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PubMed2006

Emerging sociodemographic and lifestyle predictors of intention to use condom in human immunodeficiency virus intervention among uniformed services personnel.

Appropriate and consistent use of condom remains an effective approach to human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) intervention. We analyzed the baseline data gathered for a situationally based HIV/AIDS intervention to assess the potential predictors of condom use among the Uniformed Services Personnel in Nigeria. Using condom purchase as a proxy for intention to use condom, we examined the distribution of the demographic and lifestyle characteristics, knowledge of HIV transmission mode, and knowledge of how to correctly use a condom. A univariable logistic regression was used to identify the potential predictors, followed by multivariable logistic regression modeling. The knowledge of how to correctly wear a condom was the most significant positive predictor of the intention to use a condom (adjusted prevalence odds ratio (APOR), 5.99 (95% confidence interval (CI), 1.26, 19.79). The other main positive predictors of intent to use a condom were the knowledge of the mode of HIV transmission via blood, APOR 2.43 (95% CI, 1.01, 5.82), saliva (5. 87, 95% CI, 3.15, 10.94), and pre-ejaculatory fluid (APOR, 3.58, 95% CI, 1.67, 7.48). Male gender was also a significant positive predictor of the intent to use a condom (APOR, 2.55, (95% CI, 1.10, 5.97)). The results further indicated alcohol use (APOR, 0.32, 95%CI, 0.16, 0.61), marijuana use (APOR, 0.24, 95% CI, 0.11, 0.56), and the frequency of oral sexual behavior (APOR, 0.006, 95%CI, 0.002, 0.019) as negative predictors of the intent to use a condom. Therefore, these findings suggest that for an HIV/AIDS intervention to be effective in this population, it must incorporate these predictor variables into its design and conduct.

Adolescent↗
PubMed1999

[Evidence of risk factors for condom breakage among French military personnel stationed overseas].

The French Army Medical Service has been distributing free condoms to overseas personnel since 1989. An epidemiologic study conducted in Cambodia showed that the rate of condom failure during protected sex was 16.3 p. 100. In view this high failure rate, a study to evaluate safety guidelines for condom use was deemed necessary. This report describes the results of an inquiry designed to identify risk factors for condom breakage. The study population included 124 servicemen stationed overseas who consulted an army physician following condom failure. An anonymous questionnaire was completed by the physician with the informed consent of the patient. Data was analyzed by multiple correspondence analysis. Anogenital intercourse and alcohol abuse were the main risk factors for condom failure. Oral sex before penetration, carrying the condom in the pocket, and improper application by the sex partner were also risk factors for failure. The major finding of this study was that 64 of the 124 (51.6 p. 100) denied any sexual activity or improper handling that might have led to condom breakage. Although condoms are still indispensable for prevention sexually transmitted diseases, the results of this study show that they do not provide absolute protection. Health care officials should inform the public as to the risk factors for breakage of latex condoms.

Africa↗
PubMedDate not supplied

[Changes in condom use among a cohort of prostitutes].

OBJECTIVE: To describe changes in condom use among prostitutes enrolled in a prospective cohort study in Alicante (Spain), and to identify those factors associated with changes in this behaviour. METHODS: Data from this study come from a prospective cohort study of women working at prostitution enrolled in a center for AIDS preventive at Alicante from 1986 to 1996. The proportion of condom use by prostitutes with their clients was recorded during the first visit and the last one, and changes in condom use were estimated as the difference between them. Two logistic regression analyses were done to identify those factors associated with positive or negative changes in condom use. RESULTS: A statistically significant increase in the prevalence of condom use was observed between the first, 69,2%, and the last visit, 83,9% (p < 0,001). Prostitutes working private increased the condom use more than five time than those working in clubs or at the street. The higher the follow-up time the higher the prevalence of condom user, OR > 6 years = 7,6 (95% CI: 2,2-26,0). No variable was associated with a negative change in condom use. CONCLUSION: This study shows an overall increase of condom use in a cohort of prostitutes after 10 years of follow-up. Relapse in risk behavior has been infrequent. In the future, preventive strategies to increase the use of condoms among prostitutes should be adapted to the new forms of sexual commerce.

Adult↗
PubMed2001

Consumer preference study of the female condom in a sexually active population at risk of contracting AIDS.

To determine the acceptability of the female condom among commercial sex workers in Khon Kaen, Thailand. Twenty sex workers from a massage parlor and 21 from a brothel were trained in the use of the female condom. The voluntary participants were instructed about the risk of HIV and advised that they could use the female condom as an alternative method to the male condom for protection. The female condom was used in 28.4 per cent and 17.8 per cent episodes of sex in each site during the two weeks. Continuation of use of the female condom increased from 0 per cent in the first group to 43 per cent in the second group. The reasons for discontinuing its use were that it was inconvenient and because of their partners' objection. More users said they liked the female condom even though more thought it was difficult to insert and it did cause pain. However, they would recommend it to others and most felt that other women would want to try it. The participants also saw the advantage of the female condom as a back-up method in case of clients' refusal to use the male condom but all prefered the male condom if there was a choice.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Use of a condom to control massive postpartum hemorrhage.

OBJECTIVES: To evaluate the efficacy of a condom as a tamponade for intrauterine pressure to stop massive postpartum hemorrhage (PPH). DESIGN AND SETTING: This prospective study was done in the Obstetrics and Gynecology Department of Dhaka Medical College and Hospital, Bangladesh, between July 2001 and December 2002. PATIENTS: During the study period, 152 cases of PPH were identified; 109 were managed medically; 20 were managed using the B-Lynch procedure, and 23 were managed using the condom catheter. Patients were selected for intervention with the condom catheter when PPH that occurred as a result of atonicity or morbid adhesion (accreta) could not be controlled by uterotonics or a surgical procedure. In patients who were in shock due to massive hemorrhage, a condom catheter was introduced immediately without prior medical management. INTERVENTION: With aseptic precautions, a sterile rubber catheter fitted with a condom was introduced into the uterus. The condom was inflated with 250-500 mL normal saline, according to need. The condom catheter was kept for 24-48 hours, depending upon the initial intensity of blood loss, and gradually deflated when bleeding ceased. MAIN OUTCOME MEASURES: (1) Ability of condom catheter to stop bleeding; (2) time required to stop bleeding after the tamponade was applied; (3) subsequent morbidity in terms of severe infection, despite use of prophylactic antibiotics. RESULTS: In all 23 cases in which the condom catheter was used, bleeding stopped within 15 minutes. No patient needed further intervention. No patient went into irreversible shock. There was no intrauterine infection as documented by clinical signs and symptoms and culture and sensitivity of high vaginal swab. CONCLUSION: The hydrostatic condom catheter can control PPH quickly and effectively. It is simple to use, inexpensive, and safe. In developing countries where PPH remains a primary cause of maternal mortality, any healthcare provider involved in delivery may use this procedure for controlling massive PPH to save the lives of patients.

Adult↗
PubMed1990

[The nonoxynol content in condoms is insufficient to inhibit the human immunodeficiency virus (HIV)].

The seven makes of condom which are marketed in Denmark were examined for the nonoxynol content with the object of assessing whether the content of nonoxynol in the condoms is sufficient to present HIV spread in connection with use of the condom and assessed in relation to the defects in effectivity (tearing, holes, overflow of semen, sliding off). Compared with the declared content of nonoxynol of 40 mg (100%) per condom, the following nonoxynol quantities could be demonstrated by methanol/water extraction and subsequent high-performance liquid chromatography: One make of condom contained 65%, two 50-55% and four 25-33%. The nonoxynol content was found to be evenly distributed between the outer and inner surface of the condoms. With a theoretical distribution volume of 6 ml (tearing during vaginal coitus), it was found that three of the makes of condoms examined did not achieve the HIV-inhibiting nonoxynol concentration of 0.05%, by means of measuring the quantity of nonoxynol on the distal 5 cm of the condoms. In anal sex, the distribution volume is greater resulting in lower nonoxynol concentrations and thus increased risk for HIV infection. It is concluded that the nonoxynol content in the condoms marketed in Denmark should be increased in order to inactivate HIV in case of condom failure.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Condom use and acceptance: a survey of male Zimbabweans.

In addition to their traditional contraceptive role, condoms have moved to a crucial and central position in the strategy for prevention of sexual transmission of the human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs). As a cure for AIDS remains out of sight, condom use, celibacy and extensive health education remain the immediate sole weapons for controlling HIV infection. A stratified cluster sampling design of 722 Zimbabwean men reported 35.7 percent ever use of condoms while only 4.9 percent reported current condom use. 32.4 percent had unprompted knowledge of condom use for contraception. Circumstances during which condoms were used are discussed. Asked if the men would use condoms if asked by either wife or partner, only 30.0 percent of men who had not previously used condoms indicated that they would. Reasons given by the 64 percent with no previous use of condoms are discussed. Health education to promote acceptance and use of condoms is proposed.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Barriers to condom use and needle cleaning among impoverished minority female injection drug users and partners of injection drug users.

This study was undertaken to describe sexual behaviors and drug use and other factors that inhibit condom use and needle cleaning among impoverished women who are injection drug users (IDUs) or sexual partners of IDUs. This study also investigated whether risky sexual behavior or barriers to risk reduction differ with ethnicity and level of acculturation. Survey instruments to assess drug and sexual activity were administered to 378 African American and Latina women recruited primarily from homeless shelters and drug recovery programs. The most commonly cited barriers to condom use were belief that partners did not have acquired immunodeficiency syndrome (AIDS), lack of knowledge about where to get and how to use condoms, and discomfort discussing condom use with partners. African American women were more likely to report having multiple partners and unprotected sex, and more likely to report barriers in using, discussing, and obtaining condoms. Latina women were more likely to report partners' dislike of condoms. African American and highly acculturated Latina women were more likely to be IDUs than less acculturated Latina women. The most pervasive barriers for needle cleaning were not having personal needles, being high and not interested in needle cleaning, and not having disinfectant available. In a multiple logistic regression analysis for engaging in unprotected sex and cleaning needles, not ethnic or acculturation differences were found after controlling for selected demographic characteristics and risk factors. The data indicate a need to increase the supply of free or low cost condoms, to provide easily accessible sites for obtaining condoms, to supply clean needles,and to focus counseling for women on negotiating condom use with partners and the skillful and correct placement of the condom.

Adolescent↗
PubMed1998

[Attitudes toward condoms and experience with their use among sex education teachers].

BACKGROUND: The sex education is influenced by knowledge and attitudes. The aim of presented study was to evaluate the attitudes toward condom among sex education teachers and their personal experience with its use. METHODS AND RESULTS: Attitudes toward condoms were measured by 10-items anonymous questionnaires according to Zvĕrina and Lippert. Personal experience was subjectively assumed in 5-point scale. The samples consists of 230 sex education teachers, among them 193 (84%) women. The average age was 40.5 +/- 9.7 years, in the range from 19 to 60 years. 37 teachers (16%) assigned themselves as religious. Condom was evaluated as a good protection against HIV and other STD in almost all answers. Three fifths of teachers considered condom to be an excellent contraception. 48% teachers did not know if the majority of women dislike condom. One tenth respondents rejected the opinion that the men dislike condoms. One tenth of teachers has never experienced condom personally. 12 percent stated to use it regularly, among them are more represented men. The opinions about quality of condom and decreased sensitivity by condom differ believers from atheists and users from non-users. CONCLUSIONS: Attitudes toward condom are predominantly liberal among Czech sex education teachers. The personal experience with use is common but not regular. The religion has small influence toward the attitudes and use.

Adult↗
PubMed1998

Female condom acceptability among sex workers in Costa Rica.

This study measured short-term female condom acceptability among 51 female sex workers in San José, Costa Rica. Each woman was trained in use of the female condom and was asked to use the device if clients refused to use male condoms during a 2-week study period (male condoms were also distributed). Two follow-up visits with short interviews were scheduled, including questions on general reaction to the female condom by the participants and their clients, ease and comfort of use, and preferences for male or female devices. At the first follow-up visit, 51% of the women reported they "liked the female condom very much" and 45% reported they "liked it somewhat." Similar results were reported after the second follow-up phase. Sixty-seven percent of the participants preferred the female condom over the male condom, and, according to the the women, over half of their clients liked the female condom "very much" or "somewhat." The most common problems during the first phase were difficulty to insert (61%) and discomfort (43%). However, during the second study phase a reduction in these problems (22% and 25%, respectively) and other use-related problems were noted. Although this new method is not yet available throughout Costa Rica, these results should encourage sexually transmitted diseases and HIV service organizations to make this method accessible to women.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Failure rate of condoms during anogenital intercourse in homosexual men.

Two hundred and seventy seven homosexual men participating in an AIDS study in Amsterdam, The Netherlands, were interviewed in July to December 1986 regarding their experiences with the use of condoms during anogenital intercourse. It appeared that in many cases the condoms used could not be described as reliable, or were not used safely. In 8% (117/1468) of cases the condom tore or slipped off. When different condoms were compared, it was seen that "qualified" anal condoms functioned best. Other anal condoms functioned worse, and in many cases even worse than classic vaginal condoms. Whether these differences exclusively depended on differences in quality cannot be assessed. Men who buy a qualified anal condom are possibly more motivated and thus also less likely to have failures. Regarding the apparent unreliability of the condoms used, homosexual men are advised to refrain from anogenital intercourse. When this is not feasible, a qualified anal condom should be used.

Acquired Immunodeficiency Syndrome↗
PubMed1988

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

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.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Reasons for lack of condom use among high school students.

This exploratory qualitative study was undertaken to identify barriers to condom use among high school students in Natal. Phase 1, a group discussion, with 50 high school students of all races from 10 schools, revealed that 17 (34%) were sexually active, 8 (47%) of these had used a condom at least once, but none had used condoms in every sexual encounter. Phase 2 comprised 36 focus group discussions involving about 650 black high school students. These discussions confirmed the finding of phase 1 that high school students were not using condoms to any significant degree. In their opinion, condoms limited sexual pleasure, indicated a lack of trust in the partner's faithfulness, challenged the male ego, and were associated with sexually transmitted diseases. Their contraceptive properties were viewed with suspicion and considered undesirable by those teenagers who wished to prove their fertility. In addition, condom use was not sufficiently well understood and condoms were not accessible or available when required. We recommend that condom promotion strategies should include an adequate explanation of how condoms work and detailed information on their local availability. They should be available at a government-subsidised price through more accessible outlets; popular figures and recognised leaders should be encouraged to support anti-AIDS campaigns and condom use, particularly in the public media.

Adolescent↗
PubMed1990

[Attitude towards use of condoms among Norwegian adolescents].

The article discusses the relationship between attitudes towards condoms and the use of condoms among sexually active Norwegian adolescents. The data stem from a random survey of 3,000 Norwegian adolescents aged 17-19. The responsrate was 61.8%. In general, most adolescents were positive towards condoms, and condom users were more positive than non-users. A logistic regression analysis showed that the only statistically significant predictors of condom use were the attitudes 'condoms aren't necessary to me' and 'condoms are uncomfortable'. The results indicate that attitudes towards condoms bear some relation to condom use. But, the use of condoms is also governed by factors other than attitudes.

Adolescent↗
PubMed1996

Does additional lubrication reduce condom failure?

It has been suggested that using additional spermicide with condoms provides added contraceptive effect and protection from infection, and that water-based lubricants may lower condom breakage rates. This questionnaire-based study investigated the use of additional lubrication with condoms amongst 525 female students presenting for post-coital contraception, and the current and past experience of condom and additional lubrication use amongst 481 controls attending the same health centre. Of those requesting post-coital contraception, 83% claimed condom failure as the cause, with 66% of the control group having also experienced condom failure at some time. Use of additional water-based lubrication was significantly associated with lower condom failure rates (odds ratio 8.88, 95% C.I.: 3.79, 20.8). Gender, regularity of use of condoms and using oil-based lubricants were not associated with higher failure rates. Additional lubricant use was not significantly associated with increased condom slippage.

Condoms↗
PubMed1992

Partner-specific condom use among adolescent women clients of a family planning clinic.

Because inconsistent condom use could put adolescent women at an increased risk for sexually transmitted diseases, it is important to understand when and with whom they use condoms. This study examined partner-specific condom use over time among adolescent women. The data were from a clinic-based, prospective study of 308 adolescent women who had at least one sex partner during a 6-month follow-up. Their condom use was examined with three types of partners: exclusive, nonexclusive primary, and nonexclusive secondary. Predictors of consistent condom use (using condoms 100% of the time with a specific partner) were explored in a multiple logistic regression analysis. Consistent condom use was more likely to occur in shorter relationships (less than 3 months) and with partners who preferred condoms for contraception. It was no more likely to occur with nonexclusive partners than with exclusive partners, and it was somewhat less likely to occur among consistent oral contraceptive users. These findings emphasize the importance of educating adolescent women to introduce and maintain condom use with all partners.

Adolescent↗
PubMed1997

Latex condom breakage and slippage in a controlled clinical trial.

Although millions of couples rely on male latex condoms to protect against unintended pregnancy and sexually transmitted infections, their use is limited in part by questions about their performance. Rates of condom breakage and slippage, two measures of performance, vary broadly across studies. This variation in part reflects study variability and limitations, including sample size, reliance on subjects' memory, user populations, and products evaluated. In an effort to define condom performance in a group of monogamous couples typical of those using condoms for contraception, we conducted a clinical trial of a single brand of lubricated condoms (Durex Ramses). A total of 4637 attempts to use the condom were evaluated. Six breaks occurred before intercourse (nonclinical breaks), and 10 condoms broke during intercourse or were only noted to have broken upon withdrawal (clinical breaks), resulting in a nonclinical breakage rate of 0.13% (95% confidence interval, 0.05-0.28%), clinical breakage rate of 0.28% (0.15-0.48%), and a total breakage rate of 0.41% (0.25-0.64%). The rate of complete slippage was 0.63% (0.42-0.90%), and total failure (clinical breaks plus complete slips) was 1.04% (0.76-1.37%). These rates are lower than those in other studies with the exception of one, a prospective investigation in a population of female prostitutes. Results indicate that condoms can, in experienced, motivated populations, provide excellent performance and suggest that their efficacy at preventing pregnancy may equal that of the most reliable forms of contraception. Because this study involved a single condom brand, these results may not be generalizable to other brands.

Adult↗
PubMed1996

Behavioral intervention to increase condom use among high-risk female adolescents.

OBJECTIVE: To determine whether condom use among high-risk female adolescents could be increased by a behavioral intervention, with the use of infection with Chlamydia trachomatis as a biomarker of condom practices. DESIGN: Prospective, randomized, controlled intervention. SETTING: Urban family planning and sexually transmitted disease clinics. PARTICIPANTS: Two hundred nine female adolescents, aged 15 through 19 years, who were treated for C. trachomatis genitourinary infection, were randomly assigned to standard (control) or experimental (behavioral intervention) groups. One hundred twelve subjects returned for follow-up 5 to 7 months after enrollment and comprise the study subjects. MEASUREMENTS: Subjects completed a multiinstrument questionnaire measuring sexual behavior, condom practices, attitudes and beliefs, cognitive complexity, sociodemographics, and motivation at enrollment and follow-up. Endourethral and endocervical sites were sampled for C. trachomatis. RESULTS: Among the 112 subjects who returned for repeated examination, those who had received the experimental intervention reported increased use of condoms by their sexual partners for protection against sexually transmitted diseases (odds ratio = 2.4; p = 0.02) and for vaginal intercourse (odds ratio = 3.1; p = 0.005) at the 6-month follow-up. Multivariable logistic regression analysis controlling for condom use at enrollment demonstrated that the experimental intervention (odds ratio = 2.8; p = 0.03) and the higher cognitive complexity (odds ratio = 4.6; p = 0.02) independently contributed to greater condom use at follow-up. Despite greater use of condoms among the group who had received the intervention, use remained inconsistent and rates of reinfection with C. trachomatis were not significantly different (26% vs 17%; p = 0.3). CONCLUSION: Although a brief behavioral intervention among high-risk female adolescents can increase condom use by their sexual partners, incident infection does not appear to be reduced, because condom use remained inconsistent.

Adolescent↗