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PubMed1998

Condom use by Hispanic and African-American adolescent girls who use hormonal contraception.

PURPOSE: The purpose of the present study was to examine condom use by teens who use hormonal contraceptives [i.e., Depo-Provera, Norplant, or oral contraceptives (OCs)]. METHODS: This is a cross-sectional study of 578 Hispanic and African-American female adolescents between the ages of 12 and 21 years who came to a reproductive health care clinic. A paper-and-pencil questionnaire which addressed sexual behaviors, sexual history, and communication about sexuality was distributed to adolescent girls attending the clinic. Several important analyses included only those who had been sexually active in the last 4 weeks (n = 452). RESULTS: Adolescents who used OCs [odds ratio (OR) 1.7], long-acting agents (i.e., Depo-Provera or Norplant) (OR 1.6), were less likely to have used a condom in the last 4 weeks than teens whose only method of birth control was condoms. Only those teens who had previously been diagnosed with a sexually transmitted disease (STD) were more likely to have used a condom (OR .67 for not using a condom). Overall, condom use by teens in this sample was low, with only 19% reporting that they "always" use a condom, and 47% of the teens who had been sexually active in the last 4 weeks reporting that they had not used a condom at least once during that time. CONCLUSIONS: This study provides data which suggest that adolescent girls who use hormonal contraceptives are less likely to use condoms than other sexually active teens. Therefore, when prescribing hormonal contraception to prevent pregnancy, clinicians must provide appropriate counseling to mitigate against the potential to increase the risk of STDs.

Adolescent↗
PubMed1998

Psychosocial factors associated with the stages of change for condom use among women at risk for HIV and STDs: implications for intervention development.

This study examined the prevalence of consistent condom use among inner-city women at risk for HIV, measured the distribution of these women across the stages of change for condom use, determined psychosocial factors associated with the stages, and suggested intervention strategies based on the results. The 5-city sample of women aged 15-34 years consisted predominantly of African Americans. Only 18% reported consistent condom use with main partners and 45% with other partners. Logistic regressions compared women in each stage of change with those in higher stages for each partner type. Results indicated that women who practice or intend to practice consistent condom use were more likely to talk with others about condoms, acknowledge the advantages of condoms, have higher self-efficacy for condom use, and indicate that people important to them favored condom use. Intervention approaches are suggested for women in different stages of change for condom use.

Adolescent↗
PubMed1998

Non-use of condoms by prostitute women.

Ethnographic research among Glasgow female prostitutes working in street, sauna, flat, escort agency and "sugar daddy" sectors investigated prostitutes' accounts of the occasions in which condoms were not used for penetrative sexual encounters. Such occasions were a minority of commercial sex encounters and a majority of private sex encounters. Although prostitutes saw condom use as inappropriate in private sexual relationships this was not, as has been suggested, an aid to relationship interpretation as either private or commercial. Condoms in commercial sex were seen as routine tools of the trade, and hence emerged as emblems of prostitution. These emblematic qualities were found in turn to produce both challenges to condom use from customers and opportunities for prostitutes to manipulate customer relations by judicious suspension of condom application. Both norms of gendered role-play and prostitute status were highlighted as threatening condom use in some situations, while prostitute status could also be used as the basis of rational argument for condom use in others. Relational issues such as familiarity or a desire to communicate trust were at the forefront in explanations of condom non-use. Perceptions of physical power and the authority to permit or withhold sexual service or profit were determining influences crucial in condom use negotiation.

Attitude to Health↗
PubMed1997

Factors influencing condom use among heterosexual users of injection drugs and crack cocaine.

OBJECTIVES: To study factors that influence the self-reported use of condoms among injection drug users and crack smokers. STUDY DESIGN: A cross-sectional design was used to collect data from drug-using heterosexual men (n = 247) and women (n = 107). RESULTS: Participants were largely African American (79.4%), male (69.8%), and unmarried (90.1%). The mean age for men was 39.9 years, 35.5 years for women. Drug user groups consisted of individuals who used both crack cocaine and injection drugs (40.1%), noninjecting crack smokers (33.1%), and non-crack-smoking injection drug users (26.8%). Daily injection drug or crack use was reported by 62.9% of the sample. One third of the sample reported recent vaginal sex with more than one partner. More than 70% of the participants frequently used drugs when having sex. Logistic regression showed that individuals who were high when having vaginal sex were less likely to use condoms than people who were not high (odds ratio [OR] 0.82; 95% confidence interval [CI], 0.68-0.99); individuals whose partners got high when having sex were more likely to report condom use (OR 1.20; 95% CI, 1.01-1.42); individuals were less likely to use condoms when having sex with a main partner (OR 0.40; 95% CI, 0.20-0.80); individuals who believed it was important to use condoms were more likely to use condoms (beta = 0.57, P < 0.00); and people who believed condoms reduced sexual pleasure were less likely to use condoms (beta = -0.53, P < 0.00). CONCLUSIONS: In addition to being sensitive to partner characteristics, sex risk-reduction interventions targeting users of injection drugs or crack must address the widespread use of psychoactive drugs that occurs immediately before and during sex because such use presents a significant impediment to the employment of safer-sex techniques that rely on condoms. Until such interventions are in place, access to drug abuse treatment is a critical dimension of human immunodeficiency virus and other sexually transmitted disease prevention.

Adult↗
PubMed1995

Condom availability and prevention issues for adolescents.

Sexual activity among adolescents in the United States increased during the 1970s and 1980s but appears to be leveling off in the early 1990s. Condom use among sexually active adolescents has been irregular and variable. Recent trends, however, suggest that teenagers may be using condoms more often. More than half of all high school students used a condom at last intercourse in a nationwide survey. The most recent data about adolescent sexual activity and condom use are summarized, and recent studies examining attitudes and beliefs about condoms are reviewed. Many authors suggest that knowledge alone may be insufficient to change adolescent behavior in regard to condoms. The importance of understanding cultural norms and the social meaning of condoms among groups of teenagers is discussed. Differentiating disease protection from pregnancy prevention is also examined. Suggestions are made regarding strengthening condom negotiating skills in individuals. Recently published accounts of communities that have adopted condom programs in their schools by successfully addressing political obstacles are outlined.

Adolescent↗
PubMed1999

Correlates of condom failure in a sexually active cohort of men who have sex with men.

Condom failure (slippage or breakage) has been shown to be associated with HIV seroconversion among men who have sex with men (MSM), but predictors of failure have been poorly elucidated. Of 2592 HIV-seronegative MSM participants in the HIV Network for Prevention Trials (HIVNET) multisite Vaccine Preparedness Study who reported condom use for anal sex in the 6 months before enrollment, condom failure was reported by 16.6%, with failure rates of 2.1/100 episodes of condom usage (2.5 failures/100 episodes for receptive anal sex and 1.9/100 episodes for insertive anal sex). In separate multivariate models evaluating predictors of condom failure reported by the insertive and receptive partners, more frequent condom use was associated with a decreased per-condom failure rate and amphetamine and heavy alcohol use with increased rates in both models. Being employed, having private medical insurance, and using lubricants for >80% of anal sex acts were significantly associated with decreased failure rates in the insertive model. Safer sex counseling should particularly target men of lower socioeconomic status, promote proper and consistent use of condoms with appropriate lubricants, and address the impact of drug use, especially amphetamines and alcohol, on condom failure.

Adult↗
PubMed1996

Adolescent condom use, the health belief model, and the prevention of sexually transmitted disease.

OBJECTIVE: To review factors associated with adolescent condom use for the prevention of sexually transmitted diseases (STDs). DATA SOURCES: Thirty-six references on adolescent development, STDs, STD risk factors, and factors influencing condom use among heterosexual adolescents. STUDY SELECTION: Twenty-two research articles addressing issues influencing condom use by heterosexual adolescents. DATA SYNTHESIS: This review identifies unique risk factors related to adolescents and their risk for STDs, barriers to and facilitators of condom use, and suggestions for health care providers to increase condom use among adolescents. CONCLUSIONS: Although research on condom use among adolescents has inherent difficulties, current findings, along with reported high rates of STDs in this population, indicate infrequent and inconsistent condom use. Many factors contribute to the motivation for condom use and should be assessed individually. Using the Health Belief Model as a theoretical framework, health care providers can guide the adolescent to make realistic risk assessments and identify positive ways of incorporating condoms into their sexual lives. Further research then must be conducted to test the effectiveness of this approach.

Adolescent↗
PubMed1994

Reasons for condom utilization among high-risk adolescent girls.

Two hundred forty-eight adolescent girls responded to a list of 30 statements describing reasons for using and not using condoms. For 24 of the statements, most adolescents (> 70%) gave the same response regarding why they did or did not use condoms. Therefore, only the six remaining statements were used in further analyses. The relationship between the six statements and psychosexual history, condom use, and sexually transmitted disease (STD) history was examined. Those adolescent girls who had been sexually active longer were more likely to report lack of enjoyment as a reason that they did not use condoms (P < .03), and those adolescents who had been sexually active less time were more likely to report personal (P < .005) and partner (P < .0006) enjoyment of sex with condoms as a reason for using condoms. Longer relationships before intercourse were associated with having condoms available (P < .01) and partner insistence on their use (P < .02). Partner insistence on condom use was related to fewer episodes of sexually transmitted diseases (P = .03). These findings indicate the importance of relationship and partner variables in adolescent girls' perceptions of condom use.

Adolescent↗
PubMed1998

Condom use among Aboriginal people in Ontario, Canada.

A survey of 658 Aboriginal men and women living in 11 reserve communities in Ontario, Canada, was utilized to collect data on patterns of condom use. Individuals who had sexual intercourse in the previous 12 months were included in the analysis (n=400). Descriptive statistics and multiple logistic regression were used to analyse condom use in the previous 12 months. Eight per cent always, 31% sometimes, and 61% never used condoms. Rates of condom use differed with the number of sex partners in the last year, age, gender, having a steady sex partner, and marital status. Multiple logistic regression revealed that people most likely to use condoms were under the age of 30, male, did not have a long-term steady sex partner, had more than one sex partner, worried about pregnancy, were knowledgeable about HIV/AIDS, and were not embarrassed to obtain condoms. Condom users who were knowledgeable about HIV/AIDS and who knew someone with HIV/AIDS were more likely to always use condoms. The most common reason for not using a condom was 'I was with my steady sex partner'. These results have implications for STD prevention efforts and for future research of sexual and STD preventive behaviour among Aboriginal people.

Adolescent↗
PubMed1995

Barriers to condom use and barrier method preferences among low-income African-American women.

Low-income African-American women (N = 178) entering health clinics completed surveys assessing perceived barriers to condom use for themselves personally and for African-American women generally. Following the survey, each woman received a demonstration of five barrier contraceptive methods and then rated her preference among those methods. The women perceived relatively few personal barriers to use of the male condom but perceived significantly greater barriers for other African-American women (all p < .0001). The male condom was first choice of the largest percentage of women (45%) and last choice of the smallest percentage of women (11%). The male condom was preferred for its convenience, availability, and safety, although the necessity for active cooperation by the male partner was considered a hindrance to using the method. Only 23% of women ranked the female condom as first choice and 35% ranked the female condom as last choice. Reasons for selecting the female condom included preference for a female-controlled method, safety, and protection. However, the female condom was perceived to be uncomfortable, to require the partner's acquiescence, and to interfere with sexual experience. Differences in the women's perceptions of barriers to condom use for themselves and for other African-American women are consistent with Weinstein's theory of optimistic bias. Preferences among barrier methods indicate that further research and product development are needed to develop barrier methods that are female-controlled, do not require the awareness of the male partner, and are safe, comfortable, and convenient.

Adolescent↗
PubMed1995

Plastic condom available in U.S.

The first polyurethane or "plastic" male condom is on the market. A polyurethane condom called Avanti is for sale in the western United States and should be available throughout the country by summer, according to London International Group plc in Cambridge, England, which developed the condom. Because the plastic material is stronger than latex, the condoms can be made thinner than latex condoms. The thinness of Avanti improves sensation and can heighten pleasure during sexual intercourse, says Dr. Bill Porter, scientific affairs director of London International Group. Unlike latex condoms, plastic condoms have no odor and can be used safely with oil-based lubricants. They can also be used by those who have allergic reactions to latex. The US Food and Drug Administration, a regulatory agency, has required Avanti's labeling to say research has not yet determined its effectiveness in preventing pregnancy or sexually transmitted diseases. The condoms sell for US $1 to $1.50 each, about twice the cost of a latex condom.

Americas↗
PubMed1993

Condom use among high-risk women in Honduras: evaluation of an AIDS prevention program.

In 1988, the Honduran Ministry of Health initiated an intervention study designed to increase AIDS awareness and promote preventive behavior, especially condom use, among registered commercial sex workers (CSWs). The program consisted of weekly talks and free condom distribution to all CSWs who attended the sexually transmitted disease clinic during a 10-week period. Pre- and postintervention surveys were used to evaluate change in knowledge and condom use. Condom diaries were used to measure condom use during the program. One hundred thirty-four women who participated in the intervention completed the initial and follow-up surveys. There was a statistically significant increase in mean condom use from 64% to 70% of client contacts. Condom use recorded in diaries during the program period appeared even higher. Factors found to be associated with increased use postintervention include low baseline condom use and higher client fee. The reliability of the methods of measuring condom use and the implications of the findings for future intervention studies among sex workers and their clients are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Perceptions of the benefits and costs associated with condom use and unprotected sex among late adolescent college students.

To assess the differential effects of the perceived benefits and costs associated with both condom use and unprotected sex on sexual risk behaviors, data were collected from 704 ethnically diverse male and female sexually experienced late adolescent college students (aged 17-25). Perceived benefits and costs for condom use and perceived benefits and costs for unprotected sex were measured separately through an anonymous self-report survey. In addition, participants completed measures of self-efficacy for practicing safer sex and temptation for unsafe sex in various situations, and three measures of sexual risk-taking (stage of change for condom use, consistency of condom use during the past month, and whether or not a condom was used for the last act of intercourse). Univariate analyses indicated that benefits and costs of condom use, benefits of unprotected sex, self-efficacy and situational temptation were all related to sexual risk-taking. Gender differences were identified, with females reporting more benefits of condom use and costs of unprotected sex, fewer benefits of unprotected sex and costs of condom use, greater self-efficacy for practicing safer sex, and less situational temptation for unsafe sex. Multivariate analyses indicated that sexual risk behaviors were most related to situational temptation, self-efficacy for safer sex, and perceived benefits of unprotected sex. The results suggest that, among late adolescents, perceived benefits of the unhealthy behavior (unprotected sex) were better determinants of sexual risk-taking than were perceived benefits (or costs) associated with the healthy behavior (condom use). Perceived costs associated with unprotected sex were unrelated to sexual behaviors. These findings support previous work identifying adolescents as more driven by their perceptions of the positive benefits associated with risky behaviors, rather than knowledge of the costs or dangers involved in risk-taking.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Condom attitudes and behaviors among injection drug users participating in California syringe exchange programs.

This study examined condom attitudes, preferences, barriers, and use among a sample of 550 injection drug using clients of syringe exchange programs in California. In multivariate analyses, positive attitudes toward condoms were significantly associated with consistent condom use for vaginal, anal, and oral sex in the past six months, beyond the effects of confounding socio-demographic and HIV risk variables. Participants commonly cited partner-related barriers to condom use, such as reluctance to use condoms with steady partners (34%). Almost a quarter of the sample cited dislike of condoms (e.g., because of pleasure reduction). In addition, a third of respondents stated specific preferences regarding condom brands, sensitivity, sizes, and textures. Interventions that increase awareness about positive aspects of condom use and sexual risk from steady partners may be successful in increasing condom use among injection drug users.

California↗
PubMed2005

Introducing diaphragms into the mix: what happens to male condom use patterns?

The objective of this analysis was to assess the effect of introducing the diaphragm on condom use patterns. Participants included one hundred eighty-nine women attending family planning clinics in Harare, Zimbabwe who reported less than 100% condom use. The proportion of acts where at least one method was used significantly increased over using follow-up; male condom use remained stable. A diaphragm was used with 50% to 54% of acts; male condoms were also used about 50% of the time. The proportion of acts where a female condom was used decreased. Women who used both male and female condoms were more likely to use diaphragms than those who reported not using female condoms. Introducing the diaphragm increased the overall proportion of protected acts. The proportion of acts where a male condom was used did not change. Female condoms use declined because concurrent use with the diaphragm is not possible.

Adolescent↗
PubMed2004

Condom use assessment of persons in drug abuse treatment.

The purpose of this study was to objectively and quantitatively assess individual skill level of male condom use. This study developed a reliable and face valid assessment of correct male condom use based on Centers for Disease Control and Prevention criteria. Participants (N= 163) were recruited from persons in treatment for cocaine addiction. Condom use was assessed on the basis of correct completion of eight discrete steps. An overall score of 40% correct condom use indicated the need for training in this sample. Assessment showed training needs especially related to steps involving reduction of ejaculate leakage and steps related to potential hazards of nonoxynol-9 use. Frequency of condom use was also assessed; there was no correlation between frequency of condom use and condom use skill. Drug addiction treatment programs are encouraged to incorporate HIV risk reduction programs that teach condom use skills and use the CUDOS as an empirical measure of condom skill acquisition.

Cocaine-Related Disorders↗
PubMed2004

Factors associated with condom use among young Denver inner city women.

BACKGROUND: Despite the availability of condoms and theoretically based interventions to promote their use, sexually active women aged 15 to 25 years continue to put themselves at risk for sexually transmitted diseases and unintended pregnancy. METHODS: One hundred ninety-eight inner city women were interviewed about knowledge and attitudes about condoms. Using the Transtheoretical Model, regression techniques were used to identify factors associated with condom use at last sex and the proportion of acts protected by a condom in the last 90 days. RESULTS: Constructs including intention to use (OR = 1.69, CI 1.07-2.65) and positive outcome expectancies (OR = 1.59, CI 1.03-2.46) were associated with condom use at last act of sexual intercourse. Similarly, intention to use condoms (RR = 1.58, CI 1.37-1.82), positive outcome expectancies (RR = 2.71, CI 2.41-2.99), perceived peer's use of condoms (RR = 2.25, CI 1.95-2.60), and number of places condoms were discussed (RR 1.05, CI 1.02-1.07) were associated with the proportion of protected acts. CONCLUSIONS: Constructs specified in the Transtheoretical Model are useful in describing condom use and have implications for targeting human immunodeficiency virus (HIV)/sexually transmitted diseases (STD)/unintended pregnancy interventions.

Adolescent↗
PubMedDate not supplied

[Condom use among the young engaging in vaginal intercourse].

OBJECTIVE: To describe young people's use of condoms in penetrative vaginal intercourse, and to identify the factors associated with this use. METHOD: The information was collected using a self-administered questionnaire put in 1,000 people between 14 and 24 years of age resident in the region of Andalusia (Spain). The results of the sample were representative and the trust interval was 95%. A bivariante analysis was carried out and hierarchical logistic regression equations were adjusted to verify associations between the dependent variable use of the condom in the vaginal intercourse and the variables proposed from PRECEDE model (predisposing, enabling, and reinforcing). The adjustment of the model was of a 38%, according to the Nagelkerke's statistic. RESULTS: Of the people surveyed, 750 had affective and/or sexual relations with physical contact, and 63% of these had vaginal intercourse (47% of all surveyed). Of those, people that only had vaginal intercourse once (12% of all surveyed), 83% (10,3% of all surveyed) used a condom, whereas, people that had sex more than once (34% of all surveyed), 49% always used a condom (16,9% of all surveyed). The variables associated with always using a condom were: intention of safe behaviour with their regular partner and low frequency of practice. The variables associated with never using a condom were: living emancipated, having an external locus of control (thinking that becoming infected depends upon external factors), low number of zones of the body identified as pleasure-sensitive, thinking that a condom is not necessary if one trusts his or her partner, intention of unsafe behaviour with their regular partner, and not talking with the partner about preventive methods before having sex. DISCUSSION: The most associated factors with using or not a condom in vaginal intercourse are predisposing (attitudes, values and believes) that are related with the kind of sexual partner. Interventions (based on the young active participation) are suggested to make them perceived the compatibility between the trust with the partner and the use of condom, and put in doubt the false safety given by a partner perceived as habitual.

Adolescent↗