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PubMed2006

Condoms become the norm in the sexual culture of college students in Durban, South Africa.

The aim of this study was to examine the factors contributing to the increase in condom use among college students in Durban, KwaZulu-Natal, South Africa, and some of the barriers to consistent condom use. The data were drawn from six focus group discussions with male and female students aged 18-24 in three public tertiary education institutions, supplemented by a survey of 3,000 students aged 17-24. Condoms had become "part of sex" and highly acceptable to the great majority, and were easily accessible. They were primarily being used for preventing pregnancy; many students liked not having to go to a health facility for supplies. Less than half of male and only a third of female students thought male partners had greater influence over the decision whether a condom was used. If a woman requested condoms, men and women agreed the man must comply. Some men were suspicious of women who agreed to have unprotected sex. Almost 75% of sexually active students surveyed reported condom use at last sexual intercourse, but consistent condom use, reported by only a quarter, remains the main challenge. It may be more effective to promote condoms for contraception among sexually active young people than for HIV prevention. Condoms have become the most commonly used contraceptive method among students, and this trend should be reinforced.

Adolescent↗
PubMed1997

Safety, functionality and acceptability of a prototype polyurethane condom.

Male condoms made from synthetic materials offer an alternative to latex condoms that may be more acceptable to users, thereby potentially resulting in more protected acts of intercourse. A prospective, noncomparative clinical study was conducted to evaluate the safety of using certain polyurethane materials to make condoms. Fifty-one healthy, contracepting, mutually monogamous couples were recruited between June 30 and November 24, 1993 to use a prototype roll-on polyurethane condom developed by Family Health International. Couples were to use the condoms for 10 consecutive acts of vaginal intercourse over a 4-week period. Baseline and postexposure genital examinations, including colposcopy for female participants, were performed. Fifty couples completed the study requirements and 517 acts of intercourse occurred using the condoms. Two adverse events were reported: irritation of introitus in a female participant and a small irritated erythematous lesion on a male participant's penis. Neither event was considered to be serious and both were resolved without treatment. Breakage and slippage rates were similar to those reported for latex condoms. These results suggest that polyurethane condoms represent a safe, functional and acceptable alternative to latex condoms.

Adult↗
PubMed1998

Adolescent males' combined use of condoms with partners' use of female contraceptive methods.

OBJECTIVE: Protection from both sexually transmitted diseases and pregnancy is best obtained by the combined use of male condoms and effective female contraceptive methods. This research examines dual contraceptive method use among teenage men. METHOD: Analyzed data from the 1995 National Survey of Adolescent Males, a nationally representative survey of 15 to 19-year-old males. Used bivariate analyses and logistic regression to examine the correlates of combined use of condoms and female methods. RESULTS: At last intercourse, 17% of sexually active males reported use of a condom and a female method of contraception. Condom use, alone and in combination with a female method, was positively associated with talking with the partner about contraception and condoms, believing that males have a responsibility for contraception, and being in an earlier stage of a relationship. Only high levels of worry about sexually transmitted diseases differentially influenced dual method use, increasing the likelihood of using a condom with a female method, but not using condoms alone. CONCLUSIONS: The results suggest that efforts to increase condom use in general should also influence young men's use of condoms when their partner is using a female method. Providing information to young males about the high prevalence and serious consequences of sexually transmitted diseases may increase dual method use among adolescents.

Adolescent↗
PubMed2003

Models of health-related behavior: a study of condom use in two cities of Argentina.

This study aimed at determining the relative importance of motivational and control factors in the prediction of condom use in a high-risk heterosexual sample from two cities of Argentina. Participants reported their attitudes, norms, control perceptions, intentions, and condom use with regard to main and occasional partners. Control perceptions was the main predictor for intentions to use condoms and actual condom use with both partners. Furthermore, the norm of the partner predicted condom use with the main partner, whereas the norm of family and friends predicted condom use with occasional partners. There were no differences in condom-use determinants across men and women. Interventions for this population should train at-risk heterosexuals to manage the personal and interpersonal difficulties of condom use and warn audiences of implicit theories that associate love and commitment with perceptions that condom use with main partners is unnecessary.

Adult↗
PubMed2004

A study of condom acceptability among men in an urban population in South India.

This study examines the acceptability of condoms to men from Chennai, South India. A sample of 150 male respondents who, in the main, had at least one risky sexual experience with a commercial sex worker or multiple partners was interviewed. The respondents included HIV-positive and HIV-negative individuals at sexually transmitted disease clinics, college students, and homosexuals. Awareness of condom usage was high, and 83% had used condoms at least once. The reasons for using condoms were protection from disease (43%), protection from AIDS (20%), and partner insistence (25%). Seventy-three percent of the respondents expressed dissatisfaction. Of those who used condoms for the first time, 72% were HIV negative, compared to 34% among those who did not use condoms. This indicates the need for developing the "condom habit," as using condoms at the first sexual experience is a strong predictor of future condom use.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Introducing and negotiating the use of female condoms in sexual relationships: qualitative interviews with women attending a family planning clinic.

Safe sex skills training often teach women to be assertive in condom use negotiations. However, it has been suggested that assertiveness training may be inappropriate for women who lack power in their sexual relationship. Our qualitative study of 62 women attending a family planning clinic explored various communication styles they used to introduce and negotiate female condom use in their sexual relationships. We further examined how different introduction and negotiation styles were related to actual use of the device. The device was introduced using a direct, semidirect, indirect, or nonverbal communication approach. Use of the female condom was negotiated by avoiding sex, using humor, discussing the possibility of using the condom, or being argumentative with partners. The outcome of introducing and negotiating female condom use was often mediated by other factors including partner characteristics, relationship power dynamics, situational context, and use of additional discourse strategies (e.g., describing the female condom as a sexual toy or taking the opportunity to educated partners about the female condom). Less direct approaches appeared to be as effective in facilitating use of the female condom as more direct approaches. Female condom introduction and negotiation styles that continued to engage their partners by using additional discourse strategies led to more frequent use of the device. Implications of our findings for HIV risk reduction program development are discussed.

Adult↗
PubMed2006

Low-income African American women's attempts to convince their main partner to use condoms.

In this cross-sectional study the authors examine condom use attempts and condom use among 305 high-risk, low-income African American women who reported having a main partner. Women who had recently attempted to convince their main partner to use condoms were almost 10 times more likely to have recently used condoms with their partner than women who had not made an attempt. Among the subsample of 116 women who had recently made a condom use attempt with their main partner, having a history of childhood abuse and having one's main partner raise infidelity questions in response to the condom use attempt were negatively associated with recent condom use with this partner. Findings provide initial insights into the importance of women's condom use attempts, as well as subgroups of women who may encounter special challenges convincing their main partner to use condoms.

Adolescent↗
PubMed2001

Knowledge, risk perceptions and condom usage in male sex workers from three Australian cities.

The study identifies factors associated with knowledge and perception of risk of HIV/AIDS, as well as attitudes to and usage of condoms by a sample of male sex workers (MSW). One hundred and eighty-five male sex workers completed a self-reported questionnaire, including knowledge about HIV transmission, attitudes to condom use and perceptions and personal susceptibility to HIV and sexually transmitted infection (STI) risk, and a two-week diary recording use of condom during commercial sex encounters. The findings reveal that condom use was found in 77.7% of the encounters with clients and the majority of the respondents perceived themselves to be at no risk for HIV because of sex work. Independent sex workers from Melbourne and workers who owned their place of residence used condoms in a significant lower proportion. Generally speaking, knowledge about the risks associated with AIDS was high, with respondents showing lower knowledge about the risks associated with unprotected receptive or active oral sex. Participants held a positive attitude to condom use; most considered the provisions of condoms to be their responsibility rather than clients; and they were more worried about contracting an STI than HIV. Those who scored higher on the knowledge scale had more positive attitudes to condom use and those who had a more positive attitude to condom use recorded a perceived lower risk of contracting STI but not HIV. The study discusses the relevance of these findings for public health risk reduction and sexual health education campaigns.

Adult↗
PubMed2003

Extra-relational sex among Hispanic women and their condom-related behaviours and attitudes.

Limited data are available concerning sexual behaviour of Hispanic women. A total of 318 Hispanic women were surveyed concerning extra-relational sex and their condom-related attitudes. Fifteen per cent of the sample had a secondary sex partner (apart from the first partner) during the three months preceding the survey. Of these women, 77 and 53% used condoms with their secondary and primary partners, respectively. Among women in monogamous relationships, condom use was low (17%), and nearly two-thirds (61%) of those with a high-risk partner did not use condoms. The most common concerns about condom use among these Hispanic women were a reduction in pleasurable sensations and embarrassment associated with buying condoms. Women with concurrent partners as compared to those with a single partner felt more at risk for HIV and STDs, were less likely to believe condoms have side effects or are unacceptable to their male partners and were more able to use condoms in long-term relations. In conclusion, extra-relational sex among Hispanic women may be higher than previously reported, although more favourable attitudes to condom use are seen among women with concurrent than those with a single partner. HIV/STD programmes in the Hispanic community should tailor to the sexual behaviour of their participants.

Adult↗
PubMed2004

Delayed application of condoms, withdrawal and negotiation of safer sex among heterosexual young adults.

The aim of this study was to examine delayed application of condoms and withdrawal among heterosexual young adults. Seven focus group discussions were conducted with heterosexual men and women aged 18-25 in Melbourne, Australia. The data revealed that delayed application of condoms and withdrawal are widespread. Delayed application of condoms can be divided into two categories--condom use 'after limited unprotected penetration' and condom use 'for ejaculation only'. The data reveal parallels between withdrawal and condom use 'for ejaculation only'. These two behaviours share the goal of avoiding unprotected ejaculation inside a partner, while allowing some unprotected intercourse. They are both more likely to occur in regular relationships than casual encounters, both are likely to be negotiated and both occur when there is no perceived risk of STI infection. In contrast, condom use 'after limited unprotected penetration' was likely to occur in casual encounters, and was likely to be unplanned and not negotiated. There is a need to ensure that heterosexual young adults use condoms and use them correctly. There is also a need to ensure that heterosexual young adults have the required skills to negotiate sexual activity and to negotiate condom use.

Adolescent↗
PubMed2005

Evaluating the sexual behaviour, barriers to condom use and its actual use by university students in Nigeria.

This research quantified the barriers to condom use of a sample of university students in Nigeria. It further analyzed association between condom use at last intercourse and the barriers, in addition to HIV risk sexual practices. A total of 96 women and 128 men were randomly selected, and they completed a survey. Results indicated both men and women reported that condoms hindered their sexual satisfaction, caused health problems for them and reduced their sexual interest. The findings also showed that obtaining condoms from clinics and perception that condoms do not cause health problems predicted the likelihood of condom use for both sexes. In addition, the results indicated that obtaining first time information from family members or relatives predicted the likelihood of condom use for women. It was recommended that intervention efforts should make condoms freely available in tertiary institutions, and such interventions should be tailored to overcome the relevant barriers that interfere with condom use for both the women and men.

Adult↗
PubMed2006

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

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.

Adult↗
PubMed2005

Sexual practices, barriers to condom use and its consistent use among long distance truck drivers in Nigeria.

Among the long distance truck drivers in Nigeria, a major group that transmits HIV, the use of male latex condoms is generally low and erratic. To effectively promote their consistent use, it was necessary to understand the drivers' sexual practices, experience of barriers to condom use and HIV/AIDS-related attitudes. Four hundred and twelve long distance truck drivers were selected and interviewed in major truck stops along the country highways. The interview explored the drivers condom use barriers, their demographic characteristics, HIV/AIDS-related attitudes and practices. The drivers noted that their major barriers experienced were that condoms reduced their sexual satisfaction, caused health problems for them, and hindered their sexual interest. About 70% of the drivers knew about condoms HIV preventive measure, but only 9% consistently used them. The drivers that acknowledged that they always used a condom, had secondary education, were less likely to report that a condom was inconveniencing or caused health problems, rarely used local decoctions to improve sexual energy, and frequently listened to the radio. In conclusion, it is necessary to intensify condom education for the drivers through the radio, establish counselling centres, tailor counselling to reduce the barriers, and provide free condoms for the drivers.

Adult↗
PubMed2006

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

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.

Adolescent↗
PubMed2001

Acceptability of the Reality female condom and a latex prototype.

We report on the comparative acceptability of a prototype latex female condom and the polyurethane Reality female condom. We also identified factors associated with acceptability, measured via a composite index with domains related to ease of insertion, noise, and comfort during insertion and use. There were 135 couples in this randomized crossover trial. The average age was 30 years; more than 60% had education beyond high school; 40% were married; and participants were at low risk for sexually transmitted disease and pregnancy (due to the investigational status of the prototype). Participants were asked to use three of each of the study condoms during a 6-week period. Acceptability ratings on 12 items were summed into a composite index for each participant by condom type. The index midpoint (range) for females was 48 (12-84), and it was 32 (8-56) for males, with lower scores indicating higher acceptability (men completed only a subset of the acceptability questions). Both condoms were equally acceptable: Mean scores were 37 and 40 for the women's ranking of the prototype and Reality, respectively (P =.07) and 29 and 30 for men's rankings, respectively (P =.35). Multiple regression models to predict acceptability scores by gender were somewhat uninformative (most R(2) values were less than 0.10). Nevertheless, minority ethnicity (African American or Hispanic vs. white) was associated with higher acceptability by both genders for both condom types. Among women, for both condom types, less education (less than high school compared with high school or beyond) was associated with higher acceptability. Female condom acceptability may not be equally distributed across demographic groups, which is important for health educators to keep in mind when promoting the female condom.

Adolescent↗
PubMed1998

HIV testing and counseling among men attending sexually transmitted disease clinics in Pune, India: changes in condom use and sexual behavior over time.

OBJECTIVES: To describe changes in sexual behavior and condom use among male heterosexual clients at two public sexually transmitted disease (STD) clinics in Pune, after exposure to HIV testing, counseling, and condom promotion. DESIGN: From 13 May 1993 to 11 April 1997, 6819 heterosexual men were screened for HIV infection as part of the HIV Network for Prevention Trials study. A total of 1628 HIV-seronegative men agreed to return at 3-month intervals for repeated HIV counseling and testing. Counseling at each visit focused on reinforcing messages of monogamy, condom use with sexual partners, and provision of government-provided condoms. METHODS: Data were collected at baseline and at subsequent 3-month intervals, on demographics, previous STD diagnoses, medical history, sexual behavior, knowledge of HIV/AIDS, and practices related to the prevention of HIV. STD were assessed through physical examination and specimen collection, and blood was drawn for HIV-1 and HIV-2 antibody testing. RESULTS: The level of consistent condom use with sex workers increased proportionately with follow-up time: at 6 months men were 2.8 times more likely to consistently use condoms (P < 0.001), at 18 months they were 3.6 times more likely (P < 0.001), and after 24 months they were 4.7 times more likely to be using condoms every time. The risk of HIV seroconversion in men was lowest for those who reported 'always' using condoms (adjusted relative risk, 0.68; P = 0.42; HIV incidence, 4.0) compared with those who reported 'never' using a condom (adjusted relative risk, 2.94; P < 0.001; HIV incidence, 14.0). CONCLUSION: Ongoing counseling and testing was positively associated with risk-reduction behaviors amongst a large proportion of men recruited for this study.

Adult↗
PubMed2000

Partner type and condom use.

OBJECTIVES: To examine the association between type of sexual partnership and condom use consistency. DESIGN: A prospective follow-up study of women attending two urban clinics for sexually transmitted diseases (STD). METHODS: Sexual diaries recording barrier method, partner initials and partner type for each act of intercourse were kept by 869 women. Condom use by partner type was evaluated in three ways in the entire group: among women who encountered multiple partners, during months in which women encountered multiple partners, and within sexual partnerships that changed status during the study. RESULTS: Consistency of condom use was higher with new and casual partners than with regular partners in the entire group and among women who encountered multiple partners. In months in which partners of different types were encountered, condom-use consistency was higher with new and casual partners than with regular partners. Consistent condom use decreased in partnerships that changed status from new to regular. The female condom was used more often with regular partners than with new or casual partners in the entire study group, among women who encountered multiple partners, and during months in which a woman achieved consistent use with her regular partner. CONCLUSIONS: This study provides strong evidence that condom use behavior is modified by partner type. Observations about condom use and partner type made in cross-sectional or retrospective surveys also hold in the present longitudinal analyses of individual women and of partnerships that change status. The female condom may be an important option for achieving consistent protection within stable partnerships.

Adolescent↗
PubMedDate not supplied

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

BACKGROUND: 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. OBJECTIVE: The primary aim of this study was to test a social cognitive-based model of condom use behaviors among college students. METHODS: 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. FINDINGS: 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. CONCLUSIONS: 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.

Adult↗