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PubMed1999

A prospective study of pharyngeal gonorrhoea and inconsistent condom use for oral sex among female brothel-based sex workers in Singapore.

Oral sex among female sex workers in Singapore has risen sharply from 27.1% in 1992 to 81.7% in 1997. A prospective cohort study was carried out on 724 female brothel-based sex workers who practised oral sex, to determine the risk of contracting pharyngeal gonorrhoea through inconsistent condom use. The prevalence of consistent condom use for oral sex was 70.4% compared to 96.8% for vaginal sex. One hundred and twenty-nine (17.8%) were lost to follow up because they quit prostitution. The other 595 sex workers were followed up for a maximum period of 6 months. Thirty-eight (5.2%) sex workers contracted pharyngeal gonorrhoea compared to 2.5% who contracted cervical gonorrhoea. Sex workers with inconsistent condom use for oral sex were 17.1 times (95% CI: 8.0-36.5) more likely than consistent condom users to develop pharyngeal gonorrhoea, after controlling for ethnic group, class and number of clients. STD control programmes for sex workers should place stress on consistent condom use for oral sex.

Adult↗
PubMed2001

Correct condom application among African-American adolescent females: the relationship to perceived self-efficacy and the association to confirmed STDs.

PURPOSE: To assess condom application ability and the relationship between perceived ability and demonstrated ability. Also, to examine the association between high-demonstrated condom application ability and recent sexual risk behaviors and laboratory-diagnosed sexually transmitted diseases (STDs) among African-American adolescent females. METHODS: A purposeful sample of sexually active African-American females (n = 522) completed a structured interview and provided vaginal swab specimens for STD testing. Subsequent to the interview, adolescents demonstrated their condom application skills using a penile model. A 9-item scale assessed adolescents' perceived self-efficacy to apply condoms. Sexual risk behaviors assessed by interview were noncondom use at last intercourse and the last five intercourse occasions for steady and casual sex partners as well as any unprotected vaginal sex in the past 30 days and the past 6 months. RESULTS: Approximately 28% of the sample tested positive for at least one STD and nearly 26% self-reported a history of STDs. Controlled analyses indicated that adolescents' self-efficacy for correct use was not related to demonstrated skill. Adolescents' demonstrated ability was not related to any of the sexual risk behaviors. Likewise, recent experience applying condoms to a partner's penis and demonstrated ability were not related to laboratory-diagnosed STDs or self-reported STD history. CONCLUSIONS: Adolescents may unknowingly be at risk for human immunodeficiency virus and STD infection owing to incorrect condom application. Further, high-demonstrated ability to apply condoms was not related to safer sex or STDs. Reducing sexual risk behaviors may require more than enhancing adolescent females' condom application skills and may require addressing other relational skills.

Adolescent↗
PubMedDate not supplied

Self-esteem, gender, and alcohol use: relationships with HIV risk perception and behaviors in college students.

The present study examined the confluence of alcohol use and self-esteem on risky sexual behavior and perceptions of risk for female and male college students. It was predicted that higher levels of self-esteem, female gender, and lower alcohol consumption would be associated with greater condom use and lower perceptions of risk for self and partner. Results indicated that for low drinking students, those with high self-esteem reported greater condom use. In addition, low rates of alcohol use were associated with greater frequency of past condom use. Women and students low in self-esteem indicated greater perceptions of risk for themselves and their partners. These findings are discussed in terms of their implications for developing interventions aimed at reducing risky sexual behavior.

Adolescent↗
PubMed1995

AIDS knowledge, risk behaviors, and condom use among four groups of female sex workers in Bali, Indonesia.

The objectives of this study were to discover the AIDS knowledge, risk behaviors, and condom use of four groups of female professional sex workers (n = 614). Personal interviews were conducted with women working in low-price brothels, mid-price and high-price houses, and tourist areas. Only 51% of women in the low-price brothels had heard of AIDs, although most of the women in the other groups had heard of it. Knowledge of transmission and symptoms was weak in all groups, and most women were unaware of asymptomatic transmission. Most women felt safe from HIV due to ineffective strategies such as taking medications or client selection practices. Condom use with clients varied widely by group. Women in the low-price brothels reported the lowest levels of use (19% of encounters in the previous week), with women from the mid- and high-price groups reporting higher levels (68% mid-price; 71% high-price). Women working in the tourist areas reported the highest levels of use (90%). Interventions for each group need to reflect these differences in knowledge as well as the contexts of their work; important contextual factors to consider include the level of AIDS and STD knowledge in their environment, the characteristics of the clients served, and the degree of supervision that they receive.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Changes in HIV risk behavior following alternative residential programs of drug abuse treatment and AIDS education.

We compared the effectiveness in changing human immunodeficiency virus (HIV) risk behavior of two different approaches to acquired immunodeficiency syndrome (AIDS) education given by residential drug abuse treatment programs differing in their planned duration. Two randomized controlled trials compared (a) a 6-month with a 12-month therapeutic community (TC) program, and (b) a 6-month with a 3-month relapse prevention (RP) program. Three composite variables assessing HIV risk (a) drug injection, (b) sexual partners, and (c) condom use-were measured for the 3 months prior to admission and follow-up. The TC program comprised a four-part AIDS information intervention. The RP program comprised a 21- or 42-session small-group program in the principles of RP, 5 skills-building AIDS education sessions, and 6 other health education sessions. Four hundred ninety-five clients were enrolled in the study and completed a follow-up interview within 6 months of exit (79% of those enrolled). Clients in the RP program reduced their drug injection and condom use risk. Female clients in the TC program reduced their condom use risk. There were no differential effects on risk behavior change of either planned duration (randomization assignment) or program type (RP versus TC). Thus, differences in the treatment programs, including AIDS education components, had no apparent effect on HIV risk behavior change. The contribution of residential drug abuse treatment programs to AIDS prevention remains unproved.

Adult↗
PubMed1993

Safe sex? Misconceptions, gender differences and barriers among injection drug users: a focus group approach.

Heterosexual transmission is one factor involved in the spread of the human immunodeficiency virus (HIV) within the injection drug use (IDU) population and between IDU and non-IDU individuals. Insufficient information is currently available to reduce this heterosexual transmission. As a basis for designing a questionnaire aimed at the IDU population, we conducted 5 focus groups to collect information on knowledge of and attitudes toward safe sex as held by male and female IDUs in methadone treatment. We identified misconceptions related to HIV infection, condoms, and sexual behavior. We also found gender-based differences in knowledge and learning style. Also, while individuals felt a responsibility to prevent HIV transmission, they lacked sufficient control to do so. The wide range of responses on questions concerning sexually transmitted diseases (STDs), condoms, reproductive decisions, and methods of promoting safe sex provides a basis for developing a questionnaire designed to identify and target specific subgroups for educational intervention.

Adult↗
PubMed2004

Clients of female sex workers in Lima, Peru: a bridge population for sexually transmitted disease/HIV transmission?

OBJECTIVES: The objectives of this study were to determine the prevalence of risk behaviors, gonorrhea, and chlamydia in clients of female sex workers, and to compare them with men selected from the general population. STUDY DESIGN: We conducted a cross-sectional study of men recruited from commercial sex venues in Lima, Peru from January to February 2002. Subjects answered a survey and provided a urine sample. RESULTS: Men reported that in the recently concluded commercial sex encounter, 95.8% used condoms, and 85.8% always used condoms with female sex workers. Only 16% reported always using condoms with their stable partners; 50.8% always used condoms with casual, noncommercial partners; and 59.6% always used condoms for homosexual anal sex. There were 8 (2%) cases of chlamydia and no cases of gonorrhea. CONCLUSIONS: Clients of female sex workers report high rates of condom use with sex workers and a low prevalence of chlamydia and gonorrhea. It is unlikely that they constitute a bridging population.

Adolescent↗
PubMed2000

Factors associated with condom use for oral sex among female brothel-based sex workers in Singapore.

BACKGROUND AND OBJECTIVE: The prevalence of oral sex increased from 27.1% in 1992 to 81.1% in 1997, with a concomitant increase in pharyngeal gonorrhea, among female sex workers in Singapore. The extent of condom use for oral sex among them is unknown. GOAL: To determine the prevalence of and factors associated with consistent condom use during oral sex. STUDY DESIGN: A cross-sectional study of 225 women randomly selected from the surveillance scheme register of female brothel-based sex workers with a history of oral sex documented in their medical records. RESULTS: Slightly more than half (56.9%) consistently used condoms for oral sex compared to 97% for vaginal sex. Condom use was significantly higher among middle than high class sex workers (adjusted rate ratio: 1.52, 95% CI: 1.01-2.29) and those with negotiation skills (adjusted rate ratio: 1.95, 95% CI: 1.32-2.07). CONCLUSION: Sex workers should be taught skills to negotiate condom use for oral sex.

Adult↗
PubMed2002

Social influence, AIDS/STD knowledge, and condom use among male clients of female sex workers in Bali.

The importance of social networks is increasingly being recognized in research on HIV risk behaviors. The objective of this article is to examine the association of AIDS and sexually transmitted disease (STD) knowledge, perceived susceptibility to HIV/STD infection, condom beliefs, demographic variables, and peer influence on the condom use of clients of Indonesian sex workers. Data for the study are drawn from the Bali STD/AIDS study conducted from 1997 to 1999 in Bali, Indonesia. During the project 2,026 men were selected for interviews in low price brothels. Statistical methods included multivariate regression models. Results of the study showed that younger men, men who have resided in Bali for at least a year, and more educated men were more likely to use condoms. Furthermore, men with stronger AIDS and STD knowledge and condom beliefs were more likely to use condoms. Men whose friends knew that they visited sex workers were less likely to use condoms. However, men who reported that their friends used condoms with sex workers and that their friends encouraged them to use condoms with sex workers were more likely to use condoms with sex workers. Implications for prevention of HIV infection are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1995

AIDS risk behaviours and correlates in teenagers attending sexually transmitted diseases clinics in Los Angeles.

OBJECTIVE: Of all age groups, teenagers have the highest rates of sexually transmitted diseases. Therefore, it is particularly important to target interventions at this group. Teenagers attending STD clinics are at particularly high risk since behaviours that lead to an STD can also result in the transmission of HIV. The goal of this study was to collect information concerning the prevalence and correlates of high-risk behaviours in this population as a first step in the design of an effective intervention programme. METHODOLOGY: Face-to-face interviews were conducted with patients attending five STD clinics operated by the Los Angeles County Department of Health Services. RESULTS: In the exclusively heterosexual teenage subgroup (N = 100, 55% Hispanic, 28% African-American, 10% White), males became sexually active at a younger age than females (14 years vs 14.9 years, p < 0.02), had more partners in the last 12 months (4.1 vs 2.0, p < 0.003), more "steady" partners (2.2 vs 1.4, p < 0.02) and more life time partners (14.1 vs. 4.1, p < 0.001). Only 10.0% of males and 3.8% of females reported consistent condom use with steady partners and 36% of both male and female respondents with non-steady partners. The decision to use condoms during vaginal sex was most likely made by the respondent, whereas the decision not to use condoms was most likely a joint decision. CONCLUSIONS: An intervention aimed at improving sexual communication regarding condom use could increase this behaviour among many adolescents, since only few teenagers in our sample perceived condom use as unpleasant.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Explaining the increase in condom use among South African young females.

Since 1998 South Africa has experienced stability in HIV prevalence among its 15 to 19 year olds, and to a lesser extent among its 20 to 24 year olds. While a few studies point to behavioural change, mainly an increase in condom use, none has established the reasons. This article explores the influence of various information sources about AIDS upon the use of condoms among rural and urban South African young females, using the South Africa Demographic Health Survey of 1998 (1998 SADHS), while controlling for various socioeconomic and cultural parameters. The results show that condom use among urban residents was positively correlated with mass media exposure, television as a source of information about AIDS, and the number of mass media sources from which the respondent received information about AIDS. Condom use among rural residents was associated with the number of sources of information about AIDS, exposure to mass media, and the language and education of the respondent. Among urban residents condom use was almost twice as high as among rural residents. The results from the article indicate that three elements influenced the increase in condom use among females: the threat of AIDS, mass media, and receptiveness to condom use. The receptiveness was culturally dependent.

Adolescent↗
PubMed2006

The gender ratio imbalance and its relationship to risk of HIV/AIDS among African American women at historically black colleges and universities.

African American women are at increased risk of HIV transmission through heterosexual contact. HIV/AIDS is the leading cause of death among African American women between 25 to 34 years of age, and many of these women were likely infected while in college. Four focus groups were conducted with African American students attending Historically Black Colleges and Universities (HBCUs) in order to learn about the college dating environment and how it influenced women's risk of HIV infection. We used constant comparison techniques and visual display matrixes to analyse the data. Students identified the gender ratio imbalance of more women to men on campus as a key element of the campus dating environment and described how it places women at an increased risk for HIV infection. Primary consequences of this gender ratio imbalance were men having multiple female sexual partners during the same time period and women complying with men's condom use preferences. HIV preventive intervention programmes at HBCUs must address the gender ratio imbalance and its consequences to reduce women's risk of contracting the infection.

Adult↗
PubMed1997

Condoms: still the most popular contraceptive.

Condoms can be used as a barrier contraceptive and/or to protect against many sexually-transmitted diseases. They are easy to buy and use and free from medical risk. Carefully used, and used in conjunction with a spermicide, condoms have similar reliability to IUDs, progesterone-only pills and the diaphragm. The condom must be put on before the penis touches the vaginal area. The penis should not touch the vaginal area after the condom has been taken off. Oil-based products, eg baby oil, massage oil, lipstick, petroleum jelly, suntan oil, can damage the condom. If a lubricant is required, use one that is water-based.

Adult↗