Zena A.

2011-01-01

Young men in South Africa can play a critical role in preventing new human immunodeficiency virus (HIV) infections, yet are seldom targeted for HIV prevention. While reported condom use at last sex has increased considerably among young people, consistent condom use remains a challenge. In this study, 74 male higher education students gave their…

Use of the "NYC Condom" among people who use drugs.

PubMed

Des Jarlais, Don C; McKnight, Courtney; Arasteh, Kamyar; Feelemyer, Jonathan; Perlman, David; Hagan, Holly; Cooper, Hannah L F

2014-06-01

We assessed awareness and use of the "NYC Condom" among persons who use heroin and cocaine in New York City. The NYC Condom distribution program is the largest free condom distribution program in the USA, with over 30 million condoms distributed per year. It includes a condom social marketing program for a specific brand, the NYC Condom with its own packaging and advertising. People who use heroin and cocaine are at relatively high risk for HIV infection and are an important target population for the program. In order to assess awareness of the NYC Condom, structured interviews and blood testing for HIV, HSV-2, and sexually transmitted infections (STI) were conducted among entrants to the Beth Israel Medical Center drug detoxification and methadone treatment programs. Participants were asked about drug use, sexual risk behaviors, and awareness and use of the NYC Condom. Univariate and multivariable regression analyses were conducted to examine the associations between use of NYC Condoms and consistent condom use with primary and casual sexual partners. A total of 970 subjects were recruited between February 2011 and December 2012. Subjects were primarily African-American and Hispanic, with a mean age of 43. Fifty-five percent of subjects reported being sexually active with primary sexual partners, and 25 % reported being sexually active with a casual partner for the 6 months prior to the interview. Sixty-five percent of subjects had heard of the NYC Condom, 48 % of those who had heard of the condom had used it, and 58 % of those who had ever used it were currently using it (in the previous 6 months). In multivariable regression analyses, current use of NYC Condoms was strongly associated with consistent condom use with primary sexual partners (adjusted odds ratio (AOR) = 3.99, 95 % confidence interval (CI) 1.85-8.58) and consistent condom use with casual sexual partners (AOR = 4.48, 95 % CI 1.49-13.42). In terms of market share, 38 % of subjects consistently using condoms with primary partners were using the NYC Condom, and 47 % of those consistently using condoms with casual partners were using the NYC Condom. The NYC Condom is an important tool for reducing sexual transmission of HIV and STI among persons who use drugs in the city. Given the strong relationship between using the NYC Condom and consistent condom use, further efforts to promote the NYC Condom brand would be easily justified.

Sexual activity and condom use among Eastern European adolescents—the Study of Hungarian Adolescent Risk Behaviours

PubMed Central

Gyarmathy, V A; Thomas, R P; Mikl, J; McNutt, L A; Morse, D L; DeHovitz, J; Ujhelyi, E; Számadó, Sz

2010-01-01

Summary While rates of HIV and STD infection in Eastern Europe are increasing rapidly, little is known about sexual behaviour, including condom use, among Eastern European youths. The Study of Hungarian Adolescent Risk Behaviours was designed to assess the knowledge, attitudes, and behaviours of adolescents studying in secondary schools in Budapest, Hungary. Students (n=3486) in a random sample of public secondary schools completed a self-administered questionnaire, including measures of sexual activity and condom use. Thirty-eight percent of students reported ever having had vaginal intercourse. Condom use by those reporting having had sex in the past five weeks was classified as consistent/every time (40%); irregular (25.6%); and none (34.3%). Multivariate analysis revealed positive opinions about condoms, fear of AIDS, and initiation of condom use by both partners to predict more frequent condom use. Implications for targeted AIDS/STD education and prevention among adolescents are discussed. PMID:12015014

Randomized Controlled Trial on the Effectiveness of Counseling Messages for Avoiding Unprotected Sexual Intercourse During Sexually Transmitted Infection and Reproductive Tract Infection Treatment Among Female Sexually Transmitted Infection Clinic Patients

PubMed Central

Anderson, Clive; Gallo, Maria F.; Hylton-Kong, Tina; Steiner, Markus J.; Hobbs, Marcia M.; Macaluso, Maurizio; Figueroa, J. Peter; Jamieson, Denise J.; Legardy-Williams, Jennifer; Wiener, Jeffrey; Warner, Lee

2013-01-01

Background The effectiveness of counseling messages to avoid unprotected sex during short-term treatment for curable sexually transmitted infections is unknown. Methods We randomized 300 female STI clinic patients 18 years or older with cervicitis and/or vaginal discharge in Kingston, Jamaica, in 2010 to 2011, to 1 of 2 counseling messages for their course of syndromic treatment: abstinence only or abstinence backed up by condom use. At a follow-up visit 6 days afterward, we collected vaginal swabs to test for prostate-specific antigen (PSA), a biological marker of recent semen exposure, and administered a questionnaire assessing sexual behavior. Results No differences were found in the proportions of women testing positive for PSA at follow-up in the abstinence-plus-condom group (11.9%) and abstinence-only group (8.4%) (risk difference, 3.5; 95% confidence interval, −3.5 to 10.5). There also was no significant difference in reporting of unprotected sex between groups. Reporting a history of condom use before enrollment significantly modified the effect of counseling arm on PSA positivity (P = 0.03). Among those reporting recent condom use, 10.3% in the abstinence-only arm and 4.8% in the abstinence-plus-condom arm tested positive for PSA. Conversely, among those not reporting recent condom use, 6.5% in the abstinence-only arm and 17.3% in the abstinence-plus-condom arm had PSA detected. Conclusions We found no evidence to support the superiority of either counseling message. Post hoc analyses suggest that women with recent condom experience may benefit significantly more from abstinence-plus-condom messages, whereas women without such experience may benefit significantly more from abstinence-only messages. Providers should weigh individual condom use history when determining the most appropriate counseling message. PMID:23321990

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.

Condom Use at Last Sexual Intercourse and Its Correlates among Males and Females Aged 15–49 Years in Nepal

PubMed Central

Sharma, Bimala; Nam, Eun Woo

2018-01-01

This study aimed to assess the prevalence and correlates of condom use at last sexual intercourse among people aged 15–49 years in Nepal. Secondary data analysis was performed using the Nepal Demographic and Health Survey 2011. The study was restricted to the respondents who reported ever having had sexual intercourse; 9843 females and 3017 males were included. Condom use was assessed by asking if respondents used condoms in their most recent sexual intercourse. Chi-square test and multivariate logistic regression analysis were performed using Complex Sample Analysis Procedure to adjust for sample weight and multistage sampling design. Overall, 7.6% of total, and 16.3% of males and 6.2% of females reported using condoms in their last sexual intercourse. Living in Far-Western region, age and wealth quintile were positively associated with condom use in both males and females. Being unmarried was the most important predictor of condom use among males. Higher education was associated with increased likelihood of condom use in females. However, mobility, having multiple sexual partners, and HIV knowledge were not significant correlates of condom use in both sexes. A big difference was observed in the variance accounted for males and females; indicating use of condoms is poorly predicted by the variables included in the study among females. Condom use was more associated with sociodemographic factors than with sexual behavior and HIV knowledge. PMID:29547564

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.

Perspectives on condom breakage: a qualitative study of female sex workers in Bangalore, India.

PubMed

Gurav, Kaveri; Bradley, Janet; Chandrashekhar Gowda, G; Alary, Michel

2014-01-01

A qualitative study was conducted to obtain a detailed understanding of two key determinants of condom breakage - 'rough sex' and poor condom fit - identified in a recent telephone survey of female sex workers, in Bangalore, India. Transcripts from six focus-group discussions involving 35 female sex workers who reported condom breakage during the telephone survey were analysed. Rough sex in different forms, from over-exuberance to violence, was often described by sex workers as a result of clients' inebriation and use of sexual stimulants, which, they report, cause tumescence, excessive thrusting and sex that lasts longer than usual, thereby increasing the risk of condom breakage. Condom breakage in this setting is the result of a complex set of social situations involving client behaviours and power dynamics that has the potential to put the health and personal lives of sex workers at risk. These findings and their implications for programme development are discussed.

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.

HIV prevalence and risk behaviours among men having sex with men in Nigeria.

PubMed

Merrigan, Mike; Azeez, Aderemi; Afolabi, Bamgboye; Chabikuli, Otto Nzapfurundi; Onyekwena, Obinna; Eluwa, George; Aiyenigba, Bolatito; Kawu, Issa; Ogungbemi, Kayode; Hamelmann, Christoph

2011-02-01

To evaluate HIV and syphilis prevalence among men who have sex with men (MSM) in Nigeria, and assess their HIV-related risk behaviours and exposure to HIV prevention interventions. Cross-sectional study using respondent-driven sampling conducted in Lagos, Kano and Cross River states, Nigeria, between July and September 2007. A total of 879 MSM participated, 293 from each state. Eight participants (1.1%, CI 0.1% to 2.2%) in Cross River, 27 (9.3%, CI 5.7% to 15.4%) in Kano and 74 (17.4%, CI 12.3% to 23.2%) in Lagos tested positive for HIV. No syphilis was detected. The median age was 22 years. MSM reported an average of 4.2 male anal sex partners in the past 6 months. Between 24.4% (Lagos) and 36.0% (Kano) of MSM reported selling sex to other men. Up to 49.7% of MSM reported sex with a girlfriend and ≤ 6.5% purchased sex from female sex workers. Consistent condom use in commercial sex with other men over the past 6 months ranged from 28.0% (Cross River) to 34.3% (Kano), in contrast to between 23.9% (Kano) and 45.8% (Lagos) for non-commercial sex. Associations with HIV positivity included age in the three states, having been the receptive partner in anal sex in the past 6 months in Lagos and in Lagos and Kano feeling at risk of HIV. Large differentials in HIV prevalence between states together with high mobility, inconsistent condom use and behavioural links with female sex partners, have the potential for further HIV transmission within MSM networks, and between MSM and the general population.

Gender Matters: Condom Use and Nonuse among Behaviorally Bisexual Men

PubMed Central

Hubach, Randolph D.; Dodge, Brian; Goncalves, Gabriel; Malebranche, David; Reece, Michael; Van Der Pol, Barbara; Martinez, Omar; Schnarrs, Phillip W.; Nix, Ryan; Fortenberry, J. Dennis

2013-01-01

Although frequently cited as being at high risk for HIV/STI transmission, little is known about behaviorally bisexual men’s patterns and experiences of condom use and nonuse with male and female sexual partners. Using a variety of recruitment techniques informed by a Community Advisory Committee, a total of 77 behaviorally bisexual men were recruited from Indianapolis, Indiana to participate in semi-structured interviews focused on sexual health. Qualitative data were collected containing detailed information on their patterns and experiences of condom use and nonuse with both male and female partners. Participants described numerous commonly reported barriers for consistent condom use, as well as distinct bisexual-specific barriers. The majority reported consistent condom use with male and female casual partners, but many who did not use condoms described doing so in the context of ongoing relationships. In addition, participants provided reasons for condom use and nonuse that varied based on the gender of the partner and the type of relationship with the partner. Future interventions focused on increasing condom use among behaviorally bisexual men should take into account the unique complexities of gender and relationship configurations in this distinct population. PMID:23912775

Sexual behavior and knowledge of sexually transmitted infections among university students in Sao Paulo, Brazil.

PubMed

Caetano, Maria Eugenia; Linhares, Iara Moreno; Pinotti, Jose Aristodemo; Maggio da Fonseca, Angela; Wojitani, Maria Dulce; Giraldo, Paulo Cesar

2010-07-01

To investigate the sexual behavior and knowledge about sexually transmitted infections (STIs) among undergraduate students in Sao Paulo, Brazil. Self-reported questionnaires were used. Most of the 447 students in the study were single (97.3%), in their first year of university (87.7%), and the mean ages were 20.4 years (males) and 19.8 years (females). Vaginal intercourse was practiced by 69.7% of males and 48.4% of females, oral sex by 64.5% of males and 43.7% of females, and anal sex by 18.4% of males and 14.1% of females. Use of a condom during vaginal sex was practiced by 80.4% of males and 74.8% of females and during anal sex by 47.8% of males and 30.0% of females. Knowledge of transmission of STIs was greater than 90% for HIV, syphilis, genital herpes, and gonorrhea; 63%-76% for HPV and genital warts; 30%-34% for Trichomonas and only 16% for Chlamydia. Only 25%-34% knew that HIV was transmitted by breastfeeding; 56%-60% knew that HIV was transmitted by anal sex. Many students engage in high-risk sexual behavior with multiple partners and use condoms inconsistently. Knowledge of the acquisition and modes of sexual and vertical transmission of HIV are strikingly deficient. Copyright (c) 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Condom use relative to knowledge of sexually transmitted disease prevention, method of birth control, and past or present infection.

PubMed

Fleisher, J M; Senie, R T; Minkoff, H; Jaccard, J

1994-12-01

The purpose of this study was to assess knowledge regarding STD spread and prevention, and to assess motivational and behavioral factors that influence the use of condoms to prevent STD acquisition among inner-city women at high risk for STD infection. In addition, the effect of past and/or current STD infection on a woman's knowledge of the mechanism of STD acquisition and subsequent use of a condom to prevent STD infection was explored. We utilized three inner-city clinics offering family planning or gynecologic care located in Brooklyn, New York. Our study linked clinical findings regarding current infection with chlamydia or Trichomonas vaginalis. One thousand four hundred and four sexually active black and Hispanic women participated in the study. A past history of STD (37%) or current infection (29%) was recorded for 54% of the study population (12% were positive for both past and current infection). On average, only 60% of women who reported prior treatment for STD infection reported receiving any information regarding prevention of re-infection during the course of treatment. Depending on the specific STD, from 6.8% to 42.9% of women reporting prior treatment for an STD did not know the disease they were being treated for was sexually transmitted. Condom use for disease prevention was more frequently reported by women who had previously been treated for an STD (OR = 1.62, 95% CI 1.23-2.13). However, condom use for contraception was a stronger predictor of use for STD prevention. Women who relied on condoms for contraception were almost 10 times more likely to also report condom use for STD prevention relative to women who did not use condoms for contraceptive purposes (OR = 9.71, 95% CI 7.0-13.5). In addition, condom use was associated with the perceived attitude of their sexual partner toward such use. Condom use to prevent STD acquisition was more than twice as frequently reported when a favorable attitude was perceived by a male sexual partner (OR = 2.30, 95% CI 1.54-3.43). Our findings suggest that prevention of unplanned pregnancy was a stronger motivator for condom use than disease prevention among the women comprising our study group. The findings also indicate the need for more extensive information regarding STD prevention among women at high risk for STD acquisition.(ABSTRACT TRUNCATED AT 400 WORDS)

Partner dependence and sexual risk behavior among STI clinic patients.

PubMed

Senn, Theresa E; Carey, Michael P; Vanable, Peter A; Coury-Doniger, Patricia

2010-01-01

To investigate the relation between partner dependence and sexual risk behavior in the context of the information-motivation-behavioral skills (IMB) model. STI clinic patients (n = 1432) completed a computerized interview assessing partner dependence, condom use, and IMB variables. Men had higher partner-dependence scores than women did. Patients reporting greater dependence reported less condom use. Gender did not moderate the partner dependence-condom-use relationship. Partner dependence did not moderate the relation between IMB constructs and condom use. Further research is needed to determine how partner dependence can be incorporated into conceptual models of safer sex behaviors.

Condom Use and the Risk of Recurrent Pelvic Inflammatory Disease, Chronic Pelvic Pain, or Infertility Following an Episode of Pelvic Inflammatory Disease

PubMed Central

Ness, Roberta B.; Randall, Hugh; Richter, Holly E.; Peipert, Jeffrey F.; Montagno, Andrea; Soper, David E.; Sweet, Richard L.; Nelson, Deborah B.; Schubeck, Diane; Hendrix, Susan L.; Bass, Debra C.; Kip, Kevin E.

2004-01-01

Among 684 sexually active women with pelvic inflammatory disease (PID) followed up for a mean of 35 months, we related contraceptive use to self-reported PID recurrence, chronic pelvic pain, and infertility. Persistent use of condoms during the study reduced the risk of recurrent PID, chronic pelvic pain, and infertility. Consistent condom use (about 60% of encounters) at baseline also reduced these risks, after adjustment for confounders, by 30% to 60%. Self-reported persistent and consistent condom use was associated with lower rates of PID sequelae. PMID:15284036

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.

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

Factors associated with induced abortion among female entertainment workers: a cross-sectional study in Cambodia.

PubMed

Yi, Siyan; Tuot, Sovannary; Chhoun, Pheak; Pal, Khuondyla; Tith, Khimuy; Brody, Carinne

2015-07-31

To explore risk factors associated with induced abortion among sexually active female entertainment workers (FEWs) in Cambodia. Cross-sectional study. Phnom Penh and Siem Reap, Cambodia. This study included 556 FEWs aged 18-47 years randomly selected from entertainment establishments in the two cities in 2014 using a two-stage cluster sampling method. Data were collected through face-to-face interviews using a structured questionnaire. History of induced abortion during the time working as a FEW. Of the total sample, 45.6% reported currently using a contraceptive method with condom (42.4%) being the most common method, followed by pills (25.6%). One-fourth (25%) of the respondents reported having been pregnant at least once, and 21.4% reported having at least one induced abortion during the time working as a FEW. After controlling for other covariates in a multivariate logistic regression model, FEWs with a history of induced abortion remained significantly more likely to be currently working in a karaoke bar (AOR=1.75, 95% CI 1.10 to 2.78), to have worked longer as a FEW (AOR=1.42, 95% CI 1.06 to 1.43), to have had a greater number of sexual partners in the past 12 months (AOR=1.86, 95% CI 1.02 to 1.54), to be currently using a contraceptive method (AOR=1.52, 95% CI 1.01 to 2.29), to be able to find condoms when they needed them (AOR=2.03, 95% CI 1.09 to 3.82), and to report inconsistent condom use with non-commercial partners in the past 3 months (AOR=1.62, 95% CI 1.06 to 3.44). This study highlights the high rates of unwanted pregnancies that ended in induced abortions among FEWs in Cambodia. Access of FEWs to quality sexual and reproductive healthcare services is deemed a high priority. Integrated interventions to improve sexual and reproductive health among these vulnerable women should be tailored to reach the most-at-risk groups. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Serial monogamy and biologic concurrency: measurement of the gaps between sexual partners to inform targeted strategies.

PubMed

Mercer, Catherine H; Aicken, Catherine R H; Tanton, Clare; Estcourt, Claudia S; Brook, M Gary; Keane, Frances; Cassell, Jackie A

2013-07-15

Having multiple sexual partners concurrently increases the risk of transmission of a sexually transmitted infection. Even if partnerships do not overlap, transmission potential exists when the gap between partnerships is shorter than the remaining infectious period. In the present article, we quantify the gap between partners to assess transmission potential using data collected by a cross-sectional survey of 2,203 genitourinary medicine clinic patients in England in 2009. Questionnaires asked about patients' 3 most recent partnerships. Gaps were calculated as time (days) between the last sexual encounter with a former partner and the first sexual encounter with the next partner. Among 1,875 patients who reported 1 or more partners in the previous 3 months, 47.6% of men and 27.7% of women reported 2 or more partners. Forty-two percent of the gaps were negative (i.e., partnerships that were concurrent); the median gaps were -7 and -17 days for men and women, respectively (i.e., overlaps were 7 and 17 days for men and women, respectively). Although half of the gaps were positive (serially monogamous partnerships), many were of short duration; the median gaps were 14 and 24 days for men and women, respectively. In over half of the gaps, condoms were used inconsistently with one or both partners, and in one-quarter, condoms were never used with either partner. There is thus a high potential for sexually transmitted infections, as even if partnerships are not behaviorally concurrent, they may be biologically concurrent. These data have important implications for designing and targeting effective health promotion messages.

Behavioral and community correlates of adolescent pregnancy and Chlamydia rates in rural counties in Minnesota.

PubMed

Kozhimannil, Katy B; Enns, Eva; Blauer-Peterson, Cori; Farris, Jill; Kahn, Judith; Kulasingam, Shalini

2015-06-01

Identifying co-occurring community risk factors, specific to rural communities, may suggest new strategies and partnerships for addressing sexual health issues among rural youth. We conducted an ecological analysis to identify the county-level correlates of pregnancy and chlamydia rates among adolescents in rural (nonmetropolitan) counties in Minnesota. Pregnancy and chlamydia infection rates among 15-19 year-old females were compared across Minnesota's 87 counties, stratified by rural/urban designations. Regression models for rural counties (n = 66) in Minnesota were developed based on publicly available, county-level information on behaviors and risk exposures to identify associations with teen pregnancy and chlamydia rates in rural settings. Adolescent pregnancy rates were higher in rural counties than in urban counties. Among rural counties, factors independently associated with elevated county-level rates of teen pregnancy included inconsistent contraceptive use by 12th-grade males, fewer 12th graders reporting feeling safe in their neighborhoods, more 9th graders reporting feeling overweight, fewer 12th graders reporting 30 min of physical activity daily, high county rates of single parenthood, and higher age-adjusted mortality (P < .05 for all associations). Factors associated with higher county level rates of chlamydia among rural counties were inconsistent condom use reported by 12th-grade males, more 12th graders reporting feeling overweight, and more 12th graders skipping school in the past month because they felt unsafe. This ecologic analysis suggests that programmatic approaches focusing on behavior change among male adolescents, self-esteem, and community health and safety may be complementary to interventions addressing teen sexual health in rural areas; such approaches warrant further study.

Behavioral and Community Correlates of Adolescent Pregnancy and Chlamydia Rates in Rural Counties in Minnesota1

PubMed Central

Kozhimannil, Katy B.; Enns, Eva; Blauer-Peterson, Cori; Farris, Jill; Kahn, Judith; Kulasingam, Shalini

2014-01-01

Purpose Identifying co-occurring community risk factors, specific to rural communities, may suggest new strategies and partnerships for addressing sexual health issues among rural youth. We conducted an ecological analysis to identify the county-level correlates of pregnancy and chlamydia rates among adolescents in rural (nonmetropolitan) counties in Minnesota. Methods Pregnancy and chlamydia infection rates among 15–19 year-old females were compared across Minnesota’s 87 counties, stratified by rural/urban designations. Regression models for rural counties (n=66) in Minnesota were developed based on publicly available, county-level information on behaviors and risk exposures to identify associations with teen pregnancy and chlamydia rates in rural settings. Findings Adolescent pregnancy rates were higher in rural counties than in urban counties. Among rural counties, factors independently associated with elevated county-level rates of teen pregnancy included inconsistent contraceptive use by 12th-grade males, fewer 12th graders reporting feeling safe in their neighborhoods, more 9th graders reporting feeling overweight, fewer 12th graders reporting 30 min of physical activity daily, high county rates of single parenthood, and higher age-adjusted mortality (P < .05 for all associations). Factors associated with higher county level rates of chlamydia among rural counties were inconsistent condom use reported by 12th-grade males, more 12th graders reporting feeling overweight, and more 12th graders skipping school in the past month because they felt unsafe. Conclusions This ecologic analysis suggests that programmatic approaches focusing on behavior change among male adolescents, self-esteem, and community health and safety may be complementary to interventions addressing teen sexual health in rural areas; such approaches warrant further study. PMID:25344773

Condoms for prisoners: no evidence that they increase sex in prison, but they increase safe sex

PubMed Central

Butler, Tony; Richters, Juliet; Yap, Lorraine; Donovan, Basil

2013-01-01

Objectives To determine if the provision of condoms to prisoners in two Australian state prison systems with different policies affects sexual behaviour. In New South Wales’ (NSW) prisons, condoms are freely distributed, while in Queensland prisons none are distributed. Methods We used a computer-assisted telephone interview to survey randomly selected prisoners in both states about their sexual behaviour in prison. Results Two thousand and eighteen male prisoners participated. The proportion of prisoners reporting anal sex in prison was equally low in NSW (3.3%) and Queensland (3.6%; p=0.8). A much higher proportion of prisoners who engaged in anal sex in NSW (56.8%) than Queensland (3.1%; p<0.0001) reported they had used a condom if they had had anal sex in prison. Sexual coercion was equally rare in both prison systems. Conclusions We found no evidence that condom provision to prisoners increased consensual or non-consensual sexual activity in prison. If available, condoms were much more likely to be used during anal sex. Condoms should be made available to prisoners as a basic human right. PMID:23300337

The developmental association of relationship quality, hormonal contraceptive choice and condom non-use among adolescent women.

PubMed

Sayegh, M Aaron; Fortenberry, J Dennis; Shew, Marcia; Orr, Donald P

2006-09-01

Consistent condom use is critical to efforts to prevent sexually transmitted infections among adolescents, but condom use may decline as relationships and contraceptive needs change. The purpose of this research is to assess changes in condom non-use longitudinally in the context of changes in relationship quality, coital frequency and hormonal contraceptive choice. Participants were women (aged 14-17 years at enrollment) recruited from three urban adolescent medicine clinics. Data were collected at three-month intervals using a face-to-face structured interview. Participants were able to contribute up to 10 interviews, but on average contributed 4.2 interviews over the 27-month period. Independent variables assessed partner-specific relationship quality (five items; scale range 5-25; alpha = .92, e.g., this partner is a very important person to me); and, number of coital events with a specific partner. Additional items assessed experience with oral contraceptive pills (OCP) use and injected depo medroxy-progesterone acetate (DMPA). The outcome variable was number of coital events without condom use during the past three months. Analyses were conducted as a three-level hierarchical linear growth curve model using HLM 6. The Level 1 predictor was time, to test the hypothesis that condom non-use increases over time. Level 2 predictors assessed relationship quality and coital frequency across all partners to assess hypotheses that participants' condom non-use increases over time as a function of relationship quality and coital frequency. Level 3 predictors assessed the participant-level influence of OCP or DMPA experience on time-related changes in condom non-use. A total of 176 women reported 279 sex partners and contributed 478 visits. Both average coital frequency and average condom non-use linearly increased during the 27-month follow-up. At any given follow-up, about 35% reported recent OCP use, and 65% reported DMPA use. HLM analyses showed that condom non-use increased as a function of time (beta = .12; p = .03, Level 1 analysis). Increased condom non-use over time was primarily a function of increased coital frequency (beta = .01; p = .00), although higher levels of relationship quality were associated with increased condom non-use at enrollment (beta = .44; p = .00, Level 2 analysis). The temporal rise in condom non-use significantly increased among DMPA users (beta = .06; p = .00) but not OCP users (Level 3 analysis) (beta = -.04; p = .06). Developmentally, relationship characteristics and coital frequency appear to have increasing weight in decisions about condom use. Hormonal contraceptive methods are not equivalently associated with the overall temporal decline in condom use. Future research associated with dual contraceptive/condom use should address differential factors associated condom use in combination with different hormonal methods.

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

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

HIV testing behaviors among female sex workers in Southwest China.

PubMed

Hong, Yan; Zhang, Chen; Li, Xiaoming; Fang, Xiaoyi; Lin, Xiuyun; Zhou, Yuejiao; Liu, Wei

2012-01-01

Despite the recognized importance of HIV testing in prevention, care and treatment, HIV testing remains low in China. Millions of female sex workers (FSW) play a critical role in China's escalating HIV epidemic. Limited data are available regarding HIV testing behavior among this at-risk population. This study, based on a cross-sectional survey of 1,022 FSW recruited from communities in Southwest China, attempted to address the literature gap. Our data revealed that 48% of FSW ever took HIV testing; older age, less education, working in higher-income commercial sex venues and better HIV knowledge were associated with HIV testing. Those who never took HIV testing were more likely to engage in high-risk behaviors including inconsistent condom use with clients and stable partners. A number of psychological and structural barriers to testing were also reported. We call for culturally appropriate interventions to reduce HIV risks and promote HIV testing for vulnerable FSW in China.

Do condoms cause rape and mayhem? The long‐term effects of condoms in New South Wales' prisons

PubMed Central

Yap, Lorraine; Butler, Tony; Richters, Juliet; Kirkwood, Kristie; Grant, Luke; Saxby, Max; Ropp, Frederick; Donovan, Basil

2007-01-01

Background 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. Method 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. Results 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. Conclusions 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. PMID:17179163

Partner Dependence and Sexual Risk Behavior Among STI Clinic Patients

PubMed Central

Senn, Theresa E.; Carey, Michael P.; Vanable, Peter A.; Coury-Doniger, Patricia

2010-01-01

Objectives To investigate the relation between partner dependence and sexual risk behavior in the context of the information-motivation-behavioral skills (IMB) model. Methods STI clinic patients (n = 1432) completed a computerized interview assessing partner dependence, condom use, and IMB variables. Results Men had higher partner-dependence scores than women did. Patients reporting greater dependence reported less condom use. Gender did not moderate the partner dependence-condom-use relationship. Partner dependence did not moderate the relation between IMB constructs and condom use. Conclusions Further research is needed to determine how partner dependence can be incorporated into conceptual models of safer sex behaviors. PMID:20001183

Condom use within marriage: a neglected HIV intervention.

PubMed Central

Ali, Mohamed M.; Cleland, John; Shah, Iqbal H.

2004-01-01

OBJECTIVE: To assess the contraceptive effectiveness of condoms versus oral contraceptive pills and estimate the reproductive consequences of a major shift from pill to condom use. METHODS: Secondary analysis was performed on nationally representative cross-sectional surveys of women in 16 developing countries. FINDINGS: In the 16 countries, the median per cent of married couples currently using condoms was 2%, compared with 13% for the pill. Condom users reported a higher 12-month failure and higher method-related discontinuation rates than pill users (9% and 44% vs 6% and 30%, respectively). Condom users were more likely to report subsequent abortion following failure (21% vs 14%), and also more likely to switch rapidly to another method (76% vs 58%). The reproductive consequences, in terms of abortion and unwanted births, of a hypothetical reversal of the relative prevalence of condom and pill were estimated to be minor. The main reason for this unexpected result is that the majority of abortions and unwanted births arise from non-use of any contraceptive method. CONCLUSION: A massive shift from the more effective oral contraceptive pills to the less effective condom would not jeopardize policy goals of reducing abortions and unwanted births. However, such a shift would potentially have an added benefit of preventing human immunodeficiency virus (HIV) infections, especially in countries with generalized HIV epidemics. PMID:15112006

Condom Use Among Men Who Have Sex With Men and Male-to-Female Transgenders in Jakarta, Indonesia.

PubMed

Safika, Iko; Johnson, Timothy P; Cho, Young Ik; Praptoraharjo, Ignatius

2014-07-01

This article examined differences in condom use during anal intercourse among men who have sex with men (MSM) and male-to-female transgender women in Jakarta, Indonesia. A cross-sectional design, structured interviews, and hierarchical linear modeling were used to examine condom use among MSM recruited from entertainment places (EPs; e.g., discotheques/dance clubs/karaoke bars), massage parlors (MPs), and among transgender women who congregated and/or sought sexual partners on streets/parks (S/P). The sample consisted of 91, 97, and 114 of MSM-EP, MSM-MP, and transgender-S/P, respectively. Respondents reported on 641 unique sexual partner encounters, which were "nested" within 302 respondents. Reported condom use was high, 66%, 84%, and 83% for MSM-EP, MSM-MP, and transgender-S/P, respectively, and varied across type of respondent. At the individual level, depressive symptoms and history of physical abuse during childhood and adulthood were associated with lower condom use (p < .05). By contrast, having a higher level of education was associated with more condom use (p < .05). At the partner level, condom use was associated with type of partners and the use of club drugs before sex. HIV-prevention efforts should take into account the multilevel determinants of condom use within these populations. © The Author(s) 2013.

Why don't urban youth in Zambia use condoms? The influence of gender and marriage on non-use of male condoms among young adults.

PubMed

Pinchoff, Jessie; Boyer, Christopher B; Mutombo, Namuunda; Chowdhuri, Rachna Nag; Ngo, Thoai D

2017-01-01

Zambia experiences high unmet need for family planning and high rates of HIV, particularly among youth. While male condoms are widely available and 95% of adults have heard of them, self-reported use in the past 12 months is low among young adults (45%). This study describes factors associated with non-use of male condoms among urban young adults in Zambia. A household cross-sectional survey in four urban districts was conducted from November 2015 to January 2016 among sexually active young adults ages 18-24 years. A random walk strategy was implemented in urban areas; eligible, enrolled participants were administered a survey on household characteristics, health access, and knowledge, attitudes and practices related to contraception. Relative risk regression models were built to determine factors associated with the decision to not use a male condom (non-use) at most recent sexual intercourse. A total of 2,388 individuals were interviewed; 69% were female, 35% were married, and average lifetime sex partners was 3.45 (SD±6.15). Non-use of male condoms was 59% at most recent sexual intercourse. In a multivariate model, women were more likely to report non-use of a male condom compared with men (aRR = 1.24 [95% CI: 1.11, 1.38]), married individuals were more likely to report non-use compared with unmarried individuals (aRR = 1.59 [1.46, 1.73]), and those residing in the highest poverty wards were more likely to report non-use compared with those in the lowest poverty wards (aRR = 1.31 [1.16, 1.48]). Those with more negative perceptions of male condom use were 6% more likely to report non-use (aRR = 1.06 [1.03, 1.09]). Discussion regarding contraception with a partner decreased non-use 13% (aRR = 0.87 [0.80, 0.95]) and agreement regarding male condom use with a partner decreased non-use 16% (aRR = 0.84 [0.77, 0.91)]). Non-use of male condoms is high among young, married adults, particularly women, who may be interested in contraception for family planning but remain at risk of STI infection. Effective marketing strategy of dual protection methods to this population is critical.

Bishop plays down report on condoms / AIDS in France.

PubMed

1996-02-26

Individual bishops in France and other European countries have argued that condom use can save lives by preventing the spread of HIV. The French Bishops' Conference social commission published a 200-page report which in which agreement was expressed with widespread medical opinion that condom use is the sole and necessary barrier against the sexual spread of HIV. Extensive media coverage ensued and led to Bishop Albert Rouet, the bishop of Poitiers and chairman of the French Bishops' Conference, being interviewed by the Holy See's official radio. In the interview, Bishop Rouet distanced the Roman Catholic Church in France from the report, claiming that the media had exaggerated the issue and that his commission was not bound by the reference. The Vatican remains staunchly opposed to condom use against HIV infection and preaches abstinence outside of marriage and fidelity within marriage as the only true ways to avoid HIV infection. In 1995, the Vatican fired Jacques Gaillot, the former bishop of Evreux in Normandy, for his outspoken endorsement of condom use against HIV.

Individual and Partner-Level Factors Associated with Condom Non-Use Among African American STI Clinic Attendees in the Deep South: An Event-Level Analysis.

PubMed

Marshall, Brandon D L; Perez-Brumer, Amaya G; MacCarthy, Sarah; Mena, Leandro; Chan, Philip A; Towey, Caitlin; Barnett, Nancy; Parker, Sharon; Barnes, Arti; Brinkley-Rubinstein, Lauren; Rose, Jennifer S; Nunn, Amy S

2016-06-01

The US HIV/AIDS epidemic is concentrated in the Deep South, yet factors contributing to HIV transmission are not fully understood. We examined relationships between substance use, sexual partnership characteristics, and condom non-use in an African American sample of STI clinic attendees in Jackson, Mississippi. We assessed condom non-use at last intercourse with up to three recent sexual partners reported by participants between January and June 2011. Participant- and partner-level correlates of condom non-use were examined using generalized estimating equations. The 1295 participants reported 2880 intercourse events, of which 1490 (51.7 %) involved condom non-use. Older age, lower educational attainment, reporting financial or material dependence on a sex partner, sex with a primary partner, and higher frequency of sex were associated with increased odds of condomless sex. HIV prevention efforts in the South should address underlying socioeconomic disparities and structural determinants that result in partner dependency and sexual risk behavior.

Women and postfertilization effects of birth control: consistency of beliefs, intentions and reported use

PubMed Central

Dye, Huong M; Stanford, Joseph B; Alder, Stephen C; Kim, Han S; Murphy, Patricia A

2005-01-01

Background This study assesses the consistency of responses among women regarding their beliefs about the mechanisms of actions of birth control methods, beliefs about when human life begins, the intention to use or not use birth control methods that they believe may act after fertilization or implantation, and their reported use of specific methods. Methods A questionnaire was administered in family practice and obstetrics and gynecology clinics in Salt Lake City, Utah, and Tulsa, Oklahoma. Participants included women ages 18–50 presenting for any reason and women under age 18 presenting for family planning or pregnancy care. Analyses were based on key questions addressing beliefs about whether specific birth control methods may act after fertilization, beliefs about when human life begins, intention to use a method that may act after fertilization, and reported use of specific methods. The questionnaire contained no information about the mechanism of action of any method of birth control. Responses were considered inconsistent if actual use contradicted intentions, if one intention contradicted another, or if intentions contradicted beliefs. Results Of all respondents, 38% gave consistent responses about intention to not use or to stop use of any birth control method that acted after fertilization, while 4% gave inconsistent responses. The corresponding percentages for birth control methods that work after implantation were 64% consistent and 2% inconsistent. Of all respondents, 34% reported they believed that life begins at fertilization and would not use any birth control method that acts after fertilization (a consistent response), while 3% reported they believed that life begins at fertilization but would use a birth control method that acts after fertilization (inconsistent). For specific methods of birth control, less than 1% of women gave inconsistent responses. A majority of women (68% or greater) responded accurately about the mechanism of action of condoms, abstinence, sterilization, and abortion, but a substantial percentage of women (between 19% and 57%) were uncertain about the mechanisms of action of oral contraceptives, intrauterine devices (IUDs), Depo-Provera, or natural family planning. Conclusion Women who believe that life begins at fertilization may not intend to use a birth control method that could have postfertilization effects. More research is needed to understand the relative importance of postfertilization effects for women in other populations, and in relation to other properties of and priorities for birth control methods. However, many women were uncertain about the mechanisms of action of specific methods. To respect the principles of informed consent, some women may need more education about what is known and not known about the mechanisms of action of birth control methods. PMID:16313677

Measures of Attitudes Toward and Communication about Condom Use: Their Relationships With Sexual Risk Behavior Among Young Black MSM

PubMed Central

Crosby, Richard A.; Graham, Cynthia A.; Yarber, William L.; Sanders, Stephanie A.; Milhausen, Robin R.; Mena, Leandro

2015-01-01

Objective To construct and test measures of psychosocial mediators that could be used in intervention studies seeking to promote safer sex behavior among young Black men who have sex with men (YBMSM). Methods YBMSM (N=400), ages 18–29 years, were recruited from an STI clinic, in the Southern U.S. All men had engaged in penile-anal sex with a male as a “top” in the past 6 months. Men completed an audio-computer assisted self-interview and provided specimens used for NAAT testing to detect Chlamydia and gonorrhea. Four measures were constructed and tested for criterion validity (Safer Sex Communication, Condom Turn-Offs, Condom Pleasure Scale, and a single item assessing frequency of condom use discussions before sexual arousal). Results With the exception of Safer Sex Communication, all of the measures showed criterion validity for both unprotected anal insertive, and unprotected anal receptive sex. With the exception of the Condom Turn-Offs, the three other measures were supported by criterion validity for oral sex. Both the Condom Turn-Offs and Condom Pleasure Scale were significantly related to whether or not men reported multiple partners as a “top” but only the Condom Pleasure Scale was associated with reports of multiple partners as a “bottom.” Only the Condom Turn-Offs Scale was positively associated with having been diagnosed with either Chlamydia or gonorrhea. Conclusion Findings provide three brief scales and a single item that can be used in intervention studies targeting YBMSM. Perceptions about condoms a turn off and about condoms enhancing pleasure showed strong association with sexual risk behaviors. PMID:26766525

Associations of consistent condom use among men who have sex with men in Abuja, Nigeria.

PubMed

Strömdahl, Susanne; Onigbanjo Williams, Abimbola; Eziefule, Bede; Emmanuel, Godwin; Iwuagwu, Stella; Anene, Oliver; Orazulike, Ifeanyi; Beyrer, Chris; Baral, Stefan

2012-12-01

The objective of the study was to characterize factors associated with consistent condom use among men who had sex with men (MSM) in Abuja, Nigeria. A convenience sample consisting of 297 MSM was recruited during 2008 using a combination of peer referral and venue-based sampling. Descriptive statistics with chi square and t-test were used for demographic, sexual identity, and practices variables. Univariate and multivariate logistic regressions were used to identify factors associated with consistent condom use with male partners in the past 6 months. Approximately more than half (53%, n=155/290) reported always using condoms with male partner in the past 6 months and 43% (n=95/219) reported always using condoms with female partners in the past 6 months. In all, 11% (n=16/144) reported always engaging in safe sex defined as always using condoms with both male and female partners and always using a water-based condom compatible lubricant with male partners in the past 6 months. Independent associations with consistent condom use with male partners in the past 6 months were knowledge of at least one sexually transmitted infection (STI) that can be transmitted through unprotected anal intercourse (OR 2.47, 95% CI: 1.27-4.83, p<0.01) and having been tested for HIV (OR 2.40, 95% CI: 1.27-4.54, p<0.01). MSM who had been HIV tested at least once were more likely to use condoms consistently during anal intercourse in multivariate analyses. In addition, STI knowledge was also associated with consistent condom use during anal intercourse implying that interventions targeting high-risk practices are effective as HIV prevention for this high-risk group. Future directions include intervention research to determine the appropriate package of services for MSM in Nigeria. In addition, implementation science evaluations of how best to operationalize combination HIV prevention interventions for MSM given the criminalization and stigmatization of same-sex practices are crucial.

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.

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.

Egocentric networks of Chinese men who have sex with men: network components, condom use norms, and safer sex.

PubMed

Liu, Hongjie; Feng, Tiejian; Liu, Hui; Feng, Hucang; Cai, Yumao; Rhodes, Anne G; Grusky, Oscar

2009-10-01

Research on risk behaviors among men who have sex with men (MSM) is often based on individualistic models of health behavior, but sexual behavior is inherently social in nature and often determined by constituents of social networks. The objective of this study was to examine relationships among social networks, network norms of condom use, and safer sex. A respondent-driven sampling study recruited 350 MSM in the Shenzhen region of China between November and December 2007 and collected information on network components (relations, structures, and functions) and HIV risk behavior among egos (those interviewed) and their network alters. A total of 2385 alters were nominated by the 350 egos. Egos reported an average of 4 nonsexual relation alters and 2 sexual-partner alters. Egos perceived receiving more tangible and emotional support from nonsexual relation alters than from sexual-partner alters. Two thirds (69%) of egos consistently used condoms. Sixty-seven percent of egos reported having 1 or more alters who always encouraged egos to use condoms, 84% had 1 or more alters who consistently used condoms, and 55% had 1 or more alters who insisted on condom use. Both subjective and descriptive norms were positively associated with consistent condom use. Network components were associated with the levels of the two norms. These findings suggest that social network components may activate or strengthen condom use norms within networks, which, in turn, determine consistent condom use among MSM. HIV behavioral interventions need to target the promotion of safer sex practices through enhancing peer norms of condom use within networks.

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.

Choice-disability and HIV infection: a cross sectional study of HIV status in Botswana, Namibia and Swaziland.

PubMed

Andersson, Neil; Cockcroft, Anne

2012-01-01

Interpersonal power gradients may prevent people implementing HIV prevention decisions. Among 7,464 youth aged 15-29 years in Botswana, Namibia and Swaziland we documented indicators of choice-disability (low education, educational disparity with partner, experience of sexual violence, experience of intimate partner violence (IPV), poverty, partner income disparity, willingness to have sex without a condom despite believing partner at risk of HIV), and risk behaviours like inconsistent use of condoms and multiple partners. In Botswana, Namibia and Swaziland, 22.9, 9.1, and 26.1% women, and 8.3, 2.8, and 9.3% men, were HIV positive. Among both women and men, experience of IPV, IPV interacted with age, and partner income disparity interacted with age were associated with HIV positivity in multivariate analysis. Additional factors were low education (for women) and poverty (for men). Choice disability may be an important driver of the AIDS epidemic. New strategies are needed that favour the choice-disabled.

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.

Predicting intention to use condoms in homosexual men: an application and extension of the theory of reasoned action.

PubMed

Mclaws, M L; Irwig, L M; Oldenburg, B; Mock, P; Ross, M W

1996-01-01

A questionnaire based upon the Theory of Reasoned Action was developed and tested to identify predictors of intention to use condoms. Behavioral intentions, attitudes and subjective normative beliefs, behavioral norms, and age of HIV-positive status were included on the questionnaire. Internal consistency of the four components was high, with Cronbach's alpha coefficients of 0.76-0.87. Qualitative data were collected over 2 months from 194 homosexual men who participated in Sydney's homosexual community. Participants aged 17-64 years of mean age 29.5 attended individual interviews or small focus groups to discuss their views concerning condom use. 15% reported having tested HIV-positive, 59% tested negative, and 26% reported not knowing their HIV serostatus. According to logistic modeling, the significant predictors of intentions to use a condom were attitudes and behavioral norms, while HIV antibody positive status and age directly influence behavioral intentions to use a condom. About 50% of men over age 25 years intended to use a condom, irrespective of HIV status. Overall, 59% of men aged 25 years and younger intended to use a condom; 22% of HIV-positive men and 63% of HIV-negative men.

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

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

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.

Social and behavioural factors associated with condom use among direct sex workers in Siem Reap, Cambodia.

PubMed

Wong, M L; Lubek, I; Dy, B C; Pen, S; Kros, S; Chhit, M

2003-04-01

To determine the social and behavioural factors associated with condom use among direct sex workers in Siem Reap, Cambodia. Using a structured behavioural questionnaire, interviews were conducted with 140 direct sex workers attending a health centre in Siem Reap for HIV screening. Consistent condom use with their clients was reported by 78% of sex workers compared to only 20% with their non-paying partners. Consistent condom use with clients was significantly higher among higher income than lower income sex workers (adjusted prevalence ratio: 1.91, 95% CI: 1.15 to 3.18) and those with good rather than poor negotiation skills (adjusted prevalence ratio: 1.51, 95% CI: 1.01 to 2.26), after adjustment for age, educational level, marital status, number of sexual encounters per week, and knowledge of AIDS/HIV and sexually transmitted infections. The most frequently reported reason for not using condoms with clients was not being able to persuade them (66.7%), while for non-paying partners, the reason was that they loved them (60.0%). To complement the government's current programme of client education, 100% condom policy and brothel administrative measures, additional strategies to increase condom use among clients and non-paying partners should be directed at (i) the social policy and community levels to address sex workers' economic and cultural barriers to condom use, and (ii) personal level empowerment through developing sex workers' condom negotiation skills.

Mediation of an efficacious HIV risk reduction intervention for South African men.

PubMed

O'Leary, Ann; Jemmott, John B; Jemmott, Loretta S; Bellamy, Scarlett; Icard, Larry D; Ngwane, Zolani

2015-10-01

"Men, Together Making a Difference!" is an HIV/STD risk-reduction intervention that significantly increased self-reported consistent condom use during vaginal intercourse compared with a health-promotion attention-control intervention among men (N = 1181) in Eastern Cape Province, South Africa. The present analyses were designed to identify mediators of the intervention's efficacy. The potential mediators were Social Cognitive Theory (SCT) constructs that the intervention targeted, including several aspects of condom-use self-efficacy, outcome expectancies, and knowledge. Mediation was assessed using a product-of-coefficients approach where an α path (the intervention's effect on the potential mediator) and a β path (the potential mediator's effect on the outcome of interest, adjusting for intervention) were estimated independently in a generalized estimating equations framework. Condom-use negotiation self-efficacy, technical-skill self-efficacy, and impulse-control self-efficacy were significant mediators. Although not mediators, descriptive norm and expected friends' approval of condom use predicted subsequent self-reported condom use, whereas the expected approval of sexual partner did not. The present results suggest that HIV/STD risk-reduction interventions that draw upon SCT and that address self-efficacy to negotiate condom use, to apply condoms correctly, and to exercise sufficient control when sexually aroused to use condoms may contribute to efforts to reduce sexual risk behavior among South African men. Future research must examine whether approaches that build normative support for condom use among men's friends are also efficacious.

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 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.

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

Rape Victimization and High Risk Sexual Behaviors: Longitudinal Study of African-American Adolescent Females

PubMed Central

Lang, Delia L.; Sales, Jessica M.; Salazar, Laura F.; Hardin, James W.; DiClemente, Ralph J.; Wingood, Gina M.; Rose, Eve

2011-01-01

Objectives: African-American women are affected by disproportionately high rates of violence and sexually transmitted infections (STI)/human immunodeficiency virus (HIV) infection. It is imperative to address the intersection of these two urgent public health issues, particularly as these affect African-American adolescent girls. This study assessed the prevalence of rape victimization (RV) among a sample of African-American adolescent females and examined the extent to which participants with a history of RV engage in STI/HIV associated risk behaviors over a 12-month time period. Methods: Three hundred sixty-seven African-American adolescent females ages 15–21, seeking sexual health services at three local teenager-oriented community health agencies in an urban area of the Southeastern United States, participated in this study. Participants were asked to complete an audio computer-assisted self-interview (ACASI) at baseline, 6- and 12-month follow-up. We assessed sociodemographics, history of RV and sexual practices. At baseline, participants indicating they had experienced forced sex were classified as having a history of RV. Results: Twenty-five percent of participants reported a history of RV at baseline. At 6- and 12-months, victims of RV had significantly lower proportions of condom-protected sex (p=.008), higher frequency of sex while intoxicated (p=.005), more inconsistent condom use (p=.008), less condom use at last sex (p=.017), and more sex partners (p=.0001) than non-RV victims. Over the 12-month follow-up period, of those who did not report RV at baseline, 9.5% reported that they too had experienced RV at some point during the 12-month time frame. Conclusion: African-American adolescent females who experience RV are engaging in more risky sexual behaviors over time than non-RV girls, thereby placing themselves at higher risk for contracting STIs. In light of the results from this unique longitudinal study, we discuss considerations for policies and guidelines targeting healthcare, law enforcement and educational and community settings. The complexities of RV screening in healthcare settings are examined as is the need for tighter collaboration between healthcare providers and law enforcement. Finally, we consider the role of prevention and intervention programs in increasing awareness about RV as well as serving as an additional safe environment for screening and referral. PMID:21731791

Exploring why young African American women do not change condom-use behavior following participation in an STI/HIV prevention intervention

PubMed Central

Sales, J. M.; DiClemente, R. J.; Davis, T. P.; Sullivan, S.

2012-01-01

Human immunodeficiency virus (HIV) interventions can significantly reduce risky sexual behaviors among vulnerable populations. However, not everyone exposed to an intervention will reduce their sexual risk behavior. This qualitative study sought to identify factors associated with young African American females’ lack of increase in condom use post-participation in an HIV prevention intervention. Semi-structured interviews were conducted with 50 young African American women (18–23 years; approximately half were mothers) after participating in a demonstrated effective HIV prevention intervention; 24 did not increase condom use post-intervention. Interviews were thematically coded for barriers to condom-use post-intervention. Although nearly all young women reported partner-associated challenges to using condoms, there were relational differences observed among those who changed their condom use versus those who did not. Many ‘non-changers’ were engaged in non-stable ‘on and off’ relationships, with high rates of infidelity, often with the father of their child, in which they were fearful of requesting condom use. ‘Non-changers’ also reported more substance use, feeling incapable of change and not thinking about condom use. Thus, future HIV prevention efforts may benefit from incorporating strategies on how young mothers can maintain a non-sexual relationship with their child’s father, as well as elaborating on the intersection of substance use and risky sexual decision-making. PMID:22641793

Condom vending machines stir controversy.

PubMed

1999-12-01

This article reports on the public debate on whether condoms should be made publicly available on the streets, in neighborhoods, and in schools, which could trigger discussions about sex in China. Condom vending machines have been installed in China since August 1999, and most regard the installations as a symbol of China's openness and progress, as well as an improvement in livelihood. However, some have objected to the public display and sale of condoms. Some teachers see it as damaging the reputation of the schools. Others suggest that they represent greater tolerance for premarital sex among youths, and a professor of sexual ethics stated that, while breaking the sex taboo is evidence of progress, condoms are a special type of commodity which should not be made available anywhere. In addition to the public debate concerning condoms, the banning of commercials featuring a condom-shaped cartoon character overcoming AIDS and sexually transmitted diseases touched off a debate between reproductive health advocates and government regulators. Reports indicate that the commercial was banned because it contravened the Advertisement Law, which provides that no sex product advertisement be aired or printed in the media. However, Zhang Konglai contended that condoms are not sex products but merely a means for preventing pregnancy and diseases and should be promoted actively. Moreover, Qui Renzong described the government's ban as a mistake and called on them to revise the law.

"A Baby Was an Added Burden": Predictors and Consequences of Unintended Pregnancies for Female Sex Workers in Mombasa, Kenya: A Mixed-Methods Study.

PubMed

Luchters, Stanley; Bosire, Wilkister; Feng, Amy; Richter, Marlise L; King'ola, Nzioki; Ampt, Frances; Temmerman, Marleen; Chersich, Matthew F

Female sex workers (FSW) have high rates of unintended pregnancy, sexually transmitted infections including HIV, and other adverse sexual and reproductive health outcomes. Few services for FSWs include contraception. This mixed-methods study aimed to determine the rate, predictors and consequences of unintended pregnancy among FSWs in Mombasa, Kenya. A prospective cohort study of non-pregnant FSWs was conducted. Quantitative data were collected quarterly, including a structured questionnaire and testing for pregnancy and HIV. Predictors of unintended pregnancy were investigated using multivariate logistic regression. Qualitative data were gathered through focus group discussions and in-depth interviews with FSWs who became pregnant during the study, and interviews with five key informants. These data were transcribed, translated and analysed thematically. Four hundred women were enrolled, with 92% remaining in the cohort after one year. Fifty-seven percent reported using a modern contraceptive method (including condoms when used consistently). Over one-third (36%) of women were using condoms inconsistently without another method. Twenty-four percent had an unintended pregnancy during the study. Younger age, having an emotional partner and using traditional or no contraception, or condoms only, were independent predictors of unintended pregnancy. Women attributed pregnancy to forgetting to use contraception and being pressured not to by clients and emotional partners, as well as "bad luck". They described numerous negative consequences of unintended pregnancy. Modern contraceptive uptake is surprisingly low in this at-risk population, which in turn has a high rate of unintended pregnancy. The latter may result in financial hardship, social stigma, risk of abandonment, or dangerous abortion practices. FSWs face considerable barriers to the adoption of dual method contraceptive use, including low levels of control in their emotional and commercial relationships. Reproductive health services need to be incorporated into programs for sexually transmitted infections and HIV, which address the socially-determined barriers to contraceptive use.

“A Baby Was an Added Burden”: Predictors and Consequences of Unintended Pregnancies for Female Sex Workers in Mombasa, Kenya: A Mixed-Methods Study

PubMed Central

Luchters, Stanley; Bosire, Wilkister; Feng, Amy; Richter, Marlise L.; King’ola, Nzioki; Ampt, Frances; Temmerman, Marleen; Chersich, Matthew F.

2016-01-01

Introduction Female sex workers (FSW) have high rates of unintended pregnancy, sexually transmitted infections including HIV, and other adverse sexual and reproductive health outcomes. Few services for FSWs include contraception. This mixed-methods study aimed to determine the rate, predictors and consequences of unintended pregnancy among FSWs in Mombasa, Kenya. Methods A prospective cohort study of non-pregnant FSWs was conducted. Quantitative data were collected quarterly, including a structured questionnaire and testing for pregnancy and HIV. Predictors of unintended pregnancy were investigated using multivariate logistic regression. Qualitative data were gathered through focus group discussions and in-depth interviews with FSWs who became pregnant during the study, and interviews with five key informants. These data were transcribed, translated and analysed thematically. Results Four hundred women were enrolled, with 92% remaining in the cohort after one year. Fifty-seven percent reported using a modern contraceptive method (including condoms when used consistently). Over one-third (36%) of women were using condoms inconsistently without another method. Twenty-four percent had an unintended pregnancy during the study. Younger age, having an emotional partner and using traditional or no contraception, or condoms only, were independent predictors of unintended pregnancy. Women attributed pregnancy to forgetting to use contraception and being pressured not to by clients and emotional partners, as well as “bad luck”. They described numerous negative consequences of unintended pregnancy. Conclusion Modern contraceptive uptake is surprisingly low in this at-risk population, which in turn has a high rate of unintended pregnancy. The latter may result in financial hardship, social stigma, risk of abandonment, or dangerous abortion practices. FSWs face considerable barriers to the adoption of dual method contraceptive use, including low levels of control in their emotional and commercial relationships. Reproductive health services need to be incorporated into programs for sexually transmitted infections and HIV, which address the socially-determined barriers to contraceptive use. PMID:27689699

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

Reported Condom Use among Students Enrolled in a Personal Health and Wellness Course

ERIC Educational Resources Information Center

Peterson,Yasenka; Johnson, Maureen; Hutchins, Matthew; Florence, Candace

2013-01-01

When used consistently and correctly every time, condoms can prevent against the spread of sexually transmitted infections (STIs) and unplanned pregnancies. Condoms are a significant prevention method viable for all populations. This study was conducted among students (277) at a Midwestern University who were enrolled in a personal health and…

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.

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.

Sexually transmitted diseases among female commercial sex workers in Finote Selam town, northwest Ethiopia: a community-based cross-sectional study.

PubMed

Anteneh, Zelalem Alamrew; Agumas, Yirdaw Amare; Tarekegn, Molalign

2017-01-01

Female commercial sex workers (FCSWs) are considered a high-risk group for acquiring sexually transmitted diseases (STDs), yet the reported prevalence varies in studies around the world. The aim of this study was to determine the magnitude and associated factors of STDs among female sex workers. A community-based cross-sectional study was conducted among female sex workers in Finote Selam town. A total of 389 sex workers were studied using census method. Data were collected using an interview with structured questionnaires. The data were entered and analyzed by using SPSS version 20 software package. The findings of this study showed that the overall prevalence of STDs was 20.6%. The reported prevalence of genital discharge, ulcer, and bubo was 15.9%, 15.2%, and 11.6%, respectively. In the multivariable logistic regression analysis, respondents who did not use a condom were about four times at higher risk of STDs than those who were using a condom consistently (adjusted odds ratio [AOR] = 4.07; 95% confidence interval [CI]: 1.812, 9.139). Respondents who experienced condom breakages were more than 12 times more likely to report STDs than those who never experienced condom breakages (AOR = 12.291, 95% CI: 5.701, 26.495). The findings of this study showed that one in five commercial sex workers in Finote Selam town had STDs. Sex without a condom and condom breakage during sexual intercourse showed a significant association with STDs. Therefore, the Woreda Health Office in collaboration with nongovernmental organizations in the area should work on safe sex promotion to enhance consistent condom use and reduce condom breakage through continuous education among commercial sex workers.

Unlocking the condoms: The effect on sales and theft

PubMed Central

Ashwood, Daniel; Farris, Karen B.; Campo, Shelly; Aquilino, Mary L.; Losch, Mary

2010-01-01

Community pharmacies may place condoms in locked displays or behind glass, thereby reducing access and consequent use. Objective Quantify sales and theft of condoms when condoms were unlocked and removed from behind glass in grocery pharmacies Methods Design. In this pilot study, condom displays were unlocked in selected pharmacies for three months. Participants. Eight grocery pharmacies in central Iowa agreed to participate. Intervention. Stores provided inventory at baseline, sales/theft thereafter in three monthly reports and sales for the same period one-year earlier. Outcome measures. Descriptive statistics quantified condom theft and sales. Number of pharmacies leaving condoms unlocked after the intervention was determined. Results Theft varied by pharmacy and ranged from an average of 1.33 boxes (units) per month to 27.33 per month. All stores experienced some increase in sales during the intervention. Two locations decided to re-lock their displays, only one indicated theft as the reason. Conclusion After removing condoms from locked displays, more condoms were purchased and stolen from the study pharmacies. Sales outweighed theft in all pharmacies. PMID:25132889

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.

Condom negotiation and use among female sex workers in Phnom Penh, Cambodia.

PubMed

Bui, Thanh Cong; Markham, Christine M; Tran, Ly T H; Beasley, R Palmer; Ross, Michael W

2013-02-01

We examined condom-use negotiation strategies and condom use among 81 female sex workers (FSWs) in Phnom Penh, Cambodia. Percentages of FSWs who did not negotiate condom use or could not describe a negotiation strategy with native clients, foreign clients, and non-paying partners were 15.0, 29.0 and 67.6 %, respectively. The most common negotiation strategy used was "provision of risk information" for native clients (43.8 %) and non-paying partners (26.5 %), and "direct request" for foreign clients (39.5 %). About half could not describe more than one negotiation strategy. Consistent condom use was high with native clients (98.8 %), yet comparatively lower with foreign clients (86.9 %) and non-paying partners (26.5 %). FSWs who did not negotiate or did not know how to negotiate condom use were less likely to report condom use with non-paying regular partners. Future interventions should enhance condom negotiation strategies between FSWs and all partner types.

Condom Use Self-Efficacy Among Younger Rural Adolescents: The Influence of Parent-Teen Communication, and Knowledge of and Attitudes Toward Condoms

PubMed Central

Ritchwood, Tiarney D.; Penn, Dolly; Peasant, Courtney; Albritton, Tashuna; Corbie-Smith, Giselle

2015-01-01

This study examines the role of condom use knowledge and attitudes, and parent-teen communication about sex and relationship quality on reports of condom use self-efficacy among rural, African American youth. Participants were 465 North Carolinian youth (10–14 years). Results indicated that greater condom use self-efficacy was predicted by greater knowledge of condom use (β = .206; p < .001), more favorable attitudes toward condom use (β = −.20; p < .0001) and parent-teen communication about sex (β = .13; p < .05), and actual parent-teen communication about sex and dating (β = .14; p < .05). There was low agreement between parents and youth on measures related to parent-teen communication about sex. Findings call for interventions targeting improvement of condom use knowledge among early adolescents, as well as parent-teen communication about sex. In addition, given the low parent-teen agreement regarding sexual communication, parent-teen sexual communication is an important point of intervention. PMID:28461714

Condom Use Self-Efficacy Among Younger Rural Adolescents: The Influence of Parent-Teen Communication, and Knowledge of and Attitudes Toward Condoms.

PubMed

Ritchwood, Tiarney D; Penn, Dolly; Peasant, Courtney; Albritton, Tashuna; Corbie-Smith, Giselle

2017-02-01

This study examines the role of condom use knowledge and attitudes, and parent-teen communication about sex and relationship quality on reports of condom use self-efficacy among rural, African American youth. Participants were 465 North Carolinian youth (10-14 years). Results indicated that greater condom use self-efficacy was predicted by greater knowledge of condom use (β = .206; p < .001), more favorable attitudes toward condom use (β = -.20; p < .0001) and parent-teen communication about sex (β = .13; p < .05), and actual parent-teen communication about sex and dating (β = .14; p < .05). There was low agreement between parents and youth on measures related to parent-teen communication about sex. Findings call for interventions targeting improvement of condom use knowledge among early adolescents, as well as parent-teen communication about sex. In addition, given the low parent-teen agreement regarding sexual communication, parent-teen sexual communication is an important point of intervention.

Contraception use and unplanned pregnancies among injection drug-using women in St Petersburg, Russia.

PubMed

Abdala, Nadia; Kershaw, Trace; Krasnoselskikh, Tatiana V; Kozlov, Andrei P

2011-07-01

This cross-sectional study estimated the prevalence of contraceptive methods and investigated whether abortion rates influence contraceptive behaviour among injection drug-using (IDU) women in St Petersburg, Russia. A self-administered questionnaire of behaviour in the last 3 months was applied to a convenient sample of IDU women. Of 80 sexually active participants, 67% had had an abortion. No participant reported using hormonal contraceptives or intrauterine devices (IUDs). The only valid method of contraception used was condoms, which was reported by half of the participants. Consistent condom use was reported by 22% of participants and was no more likely among those who had an abortion. Condom use was significantly associated with having multiple or casual sex partners [prevalence ratio (PR) 1.75, 95% (confidence interval) CI 1.11-2.78, p = 0.01], having an IDU sex partner (PR 0.55, 95% CI 0.36-0.85, p = 0.029) and with a negative attitude toward condoms (PR 0.53, 95% CI 0.33-0.84, p = 0.01). Abortions were less likely among those who had multiple or casual sex partners (PR 0.69, 95% CI 0.49-0.97, p = 0.03). Despite the high prevalence of abortions among IDU women, none reported the use of hormonal contraception or IUDs. Having had an abortion was not associated with greater likelihood of using condoms. Participants mostly used condoms with casual or multiple sex partners, suggesting that condoms were used mainly to prevent HIV/sexually transmitted infection transmission and not to prevent pregnancy. Programmes to prevent unwanted pregnancies and reduce abortion-related health risks among this understudied vulnerable group are needed.

Men's Understanding of and Experiences During the Postcircumcision Abstinence Period: Results From a Field Study of ShangRing Circumcision During Routine Clinical Services in Kenya and Zambia.

PubMed

Barone, Mark A; Li, Philip S; Zulu, Robert; Awori, Quentin D; Agot, Kawango; Combes, Stephanie; Simba, Raymond O; Lee, Richard K; Hart, Catherine; Lai, Jaim Jou; Zyambo, Zude; Goldstein, Marc; Feldblum, Paul J; Sokal, David C

2016-06-01

Men's understanding of counseling messages after voluntary medical male circumcision (VMMC) plays an important role in whether they follow them. Data on triggers for early resumption of sex may be useful as scale-up of VMMC for HIV prevention continues in sub-Saharan Africa. Data on understanding of post-VMMC abstinence recommendations, resumption of sex, condom use, and triggers for resuming sex were collected from participants during a follow-up interview 35-42 days after ShangRing circumcision in Kenya and Zambia. Of 1149 men who had ShangRing circumcision, 1096 (95.4%) completed follow-up. Nearly all (99.2%) reported being counseled to abstain from sex post-VMMC; among those, most (92.2%) recalled the recommended abstinence period was 6 weeks. Most men (94.1%) reported that the counselor gave reasons for post-VMMC abstinence and recalled appropriate reasons. Few (13.4%) men reported resuming sex at 35-42 days' follow-up. Among those, 54.8% reported never using a condom post-VMMC. Younger participants (odds ratio 0.3, 95% confidence interval: 0.2 to 0.5, P < 0.0001) and those reporting at least some condom use at baseline (odds ratio 0.5, 95% confidence interval: 0.3 to 0.7, P = 0.0003) were less likely to report resuming sex. Among men who reported some condom use, most (71.5%) said condoms were much easier or easier to use after circumcision. Men reported various reasons for early resumption of sex, primarily strong sexual desire (76.4%). Most men reported awareness of and adherence to the counseling recommendations for post-VMMC abstinence. A minority reported early resumption of sex, and, among those, condom use was low. Results could be used to improve post-VMMC counseling.

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

Mediation effect of perceived behavioural control on intended condom use: applicability of the theory of planned behaviour to money boys in China.

PubMed

Liu, Hongjie; Kennedy, May; Liu, Hui; Hong, Fuchang; Ha, Toan; Ning, Zheng

2013-12-01

Money boys (MBs) are male sex workers who sell sex to men who have sex with men. The objectives of this study were to assess (a) the sexual HIV risk of MBs; (b) the ability of the theory of planned behaviour (TPB) to predict MBs' intentions to use condoms; and (c) the manner in which TPB constructs (attitudes towards condom use, subjective norms and perceived behavioural control) combine to influence condom use intentions. Participants came from 10 MB-frequented clubs in two cities in China. Multiple regression and path analytic models were used to test inter-relationships among the TPB constructs. Seventy-eight percent of the 122 MB participants reported having used condoms for every anal sex act. About one-third reported having had female sexual partners in the past 2 months; of these MBs, half (53%) used condoms for every sex act. A revised model using TPB constructs accounted for 52% of the variance of condom use intentions and revealed that perceived behavioural control was a mediator in pathways beginning with attitudes and ending with condom use intentions, and beginning with subjective norms and ending with intentions. The findings suggest that a revised model of TPB applies to condom use intentions among Chinese MBs. It may be appropriate to adapt HIV interventions that are grounded in TPB and that have been shown to be effective elsewhere for use with Chinese MBs. HIV interventions for this population should give perceived behavioural control and its predictors special consideration.

HIV seroprevalence and high-risk sexual behavior among female sex workers in Central Brazil.

PubMed

Fernandes, Fernanda R P; Mousquer, Gina J; Castro, Lisie S; Puga, Marco A; Tanaka, Tayana S O; Rezende, Grazielli R; Pinto, Clarice S; Bandeira, Larissa M; Martins, Regina M B; Francisco, Roberta B L; Teles, Sheila A; Motta-Castro, Ana R C

2014-01-01

Female sex workers (FSWs) are considered a high-risk group for human immunodeficiency virus (HIV) infection due to their social vulnerability and factors associated with their work. We estimated the prevalence of HIV, and identified viral subtypes and risk factors among FSWs. A cross-sectional study using respondent-driven sampling (RDS) method was conducted among 402 FSWs in Campo Grande city, Brazil, from 2009 to 2011. Participants were interviewed using a standardized questionnaire about sociodemograpic characteristics and risk behavior. Blood samples were collected for serological testing of HIV. Of the 402 FSWs, median age and age of initiating sex work were 25 years (Interquartile range [IQR]: 9) and 20 years (IQR: 6), respectively. The majority reported use of alcohol (88.5%), had 5-9 years (median: 9; IQR: 3) of schooling (54.5%), 68.6% had tattoos/body piercings, and 45.1% had more than seven clients per week (median: 7; IQR: 10). Only 32.9% of FSW reported using a condom with nonpaying partners in the last sexual contact. Prevalence of HIV infection was 1.0% (95% CI: 0.1-2.6%). Genotyping for HIV-1 performed on three samples detected subtypes B, C, and F1. Sex work in the Midwestern region of Brazil is characterized by reduced education, large numbers of clients per week, and inconsistent condom use, mainly with nonpaying partners. Although prevalence of HIV infection is currently low, elevated levels of high-risk sexual behavior confirm a need to implement prevention measures. Specific interventions targeting FSWs must emphasize the risk associated with both clients and nonpaying partners while providing knowledge about HIV prevention.

HIV serostatus disclosure among gay and bisexual men in four American cities: general patterns and relation to sexual practices.

PubMed

Wolitski, R J; Rietmeijer, C A; Goldbaum, G M; Wilson, R M

1998-10-01

The present study examined patterns of serostatus disclosure among previously untested HIV-seropositive and HIV-seronegative gay and bisexual men recruited from four American cities (n = 701). Six months after learning their HIV serostatus, 97% of study participants had disclosed their test results to at least one other individual. Consistent with earlier studies, test results were most frequently shared with friends and the respondent's primary partner. HIV serostatus was disclosed less frequently to family members, co-workers, and non-primary sex partners. Compared with HIV-seronegative men, HIV-seropositive men were more likely to have disclosed their status to a health care provider and less likely to have shared this information with family members. Of seropositive men, 11% did not disclose their serostatus to their primary partner and 66% did not disclose to a non-primary sex partner. Of HIV-seropositive men with one or more non-primary partners, 16% of those who did not disclose their serostatus reported inconsistent condom use during anal intercourse with these partners. No significant differences in self-reported sexual practices were observed for HIV-seropositive disclosers versus non-disclosers. Compared with HIV-seronegative men who did not disclose, seronegative men who shared information about their serostatus were more likely to have had receptive anal intercourse with their primary partner (p < 0.05) and to have engaged in mutual masturbation (p < 0.005), receptive oral sex (p < 0.005) and insertive anal intercourse (p < 0.05) with non-primary partners. No significant differences were observed between disclosers and non-disclosers with regard to condom use. Implications of the findings for future research and HIV prevention programmes are discussed.

Narrative Review: Sexually Transmitted Diseases and Homeless Youth-What Do We Know About Sexually Transmitted Disease Prevalence and Risk?

PubMed

Caccamo, Alexandra; Kachur, Rachel; Williams, Samantha P

2017-08-01

Homelessness affects an estimated 1.6 million US youth annually. Compared with housed youth, homeless youth are more likely to engage in high-risk behaviors, including inconsistent condom use, multiple sex partners, survival sex, and alcohol/drug use, putting them at increased sexually transmitted disease (STD) risk. However, there is no national estimate of STD prevalence among this population. We identified 10 peer-reviewed articles (9 unique studies) reporting STD prevalence among homeless US youth (2000-2015). Descriptive and qualitative analyses identified STD prevalence ranges and risk factors among youth. Eight studies reported specific STD prevalence estimates, mainly chlamydia, gonorrhea, and syphilis. Overall STD prevalence among homeless youth ranged from 6% to 32%. STD rates for girls varied from 16.7% to 46%, and from 9% to 13.1% in boys. Most studies were conducted in the Western United States, with no studies from the Southeast or Northeast. Youths who experienced longer periods of homelessness were more likely to engage in high-risk sexual behaviors. Girls had lower rates of condom use and higher rates of STDs; boys were more likely to engage in anal and anonymous sex. Additionally, peer social networks contributed to protective effects on individual sexual risk behavior. Sexually transmitted disease prevalence estimates among homeless youth fluctuated greatly by study. Sexually transmitted disease risk behaviors are associated with unmet survival needs, length of homelessness, and influence of social networks. To promote sexual health and reduce STD rates, we need better estimates of STD prevalence, more geographic diversity of studies, and interventions addressing the behavioral associations identified in our review.

Narrative Review: Sexually Transmitted Diseases and Homeless Youth—What Do We Know About Sexually Transmitted Disease Prevalence and Risk?

PubMed Central

Caccamo, Alexandra; Kachur, Rachel; Williams, Samantha P.

2018-01-01

Background Homelessness affects an estimated 1.6 million US youth annually. Compared with housed youth, homeless youth are more likely to engage in high-risk behaviors, including inconsistent condom use, multiple sex partners, survival sex, and alcohol/drug use, putting them at increased sexually transmitted disease (STD) risk. However, there is no national estimate of STD prevalence among this population. Methods We identified 10 peer-reviewed articles (9 unique studies) reporting STD prevalence among homeless US youth (2000–2015). Descriptive and qualitative analyses identified STD prevalence ranges and risk factors among youth. Results Eight studies reported specific STD prevalence estimates, mainly chlamydia, gonorrhea, and syphilis. Overall STD prevalence among homeless youth ranged from 6% to 32%. STD rates for girls varied from 16.7% to 46%, and from 9% to 13.1% in boys. Most studies were conducted in the Western United States, with no studies from the Southeast or Northeast. Youths who experienced longer periods of homelessness were more likely to engage in high-risk sexual behaviors. Girls had lower rates of condom use and higher rates of STDs; boys were more likely to engage in anal and anonymous sex. Additionally, peer social networks contributed to protective effects on individual sexual risk behavior. Conclusions Sexually transmitted disease prevalence estimates among homeless youth fluctuated greatly by study. Sexually transmitted disease risk behaviors are associated with unmet survival needs, length of homelessness, and influence of social networks. To promote sexual health and reduce STD rates, we need better estimates of STD prevalence, more geographic diversity of studies, and interventions addressing the behavioral associations identified in our review. PMID:28703725

Prevalence of HIV and other sexually transmitted infections, and risk behaviours in unregistered sex workers in Dakar, Senegal.

PubMed

Laurent, Christian; Seck, Karim; Coumba, Ndeye; Kane, Touré; Samb, Ngoné; Wade, Abdoulaye; Liégeois, Florian; Mboup, Souleymane; Ndoye, Ibrahima; Delaporte, Eric

2003-08-15

To estimate the prevalence rates of HIV and other sexually transmitted infections (STI) among unregistered sex workers, and to describe their sociodemographic characteristics and sexual behaviours, and the reasons why they were not officially registered as sex workers, in order to design specific public health interventions. A one-stage cluster-sample survey was conducted in Dakar in 2000. Unregistered sex workers were interviewed in randomly selected establishments (official and clandestine bars, brothels and nightclubs), and blood, endocervical and vaginal samples were collected for laboratory diagnosis. A total of 390 women with a median age of 29 years were recruited. One-seventh of them were under the legal age for prostitution in Senegal (21 years). The median length of prostitution was 24 months and 73.5% of the women stated regular prostitution. Three-quarters of the women were found to have markers for at least one infection. The prevalence rates were as follows: HIV-1, 6.0%; HIV-2, 3.6%; HIV-1+2, 0.4%; syphilis, 23.8%; gonorrhea, 22.0%; chlamydial infection, 20.0%; trichomoniasis, 22.4%; candidiasis, 19.0%; and bacterial vaginosis, 28.8%. The main reported reason for non-registration was ignorance of the legal system and its procedures (19.4%); 18.9% of the women refused to register. One-third of the women reported that their clients used condoms inconsistently or never. This survey suggests that a multidimensional public health response is needed in Senegal, comprising legal information, downwards revision of the legal age for prostitution, and specific medical follow-up based on education, condom promotion and management of STI for non-registered sex workers.

Comparison of Sexual Risk, HIV/STI Prevalence and Intervention Exposure Among Men Who Have Sex with Men and Women (MSMW) and Men Who Have Sex with Men Only (MSMO) in India: Implications for HIV Prevention.

PubMed

Ramakrishnan, Lakshmi; Ramanathan, Shreena; Chakrapani, Venkatesan; Goswami, Prabuddhagopal; Deshpande, Sucheta; Yadav, Diwakar; Sen, Shrabanti; George, Bitra; Paranjape, Ramesh

2015-12-01

Using data from a cross-sectional bio-behavioral survey conducted among men who have sex with men (n = 3833) in India, we examined differences related to HIV-related sexual risk, HIV/STI prevalence and intervention exposures between men who have sex with men and women (MSMW, 35 % of the sample) and men who have sex with men only (MSMO). Among MSMW, 93 % reported having female regular partners, 14 % had female paid partners, and all types of male partners (regular 55 %; casual 77.1 %; paying 47 %; paid 19 %). Logistic regression revealed that MSMW had higher odds of being aged 26 years and above (AOR 4.45, 95 % CI 3.66-5.42), lower odds of inconsistently using condoms with male partners (AOR 0.82, 95 % CI 0.67-0.98) and lower odds of having kothi (feminine/mostly receptive) identity (AOR 0.07, 95 % CI 0.06-0.09). HIV intervention exposure and HIV/STI prevalence did not differ significantly between MSMW and MSMO (HIV 13.1 vs. 12.2 %; active syphilis 3.5 vs. 3.1 %, respectively). Concurrent sexual partnerships with men and women pose risk of HIV transmission/acquisition for MSM and their male and female partners. All subgroups of MSM require tailored information and skills to consistently use condoms with different types of partners of either gender.

Patterns of Sexual Behavior and Sexually Transmitted Infections in Young Men Who Have Sex With Men.

PubMed

Vasilenko, Sara A; Rice, Cara E; Rosenberger, Joshua G

2018-06-01

Young men who have sex with men (MSM) are at an increased risk for sexually transmitted infections (STIs). Recent research has documented the importance of understanding the multidimensional nature of sexual risk behavior; however, little is known about how multidimensional patterns of sexual behavior among MSM may be associated with STIs. This study applies latent class analysis to data from a large, HIV- sample of 18- to 25-year-old MSM recruited from social and sexual networking Web sites (N = 5965; 76% white, 11% Latino, 5% black, 4% Asian, 4% other; 74% homosexual, 21% bisexual, 1% heterosexual, 3%, unsure/questioning 1% other) to uncover multidimensional patterns of past-year sexual behaviors, partner factors, and protective behavior and their associations with self-reported STI diagnosis. We selected a model with 8 classes, with nearly half of participants belonging to a class marked by multiple behaviors with more than 1 partner, and smaller numbers of individuals in classes with a smaller number of behaviors, romantic relationships, and sexual inactivity. Class membership was associated with recent STI diagnosis, with classes marked by no penetrative sex or receptive anal sex with consistent condom use having lower prevalence than those with inconsistent condom use, including those engaging in only insertive anal sex. Findings suggest heterogeneity of behaviors within MSM and that prevention messages may be more effective if they are tailored to individuals' patterns of sexual behavior, as well as demographic and sociocontextual factors.

Developing, implementing, and evaluating a condom promotion program targeting sexually active adolescents.

PubMed

Alstead, M; Campsmith, M; Halley, C S; Hartfield, K; Goldbaum, G; Wood, R W

1999-12-01

This article describes the development, implementation, and evaluation of the Condom Campaign, a 1995 HIV prevention program promoting condom use among sexually active adolescents in three King County, Washington, urban communities. This program employed three main strategies: (a) mobilizing all levels of the target communities to support and guide program development and implementation; (b) creating and implementing a mass media campaign targeting sexually active teenagers that promoted correct condom use and favorable attitudes toward condoms; and (c) recruiting public agencies, community organizations, and businesses to distribute condoms from bins and vending machines. We evaluated the program through a series of cross-sectional interviews conducted in the three communities chosen for their elevated levels of adolescent sexual risk behavior. Overall, 73% of target youth reported exposure to the Condom Campaign; exposure did not differ by age, gender, race, or level of sexual experience. Levels of sexual activity remained stable throughout the media campaign.

Obstacles to condom use: the combination of other forms of birth control and short-term monogamy.

PubMed

Critelli, J W; Suire, D M

1998-03-01

Two hundred thirty-seven college students involved in heterosexual relationships were surveyed to determine the effects of relationship type and use of forms of contraception other than condoms on condom use. Findings indicated that in the context of a short-term, monogamous relationship, the use of another form of birth control was associated with decreased condom use. In addition, 20% of the participants reported that they had wanted to use a condom for disease prevention on at least one occasion but had decided not to do so because they were using another form of contraception. Implications for preventive health are discussed.

[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.

An Event-Level Comparison of Risk-Related Sexual Practices Between Black and Other-Race Men Who Have Sex with Men: Condoms, Semen, Lubricant, and Rectal Douching

PubMed Central

Rosenberger, Joshua G.; Schick, Vanessa R.; Novak, David S.; Reece, Michael

2013-01-01

Abstract Black men who have sex with men (MSM) living in the U.S. are disproportionately affected by HIV/AIDS. An online survey of sexual behavior was completed by Black, White, Hispanic/Latino, Asian/Pacific Islander, and other-race MSM (n=11,766) ages 18–87 years. Complete condom use, semen exposure, pre-coital rectal douching (enema use), and lubricant use at last male-partnered sexual event were compared by race, controlling for relevant sociodemographic variables and stratifying by sexual position (receptive, insertive, or both). Across sexual positions, 55–62% of Black MSM reported condom use, 5–8% reported semen exposure, 18–53% reported douching, and 33–43% reported lubricant use. Reported behavioral profiles were not significantly different from other races, except that Black MSM reported greater condom use than White MSM in the insertive position. Although findings argue against disproportionate rates of risk behavior accounting for racial disparities in HIV prevalence, they nonetheless highlight a need for continued behavioral intervention. PMID:23373663

Preference for gel over suppository as delivery vehicle for a rectal microbicide: results of a randomised, crossover acceptability trial among men who have sex with men.

PubMed

Carballo-Diéguez, A; Dolezal, C; Bauermeister, J A; O'Brien, W; Ventuneac, A; Mayer, K

2008-11-01

To assess whether men who have sex with men (MSM) prefer a gel or a suppository as a delivery vehicle for a rectal microbicide. 77 HIV-negative MSM with a recent history of inconsistent condom use during receptive anal intercourse (RAI) who acknowledged being at risk of contracting HIV were enrolled in a randomised, crossover acceptability trial. They compared 35 ml placebo gel with 8 g placebo rectal suppositories used on up to three RAI occasions each. Participants preferred the gel over the suppository (75% versus 25%, p<0.001) and so did their partners (71% versus 29%, p<0.001). The gel received more favourable ratings overall and on attributes such as colour, smell, consistency, feeling in rectum immediately after insertion and/or 30 minutes after insertion and application process. The gel resulted in less negative ratings in terms of participants being bothered by leakage, soiling, bloating, gassiness, stomach cramps, urge to have bowel movement, diarrhoea, pain or trauma. Participants liked the gel more in terms of feelings during anal sex, sexual satisfaction, partners' sexual satisfaction and liking the product when condoms were used and when condoms were not used. In this sample taken from one of the populations most likely to benefit from rectal microbicide availability, gel had greater acceptability than a suppository as a potential microbicide vehicle.

Seropositive status disclosure to partners and safer sexual behaviours among people living with HIV: An issue in prevention and treatment.

PubMed

Balogun, T M; Awofala, B; Iredu, I C; Ajayi, A O; Ohakwere, M

2014-12-01

The objective of this study was to determine the rate of disclosure to sexual partners and consequent safer sexual practices among people living with HIV (PLHIV). This was a cross-sectional study. A semi-structured interviewer administered questionnaire was used to collect demographic data of age, gender, marital status as well as HIV status disclosureand consistent condom use. This information was collected from consenting consecutive antiretroviral-therapynaive PLHIV accessing care at the Lagos State University Teaching Hospital (LASUTH), southwest Nigeria. Collected data were analysed using statistical package for social sciences (version 10.0, spss) and group comparisons were done with chi square tests. A total of 443 respondents were interviewed. The age of the respondents ranged from 18 to 75 years with a mean of 46.5±9. Majority 268 (60.5%) of respondents were females while 175 (39.5%) were males. The disclosure rate to sexual partners was 43 (9.7%) among studied PLHIV. Consistent condom use was highest (12.7%) among PLHIV who had disclosed to sexual partners while inconsistent use was highest (93.3%) among the undisclosed.p=0.26 CONCLUSION: This study reveals that there is a low sexual partner disclosure rate among studied PLHIV. Seropositive status disclosure to sexual partners was associated with consistent condom use.

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.

The effect of condoms on penile vibrotactile sensitivity thresholds in young, heterosexual men

PubMed Central

Hill, Brandon J.; Janssen, Erick; Kvam, Peter; Amick, Erick E.; Sanders, Stephanie A.

2013-01-01

Introduction Investigating the ways in which barrier methods such as condoms may affect penile sensory thresholds has potential relevance to the development of interventions in men who experience negative effects of condoms on sexual response and sensation. A quantitative, psychophysiological investigation examining the degree to which sensations are altered by condoms has, to date, not been conducted. Aim The objective of this study was to examine penile vibrotactile sensitivity thresholds in both flaccid and erect penises with and without a condom, while comparing men who do and those who do not report condom-associated erection problems (CAEP). Methods Penile vibrotactile sensitivity thresholds were assessed among a total of 141 young, heterosexual men using biothesiometry. An incremental two-step staircase method was used and repeated three times for each of four conditions. Intra-class correlation coefficients (ICC) were calculated for all vibratory assessments. Penile vibratory thresholds were compared using a mixed-model Analysis of Variance (ANOVA). Main Outcome Measures Penile vibrotactile sensitivity thresholds with and without a condom, erectile function measured by International Index of Erectile Function Questionnaire (IIEF), and self-reported degree of erection. Results Significant main effects of condoms (yes/no) and erection (yes/no) were found. No main or interaction effects of CAEP were found. Condoms were associated with higher penile vibrotactile sensitivity thresholds (F(1, 124)=17.11, p<.001). Penile vibrotactile thresholds were higher with an erect than with a flaccid penis (F(1, 124)=4.21, p=.042). Conclusion The current study demonstrates the feasibility of measuring penile vibratory thresholds with and without a condom in both erect and flaccid experimental conditions. As might be expected, condoms increased penile vibrotactile sensitivity thresholds. Interestingly, erections were associated with the highest thresholds. Thus, this study was the first to document that erect penises are less sensitive to vibrotactile stimulation than flaccid penises. PMID:24168347

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.

[Dual contraception adherence among HIV-infected women].

PubMed

Brandão, Karina de Sá Adami Gonçalves; Lima, Bruno Gil de Carvalho; Travassos, Ana Gabriela Álvares; de Brito, Fabielle de Oliveira Rocha; de Souza, Eveline Xavier Pereira; Haguihara, Tatiana; da Silva, Carlos Alberto Lima

2015-10-01

To determine adherence to dual contraception using depot-medroxyprogesterone acetate (DMPA) and condom among HIV-infected women. A cross-sectional study carried out from December 2013 to September 2014 at a local reference center, with application of questionnaire elaborated after Delphi panel and content validation to 114 HIV(+) women aged 15 to 49 years, using DMPA plus condom for contraception. Mean age was 33.2 ± 7.2 years, mean time since HIV detection was 8.1 ± 5.2 years, mean time of antiretroviral use was 6.8 ± 5 years and mean CD4 cells/mm3 count was 737.6 ± 341.1. Sexual HIV acquisition was reported by 98.2% (112/114), antiretroviral use by 85.9% (98/114), and 77.7% (84/114) had a CD4>500/mm3 count. Having a single sex partner was reported by 78.9% (90/114), with HIV serodiscordance in 41.2% (47/114) of couples, 21.9% did not know the serological status of their partner and in 37.7% of cases (43/114) the partner was unaware of the HIV(+) status of the woman. The last pregnancy was unplanned in 71.9% of cases (82/114) and 14.9% of the women had become pregnant the year before, with pregnancy being unplanned in 70.5% (12/17) of cases. Current use of DMPA was reported by 64.9% (74/114), with genital bleeding in 48.2% (55/114) and weight gain in 67.5% (77/114). Use of a male condom was reported by 62.2% of the subjects (71/114). Three reported that they always used a female condom and ten that they eventually used it. Unprotected vaginal sex was reported by 37.7% (43/114) and unprotected anal intercourse was reported by 32.4% (37/114). Partner resistance to use a condom occurred in 30.7% of cases (35/114). Dual contraception using DMPA with condom was reported by 42.9% (49/114). A partner who resisted wearing a condom was associated with poor adhesion (PR=0.3; 95%CI 0.2-0.7; p<0.001). A partner who was unaware that a woman was infected with HIV favored adherence (PR=1.8; 95%CI 1.2-2.7; p=0.013). The percentage of dual contraception using DMPA plus condom was 42.9%, maintaining unplanned pregnancies and unprotected sex. Resistance of partners to use a condom increased three times the chance of a woman not adhering to dual contraception, and the partner not knowing women's HIV infection almost doubled the chance to adhere to safe contraception. to offer new hormonal contraceptives and to involve the partners in contraception and serologic detection tests.

Evaluation of the validity of the condom use self-efficacy scale (CUSES) in young men using two behavioral simulations.

PubMed

Forsyth, A D; Carey, M P; Fuqua, R W

1997-03-01

Assessment of behavioral skills remains critical to the evaluation of HIV prevention interventions; however, investigators often rely upon participant reports of self-efficacy to estimate such skills. We evaluated the relationship between self-efficacy beliefs for condom use and behavioral performance. Forty-three men completed the Condom Use Self-Efficacy Scale (CUSES) and participated in 2 behavioral assessments. Regression analyses indicated that the CUSES subscales relevant to negotiation of condom use did not account for a significant amount of variability in interpersonal skills; similarly, the CUSES subscale relevant to technical condom use skill did not account for variability in the condom application scores. We caution investigators against the assumption that higher self-efficacy reflects behavioral competence for HIV-risk reduction.

Contraceptive Attitudes and Intention to Use Condoms in Sexually Experienced and Inexperienced Adolescent Males.

ERIC Educational Resources Information Center

Pleck, Joseph H.; And Others

1990-01-01

Assessed contraceptive attitudes and intention to use a condom at next intercourse among 1,880 adolescent males. Findings showed that about three-fifths of sexually experienced and inexperienced adolescent males intending to have sex in the next year reported an "almost certain chance" of condom use with a hypothetical future partner. (Author/PVV)

Adolescents' Self-Efficacy to Communicate about Sex: Its Role in Condom Attitudes, Commitment, and Use

ERIC Educational Resources Information Center

Halpern-Felsher, Bonnie L.; Kropp, Rhonda Y.; Boyer, Cherrie B.; Tschann, Jeanne M.; Ellen, Jonathan M.

2004-01-01

This study examined whether and how self-efficacy to communicate with parents and peers about sex relate to sexually experienced adolescent males' and females' (N = 144, 112) condom attitudes, intentions, and use. Results showed that males who reported greater self-efficacy to communicate with parents used condoms more frequently; and both males…

HIV Prevention and Social Desirability: Husband-Wife Discrepancies in Reports of Condom Use

ERIC Educational Resources Information Center

Cordero-Coma, Julia; Breen, Richard

2012-01-01

Greater use of condoms within marriage would help limit the spread of HIV in sub-Saharan Africa. Using data from the Malawi Diffusion and Ideational Change Project (MDICP), the authors examined the influence that the fidelity norm and the traditional association between marriage and reproduction have on condom use with a spouse. The sample…

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.

Intimate partner violence and condom negotiation efficacy among gay and bisexual men in Atlanta.

PubMed

Stephenson, Rob; Freeland, Ryan; Finneran, Catherine

2016-04-28

Background: The experience of intimate partner violence (IPV) has been shown to decrease condom negotiation efficacy among women; however, studies of this association among gay and bisexual men (GBM) are lacking. Methods: A venue-recruited sample of 745 GBM was recruited in Atlanta, GA, USA in 2012-13. Participants self-completed a survey including questions on recent (previous 12 month) experience and perpetration of IPV using the IPV-GBM Scale. Multivariate regression analysis examined the association between reporting low condom negotiation efficacy with the respondent's most recent sex partner (19.2% of respondents) and recent experience of IPV with the same or another partner. Results: Nearly half the sample (49.1%) reported recent receipt of IPV, although prevalence varied considerably across the forms of IPV. GBM who reported recent IPV experience were significantly less likely to report having felt able to negotiate condom use. Conclusions: These findings suggest that IPV may be a significant risk factor for HIV acquisition and transmission among GBM.

Abusive Experiences and Young Women's Sexual Health Outcomes: Is Condom Negotiation Self-Efficacy a Mediator?

PubMed

Jones, Kelley A; Cornelius, Marie D; Silverman, Jay G; Tancredi, Daniel J; Decker, Michele R; Haggerty, Catherine L; De Genna, Natacha M; Miller, Elizabeth

2016-06-01

Intimate partner violence and reproductive coercion are associated with unintended pregnancies and STDs. Greater condom negotiation self-efficacy among young women may mediate these associations. A sample of 841 female adolescents (aged 16-19) and 1,387 young adult women (aged 20-24) recruited from 24 family planning clinics in western Pennsylvania in 2011-2012 reported on intimate partner violence, reproductive coercion, condom negotiation self-efficacy and sexual health outcomes at baseline and four- and 12-month follow-ups. Mixed models were used to test associations of intimate partner violence and reproductive coercion with unintended pregnancy and STD diagnosis. The Sobel test of mediation was used to measure indirect effects of condom negotiation self-efficacy. At baseline, 15% of adolescents and 11% of young adults reported recent intimate partner violence victimization; 7% and 6%, respectively, reported recent reproductive coercion. For both age-groups, intimate partner violence and reproductive coercion were associated with a reduced level of condom negotiation self-efficacy (coefficients, -0.27 to -0.13) and increased odds of STD diagnosis (odds ratios, 1.03-1.1). However, only reproductive coercion was associated with unintended pregnancy (odds ratios, 1.1 for each group). The only association that condom negotiation self-efficacy mediated was between reproductive coercion and unintended pregnancy among young adults (17% of total effect). Targeting condom negotiation self-efficacy alone in abusive relationships would likely not translate into improved sexual health outcomes in this population. Other strategies are needed to prevent unintended pregnancy and STDs. Copyright © 2016 by the Guttmacher Institute.

Abusive Experiences and Young Women’s Sexual Health Outcomes: Is Condom Negotiation Self-Efficacy a Mediator?

PubMed Central

Jones, Kelley A.; Cornelius, Marie D.; Silverman, Jay G.; Tancredi, Daniel J.; Decker, Michele R.; Haggerty, Catherine L.; De Genna, Natacha M.; Miller, Elizabeth

2016-01-01

CONTEXT Intimate partner violence and reproductive coercion are associated with unintended pregnancies and STDs. Greater condom negotiation self-efficacy among young women may mediate these associations. METHODS A sample of 841 female adolescents (aged 16–19) and 1,387 young adult women (aged 20–24) recruited from 24 family planning clinics in western Pennsylvania in 2011–2012 reported on intimate partner violence, reproductive coercion, condom negotiation self-efficacy and sexual health outcomes at baseline and four- and 12-month follow-ups. Mixed models were used to test associations of intimate partner violence and reproductive coercion with unintended pregnancy and STD diagnosis. The Sobel test of mediation was used to measure indirect effects of condom negotiation self-efficacy. RESULTS At baseline, 15% of adolescents and 11% of young adults reported recent intimate partner violence victimization; 7% and 6%, respectively, reported recent reproductive coercion. For both age-groups, intimate partner violence and reproductive coercion were associated with a reduced level of condom negotiation self-efficacy (coefficients, −0.27 to −0.13) and increased odds of STD diagnosis (odds ratios, 1.03–1.1). However, only reproductive coercion was associated with unintended pregnancy (odds ratios, 1.1 for each group). The only association that condom negotiation self-efficacy mediated was between reproductive coercion and unintended pregnancy among young adults (17% of total effect). CONCLUSIONS Targeting condom negotiation self-efficacy alone in abusive relationships would likely not translate into improved sexual health outcomes in this population. Other strategies are needed to prevent unintended pregnancy and STDs. PMID:27077497

Knowledge, risk perception of AIDS and reported sexual behaviour among students in secondary schools and colleges in Tanzania.

PubMed

Maswanya, E S; Moji, K; Horiguchi, I; Nagata, K; Aoyagi, K; Honda, S; Takemoto, T

1999-04-01

A questionnaire survey was carried out among 1041 students in secondary schools and colleges in Dar-es-Salaam, Tanzania to evaluate the relationship between HIV-risky sexual behaviour and anti-condom bias, as well as with AIDS-related information, knowledge, perceptions and attitudes. Self-reportedly, 54% of students (75% of the boys and 40% of the girls) were sexually active, 39% had a regular sexual partner and 13% had multiple partners in the previous year. The condom use rate was higher than previous reports. However, 30% of sexually active respondents did not always use condoms (Risk-1 behaviour) and 35% of those with multiple partners in the previous year did not always use condoms (Risk-2 behaviour). Multiple logistic regression analyses indicated that 'sex partner hates condom' had association with both Risk-1 behaviour (OR 2.47; 95% CI 1.58-3.85) and Risk-2 behaviour (OR 2.47; 95% CI 1.10-5.48). 'Use of condom prevents HIV infection' also had association with both Risk-1 behaviour (OR 2.09; 95% CI 1.19-3.67) and Risk-2 behaviour (OR 3.73; 95% CI 1.28-11.03). Students engaging in risky behaviour were aware of the risk, even though they failed to change their behaviour. Reasons for the AIDS epidemic among Tanzanian students and the importance of more effective AIDS education are also discussed.

Condom Use as a Function of Number of Coital Events in New Relationships.

PubMed

He, Fei; Hensel, Devon J; Harezlak, Jaroslaw; Fortenberry, J Dennis

2016-02-01

To assess condom use as a function of number of coital events in newly formed sexual relationships. Participants who reported at least one new partner during the 12-week study interval (n = 115; ages 18-29 years; 48% women; 90% African American) completed weekly sexually transmitted infections testing and 3 times daily electronic diary collection assessing individual and partner-specific affect, daily activities, sexual behavior, and condom use. We analyzed event-level condom use percentage and participant-level behavior response effects. generalized additive mixed models were used to estimate condom use probability accounting for within-partner and within-participant correlations via random effects. The average condom use probability at the first coital event in new relationships was 55% for men and 36% for women. Analyses showed that smooth shapes of estimated condom use probabilities were similar for both sexes and were fitted using generalized additive mixed models. Relatively higher condom use percentage was followed by a sharp decline during the first 9 coital events decreasing to 16% for men and 8% for women. More rapid decline in condom use among women was highly associated with higher levels of relationship and sexual satisfaction. The likelihood of condom use declines sharply for both men and women after the early accrual experience with a partner. Relationship and sexual satisfaction also influence declines in condom use, especially among women.

Condom use as a function of number of coital events in new relationships

PubMed Central

He, Fei; Hensel, Devon J.; Harezlak, Jaroslaw; Fortenberry, J. Dennis

2015-01-01

Study Objective Assess condom use as a function of number of coital events in newly formed sexual relationships. Methods Participants who reported at least one new partner during the 12-week study interval (N=115; ages 18–29 years; 48% women; 90% African American) completed weekly sexually transmitted infections testing and three-times daily electronic diary collection assessing individual and partner-specific affect, daily activities, sexual behavior and condom use. We analyzed event-level condom use percentage and subject-level behavior response effects. Generalized Additive Mixed Models (GAMMs) were used to estimate condom use probability accounting for within-partner and within-subject correlations via random effects. Results The average condom use probability at the first coital event in new relationships was 55% for men and 36% for women. Analyses showed that smooth shapes of estimated condom use probabilities were similar for both sexes and were fitted using GAMMs. Relatively higher condom use percentage was followed by a sharp decline during the first 9 coital events decreasing to 16% for men and 8% for women. More rapid decline in condom use among women was highly associated with higher levels of relationship and sexual satisfaction. Conclusions The likelihood of condom use declines sharply for both men and women after the early accrual experience with a partner. Relationship and sexual satisfaction also influence declines in condom use, especially among women. PMID:26766522

Factors associated with condom use negotiation by female sex workers in Bangladesh

PubMed Central

Alam, Nazmul; Chowdhury, Mahbub Elahi; Mridha, Malay K.; Ahmed, Anisuddin; Reichenbach, Laura J.; Streatfield, Peter Kim; Azim, Tasnim

2013-01-01

Summary Negotiation for condom use by female sex workers (FSWs) with their male clients can enhance condom use. A cross-sectional study was conducted among 1395 FSWs; 439 from two brothels, 442 from 30 hotels, and 514 from streets of two cities in Bangladesh to determine the predictors of condom use negotiation. Consistent condom use rates in the seven days prior to interview were reported to be 16.2%, 21.7%, and 4.5% among the brothel, hotel, and street based FSWs respectively. Overall, 28.1% of FSWs negotiated for condom use with their clients. Participation in behaviour change communication (BCC) programmes (AOR, 1.5; 95% CI, 1.2.–2.0), and self-perceived risk of HIV infection (AOR, 1.8 95% CI, 1.6–2.1) were positive predictors for condom negotiation. Compared to the hotel based FSWs, street (AOR, 0.6; 95% CI, 0.4–0.9), and brothel based FSWs (AOR, 0.7; 95% CI, 0.5–0.9) were less likely to negotiate for condom use. FSWs in Bangladesh are at high risk for STI/HIV infection because of low overall negotiation for condom use. Participation in BCC programmes had positive effect on condom negotiation by FSWs, and should be strengthened in commercial sex venues. PMID:23970599

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

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

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.

[In vitro studies of factors possibly influencing the performance of latex condoms].

PubMed

Guigon, P; Breton, D; Mendes-Oustric, A C; Pech, A; Clair, P

2005-11-01

Male condoms are undoubtedly the best protection against sexually transmitted diseases. The French Military Health Service buys condoms from civilian manufacturers using a public purchasing process. This process includes strict technical analysis that allows selection of the best supplier. In addition each batch of condoms delivered to French armed forces undergoes quality testing in the laboratory of the Armed Services Central Pharmacy before being distributed to troops. Despite these strict control measures, several isss remain unclear. One issue involves the shelf life of condoms stored in warm humid tropical conditions. Another issue involves the effect of lubricants on condom quality. The purpose of this report is to describe a study designed to gain insight into these two issues. This study was conducted by the Armed Services Central Pharmacy in colaboration with the Procuremnt and Central Establishment Directorate. Findings showed that stage conditions have no negative effects on the intrinsic physico-chemial properties of condoms supplied by two different manufacturers. Conversely use of inadequate lubricants (alimentary or cosmetic compounds) appeared to have extremely deleterious effects on condom quality. Laboratory tests showed that lubricants composed mainly of fatty acids dramatically decreased the effectiveness of condoms.

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

Intimate partner violence and consistent condom use among drug-using heterosexual women in New York City

PubMed Central

Frye, Victoria; Nandi, Vijay; Galea, Sandro; Vlahov, David; Ompad, Danielle

2010-01-01

The present study examined the associations of relationship factors, partner violence, relationship power, and condom-use related factors with condom use with a main male partner among drug-using women. Over two visits, 244 heterosexual drug-using women completed a cross-sectional survey. Multivariate logistic regression models indicated that women who expected positive outcomes and perceived lower condom-use barriers were more likely to report condom use with their intimate partners. The findings suggest that future interventions aiming at reducing HIV risk among drug-using women should focus on women’s subjective appraisals of risks based on key relationship factors in addition to the occurrence of partner violence. PMID:20437300

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

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.

Determinants of condom uptake among HIV voluntary counselling and testing clients: experiences from a hospital-based study in south India

PubMed Central

2012-01-01

Background HIV voluntary counselling and testing was a key HIV prevention strategy brought to scale by India's National AIDS Control Organization. Condom uptake is an essential metric of intervention impact given the expansion of the epidemic into an increasingly diverse population. With only 20% of first-time counselling and testing clients at the largest HIV treatment hospital in south India reporting previous condom use, the question of intervention impact on condom use deserves investigation. In this study, we track intervention impact across various demographic groups and identify the added value of more thorough counselling. Methods Data were collected from 8,865 individuals who attended counselling multiple times at the Tamil Nadu Government Hospital of Thoracic Medicine over the years 2004-2009. Counsellors recorded client demographic characteristics, HIV risk behaviours reported, and counselling services provided after each counselling session. Matching and regression methods were used to determine the probability of condom uptake by serostatus, gender, and receipt of personalized risk reduction counselling while controlling for other characteristics. Results HIV counselling and testing was associated with condom uptake among 29.2% of HIV positive women (CI 24.5-34.4%), 31.7% of HIV positive men (CI 27.8-35.4%), 15.5% of HIV negative women (CI 11.2-20.8%), and only 3.6% of HIV negative men (CI 1.9-5.9%) who had previously never used condoms. Personalized risk reduction counselling increased impact in some groups; for example an additional 18% of HIV negative women (CI 11.3-24.4%) and 17% of HIV positive men (CI 10.9-23.4%) started using condoms. The number of sexual partners was not associated with the impact of counselling completeness. Conclusions Because the components of testing and counselling impact the condom use habits of men and women differently, understanding the dynamics of condom use negotiation between partners is essential to optimizing impact on Indian couples. Clients' predicted condom uptake ranged between 4% and 47% depending on factors like gender, serostatus, and services provided. Personalized risk reduction counselling is associated with increased chance of condom use, with larger gains in HIV negative women and HIV positive men. HIV negative men are least likely to start using condoms and least impacted by additional counselling. PMID:22236357

Determinants of condom uptake among HIV voluntary counselling and testing clients: experiences from a hospital-based study in south India.

PubMed

Myerson, Rebecca; Makela, Susanna M; Chandrasekhar, C; Mathew, Siju; Chakraborty, Sourabh

2012-01-11

HIV voluntary counselling and testing was a key HIV prevention strategy brought to scale by India's National AIDS Control Organization. Condom uptake is an essential metric of intervention impact given the expansion of the epidemic into an increasingly diverse population. With only 20% of first-time counselling and testing clients at the largest HIV treatment hospital in south India reporting previous condom use, the question of intervention impact on condom use deserves investigation. In this study, we track intervention impact across various demographic groups and identify the added value of more thorough counselling. Data were collected from 8,865 individuals who attended counselling multiple times at the Tamil Nadu Government Hospital of Thoracic Medicine over the years 2004-2009. Counsellors recorded client demographic characteristics, HIV risk behaviours reported, and counselling services provided after each counselling session. Matching and regression methods were used to determine the probability of condom uptake by serostatus, gender, and receipt of personalized risk reduction counselling while controlling for other characteristics. HIV counselling and testing was associated with condom uptake among 29.2% of HIV positive women (CI 24.5-34.4%), 31.7% of HIV positive men (CI 27.8-35.4%), 15.5% of HIV negative women (CI 11.2-20.8%), and only 3.6% of HIV negative men (CI 1.9-5.9%) who had previously never used condoms. Personalized risk reduction counselling increased impact in some groups; for example an additional 18% of HIV negative women (CI 11.3-24.4%) and 17% of HIV positive men (CI 10.9-23.4%) started using condoms. The number of sexual partners was not associated with the impact of counselling completeness. Because the components of testing and counselling impact the condom use habits of men and women differently, understanding the dynamics of condom use negotiation between partners is essential to optimizing impact on Indian couples. Clients' predicted condom uptake ranged between 4% and 47% depending on factors like gender, serostatus, and services provided. Personalized risk reduction counselling is associated with increased chance of condom use, with larger gains in HIV negative women and HIV positive men. HIV negative men are least likely to start using condoms and least impacted by additional counselling.

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.

Targeting condom distribution at high risk places increases condom utilization-evidence from an intervention study in Livingstone, Zambia

PubMed Central

2012-01-01

Background The PLACE-method presumes that targeting HIV preventive activities at high risk places is effective in settings with major epidemics. Livingstone, Zambia, has a major HIV epidemic despite many preventive efforts in the city. A baseline survey conducted in 2005 in places where people meet new sexual partners found high partner turnover and unprotected sex to be common among guests. In addition, there were major gaps in on-site condom availability. This study aimed to assess the impact of a condom distribution and peer education intervention targeting places where people meet new sexual partners on condom use and sexual risk taking among people socializing there. Methods The 2005 baseline survey assessed the presence of HIV preventive activities and sexual risk taking in places where people meet new sexual partners in Livingstone. One township was selected for a non-randomised intervention study on condom distribution and peer education in high risk venues in 2009. The presence of HIV preventive activities in the venues during the intervention was monitored by an external person. The intervention was evaluated after one year with a follow-up survey in the intervention township and a comparison township. In addition, qualitative interviews and focus group discussions were conducted. Results Young people between 17-32 years of age were recruited as peer educators, and 40% were females. Out of 72 persons trained before the intervention, 38 quit, and another 11 had to be recruited. The percentage of venues where condoms were reported to always be available at least doubled in both townships, but was significantly higher in the intervention vs. the control venues in both surveys (84% vs. 33% in the follow-up). There was a reduction in reported sexual risk taking among guests socializing in the venues in both areas, but reporting of recent condom use increased more among people interviewed in the intervention (57% to 84%) than in the control community (55% to 68%). Conclusions It is likely that the substantial increase in reported condom use in the intervention venues was partially due to the condom distribution and peer education intervention targeting these places. However, substantial changes were observed also in the comparison community over the five year period, and this indicates that major changes had occurred in overall risk taking among people socializing in venues where people meet new sexual partners in Livingstone. Trial registration ClinicalTrials.gov NCT01423357. PMID:22221738

Targeting condom distribution at high risk places increases condom utilization-evidence from an intervention study in Livingstone, Zambia.

PubMed

Sandøy, Ingvild Fossgard; Zyaambo, Cosmas; Michelo, Charles; Fylkesnes, Knut

2012-01-05

The PLACE-method presumes that targeting HIV preventive activities at high risk places is effective in settings with major epidemics. Livingstone, Zambia, has a major HIV epidemic despite many preventive efforts in the city. A baseline survey conducted in 2005 in places where people meet new sexual partners found high partner turnover and unprotected sex to be common among guests. In addition, there were major gaps in on-site condom availability. This study aimed to assess the impact of a condom distribution and peer education intervention targeting places where people meet new sexual partners on condom use and sexual risk taking among people socializing there. The 2005 baseline survey assessed the presence of HIV preventive activities and sexual risk taking in places where people meet new sexual partners in Livingstone. One township was selected for a non-randomised intervention study on condom distribution and peer education in high risk venues in 2009. The presence of HIV preventive activities in the venues during the intervention was monitored by an external person. The intervention was evaluated after one year with a follow-up survey in the intervention township and a comparison township. In addition, qualitative interviews and focus group discussions were conducted. Young people between 17-32 years of age were recruited as peer educators, and 40% were females. Out of 72 persons trained before the intervention, 38 quit, and another 11 had to be recruited. The percentage of venues where condoms were reported to always be available at least doubled in both townships, but was significantly higher in the intervention vs. the control venues in both surveys (84% vs. 33% in the follow-up). There was a reduction in reported sexual risk taking among guests socializing in the venues in both areas, but reporting of recent condom use increased more among people interviewed in the intervention (57% to 84%) than in the control community (55% to 68%). It is likely that the substantial increase in reported condom use in the intervention venues was partially due to the condom distribution and peer education intervention targeting these places. However, substantial changes were observed also in the comparison community over the five year period, and this indicates that major changes had occurred in overall risk taking among people socializing in venues where people meet new sexual partners in Livingstone. ClinicalTrials.gov NCT01423357.

Safe Sext: Adolescents’ Use of Technology to Communicate about Sexual Health with Dating Partners

PubMed Central

Widman, Laura; Nesi, Jacqueline; Choukas-Bradley, Sophia; Prinstein, Mitchell J.

2014-01-01

Purpose This study examined adolescents’ technology-based sexual communication with dating partners, and evaluated associations between technology-based communication and condom use. Methods Participants were 176 high school students who indicated their use of technology to communicate with partners about condoms, birth control, STIs, HIV/AIDS, pregnancy, and sexual limits. Sexually active youth also reported their frequency of condom use. Results Many adolescents (49%) used technology to discuss sexual health with partners, with rates varying by topic. Girls were more likely than boys to discuss HIV, pregnancy, and sexual limits. Ethnic minorities were more likely than Whites to discuss condoms, STIs, HIV, pregnancy, and birth control. Importantly, rates of consistent condom use were three-times higher among youth using technology to discuss condoms and birth control. Conclusions Results provide novel preliminary evidence about adolescents’ use of technology to discuss sexual health, and demonstrate links between technology-based communication and condom use among sexually active youth. PMID:24512716

Factors associated with condom use: economic security and positive prevention among people living with HIV/AIDS in the Caribbean.

PubMed

Allen, C F; Simon, Y; Edwards, J; Simeon, D T

2010-11-01

In the Caribbean region, an estimated 1.1% of the population aged 15-49 is living with HIV. We aimed to measure factors associated with condom use, the primary form of positive prevention in the Caribbean, among people living with HIV (PLHIV) in its major agency advocating on behalf of PLHIV (the Caribbean Regional Network of People Living with HIV/AIDS, or CRN +). Condom use at last sex was selected for analysis from a broad-ranging cross-sectional survey (n=394) among PLHIV who were members of or received services from CRN+ in Antigua and Barbuda, Grenada, Trinidad and Tobago. PLHIV from CRN+ traced potential participants, administered informed consent procedures and carried out structured interviews. Fifty-four percent of respondents reported using a condom the last time they had sex. Condom use was positively associated with partner being HIV negative, disclosure of HIV status, alcohol use, economic security, education level and being employed. Multivariate logistic regression found independent associations between condom use and economic security (p=0.031; odds ratio (OR) for "enough" income 5.06; 95% CI 1.47-17.39), partner being HIV negative (p=0.036; OR 2.85; 95% CI 1.28-6.33) and being married (p=0.043; OR 2.86; 95% CI 1.03-7.91). Seventy-three percent of respondents reported inadequate family income, 26% reported an HIV-negative partner and 9% were married. Condom use appears to be motivated by protection of HIV-negative partners and spouses. Low socioeconomic status is associated with the overall percentage using condoms. Restriction to members of CRN+ limits generalisability of the findings. Nevertheless, the findings support the view that programmes for the socioeconomic empowerment of PLHIV are needed to slow the Caribbean HIV epidemic. Expectations for protection of different types of partners should be further explored in order to develop culturally appropriate interventions with couples.

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

AIDS and the company: 3. Uganda's parastatals quantify the manpower losses, while condom sales run into criticism.

PubMed

1992-01-01

Railway, postal, and telecommunications companies in Uganda are experiencing a manpower crisis due to AIDS. Uganda's Railway Corporation reports for 1991 a loss of 10% of staff due to AIDS. AIDS has also contributed to a high turnover of staff (15%/year). AIDS has affected all levels of employment in the industry and there is concern about the shortage of skilled staff. Already there are staff shortages in the marine division where 132 out of 252 posts are unfilled. High absenteeism rates are also associated with AIDS. Hospital bills have risen. In the Uganda Post and Telecommunications Corporation, it is reported that 8% of the 3000 work force carry the HIV infection and 94 staff have died of AIDS between May 1991 and March 31, 1992. 238 have tested positive for HIV. The company has begun an AIDS awareness and sensitization campaign through unions and its clinic. Major mortality groups in Uganda are maria (14%), AIDS (9%), diarrhea (8.7%), pneumonia (7.9%), anemia (7.3%), and meningitis (6%) as reported in a survey of 20 hospitals and 5439 cases. Condoms are not readily accepted. Complaints arose when a firm imported condoms in Kabarole district in western Uganda when AIDS was more prevalent elsewhere. The public and public officials are against introducing condoms. Education and information should be emphasized. Objections are based on sexual practices which are abrasive and may rupture the condom. Women object due to fears of condoms falling off and exposure to the viruses in condoms. People are reckless even when family members have died of AIDS. Sexual behavior does not appear to have changed. It is suggested that condom distribution methods should change. IEC may be effective if properly implemented. Research by the International Population Services has shown that 100% acceptance is possible if the price is cheap and the product fits. A Malaysian manufactured condom seems to be appropriate for fit and is packed in quantities of 5 because 5 is the average "times per night."

Self-perceived HIV risk and the use of risk reduction strategies among men who engage in transactional sex with other men in Ho Chi Minh City, Vietnam

PubMed Central

Mimiaga, Matthew J.; Reisner, Sari L.; Closson, Elizabeth F.; Perry, Nicholas; Perkovich, Brandon; Nguyen, Thi; Trang, Nguyen N.N.; Lan, Hang X.; Thien, Dinh Duc; Mayer, Kenneth H.; Colby, Donn

2013-01-01

An emerging HIV epidemic can be seen among men who have sex with men (MSM) in Vietnam, with prevalence as high as 18%. Transactional sex represents a risk factor for HIV transmission/acquisition among MSM globally, particularly in urban contexts, but remains largely underinvestigated in Ho Chi Minh City (HCMC), Vietnam. In 2010, 23 MSM who reported exchanging sex for money in the last month completed a brief survey and semistructured qualitative interview at The Life Centre, a non-governmental organization in HCMC, to assess sociodemographics, individual- and structural-level HIV risk factors and explore acceptable future prevention interventions. Participants’ mean age was 24 years. Equal proportions of respondents self-identified as heterosexual/straight, homosexual/gay, and bisexual. Participants had a mean of 158 male clients in the past year, with a median of 60 male clients in the past year (interquartile range [IQR]=70) and reported inconsistent condom use and inaccurate perceptions of HIV risk. Nearly half of the sample reported engaging in unprotected anal sex with a male partner in the past 12 months and one-third with a male client. Major themes that emerged for HIV prevention interventions with male sex workers were those that: (1) focused on individual factors (drug and alcohol use, barriers to condom use, knowledge of asymptomatic STIs, enhancement of behavioral risk-reduction skills, and addressing concomitant mental health issues); (2) incorporated interpersonal and relational contexts (led by peer educators, built interpersonal skills, attended to partner type and intimacy dynamics); and (3) considered the exogenous environments in which individual choices/relationships operate (stigma of being MSM in Vietnam, availability of alternative economic opportunities, and varied sexual venues). HIV prevention efforts are needed that address the specific needs of MSM who engage in transactional sex in HCMC. Universally, MSM endorsed HIV prevention interventions, suggesting a need and desire for efforts in this context. PMID:23252673

Self-perceived HIV risk and the use of risk reduction strategies among men who engage in transactional sex with other men in Ho Chi Minh City, Vietnam.

PubMed

Mimiaga, Matthew J; Reisner, Sari L; Closson, Elizabeth F; Perry, Nicholas; Perkovich, Brandon; Nguyen, Thi; Trang, Nguyen N N; Lan, Hang X; Thien, Dinh Duc; Mayer, Kenneth H; Colby, Donn

2013-08-01

An emerging HIV epidemic can be seen among men who have sex with men (MSM) in Vietnam, with prevalence as high as 18%. Transactional sex represents a risk factor for HIV transmission/acquisition among MSM globally, particularly in urban contexts, but remains largely underinvestigated in Ho Chi Minh City (HCMC), Vietnam. In 2010, 23 MSM who reported exchanging sex for money in the last month completed a brief survey and semistructured qualitative interview at The Life Centre, a non-governmental organization in HCMC, to assess sociodemographics, individual- and structural-level HIV risk factors and explore acceptable future prevention interventions. Participants' mean age was 24 years. Equal proportions of respondents self-identified as heterosexual/straight, homosexual/gay, and bisexual. Participants had a mean of 158 male clients in the past year, with a median of 60 male clients in the past year (interquartile range [IQR]=70) and reported inconsistent condom use and inaccurate perceptions of HIV risk. Nearly half of the sample reported engaging in unprotected anal sex with a male partner in the past 12 months and one-third with a male client. Major themes that emerged for HIV prevention interventions with male sex workers were those that: (1) focused on individual factors (drug and alcohol use, barriers to condom use, knowledge of asymptomatic STIs, enhancement of behavioral risk-reduction skills, and addressing concomitant mental health issues); (2) incorporated interpersonal and relational contexts (led by peer educators, built interpersonal skills, attended to partner type and intimacy dynamics); and (3) considered the exogenous environments in which individual choices/relationships operate (stigma of being MSM in Vietnam, availability of alternative economic opportunities, and varied sexual venues). HIV prevention efforts are needed that address the specific needs of MSM who engage in transactional sex in HCMC. Universally, MSM endorsed HIV prevention interventions, suggesting a need and desire for efforts in this context.

Sexual behaviors and condom use at last vaginal intercourse: a national sample of adolescents ages 14 to 17 years.

PubMed

Fortenberry, J Dennis; Schick, Vanessa; Herbenick, Debby; Sanders, Stephanie A; Dodge, Brian; Reece, Michael

2010-10-01

Data on adolescents' sexual and condom use behaviors provides an empirical basis for a range of social, educational, clinical, and public health endeavors. This study has two purposes: to describe the recent and lifetime prevalence of a variety of sexual behaviors; and, to describe factors associated with condom use at last penile-vaginal intercourse. Data included those from male (N = 414) and female (N = 406) adolescents (ages 14-17 years) from a nationally representative probability sample. Survey items addressed occurrence (past 90 days, past year, lifetime) of solo masturbation, partnered masturbation, oral sex given to a partner, oral sex received from a partner, vaginal intercourse, and anal intercourse. Participants reporting partnered sexual behaviors in the past year completed additional items about condom use, location of sex, partner characteristics, other sexual behaviors, and alcohol or marijuana use at the most recent sexual event. Adjusted rates (by gender) of sexual behaviors, and characteristics of most recent vaginal sex event as a function of condom use/non-use. Lifetime prevalence of solo masturbation was common for males (80%) and females (48%). Lifetime prevalence of penile-vaginal sex increased with each year of age for both adolescent men and women; however, penile-vaginal sex within the previous 90 days was much less frequently reported. Rates of condom use for penile-vaginal sex were 80% for males and 69% for females. Lifetime anal sex rates were 4.7% for males and 5.5% for females. Sexual behavior among adolescents was more prevalent and diverse in older adolescent cohorts. Condom use for penile-vaginal intercourse was reported for a majority of events. © 2010 International Society for Sexual Medicine.

Crack smokers' intention to use condoms with loved partners: intervention development using the theory of reasoned action, condom beliefs, and processes of change.

PubMed

Bowen, A M; Williams, M; McCoy, H V; McCoy, C B

2001-10-01

Prevalence rates of HIV infection acquired through heterosexual contacts have risen steadily since 1982. Crack cocaine smokers are at particular risk of HIV infection due to heterosexual exposure. HIV risk reduction interventions seeking to increase condom use among drug users have met with minimal success, and there is a need for interventions to be strongly grounded in psychosocial models of behaviour change. This study presents the results of an investigation of predictors of intention to use condoms and related therapy processes among heterosexual drug users. Data were analyzed from 586 crack smokers recruited in Washington, DC, Miami, Florida, and Collier County, Florida who reported having both primary and casual sex partners. Participants responded to items derived from the theory of reasoned action, the theory of planned behaviour and the transtheoretical model of change. Condom use beliefs and therapy processes used to initiate and maintain condom use were assessed. Outcome expectancies and normative beliefs were the strongest predictors of intention to use condoms with a primary sexual partner. In turn, beliefs that condoms inhibit sexual romance and decrease sexual pleasure strongly predicted outcome expectancies. Therapy processes found to be associated with these constructs included: self-liberation, counter conditioning and stimulus control/reinforcement. Results suggest that HIV risk reduction interventions using a group format and targeting condom beliefs related to sexual romance and pleasure will decrease negative outcome expectancies about condom use. Also, reinforcing attempts to use condoms with intimate partners should increase positive outcome expectancies and intention to initiate or maintain condoms with a primary sexual partner.

Integrating Condom Skills into Family-Centered Prevention: Efficacy of the Strong African American Families–Teen Program

PubMed Central

Kogan, Steven M.; Yu, Tianyi; Brody, Gene H.; Chen, Yi-fu; DiClemente, Ralph J.; Wingood, Gina M.; Corso, Phaedra S.

2012-01-01

Purpose The Strong African American Families–Teen (SAAF–T) program, a family-centered preventive intervention that included an optional condom skills unit, was evaluated to determine whether it prevented unprotected intercourse and increased condom efficacy among rural African American adolescents. Ancillary analyses were conducted to identify factors that predicted youth attendance of the condom skills unit. Methods African American 16-year-olds (N = 502) and their primary caregivers were randomly assigned to SAAF–T (n = 252) or an attention control (n = 250) intervention. SAAF–T families participated in a 5-week family skills training program that included an optional condom skills unit. All families completed in-home pretest, posttest, and long-term follow-up interviews during which adolescents reported on their sexual behavior, condom use, and condom efficacy. Because condom use was addressed only in an optional unit that required caregiver consent, we analyzed efficacy using Complier Average Causal Effect (CACE) analyses. Results Attendance in both SAAF–T and the attention control intervention averaged 4 of 5 sessions; 70% of SAAF–T youth attended the condom skills unit. CACE models indicated that SAAF–T was efficacious in reducing unprotected intercourse and increasing condom efficacy among rural African American high school students. Exploratory analyses indicated that religious caregivers were more likely than nonreligious caregivers to have their youth attend the condom skills unit. Conclusions Results suggest that brief condom skills educational modules in the context of a family-centered program are feasible and reduce risk for sexually transmitted infections and unplanned pregnancies. PMID:22824447

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.

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.

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.

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.

Difference in Risk Behaviors and STD Prevalence Between Street-Based and Establishment-Based FSWs in Guangdong Province, China

PubMed Central

Li, Yan; Lin, Peng; Fu, Xiaobing; Deng, Zhongming; Liu, Yongying; Huang, Guohua; Li, Jie; Tan, Yihe

2012-01-01

The major mode of HIV/AIDS transmission in China is now heterosexual activities, but risk for HIV and sexually transmitted diseases (STDs) may differ among different strata of female sex workers (FSWs). Respondent-driven sampling was used to recruit 320 FSWs in Guangdong Province, China. The respondents were interviewed using a structured questionnaire, and tested for HIV, syphilis, gonorrhea, and Chlamydia. The street-based FSWs had lower education levels, a higher proportion supporting their families, charged less for their services, and had engaged in commercial sex for a longer period of time than establishment-based FSWs. The proportion consistently using condoms with clients and with regular non-paying partners was also lower. The prevalence of syphilis, gonorrhea, and Chlamydia was higher among street-based sex workers. Being a street-based sex worker, having regular non-paying sex partners, and having non-regular non-paying partners were independent risk factors for inconsistent condom. Street-based FSWs had more risk behaviors than establishment-based FSWs, and should therefore be specifically targeted for HIV as well as STD intervention programs. PMID:22228068

"I never thought that it would happen … " Experiences of HIV seroconverters among HIV-discordant partnerships in a prospective HIV prevention study in Kenya.

PubMed

Ngure, Kenneth; Vusha, Sophie; Mugo, Nelly; Emmanuel-Fabula, Mira; Ngutu, Mariah; Celum, Connie; Baeten, Jared M; Heffron, Renee

2016-12-01

In spite of access to behavioral and biomedical HIV prevention strategies, HIV transmission occurs. For HIV-serodiscordant couples, prevention programs can be tailored to address individual and couples' needs to preserve their relationship while minimizing HIV risk. Programs for serodiscordant couples may benefit from learning from experiences of couples who transmit HIV. We conducted 20 individual in-depth interviews with 10 initially HIV-serodiscordant couples who transmitted HIV during prospective follow-up at a peri-urban research site in Thika, Kenya. Data were analyzed inductively to identify situations that led to prevention failure and coping mechanisms. Inconsistent condom use driven by low HIV risk perception and alcohol use often preceded seroconversion while persistent blame frequently hindered couples' communication soon after seroconversion. In this emerging era of antiretroviral-based HIV prevention, couples' counseling can capitalize on opportunities to foster a supportive environment to discuss initiation and adherence to time-limited pre-exposure prophylaxis and lifelong antiretroviral therapy, in addition to strategies to reduce alcohol use, diffuse blame, and use condoms.

The AIDS-related activities of religious leaders in Malawi

PubMed Central

TRINTAPOLI, J.

2010-01-01

The AIDS-related activities of religious leaders in Africa extend far beyond preaching about sexual mortality. This study aims to quantify the involvement of religious leaders in the fight against AIDS and to identify key predictors of the types of prevention strategies they promote. Using data from a random sample of Christian and Muslim leaders in Malawi, I use logistic regression to predict six types of AIDS activities, which correspond to three distinct types: formal messages (i.e., preaching), pragmatic interventions (monitoring the sexual behaviour of members and advising divorce to avoid infection), and the promotion of biomedical prevention strategies (promoting condom use and testing for HIV). Preaching about AIDS is the most common prevention activity, and promoting condom use is the least; sizable proportions of clergy promote testing and engage in pragmatic interventions. Denominational patterns in the type of engagement are weak and inconsistent. However, inquiries into the motivation for leaders' activities show that discussions with members about AIDS is the most consistent predictor, suggesting that religious leaders' engagement with HIV prevention is primarily a demand-driven phenomenon. PMID:20552476

Factors associated with condom use negotiation by female sex workers in Bangladesh.

PubMed

Alam, Nazmul; Chowdhury, Mahbub Elahi; Mridha, Malay K; Ahmed, Anisuddin; Reichenbach, Laura J; Streatfield, Peter Kim; Azim, Tasnim

2013-10-01

Negotiation for condom use by female sex workers with their male clients can enhance condom use. A cross-sectional study was conducted among 1395 female sex workers; 439 from two brothels, 442 from 30 hotels, and 514 from streets of two cities in Bangladesh to determine the predictors of condom use negotiation. Consistent condom use rates in the 7 days prior to interview were reported to be 16.2%, 21.7%, and 4.5% among the brothel, hotel, and street-based female sex workers, respectively. Overall, 28.1% of female sex workers negotiated for condom use with their clients. Participation in behaviour change communication (BCC) programmes (AOR, 1.5; 95% CI, 1.2-2.0) and self-perceived risk of human immunodeficiency virus infection (AOR, 1.8 95% CI, 1.6-2.1) were positive predictors for condom negotiation. Compared to the hotel-based female sex workers, street (AOR, 0.6; 95% CI, 0.4-0.9) and brothel-based female sex workers (AOR, 0.7; 95% CI, 0.5-0.9) were less likely to negotiate for condom use. Female sex workers in Bangladesh are at high risk for sexually transmitted infection / human immunodeficiency virus infection because of low overall negotiation for condom use. Participation in BCC programmes had positive effect on condom negotiation by female sex workers, and should be strengthened in commercial sex venues.

Examining communication and assertiveness as predictors of condom use: implications for HIV prevention.

PubMed

Zamboni, B D; Crawford, I; Williams, P G

2000-12-01

The current study explored the relationship between communication and assertiveness in general and sexual contexts and examined each construct's differential ability to predict reported condom use among college students. The results suggest that the constructs are positively related to each other, but general communication does not predict sexual assertiveness. Although sexual assertiveness is a better predictor of condom use than general assertiveness, general communication, and sexual communication, it needs to be considered within the context of other variables (e.g., normative beliefs regarding condom use). HIV prevention programs and models of health behavior should incorporate individual characteristics such as sexual assertiveness. The results of this study suggest that sexual assertiveness, social norm perceptions of condom use, self-efficacy for HIV prevention, and condom attitudes are among the critical variables that should be examined in an integrated model of sexual health behavior.

Correlates of Mental Depression Among Female Sex Workers in Southern India.

PubMed

Patel, Sangram Kishor; Saggurti, Niranjan; Pachauri, Saroj; Prabhakar, Parimi

2015-11-01

Mental health is an integral part of overall health status but has been a largely neglected issue in the developing world especially among female sex workers (FSWs). This study examines the prevalence and correlates of major depression among FSWs in southern India. Major depression was assessed using Patient Health Questionnaire-2 depression scale data from a cross-sectional Behavioral Tracking Survey, 2010-2011 conducted among FSWs (n = 1986) in Andhra Pradesh, a state in southern India. Almost two-fifths of FSWs (39%) reported major depression. Multivariate logistic regression analysis shows a significant association between major depression and the following characteristics for FSWs: low autonomy, alcohol use, experience of violence, police arrest, inconsistent condom use with clients, mobility for sex work, and being HIV positive or not wanting to disclose HIV status. Research and advocacy efforts are needed to ensure that the mental health issues of marginalized groups are appropriately addressed in HIV prevention programs. © 2015 APJPH.

Change over Time in Police Interactions and HIV Risk Behavior Among Female Sex Workers in Andhra Pradesh, India.

PubMed

Erausquin, Jennifer Toller; Reed, Elizabeth; Blankenship, Kim M

2015-06-01

Little is known about the effectiveness of intervening to change interactions between female sex workers (FSWs) and police in order to reduce HIV risk. Using data collected in the context of a HIV prevention intervention that included components to change policing practices (n = 1,680), we examine the association of FSWs' reports of negative police interactions and HIV risk behaviors and whether these associations varied over time. Results show negative police interactions declined significantly over time. FSWs who had more than one negative police interaction were more likely to experience STI symptoms (AOR 2.97 [95 % CI 2.27-3.89]), inconsistently use condoms with their clients (AOR 1.36 [95 % CI 1.03-1.79]), and accept more money for condomless sex (AOR 2.37 [95 % CI 1.76-3.21]). Over time, these associations were stable or increased. Even where interventions have reduced the number of police incidents experienced by FSWs, stakeholders in HIV prevention must remain vigilant in challenging these incidents.

Pregnancy Experiences of Female Sex Workers in Adama City, Ethiopia: Complexity of Partner Relationships and Pregnancy Intentions.

PubMed

Yam, Eileen A; Kidanu, Aklilu; Burnett-Zieman, Brady; Pilgrim, Nanlesta; Okal, Jerry; Bekele, Assefa; Gudeta, Daniel; Caswell, Georgina

2017-06-01

Research and programs for female sex workers (FSWs) tend to focus exclusively on HIV prevention, with little attention paid to how pregnancy affects their lives. We examine the circumstances surrounding pregnancy and childbirth among women selling sex in Ethiopia. In Adama City, researchers asked 30 FSWs aged 18 and older who had ever been pregnant to participate in in-depth interviews. The women reported on pregnancies experienced both before and after they had begun selling sex. They identified some of the fathers as clients, former partners, and current partners, but they did not know the identities of the other fathers. Missed injections, skipped pills, and inconsistent condom use were causes of unintended pregnancy. Abortion was common, typically with a medication regimen at a facility. Comprehensive sexual and reproductive health services should be provided to women who sell sex, in recognition and support of their need for family planning and their desire to plan whether and when to have children. © 2017 The Population Council, Inc.

Pregnancy Experiences of Female Sex Workers in Adama City, Ethiopia: Complexity of Partner Relationships and Pregnancy Intentions

PubMed Central

Yam, Eileen A.; Kidanu, Aklilu; Burnett‐Zieman, Brady; Pilgrim, Nanlesta; Okal, Jerry; Bekele, Assefa; Gudeta, Daniel; Caswell, Georgina

2017-01-01

Research and programs for female sex workers (FSWs) tend to focus exclusively on HIV prevention, with little attention paid to how pregnancy affects their lives. We examine the circumstances surrounding pregnancy and childbirth among women selling sex in Ethiopia. In Adama City, researchers asked 30 FSWs aged 18 and older who had ever been pregnant to participate in in‐depth interviews. The women reported on pregnancies experienced both before and after they had begun selling sex. They identified some of the fathers as clients, former partners, and current partners, but they did not know the identities of the other fathers. Missed injections, skipped pills, and inconsistent condom use were causes of unintended pregnancy. Abortion was common, typically with a medication regimen at a facility. Comprehensive sexual and reproductive health services should be provided to women who sell sex, in recognition and support of their need for family planning and their desire to plan whether and when to have children. PMID:28263396

Breakage is the norm: use of condoms and lubrication in anal sex among Black South African men who have sex with men.

PubMed

Lee, Matthew; Sandfort, Theo; Collier, Kate; Lane, Tim; Reddy, Vasu

2017-04-01

This paper explores condom use and lubrication practices among Black men who have sex with men in South African townships. Results are from 81 in-depth individual interviews conducted among a purposive sample from four townships surrounding Pretoria as part of a larger qualitative study. Awareness that condoms should be used to have safer anal sex was ubiquitous. Fewer men reported that lubricants should be used to facilitate anal intercourse. Partner pressure and partner distrust were the most common barriers cited for not using condoms and lubricants. Knowledge about condom-lubricant compatibility was rare. Condom problems were a norm, with widespread expectations of condom failure. Men's subjectivities - their perceptions of and preferences for specific brands, types and flavours of condoms and lubricants - influenced engagement with such safer-sex technologies. However, what was available in these settings was often neither what men needed nor preferred. Findings show the need to enhance access to appropriate and comprehensive: safer-sex supplies, health services and health education, and underline the importance of efforts to develop targeted programmes relevant to experiences of men who have sex with men in the South African context.

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.

The impact of embarrassment on condom purchase behaviour.

PubMed

Dahl, D W; Gorn, G J; Weinberg, C B

1998-01-01

A survey on the impact of embarrassment on condom purchase behavior was conducted among 130 individuals. The survey sample (93 males, 37 females) were recruited at the University of British Columbia. The primary independent variable of interest was the embarrassment of the respondents when purchasing condoms. The background variables were also considered which included the assessments of sexual behavior, gender, age, and residency status. A 4-point scale was used to measure the intensity of embarrassment and a 5-category scale was used to determine the frequency of condom purchase. The results for purchase embarrassment indicate that 41% of females and 34% of males expressed no embarrassment when making a condom purchase. Gender, age, number of sexual partners in the past year, and residency status were not significantly correlated with purchase embarrassment. 62% of males vs. 40% of females purchased at least once every 6 months. In summary, young people feel embarrassed about purchasing condoms, thus affecting their purchase behavior. The people who reported being more embarrassed purchasing condoms did so less often and purchased fewer condoms per visit. Subjects also tended to purchase from vending machines when possible in lieu of from store clerks or pharmacists.

Preference for gel over suppository as delivery vehicle for a rectal microbicide: Results of a randomized, crossover acceptability trial among men who have sex with men

PubMed Central

Carballo-Diéguez, A.; Dolezal, C.; Bauermeister, J.A.; O’Brien, B.; Ventuneac, A.; Mayer, K.

2009-01-01

Objective To assess whether men who have sex with men (MSM) prefer a gel or a suppository as a delivery vehicle for a rectal microbicide. Methods 77 HIV-negative MSM with recent history of inconsistent condom use during receptive anal intercourse (RAI) who acknowledged being at risk of contracting HIV were enrolled in a randomized, crossover acceptability trial. They compared 35 ml of placebo gel with 8 g placebo rectal suppositories used in up to three RAI occasions each. Results Participants preferred the gel over the suppository (75% vs. 25%, p <.001), and so did their partners (71% vs. 29%, p <.001). The gel received more favorable ratings overall and on attributes such as color, smell, consistency, feeling in rectum immediately after insertion and/or 30 minutes after insertion, and application process. The gel resulted in less negative ratings in terms of participants being bothered by leakage, soiling, bloating, gassiness, stomach cramps, urge to have bowel movement, diarrhea, pain or trauma. Participants liked the gel more in terms of feelings during anal sex, sexual satisfaction, partners’ sexual satisfaction, and liking the product when condoms were used and when condoms were not used. Conclusions In this sample taken from one of the populations most likely to benefit from rectal microbicide availability, gel had higher acceptability than suppository as a potential microbicide vehicle. PMID:19028952

Preexposure Prophylaxis and Predicted Condom Use Among High-Risk Men Who Have Sex With Men

PubMed Central

Golub, Sarit A.; Kowalczyk, William; Weinberger, Corina L.; Parsons, Jeffrey T.

2010-01-01

Objectives Preexposure prophylaxis (PREP) is an emerging HIV prevention strategy; however, many fear it may lead to neglect of traditional risk reduction practices through behavioral disinhibition or risk compensation. Methods Participants were 180 HIV-negative high-risk men who have sex with men recruited in New York City, who completed an Audio Computer Assisted Self Interview-administered survey between September 2007 and July 2009. Bivariate and multivariate logistic regression models were used to predict intention to use PREP and perceptions that PREP would decrease condom use. Results Almost 70% (n = 124) of participants reported that they would be likely to use PREP if it were at least 80% effective in preventing HIV. Of those who would use PREP, over 35% reported that they would be likely to decrease condom use while on PREP. In multivariate analyses, arousal/pleasure barriers to condom use significantly predicted likelihood of PREP use (odds ratio = 1.71, P < 0.05) and risk perception motivations for condom use significantly predicted decreased condom use on PREP (odds ratio = 2.48, P < 0.05). Discussion These data provide support for both behavioral disinhibition and risk compensation models and underscore the importance of developing behavioral interventions to accompany any wide-scale provision of PREP to high-risk populations. PMID:20512046

Sex Trafficking, Violence Victimization, and Condom Non-Use Among Prostituted Women in Nicaragua

PubMed Central

Decker, Michele R.; Mack, Katelyn P.; Barrows, Jeffery J.; Silverman, Jay G.

2013-01-01

Synopsis Prostituted women report disempowerment-related barriers to condom use, extensive violence victimization and trafficking experiences; findings indicate that disempowerment must be addressed within STI/HIV prevention efforts. PMID:19577234

Trends in Condom Use and Risk Behaviours after Sexual Exposure to HIV: A Seven-Year Observational Study

PubMed Central

Casalino, Enrique; Choquet, Christophe; Leleu, Agathe; Hellmann, Romain; Wargon, Mathias; Juillien, Gaelle; Yazdanpanah, Yazdan; Bouvet, Elisabeth

2014-01-01

Objective We aimed to determine the trends in numbers and percentages of sexually exposed persons to HIV (SE) consulting an ED for post-exposure prophylaxis (PEP), as well as predictors of condom use. Study Design We conducted a prospective-observational study. Methods We included all SE attendances in our Emergency Department (ED) during a seven-year study-period (2006–2012). Trends were analyzed using time-series analysis. Logistic Regression was used to define indicators of condom use. Results We enrolled 1851 SE: 45.7% reported intercourse without condom-use and 12.2% with an HIV-infected partner. Significant (p<0.01) rising trends were observed in the overall number of SE visits (+75%), notably among men having sex with men (MSM) (+126%). There were rising trends in the number and percentage of those reporting intercourse without condom-use in the entire population +91% (p<0.001) and +1% (p>0.05), in MSM +228% (p<0.001) and +49% (p<0.001), in Heterosexuals +68% (p<0.001) and +10% (p = 0.08). Among MSM, significant rising trends were found in those reporting high-risk behaviours: anal receptive (+450% and +76%) and anal insertive (+l33% and +70%) intercourses. In a multivariate logistic regression analysis, heterosexuals, vaginal intercourse, visit during the night-shift and short time delay between SE and ED visit, were significantly associated with condom-use. Conclusion We report an increasing trend in the number of SE, mainly among MSM, and rising trends in high-risk behaviours and unprotected sexual intercourses among MSM. Our results indicate that SE should be considered as a high-risk population for HIV and sexually transmitted diseases. PMID:25157477

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.

The Association Between Men's Concern About Demonstrating Masculine Characteristics and Their Sexual Risk Behaviors: Findings from the Dominican Republic.

PubMed

Fleming, Paul J; Barrington, Clare; Powell, Wizdom; Gottert, Ann; Lerebours, Leonel; Donastorg, Yeycy; Brito, Maximo O

2018-02-01

Quantitative analyses exploring the relationship between masculinities and men's sexual risk behaviors have most commonly used one dimension of masculinities: men's gender ideology. Examining other dimensions may enhance our understanding of and ability to intervene upon this relationship. In this article, we examined the association between gender role conflict/stress (GRC/S)-men's concern about demonstrating masculine characteristics-and three different sexual risk behaviors (having two or more sex partners in the last 30 days; never/inconsistent condom use with non-steady partners; and drinking alcohol at last sex) among a sample of heterosexual men in the Dominican Republic who were participating in an HIV prevention intervention (n = 293). The GRC/S Scale we used was adapted for this specific cultural context and has 17 items (α = 0.75). We used logistic regression to assess the relationship between GRC/S and each sexual behavior, controlling for sociodemographic characteristics. In adjusted models, a higher GRC/S score was significantly associated with increased odds of having two or more sex partners in the past 30 days (AOR 1.33, 95 % CI 1.01-1.74), never/inconsistent condom use with non-steady partners (AOR 1.45, 95 % CI 1.04-2.01), and drinking alcohol at last sex (AOR 1.56, 95 % CI 1.13-2.17). These results highlight the importance of expanding beyond gender ideology to understanding the influence of GRC/S on men's sexual risk behaviors. Interventions should address men's concern about demonstrating masculine characteristics to reduce the social and internalized pressure men feel to engage in sexual risk behaviors.

Risk-based screening for Chlamydia trachomatis and Neisseria gonorrhoeae prior to intrauterine device insertion.

PubMed

Grentzer, Jaclyn M; Peipert, Jeffrey F; Zhao, Qiuhong; McNicholas, Colleen; Secura, Gina M; Madden, Tessa

2015-10-01

The objective was to compare three strategies for Chlamydia trachomatis and Neisseria gonorrhoeae screening prior to intrauterine device (IUD) insertion. This was a secondary analysis of the Contraceptive CHOICE Project. We measured the prevalence of C. trachomatis and/or N. gonorrhoeae at the time of IUD insertion. We then compared sensitivity, specificity, negative and positive predictive values, and likelihood ratios for three screening strategies for C. trachomatis and N. gonorrhoeae prior to IUD insertion: (a) "age-based" — age ≤25 years alone; (b) "age/partner-based" — age ≤25 and/or multiple sexual partners; and (c) "risk-based" — age ≤25, multiple sexual partners, inconsistent condom use and/or history of prior sexually transmitted infection (STI). Among 5087 IUD users, 140 (2.8%) tested positive for C. trachomatis, 16 (0.3%) tested positive for N. gonorrhoeae, and 6 (0.1%) were positive for both at the time of IUD insertion. The "risk-based" screening strategy had the highest sensitivity (99.3%) compared to "age-based" and "age/partner-based" screening (80.7% and 84.7%, respectively.) Only one (0.7%) woman with a chlamydia or gonorrhea infection would not have been screened using "risk-based" screening. A risk-based strategy to screen for C. trachomatis and N. gonorrhoeae prior to IUD insertion has higher sensitivity than screening based on age alone or age and multiple sexual partners. Using a risk-based screening strategy (age≤25, multiple sexual partners, inconsistent condom use and/or history of an STI) to determine who should be screened for C. trachomatis and N. gonorrhoeae prior to IUD insertion will miss very few cases of infection and obviates the need for universal screening. Copyright © 2015 Elsevier Inc. All rights reserved.

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.

Special report: the truth about condoms. Barriers to better condom "killing people"; regulatory, political hurdles stifle development.

PubMed

1995-01-01

The condom industry in the US is dominated by Carter Wallace and the London International Group. They offer very little product differentiation. Ten years ago, however, two engineers in a small California laboratory began working on a nonlatex condom which would be both stronger and more sensitive than the traditional male latex condom. Their efforts resulted in the development of the polyurethane Avanti condom currently being marketed in thirteen states of the Western US. Made by London International Group plc in Cambridge, England, Avanti should be available nationwide as of April 1995. The public, however, has received only very little information about the product and the US Food and Drug Administration (FDA) is concerned about the safety and efficacy of polyurethane/plastic condoms. Six other condom manufacturers are developing plastic condoms, with at least five such condoms awaiting FDA premarket clearance to be marketed. Recent delays in marketing Avanti are due to disagreements between the manufacturer and the FDA over labeling. Other delays have involved safety and efficacy concerns. Bob Kohmescher, public health analyst with the US Centers for Disease Control office of the assistant director of HIV/AIDS, notes that even his agency is moving slower than expected on the polyurethane condom and has not reached a consensus over how to describe them. In the effort to protect themselves, FDA officials have insisted upon labeling which recommends plastic condoms for use by only people who are allergic to latex. These labeling guidelines, finalized in November, are so restrictive that some manufacturers cannot take their products to market. Despite these current FDA obstacles to bringing a higher quality condom to the US market, industry experts and health officials hope that the polyurethane and other plastic condoms will expand the practice of safer sex, while providing an alternative method of barrier protection for the estimated 1-2 million American adults who are allergic to latex.

Modelling condom use: Does the theory of planned behaviour explain condom use in a low risk, community sample?

PubMed

Thomas, Joanna; Shiels, Chris; Gabbay, Mark B

2014-01-01

To date, most condom research has focused on young or high-risk groups, with little evidence about influences on condom use amongst lower-risk community samples. These groups are not risk free and may still wish to negotiate safer sex; yet the considerations involved could be different from those in higher-risk groups. Our research addresses this gap: We report a cross-sectional questionnaire study enquiring about recent condom use and future use intentions in community settings. Our sample (n = 311) purposively included couples in established relationships, known to be condom users. Items included demographics, sexual history and social-cognitive variables taken from the theory of planned behaviour. The strongest association with condom use/use intentions amongst our respondents was sexual partner's perceived willingness to use them. This applied across both univariate and multivariate analyses. Whilst most social-cognitive variables (attitudes; self-efficacy and peer social norms) were significant in univariate analyses, this was not supported in multivariate regression. Of the social-cognitive variables, only "condom-related attitudes" were retained in the model explaining recent condom use, whilst none of them entered the model explaining future use intentions. Further analysis showed that attitudes concerning pleasure, identity stigma and condom effectiveness were most salient for this cohort. Our results suggest that, in community samples, the decision to use a condom involves different considerations from those highlighted in previous research. Explanatory models for established couples should embrace interpersonal perspectives, emphasising couple-factors rather than individual beliefs. Messages to this cohort could usefully focus on negotiation skills, condom advantages (other than disease prevention) and reducing the stigma associated with use.

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.

“Nothing is free”: A qualitative study of sex trading among methamphetamine users in Cape Town, South Africa

PubMed Central

Watt, Melissa H.; Kimani, Stephen M.; Skinner, Donald; Meade, Christina S.

2015-01-01

South Africa is facing an established epidemic of methamphetamine, known locally as “tik”. Globally, methamphetamine has been linked to high rates of sexual risk behaviors, including sex trading. The goal of this study was to qualitatively examine the experiences of sex trading among methamphetamine users in Cape Town, South Africa. Individual in-depth interviews were conducted with 30 active methamphetamine users (17 men and 13 women) recruited from the community. Interviews were conducted in local languages using a semi-structured guide that included questions on sex trading experiences and perceptions of sex trading among methamphetamine users. Interviews were audio-recorded, transcribed, and analyzed using analytic memos and coding with constant comparison techniques. The data revealed that in a setting of high levels of addiction and poverty, sex was an important commodity for acquiring methamphetamine. Women were more likely to use sex to acquire methamphetamine, but men reported opportunistic cases of trading sex for methamphetamine. Four models of sex trading emerged: negotiated exchange, implicit exchange, relationships based on resources, and facilitating sex exchange for others. The expectation of sex trading created a context in which sexual violence against female methamphetamine users was common. Multiple sexual partners and inconsistent condom use in acts of sex trading put methamphetamine users at high risk of HIV. Interventions in this setting should address addiction, which is the primary driver of sex trading among methamphetamine users. Harm reduction interventions may include education about HIV and other sexually transmitted infections, availability of condoms and HIV testing, and sexual violence prevention. PMID:25567071

Sexual behavior among unmarried business process outsourcing employees in Chennai: gender differences and correlates associated with it.

PubMed

Charles, Bimal; Rastogi, Saumya; Sam, Asirvatham Edwin; Williams, Joseph D; Kandasamy, Aarthi

2013-01-01

Premarital sex is often associated with high risk sexual behavior such as early age of initiation, multiple partners and inconsistent condom use. Evidence shows that such sexual behavior pre-disposes to sexually transmitted diseases including HIV. This paper tried to investigate the correlates of premarital sexual behavior among male and female business process outsourcing (BPO) employees to highlight the gender differences that exist in relation to it. Data were collected from 526 unmarried BPO employees during behavioral surveillance survey in Chennai, in the year 2009. The results showed that about one-third of respondents (males - 39.6%, females - 26.1%) had experienced premarital sex. Men reported having had their first sexual intercourse at 12 years and women at 16 years of age. While the prevalence of premarital sex was found to be high, the percentage using a condom during last sex was also high, especially, among the female employees (82.4%). Logistic regression showed that monthly individual income, work in shifts, migration, peer influence and friends with previous sexual experience were significant predictors of premarital sex among the male BPO employees. Visit to night clubs was significantly associated with a higher prevalence of premarital sex among the female employees. The study concludes that there is a significant gender dimension in the premarital sexual behavior among the BPO employees and that even as the sexual behavior of the young people is transitioning; their ability to negotiate safe sex behavior is also increasing. It is recommended to enhance efforts to advocate safe sex behavior among young adults employed in the BPO industry.

Drug sharing with clients as a risk marker for increased violence and sexual and drug-related harms among survival sex workers.

PubMed

Shannon, K; Kerr, T; Bright, V; Gibson, K; Tyndall, M W

2008-02-01

Previous studies have described links between violence, decreased condom use and drug sharing among intimate partners, though limited information exists about the predictors of drug sharing among female sex workers and their clients. The following analysis explored the association between sharing illicit drugs with clients and sexual and drug-related harms among survival sex workers. A total of 198 women participated in interview-administered questionnaires and confidential HIV testing. Of the total, 117 (59%) reported sharing drugs with clients/johns in the last six months and crack cocaine was the primary drug shared (n=108). In logistic regression analysis, sharing drugs with clients/johns was associated with borrowing a used crack pipe (AOR=5.63; 95%CI: 2.71-9.44; p<0.001), intensive/daily crack cocaine smoking (AOR=3.78; 95%CI:1.60-8.92; p<0.002), inconsistent condom use by a client/john (AOR=3.17; 95%CI:1.48-6.77; p<0.003) and having a recent bad date (verbal harassment, physical and/or sexual assault) (AOR=2.71; 95%CI:1.17-6.32; p=0.021). Sharing illicit drugs with clients/johns may be a crucial risk marker for increased violence and sexual and drug-related harms among survival sex workers. HIV prevention and harm reduction initiatives targeting both women and clients/johns are urgently needed, including enhanced support for community and peer-driven sex work initiatives, to address some of the structural facilitators for HIV transmission.

"Nothing Is Free": A Qualitative Study of Sex Trading Among Methamphetamine Users in Cape Town, South Africa.

PubMed

Watt, Melissa H; Kimani, Stephen M; Skinner, Donald; Meade, Christina S

2016-05-01

South Africa is facing an established epidemic of methamphetamine, known locally as "tik." Globally, methamphetamine has been linked to high rates of sexual risk behaviors, including sex trading. The goal of this study was to qualitatively examine the experiences of sex trading among methamphetamine users in Cape Town, South Africa. Individual in-depth interviews were conducted with 30 active methamphetamine users (17 men and 13 women) recruited from the community. Interviews were conducted in local languages using a semi-structured guide that included questions on sex trading experiences and perceptions of sex trading among methamphetamine users. Interviews were audio-recorded, transcribed, and analyzed using analytic memos and coding with constant comparison techniques. The data revealed that in a setting of high levels of addiction and poverty, sex was an important commodity for acquiring methamphetamine. Women were more likely to use sex to acquire methamphetamine, but men reported opportunistic cases of trading sex for methamphetamine. Four models of sex trading emerged: negotiated exchange, implicit exchange, relationships based on resources, and facilitating sex exchange for others. The expectation of sex trading created a context in which sexual violence against female methamphetamine users was common. Multiple sexual partners and inconsistent condom use in acts of sex trading put methamphetamine users at high risk of HIV. Interventions in this setting should address addiction, which is the primary driver of sex trading among methamphetamine users. Harm reduction interventions may include education about HIV and other sexually transmitted infections, availability of condoms and HIV testing, and sexual violence prevention.

Assessing knowledge, attitudes, and behaviors related to HIV and AIDS in Nicaragua: a community-level perspective.

PubMed

Ugarte, William J; Högberg, Ulf; Valladares, Eliette; Essén, Birgitta

2013-03-01

Nicaragua's HIV epidemic is concentrated among men who have sex with men. Nevertheless, the increasing number of HIV cases among heterosexuals, high levels of poverty and migration rates, and incomplete epidemiological data suggest the need to improve the understanding of the epidemic. To examine the prevalence of HIV-related knowledge, attitudes, and sexual risk-taking behaviors, and their predictors among the adult population. A community-based cross-sectional survey was conducted in 2009 among 520 participants ages 15-49 from an ongoing Health and Demographic Surveillance System in Nicaragua. Bivariate analysis and adjusted prevalence ratios were use to examine factors associated with HIV-related knowledge, attitudes, and sexual behavior. Contributing factors for risk-taking behaviors included cognitive, psychosocial, and emotional elements. Insufficient knowledge affecting the accurate assessment of HIV risk were low educational level, poverty, and rural origin, especially among females. Recognizing risk was not sufficient to promote safer sex: 90% of the females and 70% of the males who reported being sexually active in the past year did not use condoms during their last sexual encounter. Inconsistent condom use among men was associated with older age, long-term relationships, and lack of awareness about acquiring HIV infection. Interventions to reduce social-structural contextual factors in Nicaragua are needed so that individuals may adopt and maintain HIV risk reduction strategies. Increased gender-specific HIV education and skills-building programs need to be implemented. Sensitive mass media messages may also increase the knowledge of HIV and AIDS, and serve to encourage protective attitudes and behaviors. Copyright © 2012 Elsevier B.V. All rights reserved.

[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.

Safe sext: adolescents' use of technology to communicate about sexual health with dating partners.

PubMed

Widman, Laura; Nesi, Jacqueline; Choukas-Bradley, Sophia; Prinstein, Mitchell J

2014-05-01

This study examined adolescents' technology-based sexual communication with dating partners, and evaluated associations between technology-based communication and condom use. Participants were 176 high school students who indicated their use of technology to communicate with partners about condoms, birth control, sexually transmitted infections (STIs), HIV/AIDS, pregnancy, and sexual limits. Sexually active youth also reported their frequency of condom use. Many adolescents (49%) used technology to discuss sexual health with partners, with rates varying by topic. Girls were more likely than boys to discuss HIV, pregnancy, and sexual limits. Ethnic minorities were more likely than whites to discuss condoms, STIs, HIV, pregnancy, and birth control. Importantly, rates of consistent condom use were three times higher among youth using technology to discuss condoms and birth control. Results provide novel preliminary evidence regarding adolescents' use of technology to discuss sexual health and demonstrate links between technology-based communication and condom use among sexually active youth. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Reasons People Give for Using (or Not Using) Condoms.

PubMed

Farrington, Elizabeth M; Bell, David C; DiBacco, Aron E

2016-12-01

Study participants (N = 348) were asked about 46 reasons that have been suggested for why people use or do not use condoms. Participants were asked which of these reasons motivated them when they were deciding whether to use condoms in 503 sexual relationships. Participants were classified into one of three roles based on their HIV status and the status of each sexual partner: HIV+ people with HIV- partners; HIV- people with HIV+ partners; and HIV- people with HIV- partners. Motivations were looked at in the context of each of these roles. Of the 46 reasons, only 15 were selected by at least 1/3 of the participants, and only seven were selected by at least half. Frequently reported reasons primarily concern protecting self and partner from STDs including HIV. Less frequently reported reasons involved social norms, effects of condoms on sex, and concern for the relationship. These findings have implications for clinical interventions.

Women bar drinkers' discussions about birth control and risky sexual behavior.

PubMed

Levonyan-Radloff, Kristine; Parks, Kathleen A; Collins, R Lorraine

2012-08-01

This study evaluated how birth control discussions prior to sexual activity affected condom use in a sample of 225 young women bar drinkers. The use of alcohol and other drugs (AOD) and partner type also were assessed. Data were collected through daily reports and qualitative interviews over 12 weeks. A total of 1671 sexual events were reported (M = 7.4 events per participant), of which 64.7% (n = 1081) did not involve condom use. Discussions of birth control occurred prior to 10.9% (n = 183) of all sexual events. These discussions were more likely to be initiated by the woman and to occur when AOD had been used. Thematic analysis revealed four common themes: confirmation of the need to use condoms, confirmation of oral/hormonal contraceptive use, use of sufficient birth control, and discrepant condom use. The discussions reduced rates of risky sex when the sexual partner was more intimate (i.e., boyfriend/dating partner), regardless of AOD use and when the sexual partner was a friend or ex-partner and no AOD were used. The thematic analysis suggested that pregnancy prevention was a stronger motivation for discussing condom use, rather than risk of contracting an STI. Given the substantial rate of high risk partners, history of STIs, and limited amount of time women reported knowing "regular" partners, we suggest that interventions designed to reduce risky sex should be tailored to increase women's awareness of STI and pregnancy risk when under the influence of AOD, and promote condom use regardless of partner type.

Women Bar Drinkers’ Discussions about Birth Control and Risky Sexual Behavior

PubMed Central

Levonyan-Radloff, Kristine; Parks, Kathleen A.; Collins, R. Lorraine

2011-01-01

This study evaluated how birth control discussions prior to sexual activity affected condom use in a sample of 225 young women bar drinkers. The use of alcohol and other drugs (AOD) and partner type also were assessed. Data were collected through daily reports and qualitative interviews over 12 weeks. A total of 1671 sexual events were reported (M = 7.4 events per participant), of which 64.7% (n = 1081) did not involve condom use. Discussions of birth control occurred prior to 10.9% (n = 183) of all sexual events. These discussions were more likely to be initiated by the woman and to occur when AOD had been used. Thematic analysis revealed four common themes: confirmation of the need to use condoms, confirmation of oral/hormonal contraceptive use, use of sufficient birth control, and discrepant condom use. The discussions reduced rates of risky sex when the sexual partner was more intimate (i.e., boyfriend/dating partner), regardless of AOD use and when the sexual partner was a friend or ex-partner and no AOD were used. The thematic analysis suggested that pregnancy prevention was a stronger motivation for discussing condom use, rather than risk of contracting an STI. Given the substantial rate of high risk partners, history of STIs, and limited amount of time women reported knowing “regular” partners, we suggest that interventions designed to reduce risky sex should be tailored to increase women’s awareness of STI and pregnancy risk when under the influence of AOD, and promote condom use regardless of partner type. PMID:21892691

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

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

Condom-use intentions and the influence of partner-related barriers among women at risk for HIV.

PubMed

Bonacquisti, Alexa; Geller, Pamela A

2013-12-01

To examine intentions to engage in condom use and potential partner-related barriers to condom use, including intimate partner violence (IPV), low levels of sexual relationship power and perceptions of monogamy, among women at risk for HIV. In the United States, women account for approximately one in four new HIV infections. Despite the effectiveness of consistent condom use, women often confront biological, cultural and psychosocial barriers that limit their ability to engage in condom-use. Cross-sectional, quantitative study. Participants (N = 90) were recruited from a domestic violence shelter, a domestic violence support organisation and an obstetrics/gynaecology clinic in Philadelphia, PA. Data were collected by questionnaires to assess women's condom-use intentions, actual condom-use behaviour, sexual partner risk factors, experience of IPV, level of sexual relationship power and perceptions of monogamy. Fifty-eight per cent of participants (n = 52) indicated a difference between their preference and intentions to use condoms vs. their actual use, with 62% (n = 32) using condoms less frequently than they would like. Significant differences in condom use emerged for women with low vs. high sexual relationship power and women who reported being in a monogamous relationship vs. those who did not. Of particular concern, a majority of these relationships were with high-risk partners, further increasing women's already elevated risk of acquiring HIV. Condom use is a multifaceted issue, particularly in sexual relationships involving power differentials and perceived monogamy. Condom use was complicated by women's own preferences, sexual relationship power differentials and by the perceived exclusivity of the relationship with their sexual partners. These findings have important implications for nurses as they are uniquely positioned to facilitate HIV risk reduction among their patients through the discussion of sexual health issues and barriers to negotiating condom use that women may confront. © 2013 Blackwell Publishing Ltd.

Relationship characteristics and contraceptive use among dating and cohabiting young adult couples.

PubMed

Wildsmith, Elizabeth; Manlove, Jennifer; Steward-Streng, Nicole

2015-03-01

Contraceptive decision making occurs in the context of relationships. Although many individual-level characteristics have been linked to youths' contraceptive use, less is known about associations between contraceptive use and relationship-level characteristics. Data from the 2001-2002 romantic pair subsample of the National Longitudinal Study of Adolescent Health were used to describe characteristics of 322 dating relationships and 406 cohabiting relationships among young adults aged at least 18 years. Logistic regression was employed to assess associations between these characteristics and hormonal or long-acting contraceptive use and condom use. Data from both partners allowed discordance in reports between partners in some measures to be examined. Cohabiting couples were less likely than dating couples to have used condoms (19% vs. 37%) and hormonal or long-acting methods (40% vs. 57%) at last sex. In dating relationships, couples reporting discordant levels of intimacy and couples in which neither partner reported a high level of intimacy had greater odds of condom use than couples in which both partners reported high intimacy (odds ratios, 4.5 and 3.3, respectively); mistrust and male problem drinking were negatively associated with condom use (0.3 for each). For cohabiting couples, frequency of sex was negatively associated with condom use and hormonal method use (0.8 for each). At least for dating couples, contraceptive use is linked to multiple dimensions of relationships, particularly measures reflecting relationship quality-both positive and negative. Copyright © 2015 by the Guttmacher Institute.

[Factors Associated with Sexual Risk Behaviour Among Young People in Catalonia].

PubMed

Folch, Cinta; Álvarez, Jose Luis; Casabona, Jordi; Brotons, Maria; Castellsagué, Xavier

2015-10-01

Sexual behavior in young people is influenced by external factors that may increase their vulnerability. to describe sexual behavior and other indicators of sexual and reproductive health among young people (16 to 24 years) in Catalonia and to identify factors associated with sexual risk behaviors. Cross-sectional study in 2012 carried out by an online survey from a panel of population (n=800). Factors associated with not using a condom at last sexual intercourse were evaluated using multivariate logistic regression models. 76.1% of boys and 83.3% of girls reported having had complete sexual intercourse (p=0.012). The proportion of boys and girls who reported casual partners was 39.7% and 22.5%, respectively. 31.4% of boys and 10.3% of girls reported having contacted partners through Internet. Not using a condom at first sexual intercourse showed significant association with reporting not using a condom in the last sexual intercourse, for both, boys (OR= 2.50) and girls (OR= 3.18). Having contacted partners through the Internet (OR=2.29) was associated with this risky sexual behavior in boys, and having used the emergency contraception 3 or more times (OR=3.38) was associated in girls. There are differences in the sexual behavior of young people by sex, being condom use at first sexual relationship a good predictor of condom use at last sexual intercourse. Boys show a higher number of casual partners than girls, as well as a higher use of the Internet to contact sexual partners.

An Event-Level Analysis of Condom Use During Anal Intercourse Among Self-Reported Human Immunodeficiency Virus-Negative Gay and Bisexual Men in a Treatment as Prevention Environment.

PubMed

Lachowsky, Nathan John; Tanner, Zach; Cui, Zishan; Sereda, Paul; Rich, Asheligh; Jollimore, Jody; Montaner, Julio Sg; Hogg, Robert S; Moore, David M; Roth, Eric A

2016-12-01

We sought to identify factors associated with condom use during anal intercourse among self-identified human immunodeficiency virus-negative gay, bisexual, and other men who have sex with men (GBM) in Vancouver, Canada following "treatment as prevention" (TasP) scale-up in 2010. Sexually active GBM were recruited using respondent-driven sampling from 2012 to 2014. We analyzed participants' most recent sexual encounter with up to their last 5 sexual partners within the past 6 months. In addition to individual- and event-level explanatory factors, we assessed potential associations with TasP awareness, TasP-related prevention practice (viral load sorting), and TasP-related attitudes (human immunodeficiency virus treatment optimism). Accounting for clustering at the respondent-driven sampling chain-level and participant-level, factors associated with event-level condom use versus nonuse were determined using a multivariable generalized linear mixed model built using backward selection and AIC minimization. Of 513 participants, 436 GBM (85%) reported a total of 1196 anal sex events with 56% condom use. The proportion of condom-protected sexual events decreased monthly over the study period (odds ratio [OR], 0.95 per month, 95% confidence interval [CI], 0.92-0.98). The TasP practices and attitudes were significantly associated with lower odds of condom use at the univariate level, but were no longer significant at multivariate level. In the multivariable model, event-level partner methamphetamine use (adjusted OR [aOR], 0.18; 95% CI, 0.06-0.58), frequency of recent anal intercourse with that partner (aOR, 0.97 per act; 95% CI, 0.95-0.98) and time since first sex with that partner (aOR, 0.97 per 6 months; 95% CI, 0.95-0.99) were associated with lower odds of condom use, whereas event-level participant alcohol use (aOR, 1.41; 95% CI, 1.01-1.98) and no planned future sex with that partner (aOR, 1.56; 95% CI, 1.08-2.27) were associated with greater odds of condom use. Event-level receptive-only (aOR, 2.10; 95% CI, 1.38-3.20) or insertive-only (aOR, 2.53; 95% CI, 1.64-3.90) sexual positions were associated with greater odds of condom use compared with reporting both positions. The TasP-related factors were not the most salient predictors of GBM's condom use. Health promotion must consider associations between condomless anal sex and substance use and relational factors.

The Impact of Intimate Partner Violence on Women's Condom Negotiation Efficacy

PubMed Central

Swan, Holly; O'Connell, Daniel J.

2015-01-01

HIV prevention efforts promote the use of condoms to prevent the spread of HIV and other STDs. Thus, a woman's agency to practice healthy sexual behaviors necessarily involves negotiation with another person. This poses unique challenges for women who have limited power in relationships. The current study explores how the experience of intimate partner violence (IPV) impacts a woman's confidence in her ability to negotiate condom use with a sexual partner (i.e., condom use self-efficacy), using data from incarcerated females in three states, who were interviewed just prior to release back into the community. The direct effect of experiencing IPV as an adult, controlling for other risk factors, on condom use self-efficacy has not previously been empirically tested. Results show that IPV experiences among women significantly decreases their confidence in negotiating condom use with a partner, putting them at a higher risk of HIV infection than women who do not report having recently experienced IPV. PMID:21987514

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.

Consistent Condom Use with Paying and Nonpaying Partners among Female Sex Workers in Iran: Findings of a National Biobehavioral Survey.

PubMed

Karamouzian, Mohammad; Sadeghirad, Behnam; Sharifi, Hamid; Sedaghat, Abbas; Haghdoost, Ali Akbar; Mirzazadeh, Ali

Little is known about the dynamics of condom use among female sex workers (FSWs) in Iran. We investigated the correlates of consistent condom use (CCU) among FSWs, using data from a national biobehavioral surveillance survey in 2010. A total of 872 FSWs were recruited using a facility-based sampling strategy from 21 sites in 13 cities in Iran. Data were collected through face-to-face interviews using a standardized questionnaire. Overall, 33.6% and 17.3% of FSWs reported CCU with paying and nonpaying sex partners, respectively. Consistent condom use with paying partners was significantly associated with temporary marriage, accessing family planning services and history of working in brothels. Conversely, temporary marriage or married status, condom rupture/slippage, and HIV seropositivity remained independently significantly associated with CCU with nonpaying sex partners. Our findings indicated the urgent need for scaling up condom promotion interventions catered toward FSWs and their sex partners to practice safe sex consistently.

Condom Use by Partner Type Among Military and Police Personnel in Peru

PubMed Central

Villaran, Manuel V.; Bayer, Angela; Konda, Kelika A.; Mendoza, Carlos; Quijandria, Hilda; Ampuero, Julia S.; Apolaya, Moises; Palacios, Oswaldo; Lescano, Andres G.; Vega, Antonio M.; Blazes, David L.; Kochel, Tadeusz; Montano, Silvia M.

2014-01-01

The aim of this study was to analyze the rates of condom use among military and police populations in Peru, focusing on differences in use by type of partner. A Knowledge Attitudes and Practices survey was conducted among 6,808 military and police personnel in 18 Peruvian cities between August–September 2006 and September–October 2007. A total of 90.2% of the survey respondents were male; mean age was 37.8 years and 77.9% were married/cohabiting. In all, 99.5% reported having had sex; 89% of the participants had their last sexual contact with their stable partner, 9.7% with a nonstable partner, and 0.8% with a sex worker. Overall, 20.4% used a condom during their most recent sexual contact. Reasons for nonuse of condoms included the following: perception that a condom was not necessary (31.3%) and using another birth control method (26.7%). Prevention efforts against sexually transmitted diseases should focus on strengthening condom use, especially among individuals with nonstable partners. PMID:22398988

The impact of intimate partner violence on women's condom negotiation efficacy.

PubMed

Swan, Holly; O'Connell, Daniel J

2012-03-01

HIV prevention efforts promote the use of condoms to prevent the spread of HIV and other STDs. Thus, a woman's agency to practice healthy sexual behaviors necessarily involves negotiation with another person. This poses unique challenges for women who have limited power in relationships. The current study explores how the experience of intimate partner violence (IPV) impacts a woman's confidence in her ability to negotiate condom use with a sexual partner (i.e., condom use self-efficacy), using data from incarcerated females in three states, who were interviewed just prior to release back into the community. The direct effect of experiencing IPV as an adult, controlling for other risk factors, on condom use self-efficacy has not previously been empirically tested. Results show that IPV experiences among women significantly decreases their confidence in negotiating condom use with a partner, putting them at a higher risk of HIV infection than women who do not report having recently experienced IPV.

Vaginal Douching, Condom Use, and Sexually Transmitted Infections Among Chinese Female Sex Workers

PubMed Central

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

2007-01-01

Background and Objective Vaginal douching has been hypothesized to increase a woman’s risk for human immunodeficiency virus (HIV) infection. However, data on the prevalence of this practice and its association with condom use and sexually transmitted infections (STIs) are limited. Study A cross-sectional survey among 454 female sex workers (FSWs) in a Chinese county. Results Vaginal douching was reported by 64.7% of the women. The prevalence of self-reported history of STI and that of current STI was 19.4% and 41.5%, respectively. Fifteen percent of the women reported consistent use of condoms with their clients and 8.4% with their regular partners. Vaginal douching was significantly associated with decreased use of condoms (with clients: OR = 0.31; with regular partner(s): OR = 0.22) and increased rate of self-reported STI history (OR = 1.95). However, there was no direct relation between douching and current STI. Over one third of the women believed that douching can prevent STI/HIV. Conclusion Vaginal douching exposes FSWs to a high risk of STI/HIV. Medical professional and public health workers should correct women’s misconception about the effectiveness of douching and discourage women from douching through educational activities. PMID:16254545

'Female condoms give women greater control': a qualitative assessment of the experiences of commercial sex workers in Swaziland.

PubMed

Mathenjwa, Thulile; Maharaj, Pranitha

2012-10-01

To explore commercial sex workers' experiences with the female condom in Swaziland. This is a qualitative study that draws on two focus group discussions and ten individual in-depth interviews with female commercial sex workers in Lavumisa, Swaziland. The findings suggest that the majority of female sex workers prefer to use the female condom with their clients because it offers them greater control over the sexual encounter. Other factors that facilitate its use include the absence of side effects, the enhancement of sexual pleasure and protection against the risk of STIs (including HIV). In addition, the women reported that the female condom is stronger and more resistant to breakage than the male condom. Moreover, the female condoms can be inserted well in advance of sexual intercourse. Difficulties of insertion, partner objection and limited product availability were some of the barriers to the use of the device. There was also a tendency to reuse the female condoms because of lack of product availability and privacy to insert it. Although female condom use involves negotiation with clients, the fact that it offers sex workers an independent method of protection gives them more power and also, increases their ability to control their sexual and reproductive health.

Council-supported condom vending machines: are they acceptable to rural communities?

PubMed

Tomnay, Jane E; Hatch, Beth

2013-11-01

Twenty-four hour access to condoms for young people living in rural Victoria is problematic for many reasons, including the fact that condom vending machines are often located in venues and places they cannot access. We partnered with three rural councils to install condom vending machines in locations that provided improved access to condoms for local young people. Councils regularly checked the machines, refilled the condoms and retrieved the money. They also managed the maintenance of the machine and provided monthly data. In total, 1153 condoms were purchased over 12 months, with 924 (80%) obtained from male toilets and 69% (801 out of 1153) purchased in the second half of the study. Revenue of $2626.10 (AUD) was generated and no negative feedback from residents was received by any council nor was there any negative reporting by local media. Vandalism, tampering or damage occurred at all sites; however, only two significant episodes of damage required a machine to be sent away for repairs. Condom vending machines installed in rural towns in north-east Victoria are accessible to young people after business hours, are cost-effective for councils and have not generated any complaints from residents. The machines have not suffered unrepairable damage and were used more frequently as the study progressed.

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

Protecting against both pregnancy and disease: predictors of dual method use among a sample of women.

PubMed

Harvey, S Marie; Henderson, Jillian T; Branch, Meredith Roberts

2004-01-01

Although male condoms are the best form of protection against HIV/STDs, they are not the most effective method for preventing unintended pregnancy. Consequently, use of condoms and a highly effective contraceptive-referred to as dual use-is recommended as the optimal protection against both disease and pregnancy. However, little is known about the factors that promote dual use. This study examined associations of dual method use with women's background characteristics, intrapersonal factors, and relationship characteristics. Data are from a random sample of women selected from a large managed care organization in the Pacific Northwest. The analytic sample contained 371 women who completed a telephone survey and reported use of contraceptives in the past 3 months. Three mutually exclusive method use groups were constructed: effective contraceptive only (hormonal methods, intrauterine device, surgical sterilization) (59%), condom only (24%), and dual use (18%). Variables hypothesized to influence dual use were compared across the three groups in bivariate and multivariate analyses. Findings indicate that women who were younger, reported more than one sexual partner in the past year, and were highly motivated to avoid HIV/STDs--were more likely to use dual methods rather than condoms only or an effective contraceptive method. Women confident about using condoms without feeling embarrassed or breaking the sexual mood were more likely to use dual methods rather than a single effective method. Finally, women with confidence in their ability to use condoms correctly are more likely to rely solely on condoms. Policy and practice implications are discussed.

Validity and reliability in reporting sexual partners and condom use in a Swiss population survey.

PubMed

Jeannin, A; Konings, E; Dubois-Arber, F; Landert, C; Van Melle, G

1998-02-01

To examine the validity and reliability of indicators of sexual behaviour and condom use in annual telephone surveys (n=2800) of the general population aged 17 to 45 for the evaluation of AIDS prevention in Switzerland. A test-retest study with additional focused interviews was conducted on a subsample (n=138) of the respondents aged 17 to 22 years. The subsample included more French speaking respondents (OR: 1.7, CI: 1.1-2.5) and more people in a stable relationship (OR: 2.2, CI: 1.5-3-3) than the initial sample but did not differ in any other way, although no data is available on their attitudes towards sex. The reliability of the indicators considered was high: number of lifetime, casual sex partners in the last 6 months and condom use with them, acquisition of a new steady partner during the year and condom use with this partner, condom use at last intercourse. However, the focused interviews raised questions about the validity of some of these indicators, presumably due to imprecise wording of the questionnaire items. Among sexually active respondents, 12.5% (95% CI: 4.7-25.5) of the men included non-penetrative sex in the definition of 'sexual intercourse', but only 1.9% (95% CI: 0.1-10.3) of the women. The propensity for men of counting acts or partners with whom no penetration had taken place in the total reported sex acts or partners was not significantly associated with any socio-demographic variables. In addition, among the 15 respondents who had reported consistent condom use with casual sex partners at interview, 40% (95% CI: 16.3-67.7) admitted at reinterview that sometimes they also had unprotected sex. The reliability of reports on sexual behaviour and condom use in this Swiss evaluation survey is good. The indicators derived from the annual surveys are robust measures and the monitoring of trends seems to be based on reliable measurement. However, more research is required on the validity of the data.

Female Condoms=Missed Opportunities: Lessons Learned from Promotion-centered Interventions.

PubMed

Maksut, Jessica L; Eaton, Lisa A

2015-01-01

The female condom is a barrier contraceptive device that is underutilized despite its effectiveness at preventing both unintended pregnancy and sexually transmitted infections (STIs). Prior research has highlighted that the underuse of the female condom as a contraceptive option is owing in large part to social stigma, and lacking or incorrect information about the product. In an attempt to better understand the discrepancy between the female condom's documented effectiveness and its general lack of uptake, we conducted a systematic search and qualitatively reviewed 20 published intervention studies that focus on efforts to promote the female condom. The strategies that each intervention used were coded and carefully examined. We obtained information regarding relevant characteristics of the studies, including intervention setting, sampling strategy, participant demographics, and methodology used. We found that the majority of the studies had significant positive findings concerning the female condom, for example, many were effective at demonstrating participant uptake as well as increasing the number of protected sex acts. Additionally, perceived ability to use the device was a significant predictor of female condom use in multiple studies. Finally, the studies tended to include younger women; only 10.0% (n=2) reported having participants with a mean age older than 30), meaning that older women generally have not been well-served by previous efforts to promote the use of the female condom. We offer guidelines for improving female condom uptake and recommendations for future research that seeks to establish and utilize best practice promotional strategies for female condoms. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Motivations for entry into sex work and HIV risk among mobile female sex workers in India.

PubMed

Saggurti, Niranjan; Verma, Ravi K; Halli, Shiva S; Swain, Suvakanta N; Singh, Rajendra; Modugu, Hanimi Reddy; Ramarao, Saumya; Mahapatra, Bidhubhusan; Jain, Anrudh K

2011-09-01

This paper assesses the reasons for entry into sex work and its association with HIV risk behaviours among mobile female sex workers (FSWs) in India. Data were collected from a cross-sectional survey conducted in 22 districts across four high HIV prevalence states in India during 2007-2008. Analyses were limited to 5498 eligible mobile FSWs. The reasons given by FSWs for entering sex work and associations with socio-demographic characteristics were assessed. Reported reasons for entering sex work include poor or deprived economic conditions; negative social circumstances in life; own choice; force by an external person; and family tradition. The results from multivariate analyses indicate that those FSWs who entered sex work due to poor economic conditions or negative social circumstances in life or force demonstrated elevated levels of current inconsistent condom use as well as in the past in comparison with those FSWs who reported entering sex work by choice or family tradition. This finding indicates the need for a careful assessment of the pre-entry contexts among HIV prevention interventions since these factors may continue to hinder the effectiveness of efforts to reduce the spread of HIV/AIDS in India and elsewhere.

Assessment of risky sexual behavior and practice among Aksum University students, Shire Campus, Shire Town, Tigray, Ethiopia, 2017.

PubMed

Kebede, Awoke; Molla, Bogale; Gerensea, Hadgu

2018-01-31

Having sex at early age, having multiple sexual partners, having sex while under the influence of alcohol or drugs and unprotected sexual behaviors are the common characteristics of risky sexual behavior which increases risk of individuals to sexuality and reproductive health problems. Risky sexual behavior is the most common problem in adolescents and young adults which may expose individuals for permanent social, economical, psychological and physical problem. So that this study focus on assessment of risk sexual behavior using institution based cross-sectional study design on 287 randomly selected subjects among Aksum University students. Almost 60% students reported to have ever had sexual activity. Of which 86 (83.5%) and 112 (64.4%) reported having inconsistent condom use and multiple sexual partners respectively. Even though more than half of first sexual intercourse (61.5%) starts due to their desire but still peer pressure and alcohol have significant effect. Similarly the study indicated that a significant segment of students have risk sexual behaviors which increase individuals' risk of acquiring HIV/AIDS. Unless appropriate age and institutional targeted interventions exist, certain behaviors can place the university students at greater risk of HIV infection and sexually transmitted disease.

Concurrent sexual partnerships among men who have sex with men in Shenzhen, China.

PubMed

Ha, Toan H; Liu, Hongjie; Liu, Hui; Cai, Yumao; Feng, Tiejian

2010-08-01

The HIV epidemic spreads among men who have sex with men (MSM) in China. The objective of this study was to examine and compare HIV/AIDS knowledge and sexual risk for HIV between MSM who engaged in concurrent sexual partnerships and MSM who did not. A cross-sectional study using respondent driven sampling was conducted among 351 MSM in Shenzhen, China. About half (49%) of respondents reported having concurrent sexual partnerships during the past 6 months. Among MSM with concurrent sexual partnerships, 62% had only male partners and 38% had both male and female partners. The proportion of inconsistent condom use was 42% among MSM with concurrent partners and 30% among MSM without. These 2 groups reported a similar level of self-perceived risk for HIV. Compared to MSM without concurrent sexual partners, those with such partners were more likely to work in entertainment venues and had a lower level of HIV/AIDS knowledge. The large number of MSM engaging in concurrent sexual partnerships and the high prevalence of bisexuality could accelerate the spread of HIV to the general population unless effective HIV interventions for MSM are implemented in China.

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 Negotiation, HIV Testing, and HIV Risks among Women from Alcohol Serving Venues in Cape Town, South Africa

PubMed Central

Pitpitan, Eileen V.; Kalichman, Seth C.; Cain, Demetria; Eaton, Lisa A.; Carey, Kate B.; Carey, Michael P.; Harel, Ofer; Simbayi, Leickness C.; Mehlomakhulu, Vuyelwa; Mwaba, Kelvin

2012-01-01

Background Women in South Africa are at particularly high-risk for HIV infection and are dependent on their male partners' use of condoms for sexual risk reduction. However, many women are afraid to discuss condoms with male partners, placing them at higher risk of HIV infection. Purpose To examine the association between fear of condom negotiation with HIV testing and transmission risk behaviors, including alcohol use and sexual risks among South African women. Method Women (N = 1333) residing in a primarily Xhosa-speaking African township in Cape Town and attending informal alcohol-serving venues (shebeens) completed anonymous surveys. Logistic regression was used to test the hypothesis that fear of condom negotiation would be associated with increased risk for HIV. Results Compared to women who did not fear condom negotiation, those who did were significantly less likely to have been tested for HIV, were more likely to have experienced relationship abuse, and to report more alcohol use and more unprotected sex. Conclusions For women in South Africa, fear of condom negotiation is related to higher risk of HIV. HIV prevention efforts, including targeted HIV counseling and testing, must directly address gender issues. PMID:23056211

Midlife and older women's experiences and advice about sex with men, risk behaviors, and HIV prevention education.

PubMed

Altschuler, Joanne

2017-01-01

This article reports on older women's experiences and advice on condom use, male-female relationships, HIV risk, and prevention education. It reports on findings from five written, open-ended questions with 110 ethnically and economically diverse women, 40-80 years old. Analysis revealed four themes: (a) Gap between condom use advice and condom use behavior; (b) invisibility with age; (c) negative expectations of men; and (d) desire for education that breaks the silence on sex. The article discusses the meaning of the findings as they relate to current knowledge about HIV prevention education and midlife and older women and offers recommendations for research and education.

Transgender female sex workers’ HIV knowledge, experienced stigma, and condom use in the Dominican Republic

PubMed Central

Hasbun, Julia; Charow, Rebecca; Rosario, Santo; Tillotson, Louise; McGlaughlin, Elaine; Waters, John

2017-01-01

Introduction Not only do transgender female sex workers have some of the highest rates of sexually transmitted infections (STI), human immunodeficiency virus (HIV), and experienced stigma, they also have higher likelihood of early sexual debut and some of the lowest levels of educational attainment compared to other stigmatized populations. Some of the most common interventions designed to reduce transmission of HIV and STIs seek to educate high-risk groups on sexual health and encourage condom use across all partner types; however, reaching stigmatized populations, particularly those in resource-limited settings, is particularly challenging. Considering the importance of condom use in stopping the spread of HIV, the aim of this study was two-fold; first to characterize this hard-to-reach population of transgender female sex workers in the Dominican Republic, and second, to assess associations between their HIV knowledge, experienced stigma, and condom use across three partner types. Methods We analyzed self-reported data from the Questionnaire for Transgender Sex Workers (N = 78). Respondents were interviewed at their workplaces. Univariate and bivariate analyses were employed. Fisher Chi-square tests assessed differences in HIV knowledge and experienced stigma by condom use across partner types. Results HIV knowledge was alarmingly low, condom use varied across partner type, and the respondents in our sample had high levels of experienced stigma. Average age of first sexual experience was 13.12 years with a youngest age reported of 7. Dominican Republic statutory rape laws indicate 18 years is the age of consent; thus, many of these transgender women’s first sexual encounters would be considered forcible (rape) and constitute a prosecutable crime. On average, respondents reported 8.45 sexual partners in the prior month, with a maximum of 49 partners. Approximately two thirds of respondents used a condom the last time they had sex with a regular partner. This was considerably lower than condom use reported with coercive partners (92.96%) and clients (91.78%). Bivariate analyses revealed two trends: experienced stigma was associated with lower rates of condom use, and lower HIV knowledge was associated with lower rates of condom use. The former provides additional evidence that experienced stigma may become internalized, affecting individual-level behaviors—lowering self-confidence and resilience—making it more difficult to negotiate condom use due to lack of self-efficacy and desire to show trust in one’s partner. The latter supports public health research that suggests gaps in HIV knowledge persist and are pronounced in highly stigmatized populations. Discussion The vulnerabilities experienced by transgender persons, particularly in environments that vehemently adhere to conservative ideologies related to sex and gender, are significant and harm this population. These vulnerabilities could potentially be addressed through critically examining of impact of policies that indirectly promote or allow victimization of transgender citizens and subsequently diminish the effectiveness of public health and educational interventions. By taking action through the revocation of such laws, the Dominican Republic has the opportunity to improve overall population health, to protect some of its most stigmatized citizens, and to become the flag bearer of enhanced human rights in the Caribbean and Latin America. PMID:29095843

Transgender female sex workers' HIV knowledge, experienced stigma, and condom use in the Dominican Republic.

PubMed

Budhwani, Henna; Hearld, Kristine R; Hasbun, Julia; Charow, Rebecca; Rosario, Santo; Tillotson, Louise; McGlaughlin, Elaine; Waters, John

2017-01-01

Not only do transgender female sex workers have some of the highest rates of sexually transmitted infections (STI), human immunodeficiency virus (HIV), and experienced stigma, they also have higher likelihood of early sexual debut and some of the lowest levels of educational attainment compared to other stigmatized populations. Some of the most common interventions designed to reduce transmission of HIV and STIs seek to educate high-risk groups on sexual health and encourage condom use across all partner types; however, reaching stigmatized populations, particularly those in resource-limited settings, is particularly challenging. Considering the importance of condom use in stopping the spread of HIV, the aim of this study was two-fold; first to characterize this hard-to-reach population of transgender female sex workers in the Dominican Republic, and second, to assess associations between their HIV knowledge, experienced stigma, and condom use across three partner types. We analyzed self-reported data from the Questionnaire for Transgender Sex Workers (N = 78). Respondents were interviewed at their workplaces. Univariate and bivariate analyses were employed. Fisher Chi-square tests assessed differences in HIV knowledge and experienced stigma by condom use across partner types. HIV knowledge was alarmingly low, condom use varied across partner type, and the respondents in our sample had high levels of experienced stigma. Average age of first sexual experience was 13.12 years with a youngest age reported of 7. Dominican Republic statutory rape laws indicate 18 years is the age of consent; thus, many of these transgender women's first sexual encounters would be considered forcible (rape) and constitute a prosecutable crime. On average, respondents reported 8.45 sexual partners in the prior month, with a maximum of 49 partners. Approximately two thirds of respondents used a condom the last time they had sex with a regular partner. This was considerably lower than condom use reported with coercive partners (92.96%) and clients (91.78%). Bivariate analyses revealed two trends: experienced stigma was associated with lower rates of condom use, and lower HIV knowledge was associated with lower rates of condom use. The former provides additional evidence that experienced stigma may become internalized, affecting individual-level behaviors-lowering self-confidence and resilience-making it more difficult to negotiate condom use due to lack of self-efficacy and desire to show trust in one's partner. The latter supports public health research that suggests gaps in HIV knowledge persist and are pronounced in highly stigmatized populations. The vulnerabilities experienced by transgender persons, particularly in environments that vehemently adhere to conservative ideologies related to sex and gender, are significant and harm this population. These vulnerabilities could potentially be addressed through critically examining of impact of policies that indirectly promote or allow victimization of transgender citizens and subsequently diminish the effectiveness of public health and educational interventions. By taking action through the revocation of such laws, the Dominican Republic has the opportunity to improve overall population health, to protect some of its most stigmatized citizens, and to become the flag bearer of enhanced human rights in the Caribbean and Latin America.

Nonsupportive peer norms and incarceration as HIV risk correlates for young black men who have sex with men.

PubMed

Jones, Kenneth T; Johnson, Wayne D; Wheeler, Darrell P; Gray, Phyllis; Foust, Evelyn; Gaiter, Juarlyn

2008-01-01

Black men who have sex with men (BMSM) are at considerable risk for HIV infection. A convenience sample of BMSM (n=252) attending nightclubs in three North Carolina cities was surveyed to investigate factors associated with unprotected anal intercourse (UAI). About 45% reported UAI in the past 2 months. BMSM who strongly agreed that their male friends used condoms for anal sex were significantly less likely to report any UAI. Recently incarcerated men were significantly more likely to report unprotected insertive anal sex. In secondary analyses, men who reported experiencing discrimination based on their race and nongay identified men reported more favorable peer norms for condom use. Men who reported that their family disapproved of their being gay were more likely to have been incarcerated in the past 2 months. HIV prevention for BMSM must promote supportive peer norms for condom use and address incarceration, racial discrimination, and family disapproval.

Applicability and reproducibility of condom catheter method for measuring isovolumetric bladder pressure.

PubMed

Huang Foen Chung, J W N C; Bohnen, A M; Pel, J J M; Bosch, J L H R; Niesing, R; van Mastrigt, R

2004-01-01

To report on the applicability, reproducibility, and adverse events of the noninvasive condom catheter method in the first 730 subjects of a longitudinal survey of changes in urinary bladder contractility secondary to benign prostatic hyperplasia, in which 1300 men will be evaluated three times in 5 years using this method. Subjects were recruited by general practitioners, general publicity, and e-mail. Only those meeting the study criteria were entered in the study. If the free flow rate exceeded 5.4 mL/s, at least two consecutive condom pressure measurements were attempted using the condom catheter method. The condom pressure measured reflected the isovolumetric bladder pressure, a measure of urinary bladder contractility. The reproducibility of the method was quantified by a difference plot of the two maximal condom pressures measured in each subject. In 618 (94%) of 659 eligible participants, one condom pressure measurement was completed; two measurements were done in 555 (84%). The maximal condom pressure ranged from 28 to 228 cm H2O (overall mean 101, SD 34). A difference between the two pressures of less than +/-21 cm H2O was found in 80%. The mean difference was -1 cm H2O (SD 18), significantly different from 0. Some adverse events such as terminal self-limiting hematuria were encountered. The condom catheter method is very suitable for large-scale use. It has a success rate of 94% and a reproducibility comparable to that of invasive pressure flow studies.

Sexual behavior of female sex workers and access to condoms in Kenya and Uganda on the Trans-Africa highway.

PubMed

Morris, Chester N; Morris, Sheldon R; Ferguson, Alan G

2009-10-01

Female sex workers and their clients remain a high risk core group for HIV in Africa. We measured sexual behavior of a snowball sample of female sex workers (FSW) along the Trans Africa highway from Mombasa, Kenya to Kampala, Uganda and surveyed the availability of male condoms at 1,007 bars and lodgings in Kenya along the highway trucking stops where transactional sex occurs. There were 578 FSW one month sex diaries analyzed, 403 from Kenya and 175 from Uganda. Kenyan FSW had a median of 45 sexual acts per 28 days compared to 39 sex acts per 28 days by Ugandan FSW (P < 0.05). Condom use by FSW for all sexual liaisons was 79% in Kenya compared to 74% in Uganda. In multivariate analysis, adjusting for repeated measures, Kenyan FSW were more likely to use a condom by an adjusted odds ratio of 2.54 (95% confidence interval 1.89-3.41) compared to Ugandan FSW. Condom use with regular clients was 50.8% in Uganda compared with 68.7% in Kenya (P < 0.01). The number of sex workers reporting 100% condom use was 26.8% in Kenya and 18.9% in Uganda (P < 0.01). Bars and lodges in Kenya compared to Uganda were more likely to: have condom dispensers, 25% versus 1%, respectively (P < 0.01); distribute or sell condoms, 73.9% versus 47.6% (P < 0.01); and have more weekly condom distribution, 4.92 versus 1.27 condoms per seating capacity (P < 0.01). Our data indicate that in both countries condom use for FSW is suboptimal, particularly with regular partners, and greater condom use by Trans African highway FSW in Kenya compared to Uganda may be related to availability. Targeted interventions are warranted for FSW and truck drivers to prevent transmission in this important core group.

Contraceptive method at first sexual intercourse and subsequent pregnancy risk: findings from a secondary analysis of 16-year-old girls from the RIPPLE and SHARE studies.

PubMed

Parkes, Alison; Wight, Daniel; Henderson, Marion; Stephenson, Judith; Strange, Vicki

2009-01-01

Existing failure rate studies indicate that typical use of oral contraception (OC) results in fewer unplanned pregnancies than condom use, even among teenagers. However, comparative data on pregnancy risk associated with different contraceptive methods are lacking for younger teenagers starting their first sexual relationship. This study examined associations between contraceptive method at first intercourse and subsequent pregnancy in 16-year-old girls. Six thousand three hundred forty-eight female pupils from 51 secondary schools completed a questionnaire at mean age 16 years; 2,501 girls reported sexual intercourse. Logistic regression (N = 1952) was used to model the association of contraceptive method at first intercourse with pregnancy. At first intercourse (median age 15 years) 54% reported using condoms only, 11% dual OC and condoms, 4% OC only, 4% emergency contraception, and 21% no effective method. Method used was associated with a similar method at a most recent intercourse. One in 10 girls reported a pregnancy. When compared to use of condoms only, greater pregnancy risk was found with no effective method (odds ratio [OR] 2.97, 95% confidence interval [CI] 2.12-4.15) or OC only (OR 2.44, 95% CI 1.29-4.60). Pregnancy risk for dual use and emergency contraception did not differ from that for condoms only. Both significant effects were partially attenuated by adjusting for user characteristics and sexual activity. Young teenagers may use OC less efficiently than condoms for pregnancy prevention. The characteristics of those using OC-only confirm vulnerability to unintended pregnancy, and suggest that alternative contraceptive strategies should be considered for these young women.

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.

Motivating factors for dual-method contraceptive use among adolescents and young women: a qualitative investigation.

PubMed

Lemoine, Julie; Teal, Stephanie B; Peters, Marissa; Guiahi, Maryam

2017-11-01

This qualitative study explores how adolescents and young women perceive the need for and describe the use of dual method contraception. We interviewed 20 sexually active women aged 16-24 who attended an adolescent-focused Title X family-planning clinic and were using a non-barrier contraceptive method. We used a semi-structured interview guide that included domains related to sexual activity, knowledge of and use of contraceptives and condoms, and relationship factors. We coded transcripts using grounded theory techniques and used an iterative process to develop overarching themes. Dual method contraceptive users primarily discussed pregnancy prevention as their motivating factor. Many expressed anxieties over an unplanned pregnancy and reported condom use as "back-up" contraception. Risk perception for pregnancy or STI acquisition did not necessarily change as relationship trust increased, but rather, their anxiety regarding the negativity of such outcomes decreased. Dual-method contraception use decreased when participants reported that condoms were not readily available, or when they self-described immaturity. Less frequently, participants reported dual method use for sexually transmitted infection (STI) prevention, and many substituted STI testing for condom use. Contraceptive type (short-acting vs. long-acting) did not influence reported attitudes towards dual method use. Health educators and clinicians encourage condom use in young women due to the significant morbidity associated with STI acquisition. Most participants in our study view condoms as a way to improve pregnancy prevention. Acknowledging and addressing this divergence in motivation will allow caregivers to improve strategies for communicating the importance of dual method use. Young women primarily describe pregnancy prevention as the reason for dual method use, STI protection is less salient. Consideration of this viewpoint by health educators and clinicians will allow us to communicate more effectively to prevent STI morbidity. Copyright © 2017 Elsevier Inc. All rights reserved.

Food Insecurity Increases HIV Risk Among Young Sex Workers in Metro Vancouver, Canada.

PubMed

Barreto, Daniella; Shannon, Kate; Taylor, Chrissy; Dobrer, Sabina; Jean, Jessica St; Goldenberg, Shira M; Duff, Putu; Deering, Kathleen N

2017-03-01

This research aimed to determine the effect of food insecurity on sexual HIV risk with clients among youth sex workers (YSWs) <30 years in Metro Vancouver, Canada. Data were drawn from a prospective community cohort of sex workers (2010-2013). We examined the independent relationship between YSWs' food insecurity and being pressured into sex without a condom by clients ("client condom refusal"). Of 220 YSWs, 34.5 % (n = 76) reported client condom refusal over the 3.5-year study period and 76.4 % (n = 168) reported any food insecurity. Adjusting for other HIV risk pathways, food insecurity retained an independent effect on client condom refusal (AOR 2.08, 95 % CI 1.23-3.51), suggesting that food insecurity is significantly associated with HIV risk among YSWs. This study indicates a critical relationship between food insecurity and HIV risk, and demonstrates YSWs' particular vulnerability. Public policies for food assistance as a harm reduction measure may be key to addressing this disparity.

FOOD INSECURITY INCREASES HIV RISK AMONG YOUNG SEX WORKERS IN METRO VANCOUVER, CANADA

PubMed Central

Barreto, Daniella; Shannon, Kate; Taylor, Chrissy; Dobrer, Sabina; St. Jean, Jessica; Goldenberg, Shira M.; Duff, Putu; Deering, Kathleen N.

2017-01-01

This research aimed to determine the effect of food insecurity on sexual HIV risk with clients among youth sex workers (YSWs) <30 years in Metro Vancouver, Canada. Data were drawn from a prospective community cohort of sex workers (2010–2013). We examined the independent relationship between YSWs food insecurity and being pressured into sex without a condom by clients (“client condom refusal”). Of 220 YSWs, 34.5 % (n = 76) reported client condom refusal over the 3.5-year study period and 76.4 % (n = 168) reported any food insecurity. Adjusting for other HIV risk pathways, food insecurity retained an independent effect on client condom refusal (AOR 2.08, 95 % CI 1.23–3.51), suggesting that food insecurity is significantly associated with HIV risk among YSWs. This study indicates a critical relationship between food insecurity and HIV risk, and demonstrates YSWs particular vulnerability. Public policies for food assistance as a harm reduction measure may be key to addressing this disparity. PMID:27752869

Socio-demographic, Marital, and Psychosocial Factors Associated with Condom Use Negotiation Self-Efficacy Among Mozambican Women at Risk for HIV Infection.

PubMed

Patrão, Ana Luísa; McIntyre, Teresa M

2017-12-01

In Mozambique, women are the most affected by HIV/AIDS. Self-efficacy is one of the main predictors of effective use of a condom. Therefore, it is essential to identify the factors that influence condom-use negotiation self-efficacy in vulnerable women. The aim of this paper is to identify socio-demographic, marital, and psychosocial factors associated with condom-use negotiation self-efficacy among Mozambican women at risk for HIV infection. Participants were women (173) who were patients at the Gynecology Department of the Central Hospital of Beira, Mozambique, and at risk for HIV infection. Women completed measures of condom-use negotiation self-efficacy, HIV prevention knowledge, and perceived barriers against safer sex. The results showed that demographic and marital variables are associated with condom-use negotiation self-efficacy, namely, those having more than 9 years of education, who are younger and not living with a partner, and who talk about AIDS with partners report higher condom-use negotiation self-efficacy. Regarding psychosocial factors, higher HIV prevention knowledge and fewer perceived barriers to safer sex predict higher condom-use negotiation self-efficacy. These results can contribute to sexual health promotion and HIV/AIDS prevention in Mozambican women because they identify at-risk groups and marital and psychosocial malleable factors that can be targeted in AIDS prevention among at-risk Mozambican women.

Patterns of knowledge and condom use among population groups: results from the 2005 Ethiopian behavioral surveillance surveys on HIV.

PubMed

Kassie, Getnet M; Mariam, Damen H; Tsui, Amy O

2008-12-31

Behavioral surveys help interpret the magnitude of HIV/AIDS. We analyzed indicators of knowledge on HIV/AIDS and condom use among sub populations selected for behavioral surveillance in Ethiopia. We used 2005 HIV/AIDS behavioral data from ten target groups. These were female sex workers, defense forces, police force, pastoralists, truck drivers, intercity bus drivers, road construction workers, teachers, factory workers and people in ANC catchment areas. Data from 14,524 individuals were analyzed. The majority were males (63.6%). Overall, knowledge of the three preventive methods, misconceptions and comprehensive knowledge was 57%, 75% and 18.5%, respectively. Female sex workers and the defense force showed some behavioral change in using a condom during the most recent sexual encounter and consistently used a condom with non-regular sexual partners and paying partners. Women, pastoralists and the illiterate were less likely to use condom. Misconceptions about the transmission of HIV were high and comprehensive knowledge about HIV & AIDS was low, particularly among pastoralists. Consistent condom use and condom use during the last sexual encounter were high among both female sex workers and defense force employees, both with paying and non-regular sexual partners. This might be a positive sign, though a considerable proportion in each target group did not report using a condom during sex with non-regular partners.

Correlates of safer sex communication among college students.

PubMed

Diiorio, C; Dudley, W N; Lehr, S; Soet, J E

2000-09-01

Correlates of safer sex communication among college students The purpose of this study was to examine factors that are thought to promote communication about safer sex and HIV among college students in the United States of America and to determine the extent to which communication about safer sex is important in the use of condoms. A better understanding of factors associated with safer sex communication can be helpful in developing HIV and STD prevention programmes for college students. Following approval from the institutional review boards of the six participating colleges and universities, researchers collected data from a random sample of students. The study included participant responses if participants were 18-25 years of age, single and sexually active. For the sample of 1349 participants, the mean age was 20.6 years. Sixty-three per cent of the sample was female, 50.5% white, 42.3% African-American, and the remainder of other ethnic groups. Over 50% of respondents reported frequent condom use, with 28% noting that they used a condom every time and 30.6% reporting condom use almost every time they had sex. Only 9.6% indicated that they never used a condom. The results of hierarchical multiple regression analysis revealed that the perception of quality of general communication with parents, the perception of a partner's attitude towards communication, communication self-efficacy, and communication outcome expectancies, were associated with safer sex communication. However, the association between safer sex communication and condom use was weak, suggesting that other factors excluded from this study are important in determining condom use for this sample of respondents. The findings provide some implications for HIV interventions. Interventions that enhance self-efficacy and positive outcome expectancies related to communication about safer sex are likely to foster discussion with a sexual partner. However, they might not lead to actual condom use.

Does it really matter which drug you choose? An examination of the influence of type of drug on type of risky sexual behavior.

PubMed

Ritchwood, Tiarney D; DeCoster, Jamie; Metzger, Isha W; Bolland, John M; Danielson, Carla K

2016-09-01

This study investigates whether certain types of substances are differentially related to certain risky sexual behaviors (RSBs) within the same population and determines whether combination substance use (SU) has additive, redundant or antagonistic effects on RSBs. African-American youth aged 9-19 participated in a large, community-based survey assessing substance use and sexual behaviors. Multilevel modeling was used to predict the differential influence of alcohol, marijuana, and cocaine use on condom use measured in the past 90days and at last intercourse, sex while drunk/high, and number of sexual partners. Tests of the within-participant relations showed that participants increasing their SU over time concurrently increased their RSBs, establishing a strong link between the two behaviors (alcohol: condom β=-0.045, sex while drunk/high β=0.138, sex partners β=0.102; marijuana: condom β=-0.081, sex while drunk/high β=0.255, sex partners β=0.166; cocaine: condom β=-0.091, sex while drunk/high β=0.103, sex partners β=0.031; all p's<0.01). Tests of the between-participant relations showed that, generally, youth reporting less SU across their teenage years were also more likely to report fewer RSBs over this period (alcohol: condom β=-0.128, sex while drunk/high β=0.120, sex partners β=0.169; marijuana: condom β=-0.170, sex while drunk/high β=0.638, sex partners β=0.357; cocaine: condom β=-0.353; all p's<0.05). Moreover, the combination of some substances has unique redundant or antagonistic effects on RSB. Such findings support the consideration of type of SU, and particular combinations of substances, on RSBs in intervention development. Copyright © 2016 Elsevier Ltd. All rights reserved.

Disclosure of newly diagnosed HIV infection and condom use at first sex after diagnosis: a study of young Black men who have sex with men.

PubMed

Crosby, Richard A; Mena, Leandro; Arnold, Trisha

2017-08-01

Background The first purpose of the present study was to determine whether young Black men who have sex with men (YBMSM) disclose their newly diagnosed HIV infection to a male or female partner, and to determine whether this disclosure is related to condom use; the second was to identify correlates of disclosing newly diagnosed HIV infection to male sex partners, including a measure of partner-related barriers to condom use. A sample of 125 HIV-infected YBMSM (age 15-29 years) provided cross-sectional data used for both study purposes. Recruitment occurred in a mid-size city in the southern US experiencing inordinately high prevalence and incidence rates of HIV among YBMSM. Significance was defined by an α level of <0.05. Eighty-eight YBMSM (70.4%) indicated disclosing their newly diagnosed HIV status to the first male partner they had sex with after being diagnosed. Of these, nine (9.1%) reported that condoms were not used during ensuing sex with that partner. However, of the men not disclosing, 27.0% reported not using condoms for ensuing sex (P=0.009). Similar findings were observed relative to sex with females (P=0.057). Regarding the second study purpose, in addition to a protective effect of advancing age, men scoring at or above the median on a measure of partner-related barriers to condom use were 2.4-fold more likely to not disclose compared with men scoring below the median (P=0.04). For YBMSM, a beneficial counselling objective relative to disclosing newly diagnosed HIV may be to help men resolve perceptions of partner-related barriers to condom use.

Assessing the contraceptive supply environment in Kinshasa, DRC: trend data from PMA2020.

PubMed

Babazadeh, S; Lea, S; Kayembe, P; Akilimali, P; Eitmann, L; Anglewicz, P; Bertrand, J

2018-03-01

Performance Monitoring and Accountability 2020 (PMA2020) is a population-based and facility-based survey program conducted in 11 countries to track contraceptive use dynamics and the supply environment. Annual data collection provides trend data unavailable from any other source. Two-stage cluster sampling was used to select 58 enumeration areas in Kinshasa; data were collected in 2014, 2015 and 2016 from three to six service delivery points (SDPs) per EA. Of the 228-248 SDPs surveyed each year, only two-thirds reported to offer family planning (FP) services. Of those reporting to offer FP, one-fifth or more did not do so on the day of the survey. As of 2016, only one-half of SDPs offering FP had at least three methods available, a proxy for contraceptive choice; only one in five had at least five methods. Long-acting reversible contraceptives, including implants and IUDs, were less widely offered and more often stocked out than resupply methods, including condoms, pills and injectables. Contraceptive stockouts were rampant: in 2016, over a quarter of the SDPs experienced stockouts of all methods (except condoms) in the previous 3 months, and two of the three most widely used methods-implants and injectables-were also the most likely to be stocked out. The findings documented the inconsistency in pricing of methods across facilities; moreover, less than one quarter of SDPs posted prices. Patterns in the contraceptive supply environment remained relatively unchanged between 2014 and 2016. The PMA2020 SDP module provides timely, actionable information to the DRC government, FP implementing organizations and donors involved in FP service delivery in Kinshasa, DRC. Yet the value of this information will be determined by the ability of the local FP stakeholders to use it in bringing the needed improvements identified by this survey to the contraceptive supply environment. © The Authors 2017. Published by Oxford University Press on behalf of Entomological Society of America.

Assessing the contraceptive supply environment in Kinshasa, DRC: trend data from PMA2020

PubMed Central

Babazadeh, S; Lea, S; Kayembe, P; Akilimali, P; Eitmann, L; Anglewicz, P; Bertrand, J

2018-01-01

Abstract Performance Monitoring and Accountability 2020 (PMA2020) is a population-based and facility-based survey program conducted in 11 countries to track contraceptive use dynamics and the supply environment. Annual data collection provides trend data unavailable from any other source. Two-stage cluster sampling was used to select 58 enumeration areas in Kinshasa; data were collected in 2014, 2015 and 2016 from three to six service delivery points (SDPs) per EA. Of the 228–248 SDPs surveyed each year, only two-thirds reported to offer family planning (FP) services. Of those reporting to offer FP, one-fifth or more did not do so on the day of the survey. As of 2016, only one-half of SDPs offering FP had at least three methods available, a proxy for contraceptive choice; only one in five had at least five methods. Long-acting reversible contraceptives, including implants and IUDs, were less widely offered and more often stocked out than resupply methods, including condoms, pills and injectables. Contraceptive stockouts were rampant: in 2016, over a quarter of the SDPs experienced stockouts of all methods (except condoms) in the previous 3 months, and two of the three most widely used methods—implants and injectables—were also the most likely to be stocked out. The findings documented the inconsistency in pricing of methods across facilities; moreover, less than one quarter of SDPs posted prices. Patterns in the contraceptive supply environment remained relatively unchanged between 2014 and 2016. The PMA2020 SDP module provides timely, actionable information to the DRC government, FP implementing organizations and donors involved in FP service delivery in Kinshasa, DRC. Yet the value of this information will be determined by the ability of the local FP stakeholders to use it in bringing the needed improvements identified by this survey to the contraceptive supply environment. PMID:29136172

Experience of violence and adverse reproductive health outcomes, HIV risks among mobile female sex workers in India

PubMed Central

2011-01-01

Background Female sex workers (FSWs) are a population sub-group most affected by the HIV epidemic in India and elsewhere. Despite research and programmatic attention to FSWs, little is known regarding sex workers' reproductive health and HIV risk in relation to their experiences of violence. This paper therefore aims to understand the linkages between violence and the reproductive health and HIV risks among a group of mobile FSWs in India. Methods Data are drawn from a cross-sectional behavioural survey conducted in 22 districts from four high HIV prevalence states (Andhra Pradesh, Karnataka, Maharashtra, Tamil Nadu) in India between September 2007 and July 2008. The survey sample included 5,498 FSWs who had moved to at least two different places for sex work in the past two years, and are classified as mobile FSWs in the current study. Analyses calculated the prevalence of past year experiences of violence; and adjusted logistic regression models examined the association between violence and reproductive health and HIV risks after controlling for background characteristics and program exposure. Results Approximately one-third of the total mobile FSWs (30.5%, n = 1,676) reported experiencing violence at least once in the past year; 11% reported experiencing physical violence, and 19.5% reported experiencing sexual violence. Results indicate that FSWs who had experienced any violence (physical or sexual) were significantly more likely to be vulnerable to both reproductive health and HIV risks. For example, FSWs who experienced violence were more likely than those who did not experience violence to have experienced a higher number of pregnancies (adjusted odds ratio [OR] = 1.2, 95% confidence interval [CI] = 1.0-1.6), ever experienced pregnancy loss (adjusted OR = 1.4, 95% CI = 1.2-1.6), ever experienced forced termination of pregnancy (adjusted OR = 2.4, 95% CI = 2.0-2.7), experienced multiple forced termination of pregnancies (adjusted OR = 2.2, 95% CI = 1.7-2.8), and practice inconsistent condom use currently (adjusted OR = 1.97, 95% CI: 1.4-2.0). Among FSWs who experienced violence, those who experienced sexual violence were more likely than those who had experienced physical violence to report inconsistent condom use (adjusted OR = 1.8, 95% CI: 1.4-2.3), and experience STI symptoms (adjusted OR = 1.3, 95% CI: 1.1-1.7). Conclusion The pervasiveness of violence and its association with reproductive health and HIV risk highlights that the abuse in general is an important determinant for reproductive health risks; and sexual violence is significantly associated with HIV risks among those who experienced violence. Existing community mobilization programs that have primarily focused on empowering FSWs should broaden their efforts to promote reproductive health in addition to the prevention of HIV among all FSWs, with particular emphasis on FSWs who experienced violence. PMID:21599984

Experience of violence and adverse reproductive health outcomes, HIV risks among mobile female sex workers in India.

PubMed

Swain, Suvakanta N; Saggurti, Niranjan; Battala, Madhusudana; Verma, Ravi K; Jain, Anrudh K

2011-05-20

Female sex workers (FSWs) are a population sub-group most affected by the HIV epidemic in India and elsewhere. Despite research and programmatic attention to FSWs, little is known regarding sex workers' reproductive health and HIV risk in relation to their experiences of violence. This paper therefore aims to understand the linkages between violence and the reproductive health and HIV risks among a group of mobile FSWs in India. Data are drawn from a cross-sectional behavioural survey conducted in 22 districts from four high HIV prevalence states (Andhra Pradesh, Karnataka, Maharashtra, Tamil Nadu) in India between September 2007 and July 2008. The survey sample included 5,498 FSWs who had moved to at least two different places for sex work in the past two years, and are classified as mobile FSWs in the current study. Analyses calculated the prevalence of past year experiences of violence; and adjusted logistic regression models examined the association between violence and reproductive health and HIV risks after controlling for background characteristics and program exposure. Approximately one-third of the total mobile FSWs (30.5%, n = 1,676) reported experiencing violence at least once in the past year; 11% reported experiencing physical violence, and 19.5% reported experiencing sexual violence. Results indicate that FSWs who had experienced any violence (physical or sexual) were significantly more likely to be vulnerable to both reproductive health and HIV risks. For example, FSWs who experienced violence were more likely than those who did not experience violence to have experienced a higher number of pregnancies (adjusted odds ratio [OR] = 1.2, 95% confidence interval [CI] = 1.0-1.6), ever experienced pregnancy loss (adjusted OR = 1.4, 95% CI = 1.2-1.6), ever experienced forced termination of pregnancy (adjusted OR = 2.4, 95% CI = 2.0-2.7), experienced multiple forced termination of pregnancies (adjusted OR = 2.2, 95% CI = 1.7-2.8), and practice inconsistent condom use currently (adjusted OR = 1.97, 95% CI: 1.4-2.0). Among FSWs who experienced violence, those who experienced sexual violence were more likely than those who had experienced physical violence to report inconsistent condom use (adjusted OR = 1.8, 95% CI: 1.4-2.3), and experience STI symptoms (adjusted OR = 1.3, 95% CI: 1.1-1.7). The pervasiveness of violence and its association with reproductive health and HIV risk highlights that the abuse in general is an important determinant for reproductive health risks; and sexual violence is significantly associated with HIV risks among those who experienced violence. Existing community mobilization programs that have primarily focused on empowering FSWs should broaden their efforts to promote reproductive health in addition to the prevention of HIV among all FSWs, with particular emphasis on FSWs who experienced violence.

Another condom uproar in Uganda.

PubMed

Musoke, D

1991-11-01

A campaign to promote safe sex through the use of condoms has sparked a heated controversy in Uganda, as influential religious leaders have come out in opposition to a practice which they fear will lead to sexual promiscuity. The campaign, backed by the Ugandan government, is designed to halt the rapidly spreading AIDS epidemic. With 20,000 AIDS cases as of June 1991, Uganda leads all African countries in the number of reported cases. Additionally, it is estimated that some 7 million of the country's 17 million inhabitants are HIV-positive. This alarming situation forced President Yoweri Museveni to reverse his stance and come out in favor of the condom campaign. The campaign is being launched by the Ugandan pharmaceutical firm Armtrades Ltd with financial and technical support from USAID and the Ugandan government. The condom campaign, however, has aroused strong opposition from the religious community. Angered by advertisements advising Ugandans to "love carefully" by wearing condoms, Catholic Archbishop Emmanuel Wamala urged his followers in August to reject condoms, calling then an insult to the dignity of man. Following Wamala's lead, other top churchmen came out in opposition to the condom campaign at a recent AIDS prevention leadership conference. One of the clergymen present at the conference told Health Minister James Makumbi that the condom campaign will make young people indulge in uncontrolled sexual immorality. Moslem clerics have also stated their opposition to condoms, fearing sexual promiscuity. But the religious community itself has come under criticism for their opposition to condoms. Stressing that lives are at stake, the popular weekly Topic recently cautioned churchmen that this is not the time to engage in academic and moralistic debates.

Women’s Condom Use Assertiveness and Sexual Risk-Taking: Effects of Alcohol Intoxication and Adult Victimization

PubMed Central

Norris, Jeanette; George, William H.; Morrison, Diane M.; Zawacki, Tina; Davis, Kelly Cue; Hessler, Danielle M.

2008-01-01

This experiment examined relationships among adulthood victimization, sexual assertiveness, alcohol intoxication, and sexual risk-taking in female social drinkers (N = 161). Women completed measures of sexual assault and intimate partner violence history and sexual assertiveness before random assignment to 1 of 4 beverage conditions: control, placebo, low dose (.04%), or high dose (.08%). After drinking, women read a second-person story involving a sexual encounter with a new partner. As protagonist of the story, each woman rated her likelihood of condom insistence and unprotected sex. Victimization history and self-reported sexual assertiveness were negatively related. The less sexually assertive a woman was, the less she intended to insist on condom use, regardless of intoxication. By reducing the perceived health consequences of unprotected sex, intoxication indirectly decreased condom insistence and increased unprotected sex. Findings extend previous work by elucidating possible mechanisms of the relationship between alcohol and unprotected sex – perceived health consequences and situational condom insistence – and support the value of sexual assertiveness training to enhance condom insistence, especially since the latter relationship was robust to intoxication. PMID:18556139

Women's condom use assertiveness and sexual risk-taking: effects of alcohol intoxication and adult victimization.

PubMed

Stoner, Susan A; Norris, Jeanette; George, William H; Morrison, Diane M; Zawacki, Tina; Davis, Kelly Cue; Hessler, Danielle M

2008-09-01

This experiment examined relationships among adulthood victimization, sexual assertiveness, alcohol intoxication, and sexual risk-taking in female social drinkers (N=161). Women completed measures of sexual assault and intimate partner violence history and sexual assertiveness before random assignment to 1 of 4 beverage conditions: control, placebo, low dose (.04%), or high dose (.08%). After drinking, women read a second-person story involving a sexual encounter with a new partner. As protagonist of the story, each woman rated her likelihood of condom insistence and unprotected sex. Victimization history and self-reported sexual assertiveness were negatively related. The less sexually assertive a woman was, the less she intended to insist on condom use, regardless of intoxication. By reducing the perceived health consequences of unprotected sex, intoxication indirectly decreased condom insistence and increased unprotected sex. Findings extend previous work by elucidating possible mechanisms of the relationship between alcohol and unprotected sex - perceived health consequences and situational condom insistence - and support the value of sexual assertiveness training to enhance condom insistence, especially since the latter relationship was robust to intoxication.

Effects of Brief Messages About Antiretroviral Therapy and Condom Use Benefits Among Black and Latino MSM in Three U.S. Cities.

PubMed

Herbst, Jeffrey H; Mansergh, Gordon; Pitts, Nicole; Denson, Damian; Mimiaga, Matthew J; Holman, Jeremy

2018-01-01

This pilot study examined effects of HIV prevention messages about self and partner benefits of antiretroviral therapy (ART) and condom effectiveness on increased intentions for behavior change. Data were from Messages4Men, a study examining prevention messages among 320 HIV-positive and 605 HIV-negative Black and Latino MSM. Men completed a computer-based assessment after message exposure, and multivariable models controlled for risky sex and demographics. A majority of HIV-positive men reported increased intentions for ART use; 22% reported partner benefit information was new. HIV-positive men with a detectable viral load had significantly greater adjusted odds of reporting intentions for ART use. Over half of HIV-negative MSM reported ART benefit information was new, and 88% reported increased intentions to discuss ART use with infected partners. Black MSM anticipated they would increase condom use in response to the self and partner benefit messages. Tailored messages on benefits of ART are needed for MSM.

Determinants of Behavior Change Intention Among Heterosexual Thai Males Diagnosed with Sexually Transmitted Diseases.

PubMed

Thato, Ratsiri; Daengsaard, Ekkachai

2016-11-01

This study sought to identify factors associated with intention to change sexual practices among heterosexual Thai males diagnosed with sexually transmitted infections (STIs). STI clinic patients (n = 247) reported their sexual behaviors and condom use during the previous 3 months. STI and HIV knowledge, motivation to change sexual practices, and behavioral skills were assessed. Then, self-reported behavior change intention, including consistent condom use, reducing number of sexual partners, not using drugs and alcohol when having sex, and refusal of condomless sex, was examined. Consistent condom use in the past 3 months by Thai males diagnosed with STIs was low across all types of sexual partners (lover 13.8%, casual partner 14.9%, and sex worker 2.5%). Risk reduction self-efficacy (p < 0.001), perceived benefits from condom use (p < 0.001), perceived barriers to condom use (p < 0.001), perceived risk for HIV (p < 0.05), and STI and HIV knowledge (p < 0.05) were significantly correlated with behavior change intention. Significant predictors of behavior change intention were risk reduction self-efficacy (p < 0.001), perceived benefits of condom use (p = 0.016), and perceived risk for HIV (p = 0.033). They explained 36% of behavior change intention variance. Intervention aimed at enhancing motivation and behavioral skills to adopt preventive behaviors should be developed to prevent recurrent STIs, including HIV infection, among heterosexual Thai males diagnosed with STIs.

Views about HIV/STI and health promotion among gay and bisexual Chinese and South Asian men living in Auckland, New Zealand.

PubMed

Neville, Stephen; Adams, Jeffery

2016-01-01

Ethnic minority gay, bisexual, and other men who have sex with men (MSM) are considered to have a high risk for HIV infection. The aim of this study was to identify some of the ways Chinese and South Asian MSM talk about and understand issues related to HIV/STI and health promotion, as well as highlighting some of this group's health promoting behaviours. A qualitative study using face-to-face interviews with 44 Chinese and South Asian MSM living in Auckland, New Zealand, was undertaken. Following data analysis, four major themes were identified: the importance of condoms, condom use, HIV/STI practices, and HIV health promotion. The results showed that the men interviewed had a good understanding of the benefits of using condoms for anal sex. They also reported strong recall of the local HIV health promotion campaigns which seek to influence men's behaviours through promotion of a single, unequivocal message to always use a condom for anal sex. The men however did not always report consistent condom use, and a range of reasons why this happened were identified. Among the men who discussed testing practices, regular testing was much more likely to have occurred in men who have lived in New Zealand for more than 5 years. These results suggest that future health promotion initiatives should be tailored to ensure the needs of Chinese and South Asian MSM are appropriately addressed when promoting condom use for anal sex.

Use of birth control pills, condoms, and withdrawal among U.S. high school students.

PubMed

Everett, S A; Warren, C W; Santelli, J S; Kann, L; Collins, J L; Kolbe, L J

2000-08-01

To examine the use of contraception at last sexual intercourse among currently sexually active adolescents. We analyzed data from national school-based Youth Risk Behavior Surveys (YRBS) conducted in 1991, 1993, 1995, and 1997. The YRBS is a self-administered, anonymous survey which uses a national probability sample of U.S. students in public and private schools from grades 9 through 12. From 1991 to 1997, condom use significantly increased (from 46% to 57%), birth control pill use decreased (from 21% to 17%), and use of withdrawal significantly decreased (from 18% to 13%). In 1997, although more students were using condoms, 13% reported using withdrawal and 15% reported using no method to prevent pregnancy at last sexual intercourse. In 1997, condom use among females was significantly lower in the 9th grade than in the 12th grade (p <.001), whereas birth control pill use was higher (p <.001) and use of withdrawal remained stable. Among males, condom use and withdrawal use remained stable from 9th to 12th grade, whereas birth control pill use by their partner increased (p <.001). Inadequate contraceptive use among sexually active adolescents continues to be a major public health problem in the United States. For young people who will not remain sexually abstinent, families, health care providers, schools, and other influential societal institutions should promote the correct and continued use of condoms as essential protection against sexually transmitted diseases and human immunodeficiency virus infection.

Views about HIV/STI and health promotion among gay and bisexual Chinese and South Asian men living in Auckland, New Zealand

PubMed Central

Neville, Stephen; Adams, Jeffery

2016-01-01

Ethnic minority gay, bisexual, and other men who have sex with men (MSM) are considered to have a high risk for HIV infection. The aim of this study was to identify some of the ways Chinese and South Asian MSM talk about and understand issues related to HIV/STI and health promotion, as well as highlighting some of this group's health promoting behaviours. A qualitative study using face-to-face interviews with 44 Chinese and South Asian MSM living in Auckland, New Zealand, was undertaken. Following data analysis, four major themes were identified: the importance of condoms, condom use, HIV/STI practices, and HIV health promotion. The results showed that the men interviewed had a good understanding of the benefits of using condoms for anal sex. They also reported strong recall of the local HIV health promotion campaigns which seek to influence men's behaviours through promotion of a single, unequivocal message to always use a condom for anal sex. The men however did not always report consistent condom use, and a range of reasons why this happened were identified. Among the men who discussed testing practices, regular testing was much more likely to have occurred in men who have lived in New Zealand for more than 5 years. These results suggest that future health promotion initiatives should be tailored to ensure the needs of Chinese and South Asian MSM are appropriately addressed when promoting condom use for anal sex. PMID:27211584

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

High condom use but low HIV testing uptake reported by men who purchase sex in Bali, Indonesia.

PubMed

Wulandari, Luh Putu Lila; Kaldor, John; Januraga, Pande Putu

2018-03-20

Men who purchase sex (MWPS) have long been considered as one of the population groups at risk of HIV transmission. However, while HIV-related interventions have been targeted towards this group, few studies have directly recruited MWPS to measure the impact of such interventions. This study aimed to fill the gap for Indonesia by identifying the level and predictors of condom use and HIV testing among MWPS, to inform prevention strategies. A cross-sectional study was conducted by surveying 200 MWPS in Bali, Indonesia in 2015. A structured questionnaire was administered to collect the data. Self-reported condom use on the occasion of last paid sex was very high (88.5%), while a history of HIV testing was low (8.1%). None of the variables identified in this study were associated with condom use at last paid sex. Men were more likely to report a history of HIV testing if they: perceived themselves to be at high risk of HIV, had a higher level of HIV-related knowledge, reported a history of genital ulcers or urethral discharge in the past 12 months, or were aware that confidential HIV testing was available. Implications and limitations of this study are discussed.

STI Screening Uptake and Knowledge of STI Symptoms among Female Sex Workers Participating in a Community Randomized Trial in Peru

PubMed Central

Kohler, Pamela K.; Campos, Pablo E.; Garcia, Patricia J.; Carcamo, Cesar P.; Buendia, Clara; Hughes, James P.; Mejia, Carolina; Garnett, Geoff P.; King, K.

2016-01-01

This study aims to evaluate condom use, STI screening, and knowledge of STI symptoms among female sex workers (FSW) in Peru associated with sex work venue and a community randomized trial of STI control. One component of the Peru PREVEN intervention conducted mobile-team outreach to FSW to reduce STIs and increase condom use and access to government clinics for STI screening and evaluation. Prevalence ratios were calculated using multivariate Poisson regression models with robust standard errors, clustering by city. As-treated analyses were conducted to assess outcomes associated with reported exposure to the intervention. Care-seeking was more frequent in intervention communities, but differences were not statistically significant. FSW reporting exposure to the intervention had significantly higher likelihood of condom use, STI screening at public health clinics, and symptom recognition compared to those not exposed. Compared with street or bar-based FSW, brothel-based FSW reported significantly higher rates of condom use with last client, recent screening exams for STIs and HIV testing. Brothel-based FSW also more often reported knowledge of STIs and recognition of STI symptoms in women and in men. Interventions to promote STI-detection and prevention among FSW in Peru should consider structural or regulatory factors related to sex work venue. PMID:25941053

Condom Use among Latino College Students.

ERIC Educational Resources Information Center

Gurman, Tilly; Borzekowski, Dina L.G.

2004-01-01

Recent reports indicate that Latinos, the largest racial/ethnic minority group in the United States, are disproportionately affected by HIV and AIDS. College health professionals, therefore, should understand current sexual behaviors and risk factors among Latino youth. The authors assessed students' condom use at their most recent sexual…

Consumption of Pornography, Perceived Peer Norms, and Condomless Sex.

PubMed

Wright, Paul J; Tokunaga, Robert S; Kraus, Ashley

2016-08-01

Sexual scripts in pornography rarely include condoms. Many U.S. college students consume pornography and have unprotected sex. Yet no study appears to have investigated whether pornography consumption is correlated with having unprotected sex among U.S. college students. This article reports results from two studies of pornography consumption and condomless sex among U.S. college students. Pornography consumption was directly associated with a higher likelihood of condomless sex in study 1. This finding was replicated in study 2. Study 2 also explored whether perceptions of peers' use of condoms partially mediates the association between pornography consumption and condomless sex. Pornography consumption was associated with lower estimations of peers' condom use, and lower estimations of peers' condom use were associated with personally engaging in condomless sex.

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.

HIV/Sexually Transmitted Infection Prevention Messaging: Targeting Root Causes of Sexual Risk Behavior.

PubMed

Manhart, Lisa E; Epstein, Marina; Bailey, Jennifer A; Hill, Karl G; Haggerty, Kevin P; Catalano, Richard F

2016-02-01

Sexual risk behaviors (SRBs) often lead to sexually transmitted infections (STI), yet little is known about what drives SRB and whether this differs by sex. Participants (n = 920; 75% white) were drawn from the Raising Healthy Children study, enrolled in 1993 and 1994 in grades 1 to 2, and followed up through age 24/25 years. Lifetime STI diagnosis was defined by self-report or seropositivity for Chlamydia trachomatis or herpes simplex virus 2. Multivariable models assessed individual (social skills, behavioral disinhibition) and environmental factors (family involvement, school bonding, antisocial friends) predictive of STI diagnosis as mediated by 3 proximal SRB (sex under the influence of drugs or alcohol, condom use, lifetime number of sex partners). Twenty-five percent of participants had ever had an STI. All SRBs differed by sex (P < 0.001), and female participants were more likely to have had an STI (P < 0.001). Behavioral disinhibition and antisocial friends in adolescence were associated with more SRB for both sexes, whereas social skills were associated with less SRB in female but more in male participants. Considering SRB and individual and environmental factors together, lifetime number of sex partners (adjusted relative risk [ARR], 1.04per partner; 95% confidence interval [CI], 1.03-1.05) and inconsistent condom use (ARR, 1.10per year; 95% CI, 1.04-1.16) were associated with increased risk of STI, whereas social skills were associated with decreased risk of STI (ARR, 0.84; 95% CI, 0.75-0.93). Behavioral disinhibition seemed to drive SRB, but family involvement mitigated this in several cases. Adolescent environmental influences and individual characteristics drive some SRB and may be more effective targets for STI/HIV prevention interventions than proximal risk behaviors.

Human immunodeficiency virus (HIV) infection patterns and risk behaviours in different population groups and provinces in Viet Nam.

PubMed

Tuan, Nguyen Anh; Fylkesnes, Knut; Thang, Bui Duc; Hien, Nguyen Tran; Long, Nguyen Thanh; Kinh, Nguyen Van; Thang, Pham Hong; Manh, Pham Duc; O'Farrell, Nigel

2007-01-01

To study patterns and determinants of HIV prevalence and risk-behaviour characteristics in different population groups in four border provinces of Viet Nam. We surveyed four population groups during April-June 2002. We used stratified random-cluster sampling and collected data concomitantly on HIV status and risk behaviours. The groups included were female sex workers (n = 2023), injecting drug users (n = 1391), unmarried males aged 15-24 years (n = 1885) and different categories of mobile groups (n = 1923). We found marked geographical contrasts in HIV prevalence, particularly among female sex workers (range 0-24%). The HIV prevalence among injecting drug users varied at high levels in all provinces (range 4-36%), whereas lower prevalences were found among both unmarried young men (range 0-1.3%) and mobile groups (range 0-2.5%). All groups reported sex with female sex workers. Less than 40% of the female sex workers had used condoms consistently. The strongest determinants of HIV infection among female sex workers were inconsistent condom use (adjusted odds ratio [OR], 5.3; 95% confidence interval [CI], 2.4-11.8), history of injecting drug use and mobility, and, among injecting drug users, sharing of injection equipment (adjusted OR, 7.3; 95% CI, 2.3-24.0) and sex with non-regular partners (adjusted OR 3.4; 95% CI 1.4-8.5). The finding of marked geographical variation in HIV prevalence underscores the value of understanding local contexts in the prevention of HIV infection. Although lacking support from data from all provinces, there would appear to be a potential for sex work to drive a self-sustaining heterosexual epidemic. That the close links to serious injecting drug use epidemics can have an accelerating effect in increasing the spread of HIV merits further study.